Influence of thrombus aspiration combined tirofiban on patients with acute STEMI after primary PCI / 心血管康复医学杂志

Objective:To study the influence of thrombus aspiration combined tirofiban on patients with acute ST seg-ment elevation myocardial infarction (STEMI)after primary percutaneous coronary intervention (PCI).Methods:A total of 98 patients,who received primary PCI because of STEMI in our hospital from Jan 2012 to Mar 2013,were selected.They were divided into thrombus aspiration group (n=48,received pure thrombus aspiration)and com-bined treatment group (n = 50,received thrombus aspiration combined intracoronary tirofiban injection during PCI).Coronary angiography (CAG)instantly after PCI and follow-up condition during hospitalization and six months after discharge were compared between two groups.Results:(1)Compared with thrombus aspiration group after PCI,there were significant rise in TIMI blood flow grade [(2.3±0.6)grades vs.(2.7±0.3)grades],per-centage of TIMI flow grade 3 (72.9% vs.90.0%)and ST segment regression >50% rate within 90min after PCI (52.1% vs.74.0%),P < 0.05 or < 0.01,and significant reduction in percentage of postoperative no-reflow (18.8% vs.4.0%,P =0.038)in combined treatment group in hospital;(2)After six-month follow-up,left ven-tricular ejection fraction (LVEF)of combined treatment group was significantly higher than that of thrombus aspi-ration group [(58±6.3)% vs.(51±5.6)%,P <0.05].Conclusion:Thrombus aspiration combined tirofiban can effectively reduce coronary thrombus burden and improve cardiac function in STEMI patients during primary PCI.

Role of NF-κB/survivin signal pathway on intima hyperplasia of rat carotid balloon injury restenosis model / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the role of NF-κB/survivin signal pathway in the intima hyperplasia of rat carotid balloon injury restenosis model.</p><p><b>METHODS</b>NF-κB siRNA lentivirus vector (titer was 1 × 10⁸ TU/ml) was established. Carotid balloon injury restenosis model was made in 33 SD rats. The rats were divided into 4 groups according to different processing methods, including negative control (NC) group (n = 11), NF-κB siRNA group (n =11), NF-κB siRNA+YM155 (survivin inhibitor) (n = 11), the uninjured carotid artery served as the normal control group (n = 11). After 7 days, the carotid sample (n = 5 each group) were harvested to detect the NF-κB and survivin mRNA expression by RT-PCR.The carotid sample were harvested on 28 days (n = 6 each group) for HE staining and measuring intima hyperplasia. Immunohistochemical method was also used to detect the expression of intima proliferation cell nuclear antigen (PCNA) and media α-SM-actin.</p><p><b>RESULTS</b>(1) After 7 days, NF-κB and survivin mRNA expression was significant higher in NC group than in normal control group (P<0.05), the NF-κB mRNA expression was significantly lower in NF-κB siRNA group than in NC group (P<0.05) and similar between NF-κB siRNA group and NF-κB siRNA+YM155 group. The survivin mRNA expression was significantly lower in NF-κB siRNA group compared to NC group (P<0.05) and significantly higher in NF-κB siRNA group than in NF-κB siRNA+YM155 group (P<0.05). (2) After 28 days, intima hyperplasia was observed in NC (0.13 ± 0.01), NF-κB siRNA (0.11 ± 0.01) and NF-κB siRNA+YM155 group (0.09 ± 0.01) mm² (P<0.05). Media area was similar among NC group, NF-κB siRNA group and NF-κB siRNA+YM155 group (P>0.05). I/M ratio was gradually reduced among NC group (1.55 ± 0.07), NF-κB siRNA group (0.92 ± 0.08), NF-κB siRNA+YM155 group (0.76 ± 0.06, all P<0.05). Similar results were found in the residual restenosis rate: NC group (58.71 ± 0.02) %, NF-κB siRNA group (32.13 ± 0.05) %, NF-κB siRNA+YM155 group (26.42 ± 0.03) % (all P<0.05) and expression of vascular smooth muscle cell PCNA: NC group (45.32 ± 7.21) %, NF-κB siRNA group (36.54 ± 6.42) %, NF-κB siRNA+YM155 group (28.57 ± 6.31) % (all P<0.05). On the contrary, the IOD of α-SM-actin in media increased gradually: NC group (0.055 ± 0.006), NF-κB siRNA group (0.072 ± 0.011), NF-κB siRNA+YM155 group (0.084 ± 0.008, all P<0.05).</p><p><b>CONCLUSION</b>Inhibiting NF-κB expression can significant decrease intima hyperplasia in this model, and this effect may be mediated by inhibiting survivin and reducing the proliferation of vascular smooth muscle cells.</p>

The prognostic value of serum cardiac troponin Ⅰ in unstable angina pectoris / 心血管康复医学杂志

Objective: To evaluate the prognostic value of serum troponin Ⅰ (cTnI) in unstable angina pectoris (UA). Methods: Serum cTnI, creatine kinase isoenzyme MB (CK－MB) were simultaneously measured in 25 healthy subjects, 96 UA patients, routine treatment was administered and cardiac events were observed closely within two weeks. Results: Thirteen of 28 UA patients whose cTnI was≥0.3μg/L developed cardiac events, only 3 of 68 UA patients whose cTnI was ＜0. 3 μg/L developed cardiac events within two weeks, there was a significant difference (P＜0. 05). Conclusion: There is a clinical value of serum cTnI measurement in identifying the high risk patients of UA. The patients whose cTnI was≥0. 3μg/L indicate a poor prognosis.