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Objective To investigate the protective and treatment role of ulinastatin(UTI)on con-trast-induced acute kidney injury(CIAKI)in the elderly with coronary heart disease(CHD)and chronic kidney diseases(CKD).Methods A total of 321 elderly CHD inpatients complicated with CKD undergoing coronary angiography admitted in the First Medical Center of Chinese PLA Gen-eral Hospital from November 2021 to November 2022 were enrolled consecutively and then divid-ed into UTI group(n=161)and hydration group(n=160).Their cardiac and renal function pa-rameters were collected and analyzed before and 2 d after intervention.The changes in above pa-rameters and incidence of CIAK were observed and compared between the two groups.Results In 2 d after intervention,the UTI group had significantly lower Scr,urea,CysC,homocysteine and NT-proBNP,but higher eGFR than the hydration group(P＜0.01).There were 62 patients(62/321,19.3％)developing CIAKI,including 17 from the UTI group and 45 from the hydration group,and statistical difference was observed in the incidence(10.6％vs 28.1％,P＜0.01).For the patients with comorbidities of hypertension,diabetes,hyperlipidemia and hyperuricemia,the incidence of CIAKI was obviously lower in the UTI group than the hydration group(P＜0.01).Multivariate logistic regression analysis showed that UTI was an independent protective factor for occurrence of CIAKI(OR=0.348,95％CI:0.180-0.673,P=0.001).Conclusion UTI can im-prove renal function and reduce the risk of CIAKI in elderly CHD patients with CKD.
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OBJECTIVES@#This study evaluated the prognostic power of serum uric acid (UA) in predicting adverse events in elderly acute coronary syndrome (ACS) patients with diabetes mellitus (DM).@*METHODS@#The analysis involved 718 ACS patients >80 years old whose general clinical data and baseline blood biochemical indicators were collected prospectively from January 2006 to December 2012. These patients were classified into two groups based on DM status, and then followed up after discharge. The Kaplan-Meier method was used for major adverse cardiac event (MACE) rates and all-cause mortality. Multivariate Cox regression was performed to analyze the relationship between UA level and long-term clinical prognosis. Receiver operating characteristic (ROC) curves were analyzed to predict the cutoff value of UA in elderly ACS patients with DM. There were 242 and 476 patients in the DM and non-DM (NDM) groups, respectively, and the follow-up time after discharge was 40‒120 months (median, 63 months; interquartile range, 51‒74 months).@*RESULTS@#The all-cause mortality, cardiac mortality, and MACE rates in both DM and NDM patients were higher than those in the control group (@*CONCLUSIONS@#Serum UA level is a strong independent predictor of long-term all-cause death and MACE in elderly ACS patients with DM.
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Objective: To study the effect of levosimendan treatment in patients of dilated cardiomyopathy (DCM) with different heart fraction. Methods: A total of 145 DCM patients were enrolled, based on left ventricular ejection fraction (LVEF), the patients were divided into 3 groups: Mild heart failure (HF) group, the patients with LVEF≤45%,n=15, Moderate HF group, LVEF≤40%,n=58 and Severe HF group, LVEF≤30%,n=72. LVEF, left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD) and blood levels of BNP were examined and compared at prior and 7 days after levosimendan treatment respectively. Results: Compared with prior treatment, fater7 days of levosimendan medication, LVEF was elevated at certain degree in all 3 groups, while the statistic improvement was only found in Severe HF group (26.06±3.59) % vs (24.79±2.81) %,P0.05. After levosimendan treatment, blood levels of BNP were decreased in all 3 groups as in Mild HF group (604.80±631.87) pg/ml vs (1252.17±1435.39) pg/ml, Moderate HF group (2369.78±2478.59) pg/ml vs (3206.90±2677.15) pg/ml and Severe HF group (4879.63±5302.42) pg/ml vs (6004.46±5041.59) pg/ml, allP0.05. Conclusion: Levosimendan may, in short term, improve the cardiac function in DCM patients with mild, moderate and severe HF with similar degree; while it could not really change the cardiac structure.
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<p><b>OBJECTIVE</b>To explore the association between urinary microalbumin-to-creatinine ratio (ACR) and brachial-ankle pulse wave velocity (baPWV) in hypertensive patients.</p><p><b>METHODS</b>A total of 877 primary hypertension patients were enrolled in this trial from September 2009 to December 2012, and were randomly recruited and patients were divided into normal ACR group (ACR < 30 mg/g, n = 723), micro-albuminuria group (30 mg/g ≤ ACR < 300 mg/g, n = 136) and macro-albuminuria group (ACR ≥ 300 mg/g, n = 18). baPWV was measure by automatic pulse wave velocity measuring system.</p><p><b>RESULTS</b>The baPWV values in patients of micro-albuminuria group and macro-albuminuria group were significantly higher than in the normal ACR group (all P < 0.05). The baPWV value of macro-albuminuria group was significantly higher than in the micro-albuminuria group (P < 0.05). Linear correlation analysis revealed that ACR was positively correlated with baPWV (r = 0.413, P < 0.01). Multiple linear regression analysis showed that ACR independently correlated with baPWV in patients with primary hypertension (β = 0.29, R(2) = 0.112, P < 0.01) after adjusting for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, low density lipoprotein, high density lipoprotein and triglyceride. Using ACR < 30 mg/g and ACR ≥ 30 mg/g as dichotomous variable, binary logistic regression analysis showed that ACR ≥ 30 mg/g was also a risk factor of the ascending baPWV in primary hypertension patients (OR: 1.73, 95% CI: 1.62-2.98) after adjusting the traditional cardiovascular risk factors.</p><p><b>CONCLUSION</b>ACR is positively correlated to baPWV in primary hypertension patients, and the ascending baPWV is a risk factor of early renal dysfunction in primary hypertension patients.</p>
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Humans , Albuminuria , Ankle , Ankle Brachial Index , Blood Flow Velocity , Blood Pressure , Body Mass Index , Cardiovascular Diseases , Creatinine , Urine , Essential Hypertension , Hypertension , Urine , Pulsatile Flow , Pulse Wave Analysis , Regression Analysis , Risk FactorsABSTRACT
Objective To evaluate the potential protective effects of erythropoietin (EPO) in combination with granulocyte-colony stimulating factor (G-CSF) on hypoxia cardiomyocytes. Methods After left ventricular cardiomyocytes were isolated from neonate rat, the cells were inoculated in a cultural atmosphere of 95%N2 and 5%CO2 for 24 h to establish hypoxia cardiomyocytes model. The protective effects of EPO and G-CSF at different concentrations were evaluated for the optimal concentration. Then the protective effects of EPO in combination with G-CSF were investigated under the optimized concentrations. The survival, apoptotic and necrotic rates of cardiomyocytes were assessed by flow cytometry. Results The mortality and ratio of apoptotic cells to total necrotic cell were higher in hypoxia cardiomyocytes than normal cells significantly (26.73% vs 5.63%,70.05% vs 37.83%, P0.05), and the combination group was much better than EPO and G-CSF alone groups (P