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Objective@#To investigate the effect of intracoronary administration of nicorandil prior to primary percutaneous coronary intervention (PPCI) on myocardial perfusion and short-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI).@*Methods@#A total of 158 patients with STEMI undergoing PPCI from January 2014 to December 2015 in Fuzhou General Hospital were enrolled consecutively in this prospective controlled randomized trial. Patients were assigned into three groups with random number table: the nicorandil group (patients received intracoronary administration of 6 mg nicorandil after guide wire or balloon successfully crossed the target lesion, n=53), the nitroglycerin group (patients received intracoronary administration of 300 μg nitroglycerin after after guide wire or balloon successfully crossed the target lesion, n=52) and the control group(patients received routine treatment, n=53). The primary outcomes were myocardial perfusion, including the levels of corrected TIMI frame count (cTFC), and the incidence of no reflow or slow flow after PPCI. The secondary outcomes included the incidence of major adverse cardiovascular events (MACE) during hospitalization (all-cause death, reperfusion arrhythmia within 2 hours after PPCI, angina within 24 hours after PPCI, new heart failure or worsening cardiac function, and repeat revascularization) and within 3 months of follow-up (all-cause death, nonfatal myocardial infarction, repeat revascularization, post-infarction angina, and re-hospitalization for congestive heart failure).@*Results@#The age of enrolled patients was (62.9±11.3) years old, and 130 cases (82.3%) of them were male. The median time of symptom-onset to balloon was 4.50 (3.20, 6.43) hours. There were significantly difference in cTFC immediately after PPCI((21.68±7.43)frames, (24.74±8.66)frames, and(27.06±10.40)frames), incidence of no reflow or slow flow after PPCI(5.7%(3/53), 13.5%(7/52), and 22.6%(12/53)), ST-segment resolution at 2 hours after procedure(90.6%(48/53), 84.6%(44/52), and 74.5%(38/53)), and reperfusion arrhythmia at 2 hours after procedure(15.1%(8/53), 36.6%(19/52), and 34.0%(18/53)) among the 3 groups(P<0.01 or 0.05). In the multivariate logistic regression models, intracoronary administration of nicorandil could lower the cTFC level (OR=0.17, 95%CI 0.10-0.41, P=0.001), acted as a protecting factor on lowering the incidence of no reflow or slow flow (OR=0.13, 95%CI 0.02-0.96, P=0.045) and reperfusion arrhythmia (OR=0.26, 95%CI 0.09-0.74, P=0.012), as well as facilitating the ST-segment resolution at 2 hours after procedure (OR=4.62, 95%CI 1.14-18.82, P=0.033). However, observed parameters were similar between intracoronary administration of nitroglycerin group compared with control group (all P>0.05). MACE within 3 months of follow-up were similar among the 3 groups(all P>0.05).@*Conclusion@#Intracoronary administration of nicorandil prior to balloon dilation can significantly improve the myocardial perfusion and reduce the occurrence of reperfusion arrhythmia during PPCI for STEMI, but does not affect the short-term prognosis in STEMI patients.
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<p><b>OBJECTIVE</b>1-Bromo-3-chloro-5,5-dimethylhydantoin (BCDMH) is a solid oxidizing biocide for water disinfection. The objective of this study was to investigate the toxic effect of BCDMH on zebrafish.</p><p><b>METHODS</b>The developmental toxicity of BCDMH on zebrafish embryos and the dose-effect relationship was determined. The effect of BCDMH exposure on histopathology and tissue antioxidant activity of adult zebrafish were observed over time.</p><p><b>RESULTS</b>Exposure to 4 mg/L BCDMH post-fertilization was sufficient to induce a number of developmental malformations, such as edema, axial malformations, and reductions in heart rate and hatching rate. The no observable effects concentration of BCDMH on zebrafish embryo was 0.5 mg/L. After 96 h exposure, the 50% lethal concentration (95% confidence interval (CI)) of BCDMH on zebrafish embryo was 8.10 mg/L (6.15-11.16 mg/L). The 50% inhibitory concentration (95% CI) of BCDMH on hatching rate was 7.37 mg/L (6.33-8.35 mg/L). Histopathology showed two types of responses induced by BCDMH, defensive and compensatory. The extreme responses were marked hyperplasia of the gill epithelium with lamellar fusion and epidermal peeling. The histopathologic changes in the gills after 10 days exposure were accompanied by significantly higher catalase activity and lipid peroxidation.</p><p><b>CONCLUSION</b>These results have important implications for studies on the toxicity and use of BCDMH and its analogs.</p>
Subject(s)
Animals , Antioxidants , Metabolism , Disinfectants , Toxicity , Dose-Response Relationship, Drug , Embryo, Nonmammalian , Hydantoins , Toxicity , Time Factors , Water , Chemistry , Water Pollutants, Chemical , Toxicity , ZebrafishABSTRACT
Objective To assess endothelial function before and after pharmacological cardioversion for acute onset of atrial fibrillation(AF)in the patients with hypertension.Methods 37 consecutive hypertensive patients with acute AF were investigated,in whom sinus rhythm was restored by pharmacological cardioversion within 48 hours of arrhythmia onset without anticoagulant treatment.Of these 37 patients,17 cases treated with ACEI/ARB drugs were assigned to acute AF group 1,20 cases without using ACEI/ARB drugs were assigned to acute AF group 2.20 hypertensive patients with sinus rhythm were included as control group.Plasma markers of endothelial damage/dysfunction [von Willebrand factor(vWF),endothelin(ET)and nitric oxide(NO)] and E-selectin(E-sel,an index of endothelial activation)were measured in acute AF at baseline(pre-cardioversion)and on days 1,7,14,and 30 after cardioversion.The detected results were compared with the levels of controls.Results Plasma concentrations of ET,vWF and E-sel in acute AF group were significantly higher than those of control group;plasma level of NO in acute AF group was significantly lower compared to that of control group.After cardioversion,the plasma levels of ET decreased gradually to the levels of controls by the 7th day of sustaining sinus rhythm in acute AF group 1 and 30th day in acute AF group 2,and the plasma levels of vWF decreased to approach that of controls by the 14th day post-cardioversion in acute AF group 1 and 30th day in acute AF group 2.The NO level gradually increased to that of controls by the 14th day of sustaining sinus rhythm in acute AF group 1 and 30th day in acute AF group 2.Plasma level of E-sel returned to normal by the 7th day in the both groups of acute AF.Conclusion There were evidences of endothelial damage or dysfunction at acute onset of AF among the patients with hypertension,which persisted up to 30 days after cardioversion,and the use of ACEI/ARB might improve the normalization of endothelial function after cardioversion.
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Objective To evaluate the curative effect of valsartan associated with low-dose amiodarone on the recurrence of atrial fibrillation (AF), the left atrial diameter (LAD), P wave dispersion (Pd) and the maximum P wave duration (Pmax) in patients with paroxysmal AF. Methods 76 patients with paroxysmal atrial fibrillation (PAF) were randomized to valsartan (test group) and placebo (placebo group), both associated with low-dose amiodarone, and were followed up for 18 months. The patients were asked to report any episode of symptomatic atrial fibrillation and to perform an ECG as early as possible. AF load, Pmax, Pd and LAD were measured before and at the 6th, 12th, and 18th months after the treatment. Results At least one ECG-documented episode of AF was reported in 16% of the patients in test group and in 41% in placebo group, the difference was significant(P
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Objective To observe the preventive effect against sea-sickness of “anti-sick syrup” and “prevent-sick syrup” on voyage at sea. Methods A double-blind controlled trial was carried out in landing craft. 986 volunteers unaccustomed to sailing in their fist voyage at sea were divided into four groups, control group and group A to C, with ingestion, half an hour before setting sail, of placebo syrup, “anti-sick syrup”, “prevent-sick syrup” and “anti-sick syrup” plus “prevent-sick syrup”, respectively. The symptoms of seasickness were then recorded. Results The prophylactic effects have shown in all the groups. However, the effects shown in control group were significantly less than that in other groups (P