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Objective To study effects of bivalirudin and heparin plus tirofiban on plasma P-selectin in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) and compare the clinical effects on bleeding and thrombosis.Methods 260 hospitalized patients with acute STEMI who accepted emergency PCI were enrolled in the study.They were randomly divided into the bivalirudin group (129 cases) and the heparin plus tirofiban group (131 cases).Blood samples were taken before operation,during operation (about 20 minutes after medicacion injection) and after operation (three hours after the end of operation).Serum P-selectin levels were measured.All patients were followed-up for 30 days.The main events included hemorrhage within 30 days,acquired thrombocytopenia and stent thrombosis.Results The level of P-selectin increased significantly in the heparin group during operation compared to the preoperative level and remained statistically higher at three hours after the end of operation than preoperative level (P ＜ 0.05).Compared with preoperative level,the P-selectin level of the bivalirudin group was significantly lower than that of heparin group (P ＜ 0.05).After 30 days of follow-up,bivalirudin had lower rates bleeding events compared to the heparin group(5.4％ vs.15.3％,P =0.009).The need of medical intervention for bleeding events (BRAC2-5 hemorrhage) was less in the bivalirudin group(0.8％ vs.5.3％,P =0.029).There was no significant difference in the major bleeding events between the 2 groups (BRAC3-5 hemorrhage) (0 vs.0.8％,P =0.32).No significant difference found between the two groups in acquired thrombocytopenia (P ＞ 0.05).Conclusion Bivalirudin may reduce P-selectin levels in STEMI patients undergone emergency PCI during perioperative period.Heparin increases perioperative P-selectin.Bivalirudin may reduce the bleeding events.
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Objective: To study clinical characteristics and anatomical distributions of pulmonary embolism (PE) in suspicious PE patients and to explore if CT coronary angiography (CTCA) may simultaneously exclude PE. Methods: A total of 403 consecutive patients with suspicious PE admitted to cardiology department of our hospital from 2013-01 to 2014-10 were retrospectively studied. According to embolus distribution by CT pulmonary angiography (CTPA) and CTCA, the patients were divided into 2 groups: PE group,n=261 and Non-PE group,n=142. The clinical symptoms and imaging characteristics were analyzed and compared between 2 groups. Results: The overall prevalence of PE was 64.8% (261/403), suspicious PE patients were all with chest distress, palpitation, chest pain and syncope. Compared with Non-PE group, the patients in PE group were with more female gender and palpitation, while less chest pain,P0.05. In PE group, the sign of emboli were found in 245/261 patients (93.9%) at CTCA scanning area, the rest 16 patients (6.1%) had the small area of PE, and the emboli were only located at both upper pulmonary arteries. Conclusion: In patients with dififculty of breath, palpitation, chest pain and syncope, coronary artery disease (CAD) and PE should be simultaneously considered for accurate diagnosis. CTCA may meanwhile ifnd PE during CAD diagnosis.
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ObjectiveTo investigate the prevalence and distributing feature of atrial fibrillation (AF) in Xinjiang Kazaks adult population.MethodsFour-stage selected random samples aged 30-89 years from Tacheng,Yili and Aletai were analyzed.An epidemical study of AF was performed including inquiring medical history,recording electrocardiogram and auscultation. ResultsA total of 22 514 adults were surveyed.The prevalence of AF in Xinjiang Kazaks adult population was 0.37％,which was increasing with aging.The prevalence was higher in men than in women (0.5％ vs 0.2％,P ＜0.01 ).In AF patients,23 was valvular AF.Ischemic stroke was the most frequent type and the stroke rate in the patients with AF was significantly higher than that without AF (6.0％ vs 1.2％,P ＜ 0.01 ).ConclusionsThe prevalence of AF in Xinjiang Kazaks adult population is lower than the reported national prevalence but patients with AF in this population would not like to take the necessary medicine. Therefore,the control of AF need to be reinforced.
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Objective To determine the relationship between the aggravation of CAAS and coronary atherosclerosis (CAS) ;and to summarize the pathologic character of CAAS of the patients with various coronary artery disease. Methods Review the result of coronary angiography and carotid artery ultrasonography and the related risk factors of the patients who were diagnosed as CAD through coronary angiography ( CAG). The patients were divided into the scleratheroma group and the non scleratheroma group. The patients were divided into stable angina pectoris( AP) group, unstable angina pectoris(UAP) group and acute myocardial infarction (AMI) group according to the criterion of coronary artery disease of WHO. The patients were divided into group A (coronary artery of single vessel lession) ,group B( coronary artery of double vessel lession ) , group C( coronary artery of triple vessel lession )and group D(left main vessel lession ).The aggravation of CAAS was graded. Results There were 198 patients with various CAAS among 228 patients with coronary artery disease ( 86. 8%). CAAS was much related with hypertension and non-related with age, sex, BMI, smoking, drinking, hyperlipoidemia, hyperuricosuria and diabetes mellitus. The aggravation of CAAS much graver with much graver CAS. But only the plaque number of Group A was more than Group D( P ＜0. 05). The grading integral and Crouse integral of CAAS of AP group was not remarkable less than UAP group. The grading integral of CAAS of AP group was less than AMI group and the Crouse integral of AP group was more. But there was no remarkable difference. The number of all plaque,plaque and plaque of AP group was not remarkable less than UAP group and AMI group. There was the plaque among the three group. Conclusion Carotid artery atherosclerosis (CAAS) is relative to coronary artery disease ( CAD).