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Objective To investigate whether soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) as the early diagnostic biomarker of acute ST elevation myocardial infarction (STEAMI).Methods Sixty-five patients with STEAMI and 30 patients with stable coranary heart disease or other heart disease(control group) were enrolled as our subjects.Serum sLOX-1 levels were measured.Results The median(P25,P75) of Serum sLOX-1 in the patients with STEMI were 210.0 (130.0,356.0) ng/L,significantly higher than that of control group(65.5 (55.2,85.2) ng/L,Z =6.17,P ＜ 0.001).Logistic regression analysis revealed that sLOX-1 alone was an independent factor associated with STEAMI (B =0.036,P ＜ 0.001).The area under the ROC curve of sLOX-1 for detecting STEMI was 0.895,and 95％ CI was 0.831-0.959 (P＜0.001).Taking sLOX-1 =87.5 ng/L as cut-off value,the sensitivity was 89.6％ and specificity was 82.4％for the diagnosis of STEAMI.Conclusion Serum sLOX-1 was significantly higher in the STEAMI and it might served as the early diagnostic marker for STEAMI.
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Objective To explore the efficiency and safety of fondaparinux and low molecular weight heparin(LMWH) on the elder patients with non-ST-segnent elevation acute coronary syndromes (NSTE-ACS).Methods One hundred and forty patients over 75 years old with NSTE-ACS were randomly divided into treatment group(n =70) and control group (n =70).Patients in treatment group were given the conventional treatment combined with fondaparinux,and in control group were given the basis of conventional treatment combined with LMWH.The therapeutic efficacy,the cardiovascular events at 4 d,7 d and 30 d during the treatment and bleeding incidence rate were observed.Reslts There was no statistically significant difference between the treatment group and control group in the total effective rate (x2 =0.475,P ＞ 0.05.Meanwhile,no significant differences were found between the two groups in cardiovascular events at 4 d,7 d and 30 d (x2 =0.257,0.475 and 0.317,P ＞0.05).The incidence rate of bleeding in treatment group was obviously lower than that in control group and there was statistically significant difference (2.9％ vs.31.4％ ; x2 =20.115,P ＜0.01).Conclusion The effectiveness of fondaparinux used in elderly patients with non-ST-segment elevation acute coronary syndromes is similar with LMWH,but the incidence rate of bleeding is lower than LMWH.
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Objective To investigate the significance of heat shock protein 60 (HSP60) and heat shock protein 65 (HSP65) on prognosis acute coronary syndrome (ACS) within one year.Methods Eightynine hospitalized patients were collected from department of Cardiovascular disease,the people's hospital of Wuxi city affiliated of Nanjing Medical University and the Second People's Hospital Wuxi City from November 2009 to February 2011,and divided into ACS group (n =50),stable angina pectoris (SAP) group (n =19) and nonCHD group(n =20).HSP60,HSP65 levels in human serum were measured at the time of admission.The followup records of all patients were established to observe the occurrence of coronary events during one year,and analyzed its relationship between with HSP60,HSP65.Results Eighty-four cases were successful followed-up,and lost cases were 5.Eighteen patients occurred cardiovascular events within one year,and their content of serum HSP60 and HSP65 were significantly higher than that of without cardiovascular events (HSP60:(1026.19 ± 253.47) ng/L vs.(845.75 ± 138.52) ng/L,t =2.49,P ＜ 0.05 ; HSP65:(2573.95 ± 768.75) ng/L vs.(2076.38 ± 385.46) ng/L,t =2.58,P ＜ 0.05).In ACS group,the level of serum HSP60 and HSP65 of the patients occurred cardiovascular events was significant higher than that of without cardiovascular events,and there was significant difference(HSP60:(1162.73 ±249.14) ng/L vs.(892.55 ±204.62) ng/L,t =2.19,P ＜ 0.05 ; HSP65:(2714.39 ± 738.44) ng/L vs.(2136.85 ± 472.62) ng/L,t =2.65,P ＜ 0.05).COX regression analysis showed that HSP65 was an independent risk factor for recent cardiovascular events in patients with ACS (RR =1.002,95％CI 1.000-1.004,P =0.035).Conclusion The detection of HSP60,HSP65 in prognostic coronary artery disease prognosis has important value,and HSP65 was an independent risk predictor of ACS in recent cardiovascular events within one year.
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Objective To compare the short-term prognostic value of glycohemoglobin (HbA1c) and admission plasma glucose in non-diabetic patients with acute ST-elevation myocardial infarction.Methods Eighty-four non-diabetic patients with acute ST-elevation myocardial infarction from January 2010 to June 2011 were included.Both HbA1c and plasma glucose was measured on admission.Cardiovascular event was followed up in 30 days.Results The average of HbA1c and admission plasma glucose was as cut-off point.The patients were divided into HbA1c ＜ 5.5％ group (40 cases) and HbA1c ≥5.5％ group (44 cases) according to HbA1c level.The patients were divided into admission plasma glucose ≤ 8.6 mmol/L group (42 cases) and admission plasma glucose ＞ 8.6 mmol/L group (42 cases) according to admission plasma glucose.The incidence of cardiovascular event in 30 days in admission plasma glucose ＞ 8.6 mmol/L group was higher than that in admission plasma glucose ≤ 8.6 mmol/L group [19.0％ (8/42) vs.2.4％ (1/42)],and there was significant difference(P＜ 0.05).There was no significant difference in the incidence of cardiovascular event in 30 days between HbA1c ≥5.5％ group and HbA1c ＜ 5.5％ group (P ＞ 0.05).Admission plasma glucose showed weak correlation with blood creatine kinase isoenzyme MB peak (r =0.233,P ＜0.05).Conclusion In non-diabetic patients with acute ST-elevation myocardial infarction,elevated admission plasma glucose levels are associated with higher cardiovascular event in 30 days.
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Objective To analysis the changes of heart function in early stage after lung transplantation,and to explore its relationship with decreased pulmonary artery pressure.MethodsFrom 2002 to 2010,echocardiography results of 90 patients before and after lung transplantation in Wuxi People's Hospital were collected, 20caseshadcompletedateofpreoperativeandpostoperative echocardiography.Echocardiographic changes had been analyzed.Pearson linear correlation analysis was applied to determine the relationship between the early postoperative changes in cardiac structure and function and decreased pulmonary artery systolic pressure.ResultsPostoperative pulmonary artery systolic pressure ([38.30 ± 8.92]mm Hg) compared with preoperative([60.05 ± 29.10]mm Hg) was significantly lower(t =3.120, P = 0.006) , Postoperative right ventricular diameter was significantly reduced compared with the preoperative(t = 36.000, P = 0.008) , tricuspid and pulmonary valve regurgitation significantly reduced (t =57.000 and 66, Ps ＜ 0.05) .Postoperative left atrial diameter and left ventricular end diastolic diameter ([35.15± 5.73]mm and [43.25 ± 5.56]mm) compared with preoperative([32.40 ± 7.29]mm and [40.15 ± 6.20]mm)were significantly expanded (t =-2.384 and t =-2.153, Ps ＜ 0.05) .Although postoperative stroke volume ([59.54 ± 14.97]ml)compared with preoperative ([44.18 ± 15.85]ml)significantly increased (t =-3.918, P = 0.004) , but the postoperative left ventricular ejection fraction ([63.10 ± 8.48]％)compared with preoperative ([71.75 ± 8.10]％)was significantly decreased (t =3.742, P = 0.001) .Pearson linear correlation analysis showed the greater degree of decreased systolic pulmonary artery pressure after lung transplantation, the larger rate of increased postoperative left atrial diameter and left ventricular end diastolic diameter, and the bigger range of decreased postoperative LVEF (r = 0.642,0.737 and 0.448, P ＜ 0.05) .ConclusionIn early stage after lung transplant, right heart structure was normalization, right heart function improved,left heart enlarged, stroke volume increased, but left ventricular function reduced.There were a linear correlation between those changes and reduced systolic pulmonary artery pressure.
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Objective To study the very early diagnosis of acute myocardial infarction (AMI) by harmonic imaging integrated backscatter(IBS).Methods Thirty normal persons,12 cases at the very early stage of AMI (in 2 hours),36 cases with AMI (in 2-12 hours) were examined by IBS and the cyclic variation of integrated backscatter (CVIB) with HP Sonos 5500 ultrasonic system in different areas (the areas of myocardial infarction and no myocardial infarction).Results In the areas of AMI of the very early stage (in 2 hours),IBS was much higher than that of the areas of normal (14.7 vs 8.3,P