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<p><b>OBJECTIVE</b>To explore the characteristics and therapies of patients with acute myocardial infarction (AMI) in Wuxi city, China.</p><p><b>METHODS</b>A network was established to obtain information of patients with AMI who were admitted to 9 designated hospitals between 2011 and 2012. A total of 1 714 patients were enrolled (1 334 males, 754 smokers, 1 076 hypertension, 270 hyperlipidemia and 398 diabetes) including 1 410 patients with acute ST-segment elevation myocardial infarction (STEMI) and 304 patients with acute non ST-segment elevation myocardial infarction (NSTEMI). Patients' characteristics, therapies, the incidence of major adverse cardiovascular events (MACEs) and all-cause mortality were analyzed.</p><p><b>RESULTS</b>(1) Medication therapy was as follows: antiplatelet therapy 98.3% (1 685 cases) , beta-blockers 59.1% (1 013 cases) , ACEI or ARB 67.6% (1 159 cases) , statins 98.1% (1 682 cases) , and nitrates 71.1% (1 218 cases) . Of the patients, 7.1% (132 cases) received temporary pacemakers, 34.0% (480 cases) with acute STEMI underwent reperfusion [direct PCI 18.4% (260 cases) and thrombolysis 15.6% (220 cases)]. (2) According to the hospital admission data, patients were divided into three groups: group A, transported to the hospital by ambulance (n = 361); group B, transported to the hospital by private vehicles (n = 1 318); and group C, AMI occurred in the hospital (n = 35). The median time of AMI onset to physician contact of the 3 groups was 178 min, 368 min, and 9 min, respectively. The median time from AMI onset to the first ECG was 181 min, 379 min, and 10 min, respectively. The median time from AMI onset to cardiology specialist consultation was 187 min, 431 min, and 69 min, respectively. AMI onset-to-physician contact, AMI onset-to-first ECG, and AMI onset-to-specialized treatment time was the shortest in group C, followed by group A and group B. For patients with STEMI underwent reperfusion therapy, the median AMI onset-to-reperfusion therapy time was significantly shorter in group A patients than group B patients [thrombolysis group: 224(171, 514) min vs. 378 (158, 785) min, PCI group: 318 (154, 674) min vs. 489 (143, 816) min, all P < 0.05]. (3) The total incidence of MACEs was 16.3% (279/1 714), the all-cause in-hospital mortality rate was 13.1% (224/1 714). According to the AMI onset-to-physician contact, patients were divided into 4 groups: <3 h, 3-6 h, 6-12 h, and >12 h. The incidence of MACEs [4.4% (23/517), 13.3% (60/451), 19.1% (77/404) and 34.8% (119/342),χ(2) = 114.36, P < 0.01] and all-cause in-hospital mortality rate [4.1% (21/517) , 10.4% (47/451), 18.6% (75/404), 23.7% (81/342), χ(2) = 84.36, P < 0.01] increased in proportion to the time of AMI onset-to-physician contact. Among STEMI patients, the incidence of MACEs [5.8% (15/260) , 12.3% (27/220) , 20.9% (194/930) ,χ(2) = 39.93, P < 0.01] and all-cause in-hospital mortality [1.5% (4/260) , 10.0% (22/220) , 18.2% (170/930) ,χ(2) = 50.90, P < 0.01] was the lowest in the primary PCI group, followed by thrombolysis group and was the highest in the early conservative treatment group.</p><p><b>CONCLUSIONS</b>Guideline is well followed in terms of drug treatments of AMI in this cohort, but only a small proportion of AMI patients in Wuxi received reperfusion therapy. There is a considerable out-of-hospital time delay for AMI patients in this cohort which is shorter in group A than in group B. All-cause in-hospital mortality and MACEs is the lowest in AMI patients underwent primary PCI.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , China , Cross-Sectional Studies , Myocardial Infarction , TherapeuticsABSTRACT
Objective To evaluate the significance of myocardial bridge and find a reasonable diagnosis and treatment strategy.Methods Sixty-three myocardial bridge patients and sixty-three patients with negative results of coronary artery angiography were reviewed.The clinical data of symptoms,electrocardiogram,exercise tests,coronary artery angiography,therapeutics and the serum levels of C-reactive protein(CRP)were analyzed.Results The symptoms of chest distress and chest pain were found in myocardial bridge patients.Myocardial consumption of oxygen augmentation causes the symptoms of aggravation.Positive results of electrocardiogram and exercise tests in many of myocardial bridge patients were examined.There were no relationship with severity of myocardial bridge artery stenosis.Most of myocardial bridge were discovered in anterior descending branch.At present,the main treatment of myocardial bridge was drug therapeutics.After treatment,the serum levels of CRP was significantly decreased.Conclusion Myocardial bridge was anatomy abnormality with important clinical significance.The serum levels of CRP can be used to evalue the therapeutic efficacy of myocardial bridge.
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Objective: To study the effects of Total Saponins of Panax Pseudoginseng injection on unstable angina pectoris (UAP) . Methods :Forty-eight cases of UAP patients were randomly divided into Total Saponins of Panax Pseudoginseng injection treatment group and routine treatment group. The serum levels of plasminogen activator inhibitor (PAI), soluble intercellular adhesion molecule-1 (SICAM-1) and C-reactive protein (CRP) after two weeks treatment in two groups were observed. Results:The total effective rate was significantly higher in Total Saponins of Panax Pseudoginseng injection treatment group than in control group. The indexes of PAI after Total Saponins of Panax Pseudoginseng injection treatment were lower. The levels of SICAM-1 and CRP were lower in Total Saponins of Panax Pseudoginseng injection treatment group than those in control group. Conclusion:Total Saponins of Panax Pseudoginseng injection is an effective drug for UAP, and it obviously improves fibrinolytic activity and relieves inflammatory reaction.
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AIM: To observe the effects of methionine-induced hyperhomocysteinemia on protein C(PC), antithrombin-Ⅲ (AT-Ⅲ) and von willebrand factor (vWF). METHODS:Eighteen New Zealand rabbits were randomized as methionine group (group M,n=9) and control(group C,n=9), which were fed with methionine-rich diet(600 mg/d) and regular diet respectively for sixteen weeks.By the end of sixteen weeks,the serum biochemistry and PC,AT-Ⅲ and vWF in plasma were determined and vWF expression of endothelial cells of aorta were examined.RESULTS:In group M, the levels of methionine(29.97?5.34 ?mol/L) and homocysteine(13.30?2.19 ?mol/L) in serum were signifficantly higher than those(14.48?1.97 ?mol/L and 5.36?1.19 ?mol/L, respectively,P
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AIM: To observe the oxidative modification of low density lipoprotein iinduced by hyper homocysteinaemia following application of methionine. METHODS: Thirty two rabbits were randomized as group methionine(group M, n =9), group cholesterol (group Ch, n= 9), group methionin+cholesterol (group M+Ch, n= 9) and control group (group C, n= 5).In group M, Ch and M+Ch, the animals were fed with the food containing 3% methionine, 3.75% cholesterol and 3% methionine+3.75% cholesterol, respectively. By the end of sixteen weeks, the blood were taken and the measurements were carried out. RESULTS: Following application of methionine, the levels of hyperhomocysteine, ox-LDL and TBARS in group M and group M+Ch were significntly higher than those of group C and group Ch ( P
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The purpose of this study was to determine the role of lipid peroxidation by measuring the induced-chemiluminescence (ICL) of plasma and lung lymph in endotoxin-induced acute lung injury in awake sheep. The ICL of aortic plasma and lung lymph were significantly increased, but the ICL of venous plasma was not significantly increased after endotoxin infusion. The peak level of ICL was increased and its time was delayed after endotoxin. We conclude that lipid peroxidation plays an important role in endotoxin-induced acute lung injury, and ICL of arterial plasma is a sensitive marker in reflecting oxidant damage in lung.