Clinical effect of Maixuekang Capsule (脉血康胶囊) on long-term prognosis in patients with acute coronary syndrome after percutaneous coronary intervention / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the changes of adenosine diphosphate (ADP)-induced platelet aggregation rate, and evaluate the effects of Maixuekang Capsule (, MKC) on platelet aggregation rate and long-term prognosis of patients with acute coronary syndrome after percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>A total of 236 patients with acute coronary syndrome, who received successful PCI, were randomly assigned to a trial group (116 cases) and a control group (120 cases) according to random numbers; treatment allocation occurred when the participants met the inclusion criteria and signed the informed consent forms. In the trial group, the patients were treated with MKC combined with routine medication, and in the control group the patients were treated with routine medication. The therapeutic course for the two groups was 12 months and the follow-up was 12 months. The levels of ADP-induced platelet aggregation rate and serum high-sensitive C-reactive protein (hs-CRP) were determined before PCI, 12 h and 30 days after PCI. In the meantime, the incidence of cardio-/cerebrovascular events was recorded during the 12-month follow-up.</p><p><b>RESULTS</b>Compared with before PCI, the levels of ADP-induced platelet aggregation rate and serum hs-CRP were significantly higher at 12 h after PCI (P<0.05). They were significantly reduced after 30-day-treatment of MKC, showing statistical differences when compared with those in the control group (P<0.05). During the 12-month follow-up, the incidence of cardio-/cerebrovascular events was significantly lower in the trial group than in the control group (6.9% vs. 12.5%, P<0.01).</p><p><b>CONCLUSIONS</b>ADP-induced platelet aggregation function was significantly elevated after PCI. MKC improved the prognosis of patients with acute coronary syndrome, possibly through inhibiting the platelet aggregation, fighting against inflammation, and protecting the vascular endothelial function.</p>

Using the combination of traditional risk factors and quantitative coronary angiography (QCA )in predicting the risk of individuals with subclinical artherosclerosis / 中华流行病学杂志

Objective To determine whether the combination of traditional risk factors and quantitative coronary angiography (QCA) assessment could provide accurate prognostic information on a population-based study including 1137 adults with subclinical artherosclerosis and with coronary risk factors. Methods Participants underwent coronary angiography examination before the minimal stenotic diameters, segment diameters, percent stenosis, plaque areas. Other parameters were analyzed by the computer-assisted Coronary Angiography Analysis System. The Framingham Risk Score for each participant was assessed. During the 1 year follow-up period, all kinds of endpoint cardiovascular events were screened. Endpoint events were defined as death from coronary heart disease, nonfatal myocardial infarction (MI) or unstable angina pectoris. Results During the 1 year of follow-up period, a total of 124 participants developed an endpoint event, which was significantly associated with the Framingham Risk Score, calcium of plaques and the plaque areas (all Ps＜0.05).The QCA score incorporated with the QCA parameters was related to the endpoint events. The Framingham Risk Score was combined with QCA score through logistic regression for prediction of end-point events. Data from the ROC analysis showed the accuracy of this prediction algorithm was superior to the accuracy when variables themselves were used. The event-free survival rate was inferior to the control group in participates under high risk, when being screened with this prediction algorithm (P＜0.05). Conclusion The risk of cardiovascular attack in subclinical artherosclerosis individual seemed to be associated with the Framingham Risk Score, calcium of plaques and the plaque areas. When the traditional risk factors (the Framingham Risk Score) were combined with QCA, the new method could provide more prognostic information on those adults with subclinical artherosclerosis.

Use of iodixanol in coronary intervention for patients with diabetic renal insufficiency / 中华全科医师杂志

Objective To evaluate the safety of coronary intervention using iodixanol in patients with diabetic renal insufficiency.Methods Clinical data of 97 patients with diabetic renal insufficiency undergoing coronary intervention during June 2004 to June 2006 were retrospectively analyzed,50 of them with iodixanol,an iso-osmolar contrast medium (iodixanol group),and 47 with iopromide,a hypotanic contrast medium (iopromide group).Judkin's coronary angiography showed 167 diseased vessels in the patients,65 in anterior descending branches,44 in circumflex branches,and 58 in right coronary arteries. Levels of serum creatinine and blood urea nitrogen were determined before percutaneous coronary intervention (PCI),on the day of the procedure,the 3rd and 7th days after PCI,respectively,as well as radiocontrast media-induced nephropathy (CIN) was observed.Results Totally,192 drug-eluting stents were successfully implanted in 167 diseased vessels,and all patients' angina pectoris symptom disappeared soon after the procedure,with a full success.No acute or subacute stent thrombosis and major adverse cardiac events (MACE) occurred.Two patients (4%) in iodixanol group and 10 (21%) in iopromide group got CIN,with a statistical significance (P