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Objective To identify the main etiologies of emergency room (ER) patients with chest pain or equivalent syndrome.Methods This was a prospective and cross-sectinal survey of ER patinets with chest pain or equivalent syndrome in 17 medical centre in Beijing,China from July to August 2009.Data was collected by structured interviews and medical record reviews.The mean follow up period was 30 days.Results A total of 5666 patients were enrolled in the study (2663 males and 3303 females) and the mean age was 58.1 ± 18.4years.Their final diagnoses were:coronary heart disease 1506 ( 27.4％ ),acute heart failure 149 ( 2.6％ ),pericarditis 4 ( 0.1％ ),pulmonary embolism 11 ( 0.2％ ),aortic dissection 8 ( 0.1％ ),acute cerebrovascular disease 431 ( 7.6％ ) and non-cardic chest pain 2538 ( 44.9％ ).Thirty-seven cased died and 275 cases hospitalized again 30 days later,4.9％ patients with cornary heart disease had symptoms at their presentation.Conclusion Special vigilance and thorough coronary artery evaluation are needed for all patients with chest discomfort or respiratory distress in the ER,even for patients without chest pain.
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Background and objective Apolipoprotein E is a constituent of lipoproteins with considerable variation due to cysteine-arginine exchanges. We investigated the relationship between apo E gene polymorphism and the occurrence of coronary artery disease(CAD) in the older population of northern China. Methods The distribution of the HhaI polymorphisms of the apolipoprotein E gene was determined among 55 patients with CAD (CAD group), which was compared with that of 36 elderly subjects without CAD(control group). Results Genotype distributions at both sites (apo E gene 112-bp and 158-bp sites ) were different between the CAD and control groups. The CAD group had lower apolipoprotein Eε2frequencies than the control group (P＜0.05). Conclusion Individuals with apolipoprotein Eε2are likely to have a reduced risk of developing coronary artery disease as demonstrated by elderly subjects in Northern China.
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Objective Previous studies have reported that the incidence of atrial fibrillation (AF)/atrial fluttler in patients with AMI who were treated with thrombolysis is 7%-10%. However, little is known concerning the incidence of AF/atrial fluttler and its effects on the prognosis of patients with AMI who are treated with PCI. Methods A total of 668 consecutive patients were studied in Beijing Chaoyang Hospital from Nov. 2000 to Jan. 2004. Patients were categorized into 2 groups according to the presence of AF/ atrial flutter. Results The results showed that the incidence of AF/atrial fluttler was 10% and that the patients with AF/atrial fluttler were older, were in higher Killip classes, had higher rates of previous myocardial infarction and previous cerebrovascular diseases, multivessel disease, and had poorer reperfusion of the infarc-related artery than those without AF/atrial fluttler. Patients with AF/atrial fluttler had higher in-hospital (11.9% vs 5.3%, P
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<p><b>OBJECTIVE</b>To investigate the relationship among -75 bp/+83 bp polymorphism in apolipoprotein A1 (apo A1) gene, lipids levels and the occurrence of coronary atherosclerosis disease (CAD).</p><p><b>METHODS</b>We determined distributions of two MspI polymorphisms of the apo A1 gene at -75 bp and +83 bp, and blood lipids levels among 137 Chinese patients (92 with CAD and 45 in the control group) in relation to circulating lipids and coronary angiography.</p><p><b>RESULTS</b>The demographic information for 137 subjects showed that subjects with CAD tended to have more unfavorable lipoprotein variables. Genotype distributions at both sites were different between the CAD and control groups. Furthermore, the control group had higher M1-/M2- frequencies than the CAD group (M1: P < 0.005; M2: P < 0.05) and the "M1-" (A) and "M2-" alleles were associated with increased high-density lipoprotein cholesterol (HDL-C) (M1-: P < 0.0001; M2-: P < 0.05) and apo A1 (M1-: P < 0.0001; M2-: P < 0.05) levels. "M1-" and "M2-" were significantly negatively correlated with CAD (P < 0.01 and P < 0.05, respectively).</p><p><b>CONCLUSIONS</b>Our results suggest that changes from G to A at the -75 bp site and from C to T or G to A at the +83 bp site do increase circulating levels of apo A1 and HDL-C. And those individuals with these changes are likely to have a lower risk of developing CAD.</p>
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Female , Humans , Male , Middle Aged , Apolipoprotein A-I , Blood , Genetics , Case-Control Studies , Cholesterol, HDL , Blood , Coronary Artery Disease , Blood , Genetics , Lipids , Blood , Polymorphism, GeneticABSTRACT
<p><b>OBJECTIVE</b>To investigate whether patients, who are at risk of major acute coronary events, are safe to undergo and benefit from early intervention after using simvastatin.</p><p><b>METHODS</b>The study was a randomized, open, two-dosage-controlled trial to evaluate the safety and benefits of simvastatin administered to 197 patients (10 mg group, n = 98 and 20 mg group, n = 99), within 48 hours of hospitalization for a diagnosis of unstable angina or acute myocardial infarction (MI), with total cholesterol (TC) >/= 180 mg/dL or low-density lipoprotein cholesterol (LDL-C) >/= 100 mg/dL. Lipid levels were measured immediately, followed by the 3rd, 6th and 12th month after admission and all adverse events were recorded during follow-up.</p><p><b>RESULTS</b>TC levels fell by 10.15% and 14.52% in the 10 mg and 20 mg groups (P < 0.05), and LDL-C levels fell 13.87% and 19.38% in the 10 mg and 20 mg groups, respectively (P < 0.01), 12 months after using simvastatin. The rates of achieving target TC reached 26.3% and 36.5% in the 10 mg and 20 mg groups (P < 0.01), and that of LDL-C reached 28.2% and 40.3% in the 10 mg and 20 mg groups, respectively (P < 0.01). There were higher rates of MI and re-hospitalization resulting from angina pectoris and revascularization in the 10 mg group compared with the 20 mg group.</p><p><b>CONCLUSIONS</b>The results suggest that early intervention with the HMG-CoA reductase inhibitor, simvastatin, in acute coronary syndromes is possible and safe. It also indicates that the clinical dosage of simvastatin are relatively smaller than that for satisfactory lipid control in patients with acute coronary syndromes.</p>