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Objective To explore the efficacy and safety of ticagrelor plus cilostazol of different dosage in the treatment of low-weight patients after PCI.Methods A total of 148 consecutive ACS patients (body weight ≤ 65 kg) past PCI and with aspirin intolerance were enrolled and randomly divided into four groups.Patients given cilostazol 50mg twice daily plus clopidogrel 75 mg daily were named as the CC50 mg group.Patients in the CC100 mg group were given cilostazol 100 mg twice daily plus clopidogrel 75 mg daily.The TCS0 mg group were given cilostazol 50 mg twice daily plus standard ticagrelor 90mg twice daily and the TC100 mg group were given cilostazol 50 mg twice daily plus standard ticagrelor 90 mg twice daily.All patients were followed up clinically for 6 months.The clinical endpoints were MACEs and bleeding events.Platelet aggregation at 7 and 30 days after treatment the incidence of clinical endpoints during followup were compared between the four groups.Results Patients in the TC100mg group had the lowest platelet aggregation rates tested on both the 7th and 30th day after treatment among all the 4 groups.After 6 months of follow up,the MACEs rate was not significantly different between the four groups (P =0.930).Bleeding events rates in the TC100 mg group the highest among the 4 but without groups significant differences.Conclusions In ACS patients with low body weight ≤ 65 kg) past PCI and with aspirin intolerance,cilostazol 50mg twice daily plus ticagrelor is a safe and efficacious therapeutic regimen.
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Objective: To explore the risk factors for heart failure (HF) occurrence in patients with inferior or combining right ventricular myocardial infarction (MI). Methods: A total of 143 patients with inferior or combining right ventricular myocardial infarction (MI) in our hospital from 2013-01 to 2015-06 were studied. Based on HF occurrence, the patients were divided into 2 groups:HF group, n=81 and Non-HF group, n=62. The risk factors related to HF occurrence as age, gender and hypertension were retrospectively studied and compared between 2 groups. Results: Compared with Non-HF group, HF group had more patients with hypertension, female gender, higher blood levels of Hs-CRP and creatinine, more volume of lfuid input on the 3rd day of admission and the higher ratio of V4-6 ST segment depression in ECG; while obviously lower diastolic blood pressure (DBP) at admission. Multivariate Logistic regression analysis indicated that hypertension (OR=3.275, 95% CI 1.220-8.793), female gender (OR=13.236, 95% CI 3.476-50.405), Hs-CRP (OR=1.029, 95%CI 1.005-1.070), low DBP at admission (OR=0.945, 95%CI 0.911-0.979), serum creatinine (OR=1.053, 95%CI 1.029-1.078) and V4-6 ST segment depression in ECG (OR=4.118, 95%CI 1.395-12.154) were positively related to HF occurrence in relevant patients. Conclusion: The incidence of HF has been relatively high in patients with inferior or combining right ventricular MI;hypertension, female gender, low DBP at admission, blood level of Hs-CRP, serum creatinine, V4-6 ST segment depression in ECG were the independent risk factor for HR occurrence.
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Objective: To understand the cardiac involvement of Dengue fever patients and to analyze the clinical characteristics of Dengue fever combining cardiac complications. Methods: A total of 395 patients of Dengue fever treated in our hospital were analyzed. Blood levels of CK, CK-MB, CTnT, NT-proBNP were examined, ECG and echocardiography (UCG) were conducted in all patients. Upon Dengue recovery, the levels of CK and CK-MB were re-examined in patients with elevated indexes. Results: Overall, there were 47.3% patients with increased CK, 61.3% with increased CK-MB, 42.5% with increased CTnT and 22.4% with increased NT-proBNP; 37.2% patients with abnormal ECG and 29.9% with abnormal UCG. There were 65.5% patients showing CK and CK-MB reduction more than 4 days upon Dengue recovery. Compared to those without the history of heart disease (HD), the patients with HD history had the higher abnormal rates of CTnT (17.7 vs 60.8) %, NT-proBNP (4 vs 32.3) % and ECG (25.1 vs 51.7) %, UCG (15.7 vs 41.7) %, allP Conclusion: Blood levels of CK, CK-MB, CTnT, NT-proBNP and ECG, UCG could be used to evaluate the patients with Dengue fever in order to prevent the cardiac complications at the early stage.
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Objective To explore the efficacy of recombinant human brain natriuretic peptide (rhBNP) in the treatment of heart failure patients with coronary heart disease (CHD).Methods Ninety-six CHD patients with heart failure were divided into observation group (48 cases) and control group (48 cases) by random digits table,and rhBNP was used in observation group and nitroglycerin was used in control group.The efficacy,left ventricular ejection fraction (LVEF) and urine output in two groups were observed.Results The total effective rate in observation group was 93.75％ (45/48),and 81.25％ (39/48) in control group,there was significant difference between two groups (P ＜ 0.05).LVEF and urine output after treatment were better than those before treatment [observation group:(57.7 ± 3.9)％ vs. (32.5 ± 3.1 )％,(70.5 ± 31.1 ) ml/h vs.(34.5 ± 13.7) ml/h;control group:(52.2 ± 3.3)％ vs.(33.4 ± 2.9)％,(53.6 ± 23.4) ml/h vs.(33.8 ± 13.4)ml/h,P ＜ 0.05 ].After treatment,LVEF and urine output in observation group were higher than those in control group (P ＜ 0.05 ).Incidence of adverse reaction in observation group was lower than that in control group [ 18.75％ (9/48) vs.35.42％ ( 17/48),P ＜ 0.05 ].Conclusion rhBNP has curative effect and small adverse reactions on CHD patients with heart failure,and can significantly improve the patients' general condition.
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ObjectiveTo investigate the effect of the levels of serum lipid on the prognosis of patients with severe heart failure.MethodsThe clinical data of 149 patients with severe heart failure was analyzed retrospectively,the levels of serun lipid were compared among different causes and different NYHA cardiac functional grading patients.And the prognosis was compared between low-serum lipid and non-low-serum lipid patients.Results There were significant differences in the levels of total cholesterol(TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),albumin (ALB) among different NYHA cardiac functional grading (P ＜0.05),but there was no significant difference in triacylglycerol (TG) among different NYHA cardiac functional grading(P ＞ 0.05 ).The levels of TC,HDL-C,LDL-C in dilated cardiomyopathy and rheumatic heart disease were lower than those in coronary heart disease combined with hypertension and ischemic cardiomyopathy,there were significant differences (P ＜0.05).Followed up for 2 years,the mortality,deteriorated frequency,hospitalization frequency more than 2 times a year and hospitalization time more than 1 month in low-serum lipid patients [29.0％ (9/31 ),25.8％ ( 8/31 ),48.4％ ( 15/31 ),61.3％ ( 19/31)]were higher than those in non-low-serum lipid patients [9.3 ％ ( 11/118 ),9.3％ ( 11/118 ),17.8％ (21/118 ),24.6％ (29/118 )],and there were significant differences (P ＜ 0.01 or ＜0.05).Conclusions For patients with severe heart failure,NYHA cardiac functional grading has significantly negative correlation with their serum lipid levels.Lower serum lipid levels will seriously affect the prognosis of patients.
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Objective To analyze the efficacy and safety of tirofiban treatment combined with percutaneous coronary intervention (PCI) in the elderly with acute ST segment elevation myocardial infarction prospectively. Methods From May 2008 to May 2010, 106 patients who presented with acute STEMI within 12 hours from onset and received successful primary PCI were enrolled into the study. All patients had angiographic evidence of initial total occlusion of infarct-related artery and finally restored toTIMI3 flow after PCI. All patients were divided into tirofiban group (n = 54) and control group (n = 52) according to whether tirofiban was used or not. Assessment of myocardial perfusion included Myocardial Blush Grades (MBG), and the resolution of the sum of ST-segment elevation (sumSTR) at 90 minutes after the procedure. Left ventricular ejection fraction (EF) was measured one week later. Major adverse cardiac events in hospital and bleeding complications were also assessed. Results Baseline clinical and angiographic characteristics of the two groups were similar. Significant higher rates of MBG 3 were observed in the tirofiban group (88. 9% vs57. 7%, P ＜ 0.05). Patients received tirofiban were more likely to achieve higher sumSTR (70. 3% vs 42. 3%, P ＜0. 05). Ejection fraction was also markedly increased in tirofiban group than control group (56. 2 ± 7.6 vs 46. 7 ± 8. 5, P ＜ 0. 05). In-hospital major adverse cardiac events, it was not different between the two groups(P ＞0. 05). There were slightly more minor bleeding complications in tirofiban group compared with control(11.1% vs 6. 0%, P ＞0. 05). No patient had major bleeding or thrombocytopenia.Conclusions Tirofiban can further ameliorate microvascular perfusion and it is safe and feasible for patients with STEMI undergoing primary PCI.