Association of neutrophil/lymphocyte ratio with long-term mortality after ST elevation myocardial infarction treated with primary percutaneous coronary intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Primary percutaneous coronary interventions (PCI) have been proposed as a novel superior management strategy in patients with ST elevation myocardial infarction (STEMI). This study tested the hypothesis that in the acute phase of myocardial infarction with ST-segment elevation, the neutrophil/lymphocyte (N/L) ratio is a predictor of long-term prognosis.</p><p><b>METHODS</b>We analyzed 551 consecutive STEMI patients treated with primary PCI at a single university center. Patients were stratified according to quartiles of the mean neutrophil/lymphocyte ratio.</p><p><b>RESULTS</b>Kaplan-Meier survival analysis showed a cumulative eight-year survival of 94.2% in the first quartile, 92.0% in the second quartile, 91.3% in the third quartile, and 75.4% in the fourth quartile (P < 0.001 by log rank). Relative to patients in the other three lower N/L ratio quartiles, patients in the highest quartile were more than four times more likely to die during hospitalization (P < 0.001) and during long-term follow-up (P < 0.001). By multivariate Cox regression analysis including baseline demographic, clinical, and angiographic covariables, the N/L ratio in the highest quartile remained an independent predictor of mortality (hazard ratio 2.38, 95% confidence interval (CI) 1.42 to 3.98; P = 0.001).</p><p><b>CONCLUSION</b>The neutrophil/lymphocyte ratio is a strong independent predictor of long-term mortality after ST elevation myocardial infarction treated with very early revascularization.</p>

The action-enhancing and toxicity-reducing effects of a new Coriolus versicolor polysaccharide peptide with cyclo-phosphamide on S180 sarcoma xenografted mice / 肿瘤

Objective: To investigate the effects of new Coriolus versicolor polysaccharide peptide (PSP) in enhancing the action and reducing the toxicity induced by cyclophosphamide (CTX) in mice bearing S180 sarcoma, analyze the related immunological mechanisms, and compare the effect of PSP2 (new polysaccharide peptide) with that of PSP1 (old polysaccharide peptide). Methods: S180 sarcoma xenografted mice models were established. The model mice were divided randomly into 8 groups, including model control group, CTX group, CTX plus PSP2 (200, 400, and 800 mg/kg) groups, CTX plus PSP1 400 mg/kg group, PSP2 400 mg/kg group, PSP1 400 mg/kg group. The normal blood cells and the nucleated marrow cells were counted. The survival time, the inhibitory rate of tumor growth, the index of thymus (thymus gland weight/body weight), spleen index (spleen weight/body weight) were measured. The subtypes of T lymphocytes in spleen were detected by flow cytometry. Results: PSP2 800 mg/kg combined with CTX prolonged the life span of the S180 sarcoma xenografted mice (P < 0.05). PSP2 and PSP1 alone obviously inhibited the growth of sarcoma, respectively (P < 0.05). PSP2 and PSP1 remarkably enhanced the ability of CTX to inhibit the growth of sarcoma as well (P < 0.05 or 0.01). PSP2 and PSP1 attenuated the immunological inhibition and marrow inhibition caused by CTX. PSP2 and PSP1 alone elevated the ratio of CD3+ CD4+/CD3+ CD8+ in mice bearing S180 sarcoma. The ratio tended to increase after combined treatment (PSP2 + CTX or PSP1 + CTX). Especially it increased remarkably after PSP2 400 mg/ kg combined with CTX (P < 0.05). Conclusion: PSP2 and PSP1 inhibited tumor growth, increased the action and reduced the toxicity of CTX. The mechanisms were related with enhancing the ratio of CD3+ CD4+/CD3+ CD8+ of spleen cells. PSP2 is effective than PSP1 in inhibiting tumor growth, enhancing the acion of CTX, and regulating the immunological function of nude mice.

The influence of admission glucose on epicardial and microvascular flow after primary angioplasty / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Patients with elevated admission glucose levels may be at increased risk of death after myocardial infarction, independent of other baseline risk factors and more severe coronary artery disease. However, data regarding admission glucose and epicardial and microvascular flow after primary angioplasty is limited.</p><p><b>METHODS</b>Angioplasty was performed in 308 ST-segment elevated myocardial infarction patients. Patients were divided into 3 groups on the basis of admission glucose level: group 1, < 7.8 mmol/L; group 2, (7.8 - 11.0) mmol/L; and group 3, >or= 11.0 mmol/L.</p><p><b>RESULTS</b>Compared with group 1, patients in group 2 and group 3 were more often female and older. Triglycerides (TG) in group 3 were significantly higher than group 1. At angiography, they more frequently had 2-vessel or 3-vessel disease. In the infarct-related artery, there was no relationship between hyperglycemia and thrombolysis in myocardial infarction (TIMI) 3 flow after percutaneous coronary intervention (PCI) (89.7%, 86.0% and 86.3%, P = NS). However, corrected TIMI frame count (CTFC) in group 2 and group 3 were more than group 1. TIMI myocardial perfusion grade (TMPG) 0 - 1 grade among patients with hyperglycemia after PCI were more frequent (30.9% and 29.0% vs 17.3%, P < 0.05). There was less frequent complete ST - segment resolution (STR) and early T wave inversion among patients with hyperglycemia after PCI.</p><p><b>CONCLUSION</b>Elevated admission glucose levels in ST - segment elevation myocardial infarction patients treated with primary PCI are independently associated with impaired microvascular flow. Abnormal microvascular flow may contribute at least in part to the poor outcomes observed in patients with elevated admission glucose.</p>

Glucose level on admission and outcome after primary percutaneous coronary intervention in patients with acute myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the influence of elevated glucose level on epicardial/microvascular flow and survival in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>A total of 308 patients with STEMI underwent primary PCI were divided into 3 groups according to the glucose level on admission: group 1, < 7.8 mmol/L; group 2, 7.8-11.0 mmol/L, and group 3, > or = 11.0 mmol/L.</p><p><b>RESULTS</b>Compared with group 1, patients in the group 2 and 3 were older, had higher triglycerides levels and more 2-vessel or 3-vessel diseases. Although TIMI flow after PCI were similar among groups (89.7%, 86.0% and 86.3%, P = > 0.05), corrected TIMI frame count (CTFC) in group 2 and group 3 were higher than that in group 1. Moreover, TIMI myocardial perfusion grade (TMPG) 0-1 grade rate post PCI was higher in group 2 and 3 (30.3% and 29.0%) than that of group 1 (17.3%, P < 0.05). There was less frequently complete ST-segment resolution (56.7%) and early T wave inversion (58.3%) in group 3 than that of group 1 after PCI (72.0% and 73.4% respectively, P < 0.05). Mortality rate at 30 days post PCI was significantly higher in the group 3 (10.4%) than that in the group 1 (2.6%, P < 0.05).</p><p><b>CONCLUSION</b>Elevated glucose level on admission in ST-segment elevation myocardial infarction patients treated with primary PCI is associated with reduced myocardial microvascular flow. Abnormal myocardial microvascular flow might contribute to the poor outcomes observed in patients with hyperglycemia on admission.</p>