Trends of in-hospital mortality and constituent ratio of patients with acute myocardial infarction / 中华心血管病杂志

Objective@#To analyze the trends on constituent ratio of non-ST-segment-elevation (NSTEMI) and ST-segment-elevation myocardial infarction (STEMI) and related in-hospital mortality in acute myocardial infarction (AMI) patients hospitalized in Beijing Anzhen Hospital from 2004 to 2014.@*Methods@#This is a single-center, retrospective study. We reviewed all patients hospitalized for AMI in Beijing Anzhen Hospital from January 1 2004 to December 31 2014, and collected all related information including hospitalization stay, the type of AMI, revascularization and in-hospital mortality. We analyzed the trends of constituent ratio of NSTEMI and STEMI, and their in-hospital mortalities during the 11 years.@*Results@#Data from a total of 23 864 patients with AMI, including 5 539 STEMI and 18 325 NSTEMI, were analyzed. Compared with STEMI patients, NSTEMI patients were older, less likely to be male (P<0.001), had higher prevalence of hypertension, hyperlipidemia, diabetes (P<0.001), and lower prevalence of smoking (P<0.001). Additionally, patients with NSTEMI were more likely to have prior history of MI (12.6% (695/5 539) vs. 7.4% (1 354/18 325), P<0.001) and coronary artery bypass graft surgery (2.7% (152/5 539) vs. 0.7% (124/18 325), P<0.001). The constituent ratio of NSTEMI was significantly increased during the observation period, rising from 15.8% (107/802) in 2004 to 35.7% (1 273/3 583) in 2014 (P value for trend <0.001). The in-hospital mortality of NSTEMI patients was significantly lower compared with those with STEMI (1.84% (102 cases) vs. 2.74% (502 cases), P<0.001). The mortality of both STEMI and NSTEMI were significantly decreased during the 11 years (both P value for χ2 trend test <0.001). After adjusting for other risk factors, NSTEMI was independently associated with lower in-hospital mortality (OR=0.50, 95%CI 0.40-0.63, P<0.001).@*Conclusions@#In patients with AMI, the constituent ratio of NSTEMI versus STEMI is increased during the 11 years. The in-hospital mortality is decreased for both STEMI and NSTEMI patients in the past 11 years, and the in-hospital mortality rate of NSTEMI patients is lower than STEMI patients in this patient cohort during the observation period.

Synergistic effect between Smoking and hyperhomocystinemia on incidence of coronary heart disease / 实用医学杂志

Objective To investigate the synergistic effect of hyperhomocystinemia (HHcy) and smoking on the incidence of Coronary heart disease. Methods A total of 22 043 subjects were enrolled from health care center. Participants were classified into two groups: Non-coronary heart disease group (control group, n = 19 410) and coronary heart disease group(n=2 633).A questionnaire survey,physical examination and blood homocysteine (Hcy)test were carried out among the participants.Results After controlling the confounding factors,multivariable Logistic regression analysis showed that the risk of coronary heart disease in patients with smoking was 4.832 times higher than that of patients with normal waistline. The risk of coronary heart disease in patients with HHcy was 1.019 times higher than that of patients with normal Hcy (OR = 4.832,1.019,P < 0.05).Interaction analysis showed that the risk of patients with HHcy and smoking was 2.473 times higher than that of patients without HHcy and no-smoking.The synergy index between HHcy and smoking on the incidence of Coronary heart disease was 1.739. The pure attributable proportion due to the interaction was 42.9%. Conclusions HHcy and smoking are risk factors for coronary heart disease and there is a positive synergistic effect between HHcy and smoking on the incidence of coronary heart disease.

Effect of revascularization on clinical outcome in elderly CHD patients with DM undergoing PCI / 中华老年心脑血管病杂志

Objective To assess the effect of revascularization on clinical outcome in elderly CHD patients with DM undergoing PCI.Methods 1055 CHD patients with DM undergoing PCI were divided into complete revascularization (CR) group (n=261),non-CR group 1 (n=385) and non-CR group 2 (n=409).The patients were followed up for 2 years during which the cardiovascular events were recorded.The SYNTAX revascularization index (SRI) was calculated according to the ROC curve and the best prognostic accuracy of revascularization was assayed.Results A significant difference was found in the incidence of MACE,angina pectoris,motality,cardiogenic death,myocardial infarction,unplanned revascularization during the 2-year follow-up period (P＜ 0.05,P＜0.01).Logistic regression analysis showed that SRI was a protective factor for MACE,reduced 64％ of MACE,and thus played a great role in predicting the incidence of MACE in elderly CHD patients with DM after 2 years of PCI (P=0.010).The area under the ROC curve showed the best prognostic accuracy of revascularization was 65％.Conclusion The incidence of cardiovascular events is low in elderly CHD patients with DM after 2 years of CR.The revascularization rate should be higher than 65％ for those who cannot undergo CR in order to reduce their mortality during the long-term follow-up period.

Comparing different revascularization approaches on the prognosis of elderly patients aged 75 and over with diabetes and multi-vessel coronary artery disease / 中华老年医学杂志

Objective To evaluate the clinical effects of two different revascularization approaches,one via percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and the other via coronary artery bypass graft (CABG),on short-and long-term prognosis in elderly patients with diabetes and multi-vessel coronary artery disease.Methods A retrospective analysis was conducted on 254 elderly patients with diabetes and multi-vessel coronary artery disease.Based on the revascularization approach,patients were divided into the PCI group (n=93) and the CABG group (n =161).The incidence of major cardiovascular events (MACE) were observed during hospitalization and 1-year after follow-up.Results All-cause mortality and the incidence of non-fatal myocardial infarction were higher in the CABG group than in the PCI group during hospitalization [4.9％ (8 cases) vs.1.1％ (1 cases),5.6％ (9 cases) vs.2.2％ (2 cases),each P＜0.05],while there was no significant difference in the incidence of MACE between the two groups1-year after follow-up (P＞ 0.05).The incidence of cerebrovascular events was lower in the PCI group than in the CABG group [2.2 ％ (2 cases) vs.6.2％ (10 cases),P＜0.05],while the rate of revascularization was higher in thePCI group than in the CABG group [6.5％ (6 cases) vs.1.9％ (3 cases),P＜0.05].Cox regression analysis showed that diabetes (OR =1.65,95％ CI:1.013-1.926,P =0.024) and left ventricular ejection fraction (OR =1.30,95 ％ CI:1.018-1.652,P =0.027) were independent risk factors for revascularization and cerebrovascular events.Conclusions MACEs during hospitalization are fewer in elderly patients with diabetes and multi-vessel coronary artery heart disease who received PCI than in those who received CABG.PCI has a similar mid-and long-term effect as CABG,bur PCI has a higher revascularization rate and lower risk of MACEs than CABG.

Treatment of complex coronary lesions by excimer laser coronary atherectomy:the initial experiences in China / 中国介入心脏病学杂志

Objective Excimer laser coronary atherecomy ( ELCA) has been recently used for the treatment of complex coronary lesions including calcified stenosis , chronic total occlusions and in-stent restenosis. Such complex lesions are difficult to adequately treat with balloon angioplasty and /or intracoronary stenting.The aim of this study was to introduce our early experiences in using ELCA in China . Methods Fifteen patients were enrolled through our center from March 2015 to April 2016 , and excimer laser coronary angioplasty was performed on 15 lesions.Eleven patients were previously failed cases either from uncrossable balloon ( 9 lesions ) or expandable balloon ( 6 lesions ) . The procedure and clinical endpoints were recorded .Results Laser catheter with 0.9 mm diameters were used in all 15 coronary lesions.All the lesions were successfully crossed with laser catheter and finally dilated with balloon .The procedural success rate was 100%.Drug eluting stents ( DES ) were implanted in 86.7% lesions and 2 cases were treated with drug eluting balloon .Clinical success was obtained in all patients (100%).There was no dissection , major side branch occlusion , spasm, no-reflow phenomenon nor acute vessel closure . Conclusions This study shows that laser-facilitated coronary angioplasty is a simple , safe and effective device for the management of complex coronary lesions .

Association between plasma levels of microRNA-126 and coronary collaterals in patients with coronary artery disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the relationship between plasma microRNA126 (miR-126) level and coronary collateral circulation (CCC) formation and to determine whether the miR-126 in plasma could serve as a blood-based biomarker for CCC in patients with severely narrowed coronary arteries (CAD).</p><p><b>METHODS</b>In this prospective study, a total of 120 consecutive CAD patients with ≥ 95% stenosis in one epicardial coronary artery were enrolled. Thirty healthy people served as normal control. They were divided into two groups according to Rentrop grades: patients with grade 2 and 3 collateral development (good CCC group, n = 64) and patients with grade 0 and 1 collateral development (poor CCC group, n = 56). Plasma miR-126 was measured by RT-PCR and serum VEGF was evaluated by ELISA method.</p><p><b>RESULTS</b>Fasting plasma glucose (FPG) was significantly lower in patients with good CCC than in patients with poor CCC ((5.99 ± 1.48) mmol/L vs. (6.40 ± 2.50) mmol/L). Plasma miR-126 levels and VEGF levels were significantly lower in CAD patients than in healthy people (0.04 ± 0.01 vs. 0.07 ± 0.02, P = 0.023 and (2 110 ± 455) ng/L vs. (2 574 ± 450) ng/L, P = 0.011, respectively). miR-126 and VEGF levels were significantly higher in good CCC group than in poor CCC group (miR-126: 0.06 ± 0.02 vs. 0.03 ± 0.01, P = 0.021;VEGF:(2 549 ± 614) ng/L vs. (1 759 ± 452) ng/L, P = 0.008) . In CAD patients with good CCC, the miR-126 level was positively correlated to the VEGF expression (r = 0.712, P = 0.005) while there was no correlation between miR-126 level VEGF in CAD patients with poor CCC (r = 0.342, P = 0.483) . Multivariate analysis revealed that plasma miR-126 (OR = 2.145, 95% CI 1.691-2.988, P = 0.001) and VEGF (OR = 1.279, 95% CI 1.068-2.295, P = 0.013) were independent predictors of collateral formation in patients with severely narrowed coronary arteries. In CAD patients, the area under the miR-126 ROC curve is 0.951 (P = 0.002).</p><p><b>CONCLUSION</b>Plasma miR-126 level is positively correlated to the CCC formation and is an independent predictor of CCC development in patients with severely narrowed coronary arteries, suggesting that plasma miR-126 might be a useful new, stable blood biomarker for predicting CCC formation in patients with severely narrowed coronary arteries.</p>

Impact of Anemia on Prognosis of Elder Patients With Acute Coronary Syndrome After Percutaneous Coronary Intervention / 中国循环杂志

Objective: To evaluate the impact of anemia on prognosis of elder patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods: A total of 908 consecutive ACS patients elder than 60 years of age with PCI in our hospital from 2010-06 to 2012-06 were studied. According to WHO deifnition of anemia (HB Results: There were 31%of patients suffering from anemia. Anemia group had more patients with the elder age, female gender, diabetes, hypertension, chronic kidney disease, decreased LVEF, more patients with 3 vessel-disease, and higher mortality at 1 year after PCI, higher rate of MACCE than those in Non-anemia group, all P Conclusion: Anemia may increase the incidences of mortality and MACCE in elder ACS patients after PCI for a long-term.

Reducing visit-to-visit variability in systolic blood pressure for improving the progression of carotid atherosclerosis and endothelial dysfunction in patients with hypertension management

Visit-to-visit variability [VVV] in blood pressure [BP] creates challenges to hypertension control and was independent associated with increased all-cause mortality in hypertensive patients. The major goal of the present study was to investigate the association of VVV in systolic [S]BP with progression of carotid atherosclerosis and endothelial dysfunction in on-treated hypertensive patients. Overall, 356 hypertensive patients were enrolled and completed the trial. Clinic BP was measured at base-line and at 3 monthly thereafter. Carotid artery ultrasound and endothelial function were evaluated at baseline and annually follow-up visit. VVV in BP was assessed by standard deviation [SD] and coefficient of variation [CV] of serial follow-up BP measurements. The patients were divided into low, middle, and high group by tertile of SD in SBP. Decrease percentage of maximum intima-media thickness [IMT] and stiffness index beta and increase percent-age of brachial flow-mediated dilation [FMD] and nitric oxide [NO] in lower groups were significant greater than in higher groups [P < 0.05]. Change percentage of stiffness index beta and endothelin-1 positively, and change percentage of FMD and NO negatively correlated with SD, CV, maximum, and delta of SBP [P < 0.05]. SD and CV of SBP were risk factors for change percentage of IMT, stiffness index beta, FMD, NO, and endothelin-1 independently of other influential factors, such as age, and mean SBP. Excessive VVV in SBP maybe increase carotid atherosclerosis and impair endothelial function in on-treated hypertensive patients. Reducing VVV in SBP is benefit for patients with hypertension management

Mechanism of synergistic antitumor effects of EBB and doxorubicin on multidrug resistant MCF-7/ADR / 中国药理学通报

Aim To study the mechanism of synergistic antitumor of EBB and doxorubicin in doxorubicin-resistant MCF-7/ADR breast carcinoma cells.Methods The antitumor activity of doxorubiein alone and its combination with EBB were measured by MTT assay in MCF-7/ADR and MCF-7cells. The rate of doxorubicin-induced apoptosis and the protein and mRNA levels of P-glycoprotein(P-gp) were determined in MCF-7/ADR treated with EBB by flow cytometry (FACS), respectively.Laser scanning confocal microscopy was used to detect the intracellular accumulation of drug in EBB-treated MCF-7 and MCF-7/ADR cells.Results EBB had antitumor effects for MCF-7 and MCF-7/ADR.It could potentiate the antitumor effect of dororubicin with CDI of 0.73 and 0.49 for MCF-7 and MCF-7/ADR,respectively.EBB and doxorubicin acted synergistically in elevating apoptosis of MCF-7/ADR and downregulating the expression of P-gp in a dose-dependent manner in MCF-7/ADR.EBB restored the intracellular accumulation of doxorubicin in MCF-7/ADR cells in a dose-dependent manner.After pretreatment with EBB for 24 h and 48 h,the intracellular accumulation of doxorubicin and Rh123 was obviousely restored in MCF-7/ADR cells compared with control in a time-dependent manner.Conclusion EBB is a potential agent which has strong inhibitory effect on both multidrug resistant cells and their parental cells.EBB can significantly potentiate the antitumor effects of dororubicin in MCF-7/ADR cells by blocking the function of P-glycoprotein and inhibiting the expression of P-glycoprotein.

Study on the up-regulation of expression of B7 molecules and immunogenicity of acute leukemia cells induced by cytarabine / 白血病·淋巴瘤

Objective To investigate the effects of cytarabine(Ara-C) on expression of B7 molecules and immunogenicity of acute leukemia (AL) cells. Methods The expression of B7 molecules on fresh AL ceils and on the Ara-C exposed leukemia ceils was detected by FACS cytometer. B7 mRNA in Ara-C treated HL-60 cells were detected by reverse RT-PCR. The stimulation of proliferation of allogeneic PBMC by Ara-C treated HL-60 cells was detected by MTT method. Results B7-2 was weakly expressed in four and positive in three, whereas BT-1 was positive in only one of fourty AL patiens. Ara-C significantly enhanced B7 molecules expression on AL cells. Ara-C could induce higher expression of B7 mRNAs on HL-60 cells.Ara-C treated HL-60 cells could stimulate PBMC proliferation and promote their IFN -γ production.Conclusion Fresh AL cells express low level of B7 molecules. Ara-C enhances the B7 molecules expression on AL cells. The Ara-C treated leukemia cells can significantly stimulate the proliferation of allogeneic PBMC and induce their secretion of IFN-γ.

Protection System Against and Its Effect Occupational Exposure to Hepatitis B Virus / 中华医院感染学杂志

OBJECTIVE To understand the condition of occupational exposure in hospital,and analyze the tendency during last four years.METHODS Occupational exposure in medical personnel were investivated through questionnaireand reviwed the survey report of quantitative detection of the five serological markers of hepatitis B,in the workers exposed in HBV.RESULTS The rate of occupational exposure had declined year by year during 2005-2008,but the result was opposite for HBV.CONCLUSIONS It′s very effective to decrease occupational exposure by strenghening standardization and putting professional protective knowledge in routine work.After setting up and developing protective system against occupational exposure,it′s more prompt in updating information,protective treatment and follow-up test in serum.It shows that this system is helpful to normalize medical personnel action of occupational exposure.In fact,vaccination is an effective way to avoid medical personnel of infecting HBV.

Observation of tirofiban's effect on myocardial necrosis biomarker in patients with aspitin resistance following percutaneous coronary interventions / 中国综合临床

Objective To investigate the effect of tirofiban on myocardial necrosis biomarker after percutaneous coronary interventions(PCI)in patients with aspirin resistance(AR).Methods 374 consecutive patients with aspirin 100 mg≥1 week,receiving no other antiplatelet therapy,scheduled for PCI were enrolled.all patients were given an loading dose of 300 mg clopidogrel at least 12 hours before PCI and an 75 mg maintenance dose per day.Patients were randomized into tirofiban group(n=38)and control group(n=45)after PCI.The levels of CKMB,TnI at 8,12,and 24 hours after PCI were measured in all patients;if the CK-MB,TnI value was above normal upper limitation,it was considered elevated.Results 83 patients were AR(22.2%)and 54.2%of them are females.The frequencies of CK-MB elevation were 15(39.5%)in tirofiban group and 19(42.2%)in control group,and TnI elevation was 18(47.4%)and 23(51.1%)in the two groups respectively.Conclusion Tirofiban can not decrease the elevation level of CK-MB and TnI in patients with AR after PCI.

The clinical study of low-dose facilitated PCI in acute myocardial infarction / 中国实用内科杂志

Objective To evaluate the efficacy and safety of facilitated PCI(low-dose rt-PA combined with percutaneous coronary intervention)in acute myocardial infarction(AMI).Methods One hundred and sixteen patients with AMI were divided into low-dose facilitated PCI group(n=69)and direct PCI group(n=47).69 patients in low-dose facilitated PCI group were treated with an intravenous drip of 50 mg rt-PA and PCI,while 47 patients in direct PCI group were treated with PCI.The rates of recanalization before and after PCI,and the left ventricular ejection fraction(LVEF)and major hemorrhage and major adverse cardiac events(MACE)in hospital were compared in two groups.Results There was no significant difference in the interval from hospitalization to the PCI between low-dose facilitated PCI group and direct PCI group.Compared with direct PCI group,the rates of recanalization and TIMI grade 3 before PCI were significantly higher in low-dose facilitated PCI group(44.7% vs 21.7%,P

Investigation on Essential Hypertension in the Elderly in Rural and Urban Areas of Jinan / 中国慢性病预防与控制

Objective To investigate the current condition of essential hypertension in the elderly aged over 60 yrs in rural and urban areas in Jinan. Methods 2 626 subjects aged over 60 years in rural and urban of Jinan were involved and were examined. The investigation was based on the unified questionnaire. The contents of questionnaire mainly included the history, treatment and control of hypertension. Results Prevalence of hypertension and rate of treatment in the male elderly in urban were 64.1% and 61.5% , respectively, and were higher than those in rural (56.9% and 38.3%, respectively). The treatment rate in female was higher in urban (60.8%) than in rural (43.1%) (P

Diagnostic implications of TC/HDL-C and high sensitive C-reactive protein in diagnosis of coronary heart disease / 中国医师进修杂志

Objective To investigate the value of serum high sensitive C-reactive protein (hs-CRP) together with total cholesterol(TC)/high-density lipoprotein cholesterol (HDL-C) as a predictor risk factor for future coronary heart disease (CHD). Methods TC,HDL-C and hs-CRP were measured in 260 patients. Results The serum hs-CRP levels in patients with coronary heart disease were significantly increased than those in normal group, P

Safety and efficacy of arterial closure devices (angioseal and perclose) in patients undergoing coronary angiography and angioplasty / 中国介入心脏病学杂志

Objective To assess the efficacy and safety of two kinds of arterial suture-mediated closure devices (Angioseal and Perclose) in patients after coronary arteriography(CAG) and percutaneous coronary intervention (PCI). Methods 1?020 patients (672 male, 348 female, mean age 57.8?2.4 yr) undergoing CAG or PCI were randomized into either the Angioseal group (CAG 380, PCI 120) or the Perclose group (CAG 392, PCI 128). The procedural success rate and occurance of local complications were compared between the two groups. Results Both kinds of devices had a high success rate (Angioseal 94% vs Perclose 96%) and there was no statistical difference between them. There were five cases of hematoma and no pseudoaneurysm in the Angioseal group. On the other hand, there were four cases of hematoma and three cases of pseudoaneurysm in preclose group. There was no statistal difference in terms of local complications between the 2 groups. Conclusion Both kinds of arterial suture-mediated closure devices (Angioseal and Perclose) are feasible and safe for patients undergoing CAG and PCI.

Transcatheter coil emblization of coronary artery fistula / 中国介入心脏病学杂志

Objective To probe into the safety and effectiveness of transcatheter coil embolization for congenital coronary artery fistula. Methods Between May 1999 and December 2002, coil embolization of coronary artery fistula was attempted in 6 patients aged 38 to 70 years (mean, 50.7 years). The fistulae connected the left coronary artery to the pulmonary artery in 2 patients, the right coronary artery to the pulmonary artery in 2, the right coronary artery to the right infra-pulmonary vein in 1, bilateral coronary artery (the left anterior descending artery and right coronary artery) to the pulmonary artery in 1. Results Complete fistula occlusion was achieved in 5 patients (83.3%); one failed to go through the tortuous fistula and gave up coil embolization. There were no operative or late deaths and complications. Follow-up evaluation by physical examination and echocardiography in 5 patients showed no evidence of recurrent or residual coronary artery fistula. Conclusion On the basis of our result, we believe that transcatheter coil embolization of coronary artery fistula is a safe, effective and convenient procedure without a thoracotomy and the use of cardio-pulmonary bypass in some cases.

Prospective,randomized and double-blind study on prevention of radial artery spasm / 中国介入心脏病学杂志

Objective To compare the effect of different dosage of verapamil and a cocktail therapy(verapamil 200 ?g plus nitroglycerin 200 ?g) in the prevention of radial artery spasm(RAS) during transradial PCI.Methods It is a prospective,randomized and double-blind clinical trial.Patients who received transradial coronary intervention were divided into three groups: group A(verapamil 200 ?g),group B(verapamil 1mg) and group C(verapamil 200 ?g plus nitroglycerin 200 ?g).Different drug protocols were given randomly to the patients after sheath insertion.The diagnostic criteria is clinical definition of RAS documented by angiography.The incidence of RAS and adverse effects in each group was compared.Results A total of 621 patients were enrolled,and there were 205 in group A,207 in group B and 210 in group C.The baseline characteristics were of no difference among the three groups.Univariate analysis showed that the incidence of RAS in group A is higher than that in group B(17.1% vs.10.2%,P=0.045) and in group C(17.1% vs.9.5%,P=0.029),but there was no statistical difference in the RAS incidence between group B and C(10.2% vs.9.5%,P=0.870).Binary logistic regression analysis showed that the relative risk of RAS in group B decreased by 32.1% compared with group A(P=0.038),and the relative risk in group C decreased by 43.8% compared with group A(P=0.017).The incidences of adverse effect were similar in groups A and C,but was higher in group B when compared with group A(9.7% vs.2.4%,P=0.003) and C(9.7% vs.3.8%,P=0.019),respectively.Conclusion Verapamil 200 ?g plus nitroglycerin 200 ?g is recommended to prevent RAS during transradial coronary intervention in Chinese.

Comparison of transradial and transfemoral appoaches in intervention of unprotected left main lesions / 中国介入心脏病学杂志

0.05).However,major vascular complications occurred only in the femoral group(3.9%).Conclusion Transradial LM PCI is as fast and successful as the femoral approach and results in fewer vascular complications.

The clinic characteristics of elderly patients with coronary ectasia / 中华老年医学杂志

Objective To investigate the clinic characteristics and treatment methods of coronary ectasia. Methods One hundred and fifty-four cases in Anzhen hospital during the last 10 years, whom with coronary aneurysm diagnosed by coronary artery angiogram and summarized the characteristics of symptom, sign, diagnosis and treatment. Results All patients were proved with coronary angiography. There were 112(72.7%)patients presenting angina, but with no specific manifestation in electrocardiogram, X-ray and echocardiogram.Thrombolysis in emergency were taken to 3 cases with acute myocardial infarction patients. One hundred and fifty-four cases were treated with aspirin or heparinizeation, and with nitroglycerin, Calcium channel blocker to dilate vessel. The followed up of 154 cases about 1-20 years, six cases were suffered with acute myocardial infarction. One of the 6 cases was reinfarction and one case was sudden death. Conclusions Angina is the main clinical manifestation and coronary angiography is the accurate diagnostic method. Long-term application with anticoagulant agent and vasodilator should be done to prevent coronary spasm and myocardial infarction. If acute myocardial infarction occurs, prompt thrombolysis should be used, if it is ineffective, coronary artery bypass grafting should be carried out.