Clinical characteristics of and related treatments on 1004 patients with acute myocardial infarction from March 2004 to March 2007 / 中华流行病学杂志

Objective To study the change of baseline clinical characteristics including prehospital delayed time(PDT),modes of transportation and treatment for patients with acute myocardial infarction (AMI)in the past 3 years.Methods We used the same questionnaire to accurately collect and retrospectively analyze the data regarding clinical characteristics of all 1004 patients with AMI,who consecutively presented to the Emergency Unit and Emergency Intensive Care Unit(EICU)of Beijing Anzhen Hospital from March 12th 2004 to March 11th 2007.According to the time of onset of the disease,all patients were divided into 3 groups:group A(from Mar.12th 2004 tO Mar.11th 2005),group B(Mar.12th 2005 to Mar 11th 2006)and group C(Mar.12th 2006 to Mar.11th 2007).Clinieal characteristics and treatment were compared.Results There were significant differences in the number of patients with histories of stroke,coronary artery disease or smoking among the three groups(P＜0.05).No obvious differences in the median of PDT were found among the three groups(P＞0.05).More patients accepted reperfusive therapy in group C compared to group A(P＜0.05),although the mortality rates of AMI among these 3 years were similar.Conclusion Though more people started to have accepted reperfusion therapy,mortality failed to show an obvious decrease.Subject as how tO shorten the PDT called for further study.

Clinical implications of relationship between myeloperoxidase and acute coronary syndromes / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the clinical implications of relationship between myeloperoxidase and acute coronary syndromes (ACS).</p><p><b>METHODS</b>176 consecutive patients who underwent coronary angiography for coronary atherosclerosis were divided into four groups according to the quartile of MPO Level. The characters and the relationship between MPO and the elements were studied in every group.</p><p><b>RESULTS</b>(1) ACS rate (36.2%) in the fourth quartile group of MPO level was 6 times higher than that (5.2%) in the first quartile group of MPO level, P < 0.01. (2) Gensini score (65.6 +/- 30.3) in the fourth quartile group of MPO level was significantly higher than that (17.3 +/- 10.2) in the first quartile group (P < 0.01). WBC [(7.7 +/- 1.6) x 10(9)/L] in the fourth quartile group was also significantly higher than that [(6.6 +/- 1.8) x 10(9)/L] in the first quartile group, P < 0.05. (3) When TnI < or = 0.05 ng/ml, MPO level had a positive correlation with Gensini score (r = 0.321, P = 0.002) and WBC (r = 0.230, P = 0.025). (4) Kaplan-meier event rate curve showed that there was a significant difference of the terminus incident (death, no causing death AMI, vessel reestablish and incidence rate of CABG add up) between the groups > or = 62.9 AUU/L and < 62.9 AUU/L of MPO serum level at 6-month follow-up visit (chi(2) = 13.5, P = 0.01).</p><p><b>CONCLUSION</b>Activity level of MPO in human serum seems a good biomarker for diagnosing and predicting ACS, which may be especially helpful in predicting the risk of myocardial infarction in patients with acute chest pain during 6-month follow up.</p>

Upregulation of adrenomedullin system in left ventricular hypertrophy of severe hypertension rats / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the pathophysiological role of the cardiac adrenomedullin (AM) system, including the ligand and amidating activity in the hypertrophied heart in severe hypertension.</p><p><b>METHODS</b>The following four groups were studied: control Wistar Kyoto rats (WKY), spontaneously hypertensive stroke-prone rats (SHR-SP), 8 weeks captopril-treated SHR-SP, and 8 weeks trichlormethiazide-treated SHR-SP. AM precursor was converted to inactive glycine-extended AM (AM-Gly) and subsequently AM-Gly was converted to active mature AM (AM-m) by enzymatic amidation. AM-m, AM-total (AM-T; AM-T = AM-m + AM-Gly), atrial natriuretic peptide (ANP) in the plasma and left ventricle (LV) by immunoradiometric assay, and gene expression of AM and ANP were measured.</p><p><b>RESULTS</b>SHR-SP had increased blood pressure, LV weight, plasma and LV ANP levels and mRNA levels of ANP compared with WKY. AM-m and AM-T levels in the plasma (AM-m: +31%; AM-T: +56%) and in the LV (AM-m: +84%; AM-T: +31%) were significantly higher in SHR-SP than those in WKY. The LV tissue AM-m/AM-T ratio was significantly higher in SHR-SP (93.2%) than that in WKY. The mRNA levels of AM in the LV were significantly higher in SHR-SP than those in WKY. Captopril and trichlormethiazide similarly decreased blood pressure and LV hypertrophy with the reduction of the LV AM-m and AM-T levels and mRNA abundance of AM.</p><p><b>CONCLUSIONS</b>These results suggested that cardiac AM system was upregulated in the hypertrophied heart in this hypertension model. Considering that AM being as an antiremodeling autocrine and(or) paracrine factor, upregulation of the AM system may modulate the pathophysiological course in LV hypertrophy.</p>