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Article in Chinese | WPRIM | ID: wpr-702339


Objective To investigate the risk factors of short-term and long-term mortality in elderly patients with ST-segment elevation myocardial infarction(STEMI) after primary percutaneous coronary intervention(PPCI).Methods From Sept. 2011 to Jan. 2014, there were 27397 PCI cases performedin the Fuwai Hospital. 108 consecutive patients(0.39%) who aged over 75 diagnosed as acute myocardial infarction and underwent PCI were enrolled into this study. Cox proportional hazards model was used to analysis the risk factors of mortality during follow up.Results In the study population, 5 patients (4.63%) died during in-hospital stay, 7 patients(6.5%) died within 30 days after PPCI and 17 patients (15.7%)died during follow up[averaged follow up duration was (51.17±17.75) months] . Independent risk factors of 1-year mortality included female(HR 5.482, 95%CI1.099-27.333,P=0.038) and cardiac shock(HR 11.283, 95%CI 2.841-44.805,P=0.001). Stent implantation was found to be a protective factor(HR 0.173, 95%CI 0.032-0.943,P=0.043). Independent risk factors of long-term mortality included age(HR 1.146,95%CI 1.010-1.300,P=0.034)and cardiac shock(HR 4.928, 95% CI1.718-14.130, P=0.003).Conclusions Old age, female, low LVEF, cardic shock and not having stent implantation were independent risk factors for mortality in elderly STEMI patients(≥75 years) who underwent primary PCI.

Chinese Circulation Journal ; (12): 572-575, 2018.
Article in Chinese | WPRIM | ID: wpr-703898


Objectives:To observe the clinical and coronary artery computed tomography(CT) characteristics of patients with ankylosing spondylitis. Methods:Data from 33 consecutive patients with ankylosing spondylitis admitted due to chest discomfort in Fuwai Hospital from January 2014 to June 2017 were analyzed, 33 age and sex matched patients with no ankylosing spondylitis were selected as the control group. Coronary artery CT features was compared between the two groups. Results:Incidence of hypertension, smoking, diabetes and hyperlipidemia, BMI values were similar between the two groups. Blood lipid level (high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglyceride and, total cholesterol), creatinine and uric acid values were also similar between the two groups. Erythrocyte sedimentation rate (ESR) ([14.15±12.81]m/s vs [7.79±6.26]m/s, P=0.013) and high C-reactive protein (hs-CRP) ([6.88±5.65]ng/L vs [3.16±3.13]ng/L, P=0.002) values were significantly higher in ankylosing spondylitis group than in the control group. Percent of coronary artery stenosis (>50%) was significantly higher in ankylosing spondylitis group than in the control group (23[69.7%] vs 14[42.4%], P=0.026). Coronary artery calcification was significantly higher in ankylosing spondylitis group than in the control group (22 [66.7%] vs 9[27.3%], P=0.001). Conclusions:Degree of coronary artery stenosis and calcification as well as inflammatory index (ESR and hs-CRP) are significantly higher in ankylosing spondylitis patients compared to control patients.

Chinese Journal of Cardiology ; (12): 195-198, 2013.
Article in Chinese | WPRIM | ID: wpr-292002


<p><b>OBJECTIVE</b>To analyze the short-term prognosis and risk factors of ventricular septal rupture (VSR) following acute myocardial infarction (AMI).</p><p><b>METHODS</b>A total of 70 consecutive VSR patients following AMI hospitalized in our hospital from January 2002 to October 2010 were enrolled in this study. We compared the clinical characteristics of patients with VSR who survived ≤ 30 days (n = 39) and survived > 30 days (n = 31) post AMI. A short-term prognosis index of VSR (SPIV) was established based on the logistic regression analysis.</p><p><b>RESULTS</b>The single factor analysis showed that the risk factors of death within 30 days of VSR patients were female, anterior AMI, Killip class 3 or 4, apical VSR and non-aneurysm (all P < 0.05). Logistic regression analysis revealed that female (P = 0.013), anterior AMI (P = 0.023), non-aneurysm (P = 0.023), non-diabetes (P = 0.009), Killip class 3 or 4 (P = 0.022) and time from AMI to VSR less than 4 days (P = 0.027) were independent risk determinants for death within 30 days post VSR. Patients with SPIV ≥ 9 were associated with high risk [77.4% (24/31)] of dying within 30 days post AMI. SPIV ≤ 8 were associated with low risk as the 30 days mortality is 28.6% (8/28).</p><p><b>CONCLUSION</b>Female gender, anterior AMI, non-aneurysm, non-diabetes, Killip class 3 or 4 and time from AMI to VSR less than 4 days are independent risk factors of short-term mortality of VSR.</p>

Aged , Female , Humans , Male , Myocardial Infarction , Prognosis , Retrospective Studies , Risk Factors , Ventricular Septal Rupture
Chinese Journal of Cardiology ; (12): 613-617, 2008.
Article in Chinese | WPRIM | ID: wpr-355928


<p><b>OBJECTIVE</b>To investigate the clinical features of unexpected sudden death (SUD) clustered in families in Yunnan province.</p><p><b>METHODS</b>This retrospective study analyzed the clinical features of SUD occurred between July to September 2005 in 7 families in Yunnan province.</p><p><b>RESULTS</b>All 16 SUD patients shared common clinical features such as fatigue and repeated syncope and one group of SUD patients (n = 8 from 4 families) presented with the gastric intestinal tract manifestations including nausea, vomiting, abdominal pain and diarrhea with suspected dietary history and abnormal laboratory enzyme findings (GOT/GPT, CK/CKMB, LDH/LDH1 etc.). In SUD patients without gastric intestinal tract manifestations (n = 8 from 3 families), there were no clear symptoms before death and repeated ventricular tachycardia and ventricular fibrillation were recorded in one survivor. There was no clear evidence for the involvements of hereditary and infectious factors for observed SUD.</p><p><b>CONCLUSION</b>The reason for the unexpected sudden death clustered in 7 families in Yunnan remains unclear. Repeated syncope and fatigue served as the common clinical features in the presence or absence of gastric intestinal tract manifestations in all SUD cases. Further studies are needed to clarify the pathology and detailed clinical manifestations of SUD occurred in this area.</p>

Adolescent , Adult , Bias , Cause of Death , Child , China , Epidemiology , Death, Sudden , Epidemiology , Family , Female , Humans , Male , Middle Aged , Retrospective Studies , Young Adult
Chinese Journal of Cardiology ; (12): 1155-1158, 2007.
Article in Chinese | WPRIM | ID: wpr-299513


<p><b>OBJECTIVE</b>The purpose of this study was to analyze the electrocardiographic features of the people living in the area with high incidence of unexplained sudden deaths in Yunnan province.</p><p><b>METHOD</b>The electrocardiograms of 338 residents from three villages (Dayao, Ninglang, Heqing) with high incidence of unexplained sudden deaths and one control village (Dali) were analyzed [averaged age was (33.4 +/- 11.7) years, 175 men and 163 women].</p><p><b>RESULTS</b>The incidence of cardiac arrhythmias was similar low in all groups. The left ventricular hypertrophy was observed in 34.6% of residents from Dayao. QTc significantly prolonged in the residents from all 3 high incidence areas compare the control area of Dali [control (386.8 +/- 27.22) ms, Ninglang (428.92 +/- 25.71) ms, Heqing (440.67 +/- 28.03) ms, Dayao (417.7 +/- 24.00) ms, P < 0.05 vs. control]. Incidence of U wave was significantly higher in Heqing village than that in control village (P < 0.05). The QUc of these 3 villages was: (613.67 +/- 37.34) ms, (597.19 +/- 46.47) ms, (608.59 +/- 39.59) ms respectively, and also significantly longer than the control village of Dali (589.33 +/- 41.27) ms (P < 0.05). The typical pattern of U wave presents as enlarged U wave and apparent T-U complex. In the 7 residents who have the family history of unexplained sudden death, 6 residents have U wave, and 4 of them present typical U wave pattern.</p><p><b>CONCLUSION</b>The significant ECG changes in villages with high incidence of unexplained sudden death in Yunnan province were prolonged QTc, enlarged U wave and apparent T-U complex and these ECG features suggested the repolarization abnormalities of the heart in these subjects.</p>

Adolescent , Adult , China , Epidemiology , Death, Sudden , Epidemiology , Electrocardiography , Female , Humans , Long QT Syndrome , Male , Mass Screening , Middle Aged , Young Adult
Chinese Journal of Epidemiology ; (12): 96-101, 2006.
Article in Chinese | WPRIM | ID: wpr-295598


<p><b>OBJECTIVE</b>To identify the epidemiological and clinical features of unexpected sudden cardiac deaths (SUD) in Yunnan.</p><p><b>METHODS</b>Choosing the old SUD cases from Xiangyun, Heqing, Nanjian and Dayao counties and using the standardized verbal autopsy Form, we interviewed the family members of the cases, witnesses and doctors as well as reviewing their medical files to get relative information.</p><p><b>RESULTS</b>We identified 116 SUDs in 21 villages from 1984 to 2004. The village-specific annually standardized incidence rates were ranged from 0.2/1000 to 8.9/1000 (median = 0.8/1000). 66% and 29% of the SUDs occurred in July and August respectively. The incidence rates of SUD were higher (1.6/1000, chi(2) = 16, P < 0.01) in 10 - 39 year-olds, and higher in females than in males (RR = 1.6, 95% CI: 1.1 - 2.3). Seventy percent of SUD occurred in families having clustering nature and 60% of the additional cases in the family were occurred within 24 hours (median = 20 hours) after the first SUD identified in the family. SUD occurred in 23 families followed the first affected family in a village during the same season. In these 23 families, 61% of the first SUD occurred within 8 days after the first SUD in the first affected family. 68% and 66% of the SUDs did not have any complaints or signs during the last 3 weeks or from 3 weeks to 2 days prior to the onset of the disease. 63% of the SUDs had cardiac symptoms within the last 2 days prior to the onset with major symptoms as dizziness, nausea, faintness, unconsciousness, weakness and palpitation. The median duration from acute onset to death was 2 hours.</p><p><b>CONCLUSIONS</b>The extreme time-space clustering of SUD in families and in villages suggested that the risk factors occurred in specific time and location. Familial clustered SUD cases had common exposure pattern. Sudden onset of acute cardiac symptoms often followed by sudden death. Epidemiological study on new cases was necessary to identify risk factors and to develop hypothesis for causation. In July 2005, we instituted a special SUD surveillance system for all the affected counties together with 10 counties which had no reported cases.</p>

Adolescent , Adult , Age Factors , Child , China , Epidemiology , Death, Sudden, Cardiac , Epidemiology , Female , Humans , Incidence , Interviews as Topic , Male , Retrospective Studies , Risk Factors , Sex Factors , Space-Time Clustering , Young Adult