ABSTRACT
Objective To investigate the effects of levosimendan on percutaneous coronary intervention ( PCI) in patients with ischemic heart failure. Methods From January 2013 to June 2016,eighty patients with ischemic heart failure undergoing coronary intervention in Pingdingshan People′s Hospital No. 1 were randomly divided into treatment group ( 40 cases) and control group ( 40 cases) . The treatment group was treated with levosimendan on the basis of routine medicine 2 days before operation,and the control group was given routine medication before operation. The baseline clinical data, operative success rate, complications, left ventricular ejection fraction ( LVEF%) after 1 month, 6 min walking distance, plasma brain natriuretic peptide ( BNP ) , creatinine and other cardiac and renal functions were observed and compared between the two groups. Results The differences of the baseline clinical characteristics including age (65. 5±3. 9 vs. 63. 9±3. 6),male (26 cases (65. 0%) vs. 23 cases (57. 5%) ),hypertension (21 cases (52. 5%) vs. 19 cases (47. 5%) ),diabetes (17 cases ( 42. 5%) vs. 14 cases ( 35. 0%) ) , hyperlipidaemia ( 30 cases ( 75. 0%) vs. 29 cases ( 72. 5%) ) , smoking (21 cases (52. 5%) vs. 19 cases (47. 5%) ),COPD (7 cases (17. 5%) vs. 6 cases (15. 0)%), LDL?C ( (4. 5±1. 0) mmol/L vs. (4. 4±1. 1) mmol/L),BMI ( (25. 9±3. 3) vs. (25. 6±3. 5) ) were not significant (t/χ2=1. 30,0. 47,0. 20,0. 47,0. 07,0. 20,0. 09,0. 49,0. 39,P=0. 20,0. 49,0. 66,0. 49,0. 80, 0. 66,0. 76, 0. 63, 0. 70 ) . There was no significant difference in coronary artery lesion between two groups, including single vessel lesion (11 cases (27. 5%) vs. 15 cases (37. 5%) ),double vessel lesion ( (22 cases ( 55. 0%) vs. 19 cases ( 47. 5%) ) ,three vessel lesion ( ( 7 cases ( 17. 5%) vs. 6 cases ( 15. 0%) ) and left main coronary artery disease (7 cases (17. 5%) vs. 6 cases (15. 0%) ) (Z=-0. 88,P=0. 38). The time of percutaneous coronary intervention ( ( 51. 0±8. 6) min vs. (49. 6 ±9. 6) min),the time of X?ray exposure ( (20. 3±7. 0) min vs. (18. 4±5. 6) min),material consumption ( (123. 2±16. 6) ml vs. (117. 3±25. 1) ml) between two groups have no difference ( t/χ2=0. 70,1. 39,1. 24,P=0. 49,0. 17,0. 22) . There were significant differences between the two groups in the success rate of operation ( 38 cases ( 95. 0%) vs. 31cases ( 77. 5%) , heart failure ( 1 cases ( 2. 5%) vs. 6cases ( 15. 0%) ) and complications ( 2 cases ( 5. 0%) vs. 11 cases (27. 5%) ) (χ2=5. 17,3. 91,7. 44,P=0. 02,<0. 05,<0. 01). Compared with the control group,the treatment group had greater advancement in LVEF,6 min walking distance,BNP and creatinine level at one month after operation ( F=6. 10,63. 60,51. 00,348. 00,P=0. 02,<0. 01,<0. 01,<0. 01) . Conclusion Levosimendan can effectively improve the heart function and renal function, improve the success rate of PCI in patients with ischemic heart failure and reduce the incidence of complications.
ABSTRACT
Objective To investigate the effect and safety of Guard wire technology in percutaneous coronary intervention( PCI) of ostial lesions and the treatment of passing ostial lesions. Methods Thirty?five cases patients needing PCI of ostial lesions were selected and divide randomly in to A group(n=18) and B group(n=17) . A group used Guard wire technology and B group used common method. The X?ray exposure time,complications,the amount of contrast agents of two groups were analyzed. Forty?six cases patients needing the treatment of passing ostial lesions were divided randomly into C group( n=25) and D group( n=21) . C group used Guard wire technology and D group used common method. Complications of two groups were investigated. Results The X?ray exposure time, the amount of contrast agents and complications of A group were fewer than that of B group,the difference were significant((5. 7±0. 6) min vs. (9. 3±1. 1) min,(84. 3 ±6. 4) ml vs. (94. 1±10. 0) ml,6%(1/18) vs. 35%(6/17);t or χ2=-11. 80,-3. 50,4. 80;P<0. 05). The complications of C group was lower than that of D group,and the difference was significant( 4%( 1/25) vs. 29%( 6/21);χ2=5. 30,P<0. 05) . Conclusion Guard wire technology is safe and useful in percutaneous coronary intervention of ostial lesions and the treatment of passing ostial lesions,and it is feasible in clinical practice.