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Objective:To assess the validity and reliability of the depression and somatic symptoms scale among patients with coronary heart disease.Methods:Totally 246 patients with coronary heart disease were assessed with depression and somatic symptoms scale (DSSS), Hamilton depression rating scale for depression (HAMD) and patients’ health questionnaire depression scale-9 item (PHQ-9). The structural validity was evaluated with exploratory factor analysis and confirmatory factor analysis. The validity as a screening tool was evaluated with the gold standard diagnosed by psychiatrists who were trained with the mini international neuropsychological interview (MINI) according to ICD-10. Receiver operating characteristic (ROC) curve was used to identify cutoff scores for depression. Cronbach α coefficient was used to evaluate the internal consistency.Results:Exploratory factor analysis yielded two factors: depression factor and somatic factor, and the cumulative variance was 51.8%. The fitting indexes of confirmatory factor analysis were as follows: χ2/ df=3.636, RMR=0.077, RMSEA=0.104, IFI=0.804, TLI=0.781, CFI=0.802. The intraclass correlation coefficient of DSSS and HAMD was 0.54. The area under ROC curve (AUC) was 0.828, and the best boundary value was 17 points (sensitivity and specificity: 81% and 75%, respectively). The total scores and subscale scores for internal consistency of DSSS were higher in the depression group than those in the non-depression group ( P<0.01). Cronbach α coefficient for internal consistency of DSSS was 0.917. Conclusion:The DSSS has good validity and reliability among patients with coronary heart disease for screening depression, and can be used to screen depression among patients with coronary heart disease in general hospital.
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Objective:To investigate the current situation of insomnia in patients with acute coronary syndrome (ACS), and analyze the influencing factors of insomnia in the ACS patients, so as to provide information on the development of new strategies for the treatment of insomnia in ACS patients.Methods:This is a multicenter and prospective observational study. A total of 771 ACS patients who met the criteria were selected from March 2013 to June 2015. The baseline social demographic information, sleep quality questionnaire, general anxiety disorder scale-7(GAD-7),patient health questionnaire-9(PHQ-9), short-form 12 health survey questionnaire(SF-12), and enhancing recovery in coronary heart disease patients social inventory(ESSI) were completed within 7 days after admission. Logistic regression analyses were used to analyze the influencing factors of insomnia in ACS patients.Results:A total of 741 subjects with valid questionnaires were collected, including 510 males (68.8%) and 231 females (31.2%). Among them, 487 (65.7%) subjects had at least one insomnia symptom: 308 (41.6%) subjects had difficulty in falling asleep, 369 (49.8%) subjects were easy to wake at night, 116 (15.7%) subjects woke up earlier than they expected, 74 (10.0%) subjects experienced both woke up earlier and difficulty in falling asleep, and 53 (7.2%) subjects woke up earlier, woke up at night and had difficulty in falling asleep at the same time. Logistic regression analyses showed that before admission physical activity ( OR =0.636, 95% CI 0.411-0.984), depression ( OR=1.908, 95% CI 1.101-3.305) and low social support ( OR=0.278, 95% CI 1.198-3.301) were independent factors of insomnia in ACS patients. Conclusions:Nearly 2/3 ACS patients have symptoms of insomnia. Difficulty in falling asleep and easy to wake up at night are the most common manifestations. Physical activity, depression and social support independently are associated with insomnia.
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Objective@#The aim of the study was to explore the influencing factors of exercise tolerance in patients with myocardial infarction (MI) after percutaneous coronary intervention (PCI) revascularization in acute state.@*Methods@#A total of 112 patients with first MI undergoing PCI revascularization in acute state and completing cardiopulmonary exercise testing (CPET) were enrolled. Exercise capacity was evaluated by peak oxygen consumption percentage (VO2 peak%) in CPET. Patients were divided into normal exercise capacity (NEC) group (n=40) and abnormal (AEC) group (n=72) according to VO2 peak% value. Clinical manifestations, histories of hypertension and diabetes, medications, coronary arterial angiography and echocardiography findings of patients were compared. The onsets of diabetes and blood glucose levels during the period of CPET were evaluated in the MI patients with diabetes. The patients were followed up for major adverse cardiovascular events (MACE) (admission due to chest pain, re-revascularization, re-infarction and all-cause death) within 24 months after PCI. Multivariate logistic regression analyses were conducted to examine influencing factors for exercise tolerance.@*Results@#The ratio of diabetes, type C lesions in the AEC group were higher than those in the NEC group (diabetes: 37.5% vs. 17.5%; type C lesions: 69.4% vs. 42.5%, respectively, all P<0.05). The left ventricular ejection fraction (LVEF) in patients in the AEC group was lower than that in the NEC group [(60.6±10.0)% vs. (65.0±8.2)%, P=0.019]. Multivariate logistic regression analyses showed that history of diabetes and history of type C lesions were the independent risk factors for the declined exercise capacity in the MI patients after PCI revascularization (OR=3.14, 95%CI 1.167-8.362, P=0.023; OR=3.32, 95%CI 1.444-7.621, P<0.01). Among the MI patients with diabetes, the duration of diabetes in the AEC group was significantly longer than that in the NEC group[(7.7±3.6)years vs. (5.0±2.4)years] and the proportions of subjects reaching target levels of fasting plasma glucose (40.7% vs. 57.1%) and glycosylated hemoglobin A1c(HbA1c) (55.6% vs. 71.4%) in this group were significantly lower than those in the NEC group (all P<0.05). A multivariate logistic regression analysis showed that reaching HbA1c target was an independent predictor of improved exercise tolerance in MI patients with diabetes who received PCI (OR=2.518, 95%CI 1.395-7.022, P=0.021). No significant differences were observed in incidence of admission due to chest pain, re-revascularization and re-infarction between the two groups within 24 months after PCI between the groups.@*Conclusions@#Diabetes and type C lesions are independent risk factors of declined exercise capacity in patients with first myocardial infarction who received revascularization in acute state. Reaching target HbA1c is independent factor of improved exercise capacity in patients with myocardial infarction and diabetes.
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Objective The aim of the study was to explore the influencing factors of exercise tolerance in patients with myocardial infarction (MI) after percutaneous coronary intervention (PCI) revascularization in acute state. Methods A total of 112 patients with first MI undergoing PCI revascularization in acute state and completing cardiopulmonary exercise testing (CPET) were enrolled. Exercise capacity was evaluated by peak oxygen consumption percentage (VO2 peak%) in CPET. Patients were divided into normal exercise capacity (NEC) group (n=40) and abnormal (AEC) group (n=72) according to VO2 peak% value. Clinical manifestations, histories of hypertension and diabetes, medications, coronary arterial angiography and echocardiography findings of patients were compared. The onsets of diabetes and blood glucose levels during the period of CPET were evaluated in the MI patients with diabetes. The patients were followed up for major adverse cardiovascular events (MACE) (admission due to chest pain, re?revascularization, re?infarction and all?cause death) within 24 months after PCI. Multivariate logistic regression analyses were conducted to examine influencing factors for exercise tolerance. Results The ratio of diabetes, type C lesions in the AEC group were higher than those in the NEC group (diabetes: 37.5% vs. 17.5%; type C lesions: 69.4% vs. 42.5%, respectively, all P<0.05). The left ventricular ejection fraction (LVEF) in patients in the AEC group was lower than that in the NEC group [(60.6±10.0) % vs. (65.0±8.2) %, P=0.019]. Multivariate logistic regression analyses showed that history of diabetes and history of type C lesions were the independent risk factors for the declined exercise capacity in the MI patients after PCI revascularization ( OR=3.14, 95%CI 1.167-8.362, P=0.023; OR=3.32, 95%CI 1.444-7.621, P<0.01). Among the MI patients with diabetes, the duration of diabetes in the AEC group was significantly longer than that in the NEC group[ (7.7 ± 3.6)years vs. (5.0 ± 2.4)years] and the proportions of subjects reaching target levels of fasting plasma glucose (40.7% vs. 57.1%) and glycosylated hemoglobin A1c(HbA1c) (55.6% vs. 71.4%) in this group were significantly lower than those in the NEC group (all P<0.05). A multivariate logistic regression analysis showed that reaching HbA1c target was an independent predictor of improved exercise tolerance in MI patients with diabetes who received PCI ( OR=2.518, 95%CI 1.395-7.022, P=0.021). No significant differences were observed in incidence of admission due to chest pain, re?revascularization and re?infarction between the two groups within 24 months after PCI between the groups. Conclusions Diabetes and type C lesions are independent risk factors of declined exercise capacity in patients with first myocardial infarction who received revascularization in acute state. Reaching target HbA1c is independent factor of improved exercise capacity in patients with myocardial infarction and diabetes.
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Objective To investigate the effects of Hedan tablet on serum adipocytokines and inflammatory factors in rats with metabolic syndrome.Methods The 24-rat model of metabolic syndrome were randomly divided into three groups(n=8,each):normal group were given normal diet,model group were given high-lipid and high-salt diet and intervention group were given high lipid and high salt dict plus Hedan tablet 6.0 g · kg-1 · d-1 by intragastric administration for 3 weeks.Body weight,blood pressure,blood levels of glucose,lipid,leptin,visfatin,adiponectin and CRP were measured in all rats at the beginning and the end of the study.Results Compared with normal group,model group (model versus normal) showed significantly increased serum levels (P ＜ 0.05) of weight,total cholesterol(TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),glucose,leptin(5.5±0.1 vs.5.2±0.0 mmol/L),visfatin(17.5±0.5 vs.16.6±0.0 mmol/L and CRP(1 676.6 ± 74.8 vs.1 642.3 ± 52.2 mmol/L),and showed significantly decreased (P ＜ 0.05) serum level of adiponectin(74.6±2.4 vs.81.3±2.1 mmol/L).Compared with 20 weeks of age group,the 23 weeks of age group(23 weeks versus 20 weeks)showed significantly decreased levels of weight,TC,TG,LDL-C,serum leptin(5.4±0.1 mmol/L vs.5.9±0.2 mmol/L),visfatin(16.7±0.4 mmol/L vs.17.7±0.6 mmol/L)and CRP(1 498.8±51.0 mmol/L vs.1 682.1±76.6 mmol/L(all P＜0.05),and showed significantly increased serum adiponectin level(81.2±3.0 mmol/L vs.73.9±3.1 mmol/L)(P＜0.05).But there was no significant change in model group between 20 weeks and 23 weeks of age.Conclusions Hedan tablet reduces the body weight and ameliorates blood lipid level in rats with metabolic syndrome.These effects may be related to regulation of Hedan tablet on adipocytokines and inflammatory factors.
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Objectives@#To investigate the social support status, related influential factors and the impact on one year outcome in patients with acute coronary syndrome (ACS), our data might be helpful to provide basis for making new treatment strategy aimed at improving social support for patients with ACS.@*Methods@#From January 2013 to June 2014, a total of 778 hospitalized patients with ACS were enrolled in the study. All patients completed enhancing recovery in coronary heart disease patients social support inventory(ESSI), general anxiety disorder scale(GAD-7), patient health questionnaire(PHQ-9), short-form 12 health survey questionnaire(SF-12), sleep questionnaire and demographic questionnaire within 7 days after admission and at 6 months and one year post discharge. Multiple linear regressions were performed to analyze factors that influenced the social support.@*Results@#The total score of social support was 17.08±3.61, 17.72±3.04, and 17.76±3.05 respectively in patients with ACS at baseline, 6 months and 12 months after discharge. Patients had a higher point of social support at 6 months (t=-2.69, P<0.01) and 12 months (t=-2.86, P<0.01) after discharge than at baseline. Multiple regression analysis for baseline data identified five significant predictors of low social support status: workers or farmers (t=2.82, P<0.01), low family monthly income (t=2.42, P<0.05), anxiety (t=-3.66, P<0.01), depression (t=-3.22, P<0.01) and low quality of life (t=4.38, P<0.01).@*Conclusions@#Social support of patients with ACS is lower in China, and there are significant relationships between low social support and occupation, economic status, anxiety, depression, quality of life of ACS patients.
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Objective@#To explore the efficacy and safety of tertiary hospital guided and community-driven family self-help cardiac rehabilitation model.@*Methods@#This study was a prospective randomized controlled study, 80 patients from Beijing Electrical Power Hospital and Beijing Jingmei Group General Hospital with acute coronary syndrome were included from June to December 2015 and divided into 2 groups. Patients in rehabilitation group (n=52) received tertiary hospital(Peiking University Peoples′ Hospital) guided and community-driven family self-help cardiac rehabilitation for 3 months, and patients in control group (n=28) received routine secondary treatment for 3 months. Following parameters including 6 minutes walk distance, score of life quality (evaluated by Short Form-12), score of anxiety (evaluated by Generalized Anxiety Disorder-7), score of depression (evaluated by Perceived Health Questionnaire-9), self-management competency (evaluated by questionnaire) were collected at baseline and after treatment for 3 months.@*Results@#Compared with control group, 6 minutes walk distance was longer in rehabilitation group((60.2±6.8) meters vs. (24.9±10.5)meters, P<0.01). The difference values between after and before intervention of life quality scores((0.14±3.90)scores vs.(-7.44±5.85)scores, P>0.05), anxiety scores((-0.16±2.12 ) scores vs.(0.70±1.13)scores, P>0.05) and depression scores((-1.17±2.79) scores vs.(0.60±0.36)scores, P>0.05) were similar between the 2 groups. The amplification of patients with regular exercise (50.26% vs. 0, P<0.05), limit sugary foods usually and always (53.22% vs. 3.98%, P<0.05), eat 200-400 g fruits usually and always (78.61 % vs. 0, P<0.05), eat 300-500 g vegetables usually and always (9.74% vs. 0, P<0.05), and answering very confident to questions such as let the physicians know about your diseases (40.17% vs. 5.00%, P<0.05), know how to take medicines (44.52% vs. 5.00%, P<0.05), know how much exercise was right for yourself (26.43% vs.0, P<0.05) were significantly higher in rehabilitation group than in control group. There were no cardiac rehabilitation training related cardiovascular events.@*Conclusion@#Tertiary hospital guided and community-driven family self-help cardiac rehabilitation model is an effective and safe management model of cardiovascular disease in chronic phase, and it is necessary to further expand the study population to verify the efficacy of this model.
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<p><b>OBJECTIVE</b>To analyze the value of 2- and 9-question patient health questionnaires (PHQ-2 and PHQ-9) for screening status of depression in cardiovascular outpatients.</p><p><b>METHODS</b>From June 2013 to January 2014, a total of 201 outpatients from psycho-cardiological outpatients departments were consecutively enrolled into this study. All patients were asked to complete PHQ-9 and the mental psychological assessment by qualified researchers trained by psychiatry according to the composite international diagnostic interviews (CIDI), 50 cases were retested to assess the retest reliability after one week. The PHQ-2 and PHQ-9 were validated with the CIDI as the reference criteria.</p><p><b>RESULTS</b>According to the CIDI, 42 (21.3%) out of the 201 outpatients were diagnosed as depression. For PHQ-9 scale, a cutoff value of 10 presented satisfactory results with 87.1% sensitivity, 83.5% specificity, 58.7% positive predicting value, 95.6% negative predicting value and the area under the ROC curve (AUC) was 0.877 (SE = 0.032, 95% CI: 0.813-0.938). The Cronbach's alpha coefficients and test-retest reliability of the PHQ-9 were 0.809 and 0.882, respectively. Compared with CIDI, the cutoff value of the PHQ-2 was 3 with 85.7% sensitivity, 69.2% specificity, 57.1% positive predicting value, 93.6% negative predicting value, and the AUC was 0.806 (SE = 0.042, 95% CI: 0.774-0.889). The Cronbach's alpha coefficients and test-retest reliability of the PHQ-2 were 0.785 and 0.813, respectively.</p><p><b>CONCLUSION</b>The PHQ-2 and PHQ-9 are reliable and efficient instruments for screening and especially excluding depression in cardiovascular outpatients.</p>
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Humans , Area Under Curve , Cardiovascular Diseases , Psychology , Depression , Diagnosis , Mass Screening , Outpatients , Psychology , Reproducibility of Results , Sensitivity and Specificity , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To explore if the new onset hypertension was related with metabolic risk factors and lifestyle in Beijing community residents to guide the targeted prevention of hypertension.</p><p><b>METHODS</b>A population-based survey with a randomly cluster sampling was made to observe the relationship between metabolic risk factors and lifestyle with new onset hypertension by multivariate and logistic regression.</p><p><b>RESULTS</b>A total of 4 034 subjects with normal blood pressure at baseline were included and 978 (24.2%) residents developed hypertension two years later. Multiple logistic analysis demonstrated that risk factors that contributed to new onset hypertension were prehypertension, overweight, obesity, frequent alcohol drinking, metabolic syndrome (MS), age and male gender, the respective Odds Ratios(OR) and 95% confidence interval (95%CI) are as follows: 3.512 (2.965-4.168), 1.654 (1.423-1.918), 2.264 (1.633-2.951), 1.493 (1.231-1.775), 1.329 (1.227-1.414), 1.226 (1.115-1.335), 1.135(1.018-1.221). College education serves as the protective factor, and the OR (95%CI) was 0.692 (0.476, 0.897).</p><p><b>CONCLUSIONS</b>New onset hypertension in Beijing community residents is mainly related with prehypertension, overweight or obesity, MS, frequent alcohol drinking and low education level. We should pay more attention to modulating metabolic risk factors and lifestyle to reduce the new onset hypertension in China.</p>
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Humans , Male , Beijing , Blood Pressure , China , Hypertension , Life Style , Logistic Models , Metabolic Syndrome , Overweight , Prehypertension , Risk FactorsABSTRACT
Objective This study was aimed to investigate the relationship between serum leptin,adiponectin,visfatin levels and obesity and essential hypertension in female subjects.Methods According to BMI and blood pressure,206 female participants enrolled were divided into four groups:group 1:obesity and hypertension (48 cases);group 2:non-obesity but hypertension (48 cases);group 3:obesity and normotension (56 cases) and group 4:normal BMI and blood pressure (54 cases).Serum leptin,adiponectin and visfatin levels were detected and their relationships to BMI,blood pressure and waist circumference were analysed.Results Serum leptin levels were significantly higher in non-obese groups [group 2:(4.47 ±1.26) ng/L,group 4:(3.73-±1.18)ng/L] than in obese groups [group 1:(2.97 ± 1.46) ng/L,group 3:(3.02 ± 1.18) ng/L],and higher in hypertension groups than in normotension groups.Serum adiponectin levels were obviously higher in group 4 [38.99 (19.75,103.71) μg/L] than in the other three groups.There were no significant differences in adiponectin levels among group 1,2 and 3.Serum levels of visfatin were lower in normotension groups [group 3:3.19 (0.96,9.45) ng/L;group 4:3.23 (1.92,4.64) ng/L] than in hypertension groups [group 1:3.84 (3.40,5.35) ng/L;group 2:3.75 (1.63,6.67) ng/L] irrespective of obesity.Logistics regression analysis showed that there was 1.6％,8.3％,or 5.45％ increased risk for hypertension for each 1 μg/L decrease in adiponectin,1 cm increase in waist circumference,or 1 μg/L increase in visfatin level in obesity,respectively.No relationship could be viewed between leptin and hypertension.Conclusions Adiponectin and visfatin levels were correlated with obesity and blood pressure in females.Both adipokines may play a crucial role in the development of hypertension in female obesity.
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Objective To investigate the prevalence,awareness,control status and associated risk factors of hypertension in a rural population in Xianghe county in North China.Methods A total of 830 adults (aged≥35) from Xianghe county were examined during July to August,2011.Blood pressure was obtained using a standardized sphygmomanometer after a 5-minute sitting rest.Information on gender,age,education level,marital status,smoking,drinking,income,family history of hypertension and use of antihypertensive medications was obtained.Results A total of 42.4％ of all subjects had hypertension.Among those with hypertension,the awareness rate was 54.8％ and 50.0％ of the patients were taking antihypertension medication with the control rate of 11.9％ [BP ＜ 140/90 mm Hg (1 mm Hg =0.133 kPa)].Lower age and education level,lower body mass index,negative family history of hypertension were associated with poor awareness of hypertension and worse compliance with the treatment.Older age,positive family history and alcohol consumption were associated with poor blood pressure control.Conclusions Hypertension is highly prevalent in Xianghe rural area.The awareness,treatment and control rate are all low.There is an urgent need for comprehensive strategies to improve prevention,screening,and treatment of hypertension in rural China.
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Objective To evaluate the effect of pitavastatin on blood glucose in patients with hypercholesterolemia,and to investigate the efficacy of pitavastatin in diabetic patients combined with hypercholesterolemia.Method This study was a 12-week,multi-center,open-label,without parallel-group comparison,phase Ⅳ clinical trail.Results Contrasting to baseline,the prevalences at week 4 and 12 post-treatment of abnormal fasting plasma glucose (FPG) and glycosylated hemoglobin Alc (HbA1c)( FPG:14.2％ vs 14.1％ and 11.0％ ; HbA1c:14.3％ vs 15.1％ and 16.1％ ) in the safety set subjects without diabetes mellitus (DM),as well as in those with DM but not taking glucose-lowering drugs (FPG:7/7 vs 4/7 and 5/7; HbAlc:5/5 vs 4/4 and 5/5) had no significant changes (all P vaules ＞0.05).Contrasting to baseline,the levels of TC [ (6.51±0.94) mmol/L vs (5.12 ±0.93) mmol/L and (4.54 ±1.00) mmol/L],LDL-C [(4.11 ±0.79)mmol/L vs (3.02 ±0.81) mmol/L and (2.51 ±0.70)mmol/L] and TG [2.10(1.53,2.54) mmol/L vs 1.62(1.26,2.00) mmol/L and 1.35(1.10,1.86)mmol/L]at week 4 and 12 post-treatment in the per protocol set 55 subjects with DM were significantly reduced (all P values ＜ 0.05 ) ; 33.3％ of subjects at high risk and 10.0％ of subjects at very high risk had achieved a TC target value; 55.6％ of subjects at high risk and 40.0％ of subjects at very high risk had achieved a LDL-C target value.Conclusion Pitavastatin has a safe effect on blood glucose and it could be used to treat diabetic patients combined with hypercholesterolemia in China.
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Objectives To compare the safety and efficacy of radial artery access versus femoral artery access for percutaneous coronary intervention in acute myocardial infarction population. Methods From June 2004 to December 2006, 446 patients with acute myocardial infarction treated with percutaneous stenting were reviewed retrospectively. The radial artery approach was used in 242 patients, and the femoral artery approach in 204 patients. The success of the procedure, procedure duration, X-ray exposition, volume of contrast, incidence of major adverse cardiac events and complications were compared between the radial artery and femoral artery approach. Results Total procedure duration, X-ray exposition, the immediate success of the procedure and the proportion of patients with reperfusion time above 60min are higher in patients with radial artery acess than that with femoral artery access [(62. 1 ± 23. 4) min vs(56. 8 ± 16. 7)min,(2829. 4 ± 1365.2) mGY vs (2352. 3 ± 903.1) mGY, 4% vs 0.9% and 7.44% vs 2.94%respectively, all P ＜ 0. 05]. Conclusions In non-selected patients with acute myocardial infarction treated with primary stent implantation, the success rate of the radial artery approach is lower than the femoral artery approach and could prolong the reperfusion time. It is suitable to change artery access immediately if abnormality is found via radial artery access.
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Objective To evaluate the abstinence rate and relapse rate of smoker with ACS after discharged from hospital, to evaluate the effect of simple smoking cessation interventions.Methods 150 smokers with ACS were collected and was divided into simple intervention group ( n = 87) and control group (n = 63) , respectively, followed up for 6 months.2 months, 6 months abstinence rate, relapse rate were compared between two groups, logistic regression model was used to analyzed the relevant factors for relapse.Results The smoking rate in patients with ACS was 31.14% , 6-month continuous abstinence rate and 6-month relapse rate was 64.6% , 36.4% , respectively.6-month continuous abstinence rate and relapse rate between simple quit-smoking intervention group and control group showed no difference.Nicotine dependence score more than 4 points can be used as predictor of relapse.Conclusions The smoking rate and the abstinence rate of smoker with ACS is higher than the general population, simple quit-smoking intervention do not increase the success rate of quit-smoking, indicated the need to strengthen the intervention in patients with ACS and smoking.
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Objective To evaluate the effect of urapidil on myocardial reperfusion and cardiac function during primary percutenons coronary intervention (PCI) in acute myocardial infarction (AMI) patients.Methods 54 AMI patients undergoing primary PCI were randomized to intracoronary urapidil (n=27) and nitroglycerin (n=27) group.When blood flow grade TIMI-l or more appeared in the infarct related artery (IRA) before or after percutenous transluminal coronary angioplasty (PTCA),urapidil (12.5 mg) or nitroglycerin (0.2 mg) was given intracoronary and then stents were implanted as needed.TIMI blood flow,no reflow/slow floW,corrected TIMl frame count (cTFC),myocardial blush grade (MBG),ST resolution (STR) on ECG, peak of creatine kinase (CK),cardiac troponin T (cTnT) were observed before and after PCI.Left ventricular ejection fraction (LVEF) was measured 24 hours and 30 days after PCI and MACE including death,reinfartion,revascularization in hospital were observed. Resuits Urapidil group compared to the nitroglycerin group,cTFC (18.38±3.30 vs.21.44±4.26,P=0.005) decreased and MBG (P=0.040) improved.STR in the urapidil group improved significantly compred to the nitroglycerin group (93% vs.70%,P=0.038).LVEF of 24 hours and 30 days after PCI in the urapidil group was higher than that ofthe nitroglycerin group (0.55±0.05 vs.0.52±0.06,P=0.021 and 0.58±0.06 vs 0.54±0.06,P=O.041,respectively).Peak CK (1895.26±1239.02 vs.1269.96±515.84,P=0.021) and peak TnT (5.81±5.27 vs 3.64±2.35,P=0.050) in the urapidil group decreased more significantly than that of the nitroglycerin group.No difference of MACE was found in the two groups.Conclusion Intracoronary urapidil administration adjunct to primary PCI in AMI ameliorates coronary blood flow and myocardial perfusion, improves ventricular function,and reduce the infarct size and does not incllase the incidence of complications during hospitalization.
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Policosanol is a new drug for regulating lipid,which can inhibit cholesterin synthesis and increase blood clearance of low-density lipoprotein(LDL).It has similar effect as statins and its clinical efficiency,safety and tolerance for special people such as the old and those with hepatopath have been confirmed by many clinical studies.Policosanol combined with statins or fibrates is also safe,which can be used as primary prevention for the patients with hypercholesterinemia,high low-density lipoprotein-cholesterolor low high-density lipoprotein-cholesterol and as secondary prevention for the patients who could not tolerate other lipid-regulating drugs.The long-term clinical effect of Policosanol on the risk factors of atherosclerosis need further researches.