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Objective@#Previous cross-sectional studies suggested that elevated levels of total cholesterol content of erythrocyte membrane (CEM) could significantly increase the risk of acute coronary syndrome (ACS). The purpose of the present study was to assess the predictive value of baseline CEM levels for the risk of clinical endpoint events in patients with ACS through prospective follow-up studies.@*Methods@#This study is a prospective follow-up study, which consisted of 859 patients with first ACS (698 patients with unstable angina pectoris and 161 patients with acute myocardial infarction), diagnosed and hospitalized in the First and Second Affiliated Hospital of Anhui Medical University. The routine blood lipid levels and CEM were measured. Patients were divided into two groups according to the median of baseline CEM: CEM≤131.56 μg/mg group (n=430) and CEM>131.56 μg/mg group (n=429). Patients were followed up at 6 months interval. The clinical endpoints were nonfatal myocardial infarction, nonfatal stroke, all-cause mortality, all-cause mortality, heart failure requiring hospitalization, and coronary artery revascularization. Kaplan-Meier curve analysis and Cox proportional hazard model were used to analyze the impact of elevated CEM on the occurrence of clinical end-point events. HR values and 95%CI of each variable were obtained. Cox regression analysis of all-cause mortality was performed according to whether patients had risk factors for coronary heart disease (hypertension, diabetes, smoking and elevated LDL-C) and whether they were treated with PCI.@*Results@#The follow-up time was 1 640 (1 380, 2 189) days. Cox analysis after adjustment showed that an elevated baseline of CEM (>131.56 μg/mg) was associated with an increased risk of all-cause mortality (HR=1.690, 95%CI 1.041-2.742, P=0.034), but had no significant predictive effect on the other clinical endpoints. Subgroup analysis showed that elevated baseline CEM levels in ACS patients with LDL-C>1.8 mmol/L (HR=1.687, 95%CI 1.026-2.774, P=0.039), receiving in-hospital PCI (HR=2.365, 95%CI 1.054-5.307, P=0.037), or male (HR=1.794, 95%CI 1.010-3.186, P=0.046) were associated with an increased risk of all-cause mortality.@*Conclusion@#The results showed that elevated CEM levels can increase the risk of all-cause mortality in ACS patients.
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Objective To investigate the effect of baseline Left-ventricular ejection fraction (LVEF) on the cardiac resynchronization therapy (CRT). Methods A retrospective analysis of patients with heart failure was performed. Fifty-four patients [aged (59.73 ± 11.61)years, 31 males, 23 females] who underwent CRT/CRTD were divided into 2 groups according to LVEF ( group A, LVEF≤ 35%; group B, LVEF > 35% ). NYHA class, LVEF,CRT respond rates and medical adverse event (MAE) due to worsening heart failure were detected at 3 and 12 months post-surgery. Results The score of NYHA class changing wasn′t different between these two group. Compared to group B, LVEF was markedly increased (5.08 ± 2.81)% vs (2.45 ± 1.80)%, P < 0.05;(5.38 ± 2.92)% vs (2.39 ± 3.53)%, P < 0.05)at 3 and 12 months post-surgery. Similarly, group A owned high CRT response rates(66.1% vs 33.9%, P < 0.05; 81.25% vs 47.83%, P < 0.05) at the both two time points. At 12 months post-surgery , LVED decreased and the MAE was similar in all groups. Conclusion Patients with EF≤ 35% have more increases in LVEF and own high CRT response rates post-CRT.
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Objective To investigate influencing factors of perioperative myocardial injury in patients undergone percutaneous coronary intervention (PCI). Methods Ninty one patients with coronary heart disease (including stable angina and unstable angina) underwent PCI, the perioperative myocardial injury incidence were observed prospectively by monitoring the preoperative and postoperative high sensitivity troponin protein levels to investigate the influencing factors of perioperative myocardial injury by Logistic regression analysis. Results There were no statistically significance in perioperative myocardial injury incidence (62.5%vs 68.7%, P=0.618) and perioperative myocardial infarction incidence (29.2%vs 20.9%, P=0.411) between stable angina and unstable angina groups . These factors of perioperative myocardial injury in patients undergone PCI by Logistic regression analysis were analysed, and we found that the influencing factors were the application loading dose rosuvastatin before PCI, preoperative statin therapy more than one month, apolipoprotein A levels and total stent length. Conclusion Application loading dose of rosuvastatin before PCI, preoperative statin therapy more than one month, apolipoprotein A levels are related to perioperative myocardial injury reduction, whereas the total length of the stent is associated with an increased occurrence of perioperative myocardial injury.
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Objective To investigate the diagnostic value of urine neutrophil gelatinase apolipoprotein (NGAL) and kidney injury molecule 1 (KIM-1) as markers of CIN,and the effectiveness of hydration therapy in the prevention of CIN.Methods One hundred and twenty patients were randomly divided into control group and treatment group.The patients of treatment group received hydration therapy through intravenous fluid infusion.Urine samples were taken for detecting the value of albumin (mAlb),NGAL,and KIM-1 before surgery (T0),after surgery 12 h (T1),24 h (T2),48 h (T3),72 h (T4) by ELISA assay.The levels of urinary mAlb,Scr,BUN and cystatin C were detected at the same time.Results (1) The urine NGAL/Cr and KIM-1/Cr significantly increased and were more than twice the baseline value at the time of 12 h after PCI in 87 of 120 cases of the participants.There are eight cases occurred CIN (6.67％) and one case occurred in hydration treatment group (1.7％),seven cases were in control group (11.7％).The difference was statistically significant.(2) There were no significant difference in BUN,Scr,mAlb/Cr,Cys-C and GFR between two gToUps (P ＞ 0.05).(3) NGAL/Cr,KIM-1/Cr were elevated at T1 in both groups (P ＜ 0.01).In hydration treatment group,levels of NGAL/Cr and KIM-1/Cr decreased substantially to the level of T0 at T4(P ＜ 0.01),while in the control group they didn't.(4) Area under the ROC curve (AUC) of NGAL/Cr and KIM-1/Cr 12 h after PCI were 0.931 [95％ CI (0.889,0.973)] and 0.811 [95％ CI(0.736,0.886)] respectively (all P＜0.05).Conclusions NGAL and KIM-1 are sensitive and specific indicators for predicting early renal injury induced by contrast medium and can be used for early diagnosis of CIN.Hydration therapy can prevent the contrast agent-induced renal damage.
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Objective To evaluate the correlation between seram interleukin-10 (IL-10) and testosterone with coronary heart disease (CHD). Methods 387 patients were divided into CHD group (n = 239) and control group ( n = 148 ) according to the results of coronary angiography. CHD patients were divided into subgroups accord-ing to the numbers, Gensini score of lesions in the coronary arteries and clinical severity ( statue of stable coronary artery disease, unstable angina or acute myocardial infarction). Serum IL-10 and testosterone levels were measured by ELASA. Logistic regression and partial correlation were used to evaluate the correlation of serum IL-10 and testoster-one with CHD. Results IL-10 was significantly lower in the CHD group than in the control group[ (39.08 ± 14.22) ng/L vs (49.27 ± 24.67)ng/L, P < 0. 001 ]. The partial correlation analysis results in subgroups showed that the correlation coefficient of IL-10 with number of lesions,gensini score and clinical severity of CHD was - 0.25, P < 0.001, -0.25 ,P <0.05 and -0.25 ,P <0.001 ,respectively. Serum testosterone had no difference in control group and CHD group (P >0.05 ). Logistic regression analysis found that only smoking (OR = 3.79,95% CI 2.09～ 6.84,P<0.01) ,diabetes mellitus (OR =2.48,95% CI 1.05 ～5.88,P <0. 05) ,apoB ( OR = 14.3,95% CI 4.29～46.61 ,P <0.01 ) and IL-10 ( OR =0.74,95%, CI 0.57～0.89 ,P <0.01 ) entered the model. Conclusions Serum IL-10 is not only significantly correlated with CHD but also with its severity. IL-10 is an independent pro-tective factor for CHD.
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cases of coronary heart disease with the left main coronary artery (LM) Lesion (≥50% stenosis) were analyzed In 8 cases the LM Lesion was only involved,and in the others (43),the LM Lesions were accompanied by other branch lesions of coronary artery Compared with 210 cases of coronary heart disease without LM Lesions,in the LM Lesion groups,the patients clinically manifested severe unstable angina,and the incidences of acute myocardial infarction and sudden death were higher In the two groups of patients with and without LM Lesion The risk factor for coronary heart disease and left ventricular ejection fraction was unsignificantly different The clinical manifestations were similar in the two groups of patient with only LM Lesion and without LM Lesion But when angina onset myocardial ischemia is severe in the patients with only LM Lesion The coronary artery bypass graft may improve symptom and prognosis of patients with LM Lesion