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Objective To evaluate the prognosis and influencing factors of unprotected left main coronary artery lesion intervention with drug-eluting stents.Methods Forty-five patients with unprotected left main coronary artery disease were treated with percutaneous coronary intervention (PCI).According to whether the lesions involving the distal left main bifurcation,the patients were divided into two 2 groups:nonbifurcation lesion group (26 cases) with opening or body disease,bifurcation lesion group (19 cases) with involving the distal left main or anterior descending artery,circumflex openings.Fifteen patients were guided by intravascular ultrasound (IVUS) during PCI,and 13 patients were reviewed by coronary angiography at (9.5 ±6.3) months after PCI.Results All the 45 patients were successful.There were 42 patients successfully finished the follow-up study for the average of 8-48 (19.9 ± 10.2) months,non-bifurcation lesion group was 24 cases,bifurcation lesion group was 18 cases.The incidence of recurrent angina pectoris during the follow-up period in bifurcation lesion group was significantly higher than that in non-bifurcation lesion group [6/18 vs.12.5％ (3/24)],there was statistical difference (P ＜ 0.05),but there was no statistical difference in the incidence of major adverse cardiac events (MACE) between 2 groups [3/18 vs.12.5％ (3/24),P ＞ 0.05].Single-variable analysis results showed that MACE in IVUS guided during PCI was less than that in non-IVUS guided during PCI [1/15 vs.18.5％(5/27)],there was statistical difference (P ＜0.05).In 13 patients who reviewed by coronary angiography,4 patients were found in-stents restenosis,all in bifurcation lesion group,the rate of restenosis in double stents was 3/6,in simple stents was 1/4.Conclusions PCI with drug-eluting stents is safe and feasible for the treatment of selective left main coronary artery lesion,it could bring the better short and long-term outcomes.IVUS guided PCI could significantly reduce MACE.
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Objective To investigate the etiology and relative factors of dilated cardiomyopathy (DCM) in Chinese patients. Methods A case-control study was conducted to compare 233 patients with DCM in high-incidence areas (case group) and 150 patients with stable angina pectoris (control group). Life styles and history of diseases information was collected by questionaire; human anti-myocardial antibody IgG (AMA- IgG), human Coxsackie B virus IgG (CBV- IgG) and human adenovirus antibody IgG (ADV- lgG) were measured with ELISA. General chemical and toxicological indicators in drink water from high and low prevalence areas and serum trace elements also were compared. Results 1 ) Compared with the control group, the case group had more farmers (P < 0.01), with low average incomes (P < 0.01), higher alcohol consumption (P < 0.01) and higher incidence of the history of myocarditis (P < 0.01 ). 2) AMA-IgG, CBV-IgG and ADV-IgG levels were low and the positive rates ofAMA-IgG, CBV-IgG and ADV-IgG of patients with DCM were respectively 7.78%, 6.67% and 6.67%, no statistical significance comparing with those in the control group. 3) The content of iron (1.36±2.18 vs 0.39±0.67 mg/L, P<0.05) and manganese (0.384±0.35 vs 0.15±0.14, P<0.01 ) in drinking water of high-incidence areas was significantly higher than that in low-incidence areas. 4) The content of serum iron (69.14±57.8 vs 20.04±17.5 μ mol/L, P<0.01 ) and copper (25.74±4.2 vs 19.7±4.5 μmol/L, P<0.01) in the case group evidently exceeded the normal range and obviously higher than that in the control group. Conclusions 1) The incidence of some DCM is related with low incomes, high alcohol consumption and myocarditis. 2) These data do not support that DCM is related with persistent virus infection and autoimmunization; 3) Iron and manganese contents exceeding standards in drinking water and the high content of serum iron and copper is comparatively related with the incidence of DCM.
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Objective To study the etiology and relative factors of dilated cardiomyopathy (DCM). Methods A total of 233 DCM patients were enrolled and conducted epidemiological survey. Stable angina patients in the same region were collected as control group. The epidemiological investigation included: life styles and history of diseases; blood pressure, electrocardiogram and echocardiography; serum lipids, glucose, hs-CRP, cTNI and NT-proBNP. Results The prevalence rate of DCM was 29.1 per 100 000 population, the male being almost 2-fold more involved than female, and farmers accounted for 77.7%. Familial clustering was not obvious. There were low level of history of hypertension (12.4%), ischemic heart disease (2.1%), myocarditis (5.2%) and diabetes (3.4%). Compared with control group, DCM patients had higher proportion of farmer (60.0% vs 77.7%, P