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Objective To explore the strategies of perioperative antithrombotic therapy in the patient undergoing revision total hip arthroplasty after coronary stent implantation. Methods The antithrombotic therapy in one patient undergoing revision total hip arthroplasty after coronary stent implantation was analyzed with the review of related literatures. Results The patient developed non-ST segment elevated myocardial infarction due to the stop of aspirin three days before operation and no low molecular weight heparin was used. The antithrombotic treatment and prevention of venous thromboembolism were analyzed. Conclusion Antithrombotic therapy should be selected reasonably in patients undergoing revision total hip arthroplasty after coronary stent implantation.
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OBJECTIVE To syste matically evaluate the prevention effects of nicorandil on contrast-induced nephropathy in patients underwent coronary angiography （CAG）or stent implantation （CSI），and to provide evidence-based reference for clinical drug use. METHODS Retrieved from PubMed ，Embase，Cochrane library ，Wanfang database ，CBM and CNKI ，randomized controlled trial （RCT）about nicorandil （trial group ）versus normal saline or placebo （control group ）prevented contrast-induced nephropathy in patients underwent CAG or CSI were collected during the inception to Nov. 2021. After extracting literature that met the inclusion criteria ，the bias risk assessment tool of RCT in Cochrane manual was used for quality evaluation ，and meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 17 RCTs were included ，involving 3 279 patients. Among them，there were 1 587 patients in trial group ，and 1 692 patients in control group. Results of meta-analysis showed that the incidence of contrast-induced nephropathy in trial group was significantly lo wer than control group [RR ＝0.40，95％CI（0.31，0.51）， P＜0.000 1] . Results of subgroup analysis showed that the incidence of contrast-induced nephropathy in trial group was significantly lower than control group ，whether intravenous administration [RR ＝0.47，95％CI（0.29，0.74），P＝0.001] or oral administration [RR ＝0.37，95％CI（0.28，0.50），P＜0.000 01]，whether patients with normal renal function [RR ＝0.42，95％CI（0.30， 0.59），P＜0.000 01] or with renal insufficiency [RR ＝0.38， 95％ CI（0.26，0.54），P＜0.000 01]. Scr of 24 h[SMD＝ －1.38，95％CI（－2.32，－0.44），P＝0.004]，48 h[SMD＝ －0.81，95％CI（－1.19，－0.43），P＜0.000 1] and 72 h[SMD＝ －0.24，95％CI（－0.43，－0.05），P＝0.01] after surgery in trialgroup were significantly lower than control group ；the 163.com decrease of creatinine clearance rate of 48 h[SMD＝1.27， 95％CI（0.48，2.07），P＝0.001] and 72 h[SMD＝0.37，95％CI（0.07，0.67），P＝0.02] after surgery in trial group were significantly lower than control group ；cystatin C of 24 h[SMD＝－0.93，95％CI（－1.72，－0.14），P＝0.02]，48 h[SMD＝－1.72，95％CI （－2.33，－1.10），P＜0.000 01] and 72 h[SMD＝－0.36，95％CI（－0.62，－0.10），P＝0.006] after surgery in trial group were significantly lower than control group. CONCLUSIONS Pretreatment of nicorandil can reduce the incidence of contrast-induced nephropathy in patients underwent CAG or CSI ，and reduce the damage of renal function after application of contrast.
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Objective To investigate the effect of aspirin and ticagrelor or clopidogrel anticoagulant therapy on platelet aggregation,endothelial function and levels of inflammatory mediators in patients with acute coro-nary syndrome(ACS)after coronary stent implantation(PCI).Methods 100 cases of patients with ACS who underwent coronary stent implantation in our hospital from April 2014 to May 2016 were enrolled in the stud-y.The patients were randomly divided into the observation group and the control group by random number ta-ble method,50 cases in each group.The observation group were treated with aspirin and ticagrelor anticoagu-lant therapy after operation,while the control group were treated with aspirin and clopidogrel anticoagulant therapy.All patients were followed up for 1 year.The platelet aggregation rate within 1 year of medication, levels of serum endothelin-1(ET-1),nitric oxide(NO),plasminogen activator inhibitor-1(PAI-1),high-sen-sitivity C reactive protein(hs-CRP),interleukin-6(IL-6)and soluble CD40 ligand(sCD40L)were compared between the two groups.The outcome events and adverse reactions were recorded.Results 1 month,6 months and 1 year after treatment,the platelet aggregation rates in the observation group were lower than those in the control group(P<0.05).After treatment,levels of serum ET-1,PAI-1,hs-CRP,IL-6 and sCD40L were sig-nificantly lower in the observation group than the control group(P<0.05),while NO level was higher than the control group(P<0.05).The incidence rates of outcome events and adverse reactions in the observation group were slightly lower than those in the control group(6.00% and 8.00% vs.10.00% and 10.00%,P>0.05).Conclusion The effect of aspirin combined with ticagrelor anticoagulant therapy is better than that of aspirin combined with clopidogrel anticoagulant therapy in patients with ACS after PCI.The former can signif-icantly improve platelet aggregation,endothelial function and levels of inflammatory mediators,and it is safe and reliable.
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Objective:To research the application value of coronary CT angiography(CTA) detection for epicardial adipose tissue(EAT) and pericardial adipose tissue(PAT) in the diagnosis of coronary stent restenosis.Method:Selected 68 cases coronary atherosclerotic stenosis patients who were treated by coronary stent from June 2012 to June 2013 in hospital. All patients were detected after the operation of CTA within 3 years and they were divided into two groups (coronary stent restenosis positive group included 29 cases, negative group included 39 cases). To analyze the relationship between EAT and PAT through the statistical method and analyze the application value of EAT and PAT in the diagnosis of coronary stent restenosis based on calcification score image measurement of EAT and PAT volume.Results: Correlation analysis results showed there was correlation between EAT volume and PAT volume (r=0.859,P<0.05); through compared CAG and the diagnostic results of coronary artery stent restenosis by EAT and PAT, the sensitivity was 82.87%, specificity was 84.62%, CCTA positive predictive value was 80.00%, negative predictive value was 86.84% and diagnostic accuracy was 83.82% of the stent patency which was evaluated by CAG. The consistency evaluation marker Kappa was 0.554. The analysis of patients with coronary stent restenosis showed that there was significant correlation between Gensini score of coronary stent restenosis and EAT and PAT(P<0.05).Conclusion:There was significant correlation between EAT volume and PAT volume, and they can be used to evaluate the sensitivity and specificity of coronary stent operation restenosis and the results were higher. Besides, its clinical diagnostic value was similar with CAG.
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Objective To investigate the myocardial protective effects of rosuvastatin in patients with unstable angina pectoris undergoing coronary stent implantation.Methods Patients (90 cases) with unstable angina pectoris undergoing coronary stent implantation in No.215 Hospital of Shanxi Nuclear Industry from January 2014 to May 2016 were divided into observation group and control group,45 cases in each group.Patients in the observation group were treated with rosuvastatin,and patients in the control group were treated with atorvastatin.The levels of CK-MB,cTnⅠ,h-FABP,hs-CRP,TNF-α,INF-γ,IL-6,IL-10,and IL-18 were compared between two groups.Adverse drug reaction and major adverse cardiac events of two groups were recorded.Results After 24 h operation,the levels of CK-MB,cTnⅠ,hs-CRP,TNF-α,INF-γ,IL-10,and IL-18 of two group were significantly higher than those before operation (P ＜ 0.05),and those in observation group were significantly lower than control group (P ＜ 0.05).There was no difference in h-FABP between two groups before and after operation (P ＜ 0.05).The level of IL-6 in the observation group after operation was higher than that before operation,but the difference was not significant (P ＜ 0.05);The level of IL-6 in the control group was significantly higher than that before operation and that of observation group (P ＜0.05);The rates of drug adverse reactions and major adverse cardiac events were similar in two groups.Conclusion Compared with same doseatorvastatin,the effects of rosuvastatin in muscle damage and inflammatory response are better,and do not increase adverse reactions.
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Objective To analyze whether routine prophyrlactic antibiotic administration is necessary for the patients undergoing coronary stent implantation. Methods The clinical data of 156 patients from January 2010 to December 2010 (prophylactic antibiotic therapy),and 466 patients from January 2014 to December 2014(no-prophylactic antibiotic therapy), who underwent coronary stent implantation, were retrospectively analyzed. The prophylactic antibiotics and the infection rates in two groups were compared. Results The rate of infections related to coronary stent implantation in no-prophylactic antibiotic therapy group and prophylactic antibiotic therapy group, such as surgical site infection (0.2% vs 1.3%,P>0.05) and catheter-related infection(0.6% vs 1.9%,P>0.05), was not significant different(P>0.05). Similarly, the unrelated to coronary stent implantation was not significant different, too ( P > 0. 05). Conclusion Routine prophylactic antibiotic administration is unnecessary for the patients undergoing coronary stent implantation.
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Objective To investigate the patients with coronary heart disease percutaneous coronary stent implantation after 1 year follow-up of curative effect and analysis of its risk factors.Methods 392 cases of patients treated with coronary heart disease percutaneous coronary stent implantation was in vestigated for a period of 1 years of follow-up and analyzed the prognosis of patients and related risk factors.Results In this group of patients in cardiovascular events in 121 cases,71 cases of ACS group,50 cases in group SAP; age,coronary heart disease,diabetes health education,medication compliance and hs-CRP were the cardiovascular event risk factors in patients with ACS;age,medication compliance,health education,hs-CRP were risk factor for cardiovascular events for SAP coronary heart disease patients;health education,compliance and hs-CRP in patients with coronary artery disease 1 years after PCI were independent prognostic risk factors for.Conclusion Patients with coronary heart disease shoned strengthen the health education and improve the compliance of patients,and hs-CRP levels should be controlled to improve the prognosis of patients.
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Objective To analyze the advantages and disadvantages of two surgical methods for treatment of lung cancer complicated with coronary heart diseases (CHD), so as to provide evidence for clinical practice. Methods Nine patients with lung cancer complicated with CHD received radical resection of lung cancer shortly after percutaneous coronary intervention (PCI) with stent implantation from Dec. 2010 to Dec. 2011 in the General Hospital of PLA. During the same period eight patients with lung cancer and severe coronary artery stenosis underwent off-pump coronary artery bypass grafting (OPCABG) and radical operation for lung cancer in the Third Hospital of Peking University. The clinical data of the two groups (PCI group and OPCABG group) were analyzed and compared. Results There were no perioperative myocardial infarction, pulmonary infection, incision infection, reoperation due to bleeding, or perioperative death in both groups. Compared with the PCI group, OPCABG group had significantly longer overall operation time ([428 ± 22] min vs [149 ± 32] min), more blood loss ([367 ± 19] ml vs [171 ± 19] ml), and more chest drainage in the first postoperative 24 hours ([527 ± 17] ml vs [250 ± 14] ml, P< 0. 01). The operation time for lobectomy ([158 ± 27] min vs [149 ± 32] min) and postoperative hospital stay ([10 ± 0. 5] d vs [11 ± 0. 5] d) were not statistically different between the two groups. Conclusion Coronary intervention and coronary artery bypass grafting have their own advantages in treating lung cancer complicated with severe ischemic heart disease. Appropriate revascularization techniques should be chosen according to indications before radical operation for lung cancer, while considering the patients' physical condition and specific site of coronary lesions.
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Objective:To observe the effect of Shuxuetong Injection on unstable angina pectoris in diabetic pa- tients after coronary stent implantation.Method:40 diabetic patients after coronary stent implantation were randomly divid- ed into two groups.The patients in the two groups were treated with basic drugs.17 patients in the controlled group were venously treated with Danshen injection 6 milliliters dissolved in 250 milliliters 0.9% sodium chloride injection once daily. 23 patients in the treatment group were venously treated with Shuxuetong injection 6 milliliters dissolved in 250 milliliters 0.9% sodium chloride injection once a day.The treatment course was fifteen days in both groups.The clinical effect and the frequency of angina attack were observed in both groups.The concentrations of plasma fibrinogen(FBG)and serum C- reactive protein(CRP)were measured before and after the treatment.Result:Compared with those of the controlled group, the frequency of angina attack and the indication of myocardial ischema in electrocardiogram greatly improved(P
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Objective To investigate the clinical value of the intra-cronary interventional techniquein the treatment of coronary heart disease. Methods The 110 patients with coronary heart disease weretreated with 63 balloon angioplasties and 47 coronary-stent implantations. Results The ballloon angioplasty was made in 94 coronary lesion arteries with success of 88 vessels. In the following up periods of2-72 months, the angina pectoris and acute myocardial infarction were occurred respectively in 11 and2 cases (24.07 % ). The 63 stems were implanted into 59 coronary lesion arteries with success of 58 vessels. All patients were followed up for 2~12 months and the angina pectoris were occurred in 6 cases(13.3 % ). Conclusion The intracoronary intervetional technique was an effective method for treatmentof the coronary heart disease.