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OBJECTIVE:To explore the effect of dabigatran etexilate on coagulation indexes and safety of elderly patients with persistent atrial fibrillation. METHODS:52 elderly patients with persistent atrial fibrillation were randomly divided into obser-vation group and control group by random number table,26 cases in each group. Creatinine clearance rate in observation group was higher than 30 ml/min,110 mg Dabigatran etexilate capsule was orally given,bid;when 15-30 ml/min,55 mg capsule was orally given,bid. Control group orally received Warfarin sodium tablet with initial dose of 2.5 mg,qd,according to international normal-ized ratio (INR) after 3-5 days till maintained in 2.0-3.0. After 3 months,coagulation indexes [prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),INR,platelet count (PLT),fibrinogen (FIB)] before and after treat-ment,incidences of clinical events (cerebral embolism,cerebral hemorrhage,fatal bleeding,the remaining parts of embolism, death)and adverse reactions in 2 groups were compared. RESULTS:There was no significant difference in PT,APTT,TT,PLT and FIB between 2 groups before treatment(P>0.05);after treatment,PT and INR in 2 groups significantly increased,and obser-vation group was obviously better than control group,the difference was statistically significant(P0.05);the incidence of remaining parts of embolism,death in observation group significantly lower than control group,the difference was statistically significant(P<0.05). The incidence of adverse reactions in observation group was significant-ly lower than control group,the difference was statistically significant (P<0.05). CONCLUSIONS:Dabigatran etexilate shows good coagulation effect on elderly patients with persistent atrial fibrillation,which can effectively improve PT and INR levels and reduce the incidences of clinical events,with good safety.
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Objective: To explore the possible mechanism of statins improving endothelial function via observing the effect of a high single dose atorvastatin on endothelial dysfunction and peripheral blood leucocyte Rho kinase activity in patients with unstable angina (UA). Methods: A total of 78 consecutive UA patients admitted in our hospital from 2012-08 to 2014-02 were enrolled. The patients received a single dose of atorvastatin 80 mg on the day of admission. Flow-mediated vasodilation (FMD) of brachial artery was examined by high-resolution ultrasound at before and 12 hours after medication. Protein expression of phospho-speciifc Thr853-MYPT1 (p-MYPT1Thr853) and MYPT1 was measured by Western blot analysis; peripheral blood leukocyte Rho kinase activity was assayed by the proportion of phospho-Thr853 in myosin binding subunit of light chain phosphatase (MYPT1). Results: Compared to prior medication, with atorvastatin 80 mg for 12 hours, FMD was increased 28.15% as (6.50 ±1.68) % vs (8.33 ± 1.93) %,P<0.001 and peripheral blood leucocyte Rho kinase activity was decreased 32.78% as (58.91 ± 5.22) % vs (39.6 ± 3.85 ) %,P=0.002. Conclusion: High dose atorvastatin could rapidly improve vascular endothelial dysfunction in UA patients. inhibiting of RhoA/Rho kinase pathway may involve in the effect of statins improving endothelial function.
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Objective To discuss the relationship between part of risk factors and the characters of coronary artery lesion of different gender patients with coronary heart disease(CHD). Methods Two hundred and eight patients who were diagnosed CHD by coronary angiography (CAG) were selected. All patients were divided into male group (122 cases) and female group (86 cases). The characters of CHD and part of clinical data in different gender CHD patients were compared and analyzed. The independent risk factors of different gender CHD patients were analyzed. Results The age of onset in female group was later than male group:(69.22±10.12) years vs.(62.80±11.34) years, P=0.000. The incidence rate of hypertension and diabetes in female group were significantly higher than those in male group: 83.7%(72/86) vs. 63.1%(77/122), 53.5%(46/86) vs. 32.8%(40/122);and the levels of total cholesterol(TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) in female group were significantly higher than those in male group:(5.16±1.26) mmol/L vs. (4.60±1.23) mmol/L,(1.16±0.27) mmol/L vs. (1.05±0.27) mmol/L, (3.17±1.16) mmol/L vs. (2.74±1.06) mmol/L;the level of uric acid (UA) in female group was significantly lower than that in male group: (319.83±90.05)μmol/L vs. (357.91±98.51)μmol/L, there were significantly differences(P<0.01). The level of trigalloyl glycerol (TG) in two groups had no significant difference: (1.91 ± 1.23) mmol/L vs. (1.75±0.97) mmol/L, P=0.298. Logistic regression analysis showed that age and diabetes were the risk factors of CHD in different gender (P<0.01 or <0.05). Conclusions There are different risk factors between different gender CHD patients, while the coronary artery lesion is similar. Diabetes is the most important independent risk factor of different gender CHD patients, which is more important for female patients with more risk factors.