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Objective To investigate the association between chronic kidney dysfunction and the complexity of coronary artery disease in elderly patients.Methods A prospective study was conducted on 1380 consecutive patients underwent coronary angiography for the first time in our hospital and with angiographically diagnosed coronary artery disease from January 2011 to June 2012.The complexity of coronary artery disease were classified according to the American College of Cardiology/American Heart Association (ACC/AHA) grading system as types A,B1,B2,and C.Estimated glomerular filtration rate (eGFR) was calculated by the simplified Modification of Diet in Renal Disease(MDRD)equation.Patients were classified into 3 stages according to eGFR as follows:normal renalfunction(n=234,eGFR≥90 ml· min-1 · 1.73 m-2),mild renaldysfunction(n=881,60≤eGFR＜90 ml · min-1 · 1.73 m-2,and moderate or severe renaldysfunction(n=265,eGFR＜60ml · min-1 · 1.73 m-2).Ordinal logistic regression was used to analyze the association between chronic kidney dysfunction and the complexity of coronary artery disease.Results Patients with mild,moderate or severe renal dysfunction were older (F=56.82,P＜0.001),more predominantly female (x2 =66.29,P＜ 0.001) and more likely to have history of hypertension (x2 =17.57,P ＜ 0.001),diabetes (x2=20.97,P＜0.001) and hyperlipidemia (x2=10.48,P 0.005) than those with normal renal function.The percentage of lesions of types B2 or C in moderate or severe renal dysfunction group was higher than that in normal renal function group (x2=175.03,P＜0.001).The ordinal logistic regression showed that age,male,hypertension,diabetes,C-reactive protein and eGFR were independent risk factors for the ACC/AHA lesion classification.Conclusions Age,male,hypertension,diabetes,C-reactive protein and eGFR are independent risk factors for the complexity of coronary artery disease.
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0.05).The duration of procedure,fluoroscopy time and amount of contrast media consummed in the transradial angioplasty group were more than those in the transfemoral angioplasty group(54.9?15.2 min vs 40.1?10.6 min,P
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Objective To observe the efficacy and safety of applying platelet glycoprotein Ⅱb/Ⅲa receptor antagonist(tirofiban) during the perioperation period of emergency percutaneous coronary intervention(PCI) in acute myocardial infarction(AMI).Methods Patients with coronary artery TIMI blood flow 0-1 grade and underwent emergency PCI were consecutively randomized into tirofiban group(n=45) and control group(n=45).Tirofiban was used in the former group before operation and continued for 36-48 hours after PCI.In the latter group,PCI was performed through routine process.The reflow rate,30 days reinfarction rate,mortality and platelet activation degree before and after PCI were recorded during the study.Results All patients in the tirofiban group were recovered with TIMI 3 grade flow and neither slow-reflow nor no-reflow phenomena were observed.In the control group 88.90% of patients restored TIMI 3 grade flow and 11.10% of patients were just recovered with TIMI 0-2 grade flow.The difference was found to be statistically significant(P