ABSTRACT
<p><b>OBJECTIVE</b>To assess the association between smoking status at follow-up and clinical outcomes in patients undergoing successful percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>The smoking status at follow-up was investigated in 592 patients undergoing successful PCI between Jan. 2003 and Nov. 2006. The patients were divided into three groups on the basis of their smoking status at follow-up: non-smokers (n = 272), quitters (n = 215) and current smokers (n = 105). Major adverse cardiac events were recorded.</p><p><b>RESULTS</b>The average follow-up time was 19.0 months. At follow-up, current smokers were significantly younger (P < 0.01), more likely to be male (P < 0.01) than non-smokers and had more favorable clinical and angiographic characteristics: lower prevalence of hypertension (P < 0.05) and diabetes (P < 0.05), fewer diseased vessels (P < 0.05) and fewer implanted coronary stents (P < 0.01), larger target vessel diameter (P < 0.01). However, the incidence of non-fatal myocardial infarction (MI) in quitters (1.40%) was significantly higher than in nonsmokers (0.37%, P < 0.05), the incidence of nonfatal MI in current smokers (4.76%) was significantly higher than quitters (1.40%, P < 0.05) and nonsmokers (0.37%, P < 0.01). After adjustments for age, gender, hypertension, diabetes, dyslipidaemia, target vessel diameter, the number of diseased vessels, the kind and number of implanted stents, and the follow-up time, multi-variables logistic regression analysis showed that current smoking was a independent predictive factor for non-fatal MI (beta = 1.28, wald chi2 = 6.91, P < 0.01).</p><p><b>CONCLUSIONS</b>Smokers, especially current smokers, were at increased risk for non-fatal MI post successful PCI. Therefore, all patients underwent PCI should be encouraged to stop smoking.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Angioplasty, Balloon, Coronary , Coronary Disease , Therapeutics , Follow-Up Studies , Myocardial Infarction , Therapeutics , Prognosis , Risk Factors , SmokingABSTRACT
<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of intracoronary autologous bone marrow mononuclear cells (BM-MNCs) transplantation in patients with dilated cardiomyopathy (DCM).</p><p><b>METHODS</b>On top of standard therapy, DCM patients received BM-MNCs transplantation (n = 71) or saline injection (n = 187). The baseline clinical characteristics of two groups were comparable. Data on echocardiography, Holter, six-minute-walk test, cardiac SPECT and annual hospital days were obtained in all patients at baseline, 1, 3, 6, 12 and 24 months after transplantation.</p><p><b>RESULTS</b>Six-minute-walk distance was significantly longer at one month [(345 +/- 76) m vs. (286 +/- 104) m, P < 0.05] and thereafter (all P < 0.05) in BM-MNCs group compared with saline group. Left ventri ocular ejection fraction (LVEF) at one month in BM-MNCs group was significantly higher compared with saline group [(41.5 +/- 9.4)% vs. (37.3 +/- 6.6)%, P < 0.05] and with pre-transplantation value [(41.5 +/- 9.4)% vs. (32.4 +/- 8.5)%, P < 0.05] while LVEF was similar at 24 months after transplantation between the two groups [(43.6 +/- 6.3)% vs. (43.2 +/- 6.0)%, P > 0.05]. Three months after transplantation, the number of ischemic segments of BM-MNCs group was significantly reduced compared with that of saline group (2.0 +/- 1.0 vs. 3.1 +/- 1.4, P < 0.05) and with baseline (2.0 +/- 1.0 vs. 3.1 +/- 1.2, P < 0.05) while the number of necrotic segments were similar in both groups during the follow-up. There were no significant difference in survival between two groups during 2 years follow-up (95.4% vs. 94.9%, P > 0.05) but the annual hospitalization days of BM-MNCs group was significantly lower than that of saline group [(23.6 +/- 13.4) d vs. (33.0 +/- 14.0) d, P > 0.05].</p><p><b>CONCLUSIONS</b>Intracoronary transplantation of autologous BM-MNCs was safe and could increase LVEF and the six-minute-walk distance and reduce hospitalization days for patients with dilated cardiomyopathy.</p>