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OBJECTIVE:To discuss the expression of voltage-gated potassium channel(KV1.3)and calcium activated potassi-um channel(KCa3.1)in peripheral monocyte from patients with coronary artery disease(CAD)and the regulatory effect of simvas-tatin. METHODS:20 patients with CAD and 8 control patients without CAD diagnosed by percutaneous coronary intervention but correlated to risk factor of CAD were enrolled. The expression of KV1.3 mRNA and KCa3.1 mRNA were measured by RT-PCR in 2 groups,and those of CAD group were measured by RT-PCR after 1 month of simvastatin treatment. RESULTS:Compared with control group,mRNA expression of KV1.3 [(1.54±0.08)vs.(0.77±0.06),P<0.01] and KCa3.1 [(1.32±0.08)vs.(1.06±0.06), P<0.05] were significantly increased in CAD group. mRNA expression of KV1.3 was significantly correlated to the concentration of C reactive protein (CRP)(P=0.003)and was decreased by simvastatin for one month [(1.54 ± 0.08)vs.(1.14 ± 0.05),P<0.01]. However,mRNA expression of KCa3.1 was not correlated to the concentration of CRP and simvastatin didn’t affect it’s expression. CONCLUSIONS:KV1.3 and KCa3.1 in peripheral monocytes may be two new markers of CAD. Regulating KV1.3 may be one of mechanisms of statin’s pleiotrophic effect.
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Objective To investigate the the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute non-ST-segment elevation myocardial infarction patients with heart failure.Methods 80 patients with heart failure caused by acute non-ST-segment elevation myocardial infarction were chosen,they were divided into the observation group and control group based on a random number table,each group included 40 patients.The observation group were treated with intravenous injection of recombinant human brain natriuretic peptide,the control group were treated with intravenous nitroglycerin.vital signs,dyspnea,brain natriuretic peptide (BNP),associated hemodynamic changes and adverse reactions of two groups were compared before and after treatment.Results The total effective rate in observation group was 87.5％ (35/40),which were significantly higher than 50.0％ (20/40) of the control group,there were significant difference (x2 =13.09,P ＜ 0.05).In the observation group,after treatment,the left ventricular ejection fraction (LVEF) and average hourly urine output were significantly higher than those of before treatment (t =26.40,3.22,all P ＜ 0.05),and the brain natriuretic peptide (BNP) concentration levels were significantly lower than those of before treatment (t =14.11,all P ＜ 0.05).The control group before and after treatment LVEF,BNP and changes in urine levels were not significantly.Conclusion In the treatment of heart failure caused by acute non-ST-segment elevation myocardial infarction,the recombinant human brain natriuretic peptide (rhBNP) has significant effect,feasible and safe with few side effects,which has a high clinical value.
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Objective To explore the effect of prehospital 12-lead electrocardiogram (ECG) and transtelephonic notification on door-to-balloon time in patients with ST-segment elevation myocardial infarction (STEMI). Methods Four hundred and two patients with STEMI who underwent primary PCI from January 2006 to December 2007 in Beijng Anzhen Hospital were analyzed. They were divided into 3 groups: 137 patients without prehospital ECG (group A), 176 patients with prehospital ECG (group B) and 89 patients with prehospital ECG and early transtelephonie notification (group C). Door-to-balloon time and in-hospital mortality were compared among the groups. Results There were no significant differences in age, sex, past medical history and infarcted area among three groups. Compared with group A, patients in group B and group C had much shorter door-to-balloon time (96 minutes and 86 minutes vs. 113 minntes in group A, all P<0. 01). No difference was found in in-hospital mortality among three groups (2. 9% vs. 2.3% vs. 2. 2%, P> 0. 05). Conclusions Prehospital ECG and early transtelephonic notification can significantly shorten door-to-balloon time in patients with STEMI. Coordinated system including prehospital ECG and transtelephonie notification is proved to be feasible and effective.
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Objective: To evaluate the safety and efficacy of overlapping Sirolimus-eluting stents (SES) in very long lesions during primary percutaneous coronary intervention (PCI) in patients with ST-elevated myocardial infarction (STEMI).Methods: A total of 297 consecutive patients with STEMI underwent primary PCI from January to December 2007 in our hospital were studied.We identified the patients who had 2 or more SES implanted in single long lesion with a single procedure.6 months angiographic and clinical follow-up was performed.The incidences of restenosis and major adverse cardiac event (MACE) during hospitalization and at the follow-up time were analyzed.Results: We identified 31 patients with 31 long lesions who had been implanted more than 2 stents.A median of 2.1 stents were implanted, the median lesion length was 47.2±10.3mm and a median implanted stents'length was 53.2±10.5 mm.6 months clinical follow up rate was 100% and 6 months angiographic follow-up rate was 74.2%, respectively.The incidence of MACE was 8.7% which including target lesion revascularization (TLR).No cardiac death and no fatal myocardial infarction were found.Conclusion: Implantation of SES for very long target lesions seemed to be safe and effective in patients with ST elevated myocardial infarction.Its long-term safety and effectiveness should be further investigated.
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Objective To evaluate the safety and efficacy of overlapping sirolimus-eluting stent (SES) for long lesions during primary percutanous coronary intervention(PCl) in elderly patients with ST-segment elevation myocardial infarction (STEMI).Methods Seven hundred and seventy-five elderly patients with STEMI who underwent primary PCI were enrolled and followed up. Patients with two or more SES implanted for long lesions during PCI were taken as long lesion group and patients with single stents implanted were regarded as control group. The safety endpoints were in-hospital and follow-up death and stem thrombosis, and the clinical endpoints were the incidence of restenosis and target vessel revascularization rate during in-hospital follow-up and 6 months" follow-up.Results Among 775 patients, 62 patients had 64 long lesions. The average number of stents was 2. 2, and the average lesion length and stent length implanted were (45.3±10. 4)mm and (52.2±11.0)mm, respectively. During the 6 months' follow-up, the incidence of angiographically documented stent thrombosis were 1.6% in long lesion group and 1.1% in control group, respectively. No death or myocardial infarction occurred in two groups. There was no significant difference in the incidence of restenosis and target vessel revascularization rate between long-lesion group and control group (8. 1 vs. 4.8%, 6.9% vs. 3. 7%, both P>0.05). Conclusions Overlapping implantation of homemade SES is safe and effective for STEMI patients with long lesions in short-term period.
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Objective To investigate the influencing factors for prehospital delay in patients with acute myocardial infarction (AMI).Methods A total of 807 consecutive patients with AMI who presented to the emergency department of Beijing Anzhen Hospital were analyzed. The influence of several potential risk factors on the prehospital delay time (PDT) was evaluated by comparing patients admitted more than 2 hours after onset of chese pain with those admitted within 2 hours after onset. Results Among 807 patients, 402 came to the hospital within 2 hours while the others arrived at the hospital after 2 hours. The median PDT was 130 min. Among the potential variables, advanced age, history of diabetes mellitus, occurrence of symptom at night and use of emergency medical service significantly affected PDT by multivariate analysis. Conclusion Interventions aimed at reducing the prehospital delay in AMI should primarily focus on the awareness of the risk and help-seeking behavior of patients.