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Objective@#To explore the predictive value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) on admission on left ventricular ejection fraction (LVEF) and the in-hospital major adverse cardiac and cerebrovascular events (MACCE) in hospitalized patients with unstable angina (UA).@*Methods@#Data of 2 972 consecutive hospitalized patients with UA in Beijing Friendship Hospital from January 2013 to September 2017 were retrospective analyzed. Patients were divided into 4 groups according to the level of NT-proBNP on admission: 733 cases with NT-proBNP lower than 61 ng/L, 749 cases with NT-proBNP between 61 and 133 ng/L, 747 cases with NT-proBNP between 133 and 326 ng/L, and 743 cases with NT-proBNP higher than 326 ng/L. LVEF and in-hospital MACCE were compared among 4 groups and the predictive value of NT-proBNP on admission on LVEF and in-hospital MACCE was determined by multiple logistical regression analysis.@*Results@#LVEF value became lower with increasing on admission NT-proBNP value ((68.4±4.8)%, (68.2±5.2)%, (67.2±6.7)% and (62.6±10.4)%, F=77.98, P<0.01), while in-hospital MACCE was higher with increasing on admission NT-proBNP value (3.4% (25/733), 3.5% (26/749), 5.5% (41/747) and 7.3% (54/743), χ2=16.23, P<0.01) in NT-proBNP lower than 61 ng/L, NT-proBNP between 61 and 133 ng/L, NT-proBNP between 133 and 326 ng/L, and NT-proBNP higher than 326 ng/L group. Multiple logistic regression analysis showed that on admission NT-proBNP was an independent predictor for LVEF<50% (Exp(β)=5.875, 95%CI 3.382-10.207, P<0.001), but not predictor for in-hospital MACCE (Exp(β)=0.783, 95%CI 0.400-1.996, P=0.783).@*Conclusion@#The on admission NT-proBNP level is an independent predictor of left ventricular systolic dysfunction (LVEF<50%), but not an independent predictor of total in-hospital MACCE in hospitalized patients with UA.
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Objective To summarize the experience and technique of complex transradial percutaneous coronary intervention ( PCI) using a 4F KIWAMI ST01 catheter with Mother-Child technique for patients with coronary heart disease. Methods Retrospectively analyzed the data from 30 patients who had received PCI using a 4 F catheter with Mother-Child method. Results PCI were performed on a total of 30 patients with complex lesions. Angiographic success was achieved in 100% of lesions. 19 patients were found to have moderate-to-severe calcified lesions, 13 patients had chronic total occlusion ( CTO ) , 11 patients had moderate-to-severe tortuous lesions, and 6 patients had moderate-to-severe angulated lesions. Four patients suffered from in-stent restenosis. 4 F catheter with Mother-Child method was used in all patients, and all 4F catheters successfully passed through the target lesions with all stents implanted in place along the 4 F catheter. There were no 4 F catheter-related complications in all patients. Conclusions Use of 4F catheter with Mother-Child method is safe and effective for patients where stent delivery is difficult by the conventional method.
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Objective To investigate the coronary characteristics and interventional treatment results of coronary artery patients on dialysis due to uremia.Methods Twenty-five cases coronary artery disease patients,including 3 cases with stable coronary disease,7 cases with ST elevation myocardial infarction,and 15 cases with non-ST elevation myocardial infarction,who were treated with uremia dialysis from January 2001 to December 2014 in Friendship Hospital of Beijing Affiliated to Capital Medical University were selected.Emergency or regular coronary angiography was done after admission,and coronary angiography characteristics of vascular lesions and interventional treatment outcomes,clinical results during hospitalization and 12-month follow-up were observed.Results (1) The proportion of three-vessel disease of 19 cases,moderate and severe calcification of 20 cases,and diffuse disease of 11 cases were observed in coronary artery disease with dialysis.No differences were found in the proportion of three-vessel disease(x2=1.08,P=0.58),moderate and severe calcification(x2 =0.48,P =0.79),and diffuse disease (x2 =4.52,P =0.11) among the groups of stable coronary disease,ST elevation myocardial infarction and non-ST elevation myocardial infarction.(2) The interventional therapy in 24 patients with coronary heart disease complicated with uremia was successful,and the average total operation time was (55.3±7.1) min,the average contrast volume was (126.0±12.6) ml.There was 1 case with complication of side branch occlusion.(3) Cardiovascular events rates during hospitalization and after 12-month follow-up were 20.0％ (5/25) and 48.0％ (12/25),respectively.Conclusion In coronary artery patients with uremic on dialysis,the proportion of three-vessel disease,moderate and severe calcification,and diffuse disease are relatively high.The success rate of intervention therapy is high and safe but with a relatively high cardiac events during hospitalization and 12-month follow-up.
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Objective To summarizes the experiences and technique of complex transradial percutaneous coronary intervention (PCI) using sheathless guide catheter (Sheathless Eaucath, ASAHI) for 60 patients with coronary heart disease. Methods Retrospectively analyzed the data from 60 patients received PCI using sheathless guide catheter. Results PCI were performed on a total of 60 patients with complex lesions. Angiographic success was achieved in 95.0%and failed in three patients with CTO. 7 patients were with left main lesions, and 32 patients were with bifurcation lesions(including 7 patients with left main lesions and 2 patients with CTO), and 13 patients were with CTO, and the other 17 patients were with tortuous and calcified lesions. Sheathless guide catheters of 7.5Fr were used for PCI in all patients, and all catheters successfully passed through the radial artery and were put in place. No other vascular complications associated with the use of the catheter occurred. Sheathless guide catheters were respectively JL(8 patients), PB(2 patients), AL(2 patients), and JR(1 patient) in 13 patients with CTO, and were respectively JL(8 patients), JR(6 patients), SPB(2 patients), AL(1 patient) in 17 patients with tortuous and calcified lesions. JL or JR were used in all 32 patients with bifurcation. Conclusions Use of the Sheathless of 7.5 Fr is safe and feasible, and allows complex interventions to be undertaken transradially with a high success rate.