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Objective To explore the clinical pathological data of the elderly patients with paroxysmal supraventricular tachycardia(PSVT) and the timing of the radiofrequency ablation treatment for PSVT and its clinical efficacy.Methods The clinical pathological data of 45 elderly patients with PSVT for radiofrequency ablation were retrospectivly analyzed,and the information of cardiovascular and cerebrovascular diseases,the duration of PSVT and frequency of attacks,the reason of patients had to accept radiofrequency catheter ablation,the treatment effective of electrophysiological study and radiofrequency ablation were recorded.Results The duration and frequency of attacks with PSVT were positively related with pathogenesis in the elderly patients.Elderly PSVT patients with severe cardiovascular disease accounted for 28.89％.The first radiofrequency ablation treatment success rate was 100％ in this research and the recurrence rate was 4.4％.Conclusion It is recommended that elderly PSVT patients early access to the radiofrequency ablation.
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Objective To evaluate the relationship between NT-probrain natriuretic peptide (NT-proBNP) levels and the degree of coronary artery stenosis in elderly patients with non-ST elevation acute coronary syndromes (NST-ACS).Methods The levels of NT-proBNP were determined in 258 elderly patients with NST-ACS divided into 3 quartile groups based on the degree of coronary artery stenosis,and 62 normal controls.And NT-pro BNP were compared among 4 groups.Results The serum levels of NT proBNP were increased in the NST-ACS patients with single,two or three-artery lesion compared with normal controls [(197.3±80.2)ng/L,(381.7±73.5)ng/L,(496.5± 99.8) ng/L vs.(68.2 ± 36.1) ng/L].The level of NT proBNP was enhanced along with increasing severity coronary artery disease (all P＜0.01).And with aging,the NT-proBNP levels were rising [aged＞60-69 years:(182.34±69.13) ng/L; aged≥70-79 years:(302.68±87.51)ng/L; aged≥80 years:(482.09±82.2)ng/L] (all P＜0.01).Conclusions The NT-proBNP level is enhanced along with aging and increasing severity of coronary artery stenosis in elderly NST-ACS patients.
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Objective To assess the effects of intracoronary tirofiban on preventing no-reflow during emergency percutaneous coronary intervention(PCI).Methods All 99 cases with acute myocardial infarction who underwent emergency PCI between March 2009 and March 2012 were randomized into test group of intracoronary bolus administration of tirofiban (n=50) and group of control (n =49).The clinical characteristics and the result of coronarography were observed.Thrombolysis in myocardial infarction (TIMI) flow grade,and corrected TIMI frame count (cTFC) of the two groups were compared.Incidence of 30 days follow-up major adverse cardiac events(MACE) and major bleeding events were also observed in both groups.Results Compared with control group,tirofiban treated group showed significantly more patients higher TIMI-3 flow (P＜0.05).cTFC was decreased in tirofiban treated group (21.3 ± 6.7) as compared to control group (37.6 +7.2),(P＜0.05).The incidence of no-reflow in tirofiban treated group was lower than in control.The incidence of major bleeding events were the same among two groups,while the incidence of 30 days follow-up MACE in tirofiban treared group (8％) was reduced compared with control group (18.4 ％),(P＜ 0.05).Conclusions Intracoronary tirofiban prior to emergency PCI is safe and effective for the patients with acute STEMI.It might lead to improved TIMI flow and myocardial reperfusion.
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Objective To evaluate and analyze relationship of plasma level of N-terminal probrain natriuretic peptides (NT-proBNP) and serum level of cystatin C (CysC) with cardiac and renal functions in patients with chronic heart failure (CHF) , and explore significance of CysC measurement in early diagnosis for renal damage in patients with CHF. Methods Totally, 162 patients with CHF and 150 normal healthy (controls) undergone routine physical check-up at, Taizhou People's Hospital, Jiangsu were enrolled in the study. Their plasma level of NT-proBNP and serum level of CysC, as well as serum levels of creatinine ( SCr) , urea nitrogen ( BUN) were measured and echocardiography was performed. Glomerular filtration rate (eGFR) was evaluated by modification of diet in renal disease (MDRD) study group formula. Results Compared with the control group, blood levels of NT-proBNP, CysC, SCr, BUN and left ventricular end diastolic diameter ( LVEDD) all elevated, both eGFR and left ventricular ejection fraction ( LVEF) decreased (P <0. 05 or P <0. 01 ) in CHF group, and CHF patients were prone to complicate with renal dysfunction (P<0. 01). Blood levels of NT-proBNP and CysC elevated significantly and LVEF lowered significantly in CHF patients with NYHA functional classes II , III and IV than those in control group. There was significant difference in blood levels of NT-proBNP and CysC between patients with varied NYHA functional classes (P<0. 05). Blood levels of NT-proBNP and CysC reversely correlated with LVEF (r = -0. 36, P < 0. 01 and r = - 0. 39, P < 0. 01) . Blood level of CysC correlated with that of NT-proBNP ( r = 0. 87 , P < 0. 01). Results of logistic regression analysis showed that elevated blood levels of NT-proBNP and CysC were risk factors for mortality during hospitalization in patients with CHF. Conclusions Patients with CHF were more likely to complicate with renal dysfunction than controls, with main manifestations of more severe damaged eGFR, more severe heart failure and more obviously renal damage. Blood levels of NT-proBNP and CysC can be used as indicators for evaluating exacerbation of chronic condition, and serumlevel of CysC can be used as marker for early diagnosing renal damage in patients with CHF.
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Objective To study whether prostaglandin E1 (LipoPGE1) could prevent contrast medium-induced nephropathy (CIN) in patients with coronary heart disease (CHD) plus diabetes mellitus type 2 (DM).Methods Total 198 CHD patients with DM received coronary angiography (CAG) or PCI were randomly divided into PGE1 group and control group.All patients received routine treatment,and the PGE1 group also received 20 ml normal saline and 20 μg PGE1 (intravenous injection,1 time/d) for 10 days.The rate of CIN and the level of serum urea nitrogen (BUN),creatinine (Scr),cystatin C (Cys C) were measured before and 48 hours and 5 days after contrastmedium administration.Results The level of Scr,BUN and Cys C were lower in PGE1 group [(113.92±54.89)μmmol/ L,(7.85±4.05)mmol/L,(1.38±0.34)mg/L]for 48 hours and[(86.72±35.26)μmmol/L,(6.61 ± 3.09 ) mmol/L,( 1.29 ± 0.29) mg/L]for 5 days than in control group [(129.22±50.18)μmmol/L,(9.26±3.95)mmol/L,(1.56±0.23)mg/L]for 48 hours and[(109.83+31.76)μmmol/ L,(8.07±3.11)mmol/L,(1.37±0.21)mg/L]for 5 days (all P＜0.05).The dose of contrast-medium was positively correlated with the level of Scr and BUN (r=0.74,P＜0.05 and r =0.82,P＜0.01,respectively).The patients' renal function in the PGE1 group was better than in control group after contrast-medium administration (P ＜0.05).BUN and Scr were positively correlated with the volume of contrast-medium (r=0.74,P＜0.05,r=0.82,P＜0.01).Conclusions PGE1 may prevent contrast medium-induced nephropathy in patients with CHD combined with DM.
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Objective To investigate the efficacy and safety of Lipo-prostaglandin E1 (LipoPGE1) in the treatment of non-ST segment elevation acute myocardial infarction (NSTEAMI).Methods A total of 86 patients with NSTEAMI were randomly and equally divided into LipoPGE1 group (n= 43) which received intravenous LipoPGE1 combined with low-molecular-weight heparin,aspirin, clopidogrel and other basic therapy, and the control group (n=43) which received placebo combined with the same therapy. The basic clinical settings, curative effect, main adverse cardiovascular events (MACEs) within 30 days including sudden death, new-onset myocardial infarction and target vessel revascularization, bleeding complications and drug adverse effects were observed. Results There were no significant differences in basic clinical characteristics between the two groups. Compared with control group, the patients in LipoPGE1 group showed. significant improvements of ECG (93.0% vs. 74.4%), angina (95.3% vs. 81.4%, both P＜0. 05), the incidences of left heart failure (2.3% vs. 14.0%) and MACEs within 30 days (4.7% vs.18.6%)(both P＜0.05). There were no serious drug adverse effects. Conclusions The LipoPGE1 combined with heparin, aspirin and clopidogrel is effective and safe in the treatment of NSTEAMI,which could improve the clinical symptoms, distal myocardium perfusion and cardiac function,decrease the incidence of MACEs.