ABSTRACT
Objective: To explore influence of trimetazidine on cardiac function, levels of inflammatory factors, brain natriuretic peptide (BNP) and homocysteine (Hcy) in patients with congestive heart failure (CHF) and its therapeutic effect.Methods: A total of 120 patients diagnosed as CHF in our department were selected.According to random number table, they were randomly and equally divided into routine treatment group and trimetazidine group (received trimetazidine based on routine treatment group, 20mg/time, twice/d), both groups were treated for six months.Left ventricular relaxation time (LVRT), E peak decrease time (EDT), early diastolic peak velocity/late diastolic peak velocity (E/A), left atrial diameter (LAD), levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, BNP and Hcy were measured and compared between two groups before and after treatment.Results: After six-month treatment, total effective rate of trimetazidine group was significantly higher than that of routine treatment group (93.3% vs.80.0%, P=0.032);compared with routine treatment group after treatment, there were significant reductions in LVRT [(92.1±4.6)ms vs.(74.5±2.7)ms], EDT [(165.3±5.1)ms vs.(139.2±3.9)ms] and LAD [(41.1±2.6)mm vs.(33.1±1.8)mm], and significant rise in E/A [(0.89±0.21) vs.(1.16±0.51)] (P<0.01 all);and significant reductions in serum levels of IL-6 [(16.3±2.8) ng/ml vs.(11.3±1.3) ng/ml], TNF-α [(3.17±0.99) ng/ml vs.(2.01±1.12) ng/ml], BNP [(311.4±27.9)pg/ml vs.(278.2±31.3) pg/ml] and Hcy [(15.6±4.2) pg/ml vs.(11.3±2.7) pg/ml] in trimetazidine group, P<0.01 all.Conclusion: Trimetazidine can significantly improve heart function, reduce inflammatory factor levels and inhibit atrium remodeling in patients with congestive heart failure, and the therapeutic effect is significant.
ABSTRACT
Objective To evaluate the safety,feasibility and efficacy of emergency percutaneous coronary intervention(PCI)on the spot in the patients with acute myocardial infarction(AMI)in country hospitals by interventional cardiologists from higher-level hospitals(converse transport).Methods A total of 81 AMI patients received emergency PCI on the spot by interventional cardiologists from other higher-level hospitals (transported doctors)from Mar 2004 to Sep 2008 in our hospital.The mean age of patients was 68.6 ± 3.6 years (36.0-83.0 years).Forty-six patients were male and 35 were female.There were 56 cases with anterior myocardial infarction and 25 with inferior myocardial infarction(including 11 cases combined with right ventricular infarction).The average time from symptom onset to admission was 6.2 ± 1.8 hours(2.0-12.0hours).Results Three cases were transported to higher-level hospitals for CABG because of severe conditions.The other 78 cases received emergency PCI on the spot,among whom 66 cases received primary PCI.Another 12 cases received rescue PCI.Eight one stents were implanted in total into the infarcted arteries.One operation was failed because the balloon could not go through the lesion.The success.rate was 98.7％.Four patients occurred peri-operative cardiac adverse events and 2 cases died.Four cases died during the 32-86 months follow-up,of whom I was cardiac death and 3 was non-cardiac deaths.No fatal cardiovascular events occurred in the remained cases.Conclusion Emergency PCI on the spot by interventional cardiologists from other cities(converse transport PCI)in AMI is safe,feasible and effective.But it needs to be confirmed in a large-scale study in the future.