ABSTRACT
Objective To investigate the efficacy and safety of 6-month and 12-month oral dual-antiplatelet therapy This work was supported by the National Key Technology Research and Development Program in the Twelfth Five-year Plan of China (2011BAIl1B07) and the Military Clinical Key Technology and Development Program (2010gxjs001)(DAPT) on patients implanted with biodegradable polymer-coated and drug-eluted long stents (BP-DES).Methods In the I-LOVE-IT 2 trial,574 patients implanted with biodegradable polymer-coated and sirolimus-eluted long stent (BP-SES) (total stent length ≥50mm) were randomized to accepting either 6-month (n=270) or 12-month (n=304) DAPT.The primary endpoint of present study was 12-month target lesion failure (TLF),including cardiac death,target vessel myocardial infarction and clinically indicated target lesion revascularization (CI-TLR).The major secondary endpoint was 12-month net adverse clinical events (NACE),including all-causes of death,myocardial infarction,stroke,all revascularization (CI-TLR plus clinically indicated nontarget lesion revascularization) and bleeding.Results For the patients implanted with BP-SES of total stent length≥ 50mm,the total stent length was 73.0 ± 22.5mm and 69.8 ± 19.4mm in the 6-month DAPT group and 12-month group,respectively (P=0.07).No significant difference existed in the incidence of 12-month TLF between 6-month DAPT group and 12-month DAPT group (11.1％ vs.9.2％,P=0.47).The incidence of NACE was similar between the 2 groups (21.9％ vs.19.7％,P=0.57).The incidence of revascularization was lower in 12-month DAPT group (5.6％) than in 6-month DAPT group (11.1％,P=0.01).Furthermore,6-month landmark analysis showed that 12-month DAPT was associated with significantly lower risk of TLF (2.6％ vs.6.3％,P=0.03) at a cost of slightly increased risk of all bleeding events (1.6％ vs.0.7％,Log-rank P=0.32) between 6 and 12-months compared to 6-month DAPT.Conclusions In patients treated with BP-SES of total stent length ≥ 50mm,12-month DAPT have similar impacts on 12-month clinical outcomes except for all revascularization.However,12 months DAPT decreased the incidence of TLF and total revascularization between 6 months to 12 months after PCI.
ABSTRACT
Objective To investigate the action of ulinastatin in protection of hepatic-renal function in patients with acute myocardial infarction (AMI) receiving emergency percutaneous coronary intervention (PCI). Methods 104 patients with acute myocardial infarction were randomly selected and divided into a study group (n = 55) and a control group (n = 49). The study group received intravenous ulinastatin of 300,000 units one hour before PCI, and 300,000 units daily for 3 days after the procedure; while the control group received the same amount of normal saline instead of ulinastatin before and after PCI. Levels of AST, ALT, and CRE were compared between the two groups and CCR was counted before and 72 hours after the procedure. Result Serum AST level was increased and CCR was decreased after PCI; and the change in the study group was lower than that in the control group (P < 0.05). ALT level was declined in the study group but was elevated in the control group after the procedure, with a significant difference between the two groups (P < 0.05). Conclusions Ulinastatin can protect hepatic-renal function in patients undergoing emergency PCI, lowering contrast-induced nephropathy and damage of liver and kidneys.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the changes of myocardial energy expenditure in patients with heart failure following myocardial infarction after treatment with different doses of perindopril.</p><p><b>METHODS</b>Sixty-three patients with heart failure after myocardial infarction were treated with perindopril for 12 months at the doses of 4 mg (group N) and 8 mg (group H). Doppler imaging was used to measure the structural and systolic functional parameters before and after the treatment, and the circumferential end-systolic wall stress (cESS) and myocardial energy expenditure (MEE) were calculated. The biochemical indicators including serum creatinine and plasma NT-proBNP were detected before and after the treatment.</p><p><b>RESULTS</b>The two groups had similar measurements before treatment. After 12 months of perindopril treatment, the patients in group N showed higher LA, LV, RA, RV, LVIDs, AD, cESS, lgNT-proBNP, and MEE with lower LVFS and LVEF than those in group H. Compared to those before treatment, LVFS and LVEF were increased and LA, LV, RA, RV, AD, LVIDs, LVMI, lgNT-proBNP and MEEm lowered after the 12-month treatment in group H. Significant changes were also found in the measured parameters except for PWTs, LVET, LVSV and LVFS in group N after the treatment. Bivariate analysis showed a significant positive correlation between MEE and lgNT-proBNP (r=0.513, P<0.01).</p><p><b>CONCLUSION</b>A 12-month treatment with perindopril can suppress myocardial remodeling, improve left ventricular systolic function, and lower NT-proBNP and myocardial energy expenditure in patients with heart failure after myocardial infarction, and a higher dose can produce better results.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Energy Metabolism , Heart Failure , Drug Therapy , Metabolism , Myocardial Infarction , Drug Therapy , Myocardium , Metabolism , Perindopril , Therapeutic Uses , Treatment Outcome , Ventricular Function, Left , Ventricular RemodelingABSTRACT
Objective To evaluate the clinical effect in prevention of intravenous catheter-related infection(CRI) using antiseptic impregnated central venous catheter.Methods Intravenous catheter-related infection was retrospectively analyzed between 440 cases performed with general centrol venous catheter and 420 cases performed with antiseptic impregnated central venous catheter in ICU.Results There were 34 cases of CRI in 860 cases,28 cases were inserted general central venous catheter and 6 cases inserted antiseptic impregnated central venous catheter,the group of antiseptic impregnated was lower singificantly than the group of general in infection rate(P=0.0002).Conclusion Using antiseptic impregnated central venous catheter can reduce CRI,which has clinical effect in prevention of CRI.