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Objective To study the effect of sex on reperfusion time delay in ST-segment elevation myocardial infarction (STEMI) patients after diagnosis.Methods A total of 1647 STEMI patients admitted to our hospital were included in this study.Their clinical data and treatment time points were recorded.The reperfusion time delay after diagnosis refers the time from ECG-based diagnosis to PCI.The reperfusion time delay after diagnosis was divided into 0-3 h,＞3-6 h,＞6-12 h,＞12-24 h and ＞24 h.The effect of sex and other risk factors on reperfusion time delay after diagnosis was assessed according to the established logistic regression model.Results The age of female STEMI patients was older than that of male STEMI patients (65±10 years vs 60±11 years,P＜0.05).The rate of past CABG and PCI was significantly higher and the reperfusion time delay was significantly longer in female STEMI patients than in male STEMI patients (4.3 ％ vs 1.5％,20.7％ vs 17.4％,P＜0.05;404±34 min vs 280±14 min,P＜0.01).Multivariate logistic regression analysis showed that female and visiting form were related with the reperfusion time delay for ＞3-6 h and ＞12-24 h (95％CI:1.052-264.306,P=0.046;95％CI:1.089-2.751,P=0.013).Conclusion Female is related with reperfusion time delay,visiting form and call for emergency treatment in STEMI patients.
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ObjectiveTo validate a modified HEART [History, Electrocardiograph (ECG), Age, Risk factors and Troponin] risk score in chest pain patients with suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in the emergency department (ED).Methods This retrospective cohort study used a prospectively acquired database and chest pain patients admitted to the emergency department with suspected NSTE-ACS were enrolled. Data recorded on arrival at the ED were used. The serum sample of high-sensitivity cardiac Troponin I other than conventional cardiac Troponin I used in the HEART risk score was tested. The modified HEART risk score was calculated. The end point was the occurrence of major adverse cardiac events (MACE) defined as a composite of acute myocardial infarction (AMI), percu-taneous intervention (PCI), coronary artery bypass graft (CABG), or all-cause death, within three months after initial presentation.Results A total of 1,300 patients were enrolled. A total of 606 patients (46.6%) had a MACE within three months: 205 patients (15.8%) were diag-nosed with AMI, 465 patients (35.8%) underwent PCI, and 119 patients (9.2%) underwent CABG. There were 10 (0.8%) deaths. A progres-sive, significant pattern of increasing event rate was observed as the score increased (P < 0.001 byχ2 for trend). The area under the receiver operating characteristic curve was 0.84. All patients were classified into three groups: low risk (score 0–2), intermediate risk (score 3–4), and high risk (score 5–10). Event rates were 1.1%, 18.5%, and 67.0%, respectively (P < 0.001).ConclusionsThe modified HEART risk score was validated in chest pain patients with suspected NSTE-ACS and may complement MACE risk assessment and patients triage in the ED. A prospective study of the score is warranted.
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Objective To investigate the clinical and angiographic characteristics of no reflow phenomenon after primary percutaneous coronary intervention (PCI) with acute myocardial infarction (AMI).Methods A total of 319 patients with AMI undergoing primary-PCI was divided into no-reflow and normal reflow groups.The incidence of no-reflow phenomenon,the clinical date,angiography findings,and surgical date were compared between two groups.Results No-reflow phenomenon occurred in forty(13.4％)of the patients after primary PCI.There was dramatic difference in combined hyperlipidemia,angina pectoris history before AMI,heart function ≥2 grades on admission,the length of the vascular lesions,vascular stenosis degree,blood clot load level,coronary artery opening time,and the expansion of the balloon between no-reflow and normal blood flow groups.Multiple logistic regression analysis identified that angina pectoris history before AMI,heart function classification on admission,high thrombus burden,the expansion of the balloon,and coronary artery opening time on angiography as independent predictors of no-reflow phenomenon.Conclusions The occurrence of no-reflow phenomenon after primary PCI was associated with high cholesterol history,no history of pre-infarction angina,heart function classification on admission,long vascular lesions,narrow degree of heavy,blood clots in the high load,coronary artery opened long time,and the expansion of the balloon more frequently.
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BACKGROUND: The problem of the high rate of acute restenosis at an early and advanced stage has been a hot spot, while the stent with paclitaxel (poly-L-lactide, PLLA/polyglycolic acid, PGA) degradable material will resolve it. OBJECTIVE: To seek an ideal biologic degradable material used in biologic degradable stent. DESIGN, TIME AND SETTING: The comparative cytological study was performed at the Laboratory of Toxicology, Institute of Public Health, Jilin University (Key Laboratory of Radiobiology of Ministry of Public Health of China, Key Laboratory of Toxicology of Jilin Province) from July 2003 to July 2005. MATERIALS: Paclitaxel degradable material (PLLA/PGA) (PLLA:PGA= 9: l ) were offered by Changchun Applied Chemistry Institute of Chinese Academy of Science). Human umbilical arterial smooth muscle cells (SMCs) were purchased from Boster, Wuhan, China. METHODS: The sixth passage of SMCs were digested by 0.25% Trypsin under ambient temperature for 3 minutes, incubated in 10 mL 10% ox serum BMEM, and made into SMC suspension. The materials kept in hypothermal disinfectant Co60 were heated to 37 ℃ by waterbath after surface treatment, and then placed in a 6-well culture plate. SMC suspension was added into the middle of the materials. The density of cells was about 5×106/cm2. Cell suspension diffused around the materials gradually. At last, 10% ox serum BMEM culture solution was added into it, and cultivated in a 5% CO2 incubator at 37 ℃. The growth of cells in and surrounding the materials was observed by inverted microscope everyday. MAIN OUCOME MEASURES: The materials were obtained after culture for 3, 6, 12, 19, 26, 34 days and vacuum dehydration, and were weighed. The weight loss of materials was compared before and after culture. The average degradable rate of materials was calculated.RESULTS: Degradable material had no influence on the development of SMCs. The average degradation rate ex vivo was 0.45% per day. CONCLUSION: PLLA/PGA with good cellular compatibility could be applied to intravascular stents.
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BACKGROUND:High-incidence early acute reocculision and later restenosis following coronary artery stenting has been widely studied.Biodegradable material metal coated stent carrying paclitaxel,which can effectively inhibit restenosis,is promising for solving this problem.OBJECTIVE:To evaluate the effects of paclitaxel containing degradable material [poly (L-lactide) (PLLA)/polyglyoolide(PGA)]on human umbilical arterial smooth muscle cells.DESIGN,TIME AND SETTING:The present controlled observational cytological experiment was performed at the Laboratory of Toxicity,College of Public Health,Jilin University between July 2003 and July 2005.MATERIALS:Paclitaxel (PLLA/PGA) (PLLA:PGA=9:1) was provided by the Changchun Institute of Applied Chemistry,China.METHODS:The primary human umbilical arterial smooth muscle cells were cultured for passage cells.Thereafter,passage cells were co-cultured with degradable materials containing different concentrations of paclitaxel (1,2,and 3 g).Mental stent and paclitaxel-free PLLA/PGA were used for controls.MAIN OUTCOME MEASURES:At 0,24,48,and 72 hours after culture,effects of degradable materials containing different concentrations of paclitaxel on smooth muscle cell growth were observed under a contrast microscope.RESULTS:Mental stent and paclitaxel-free PLLA/PGA had no influences on smooth muscle cell growth.Paclitaxel(PLLA/PGA) degradable material (1,2,and 3 paclitaxel) inhibited smooth muscle cell growth till 72 hours.There were significant differences between mental stent and paclitaxel-free PLLA/PGA and paxlitaxel(PLLA/PGA) groups (P＜0.01).CONCLUSION:Paclitaxel (PLLA/PGA) degradable material can be used as the intravascular stenting material for inhibiting smooth muscle cell growth.