ABSTRACT
Objective To study effects of bivalirudin and heparin plus tirofiban on plasma P-selectin in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) and compare the clinical effects on bleeding and thrombosis.Methods 260 hospitalized patients with acute STEMI who accepted emergency PCI were enrolled in the study.They were randomly divided into the bivalirudin group (129 cases) and the heparin plus tirofiban group (131 cases).Blood samples were taken before operation,during operation (about 20 minutes after medicacion injection) and after operation (three hours after the end of operation).Serum P-selectin levels were measured.All patients were followed-up for 30 days.The main events included hemorrhage within 30 days,acquired thrombocytopenia and stent thrombosis.Results The level of P-selectin increased significantly in the heparin group during operation compared to the preoperative level and remained statistically higher at three hours after the end of operation than preoperative level (P ＜ 0.05).Compared with preoperative level,the P-selectin level of the bivalirudin group was significantly lower than that of heparin group (P ＜ 0.05).After 30 days of follow-up,bivalirudin had lower rates bleeding events compared to the heparin group(5.4％ vs.15.3％,P =0.009).The need of medical intervention for bleeding events (BRAC2-5 hemorrhage) was less in the bivalirudin group(0.8％ vs.5.3％,P =0.029).There was no significant difference in the major bleeding events between the 2 groups (BRAC3-5 hemorrhage) (0 vs.0.8％,P =0.32).No significant difference found between the two groups in acquired thrombocytopenia (P ＞ 0.05).Conclusion Bivalirudin may reduce P-selectin levels in STEMI patients undergone emergency PCI during perioperative period.Heparin increases perioperative P-selectin.Bivalirudin may reduce the bleeding events.
ABSTRACT
ObjectiveTo investigate the prevalence and distributing feature of atrial fibrillation (AF) in Xinjiang Kazaks adult population.MethodsFour-stage selected random samples aged 30-89 years from Tacheng,Yili and Aletai were analyzed.An epidemical study of AF was performed including inquiring medical history,recording electrocardiogram and auscultation. ResultsA total of 22 514 adults were surveyed.The prevalence of AF in Xinjiang Kazaks adult population was 0.37％,which was increasing with aging.The prevalence was higher in men than in women (0.5％ vs 0.2％,P ＜0.01 ).In AF patients,23 was valvular AF.Ischemic stroke was the most frequent type and the stroke rate in the patients with AF was significantly higher than that without AF (6.0％ vs 1.2％,P ＜ 0.01 ).ConclusionsThe prevalence of AF in Xinjiang Kazaks adult population is lower than the reported national prevalence but patients with AF in this population would not like to take the necessary medicine. Therefore,the control of AF need to be reinforced.