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Objective To assess the influence of metabolic syndrome(MS)on the success rate of catheter ablation for the treatment of atrial fibrillation (AF)in the elderly. Methods A retrospective study included a total of 221 aged patients with AF who underwent AF ablation for the first time. The patients were divided into two groups :an MS group(n＝72)and a control group(without MS)(n＝149) . The MS group had a mean age of (67.1 ± 5.2) years ;the control group had a mean age of (68.3 ± 5.7) years. Forty-six patients in the MS group and 105 patients in the control group experienced paroxysmal atrial fibrillation. Prognoses in two groups were compared at the end of the follow-up. Results At the end of the follow-up ,the success rates of the procedure in the MS group and the control group were 37.5%(n ＝ 27)and 51.7%(n ＝ 77) ,respectively (χ2＝ 3.917 ,P ＝ 0.049) .Recurrence happened in 19 patients of the MS group and 28 patients of the control group ,and they underwent a repeat ablation. The overall success rates after the last ablation in the two groups were 51.4%(n＝37)and 65.8%(n＝98) ,respectively (χ2＝4.224 ,P＝0.034).In the multivariable model adjusted for risk factors ,MS(HR＝1.42 ,95% CI :1.11-1.64 ,P＝0.033)and left atrial diameter(HR＝ 1.83 ,95% CI :1.27-3.19 , P ＝ 0.017 ) were independent predictors for recurrence. Conclusions MS can affect the success rate of catheter ablation for AF in elderly patients and the effect remains even after the procedures are repeated
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Objective To evaluate the efficacy and safety of intracoronary thrombolysis during primary percutaneous coronary intervention(PCI)in elderly patients with acute ST segment elevation myocardial infarction(STEMI).Methods This prospective study was conducted at the Department of Cardiology of Shangqiu First People's Hospital.Elderly patients diagnosed with STEMI and undergoing primary PCI were consecutively recruited from September 2016 to September 2017.Of all recruited patients,106 patients were successfully followed up and were randomly divided into a treatment group(intracoronary thrombolysis group,n=54)and a control group (intracoronary saline group,n=52).Patients in the treatment group received an injection of 10 mg recombinant prourokinase (10 ml)via a balloon catheter while patients in the control group were injected with 10 mL saline instead.The incidences of slow flow,bleeding in 3 days after operation,left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter(LVEDD),and major adverse cardiovascular events (MACE) in 90 days after operation were compared between the two groups.Results Compared with the control group,the treatment group had a decreased incidence of slow flow (x2 =4.06,P＜ 0.05).The incidence of bleeding in 3 days after operation showed no difference between the two groups(x2 =0.71,P＞0.05).The treatment group also had an elevated incidence of LVEF(t=-2.95,P ＜0.05)and a decreased incidence of LVEDD in 90 days after operation(t=2.86,P＜0.05),compared with the control group.No significant difference in the incidence of MACE in 90 days after operation was observed between the two groups(x2 =1.46,P＞0.05).Conclusions In elderly patients with STEMI,intracoronary thrombolysis during primary PCI can reduce the incidence of slow flow during operation,and improve the function and size of left ventricle without increasing the incidence of bleeding.
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Objective To investigate effects of early administration of high-dose rosuvastatin(40 mg) on coronary microvascular function and short-term outcome in patients treated with primary percutaneous coronary intervention (PCI) for acute myocardial infarction(AMI). Methods Ninety-four consequent AMI patients treated with primary PCI were divided into rosuvastatin group (50 patients) and control group (44 group). The infarct-related artery flow of epicardium was classified in compliance with the TIMI criteria. Myocardial and microvascular perfusion was assessed using the TMPG. The incidence of the MACE and the cytotoxicity and hepatotoxicity of rosuvastatin was respectively recorded in 30 d follow-up period. Results Either patients in the rosuvastatin group or in the control group showed better TMPG immediately after PCI (P<0.05), compared with that before treatment. However, the post-PCI TMPG of the rosuvastatin group was obviously much better than that of control group (P<0.05). Compared with that in control group, the 30-day composite MACE rate was lower in rosuvastatin group and in the TMPG 3 patients of rosuvastatin group:12.0%(6/50) vs. 34.1%(15/44), P<0.05;11.1%(3/27) vs. 42.9%(6/14). There was no cytotoxicity and hepatotoxicity in two groups. Conclusions Early administration of high-dose rosuvastatin (40 mg) can improve coronary microvascular function and short-term outcome in patients treated with primary PCI for AMI, and it is efficient and safety.
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Objective To evaluate effects of irbesartan and low dose amiodarone in patinets with paroxysmal atrial fibrillation who had normal heart function,and long-term therapeutic effect of maintain sinus rhythm.Methods A total of 142 patinets with paroxysmal atrial fibrillation were divided into two groups randomly:amiodarone group(n = 72),irbesartan and amiodarone group(n = 72),term of follow-up was 18 months.First class end point was atrial fibrillation recrudescence.The post-treatment rate of maintain sinus rhythm,and inner diameter of left au- ricle at pretherapy and post-treatment for 6,12,18 months with amiodarone group and irbesartan and amiodarone group were compared.Results After treatment for 12 months,inner diameter of left auricle in amiodarone group ex- ceeded irbesartan and amiodarone group(P
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Objective To study effects of early intensive atorvastatin treatment in patients with acute coro- nary syndrome.Methods A total of 196 patients with acute coronary syndrome were divided into two groups ran- domly:one group had 101 patients and were given low dose atorvastatin(10mg/d)for 30 days and the other group had 95 patients and took large dose atorvastatin(80mg/d)for 30 days.The serum levels of serum lipid,MMp-1, MMP-9 and high sensitivity-C reactive protein(hs-CRP)were detected before and after therapy.Some clinical data such as symptoms and treadmill exercise test were compared before taking medicine and every week later in the total of 30 days.Results 30 days later,the levels of MMP-1,MMP-9,hs-CRP decreased significantly and had statistical difference between two groups(P