Safety of percutaneous coronary intervention in patients with acute coronary syndromes complicating chronic kidney disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the safety of percutaneous coronary intervention (PCI) in patients with acute coronary syndromes (ACS) complicating chronic kidney disease (CKD).</p><p><b>METHODS</b>We retrospectively evaluated the medical data of 335 patients hospitalized in our hospital with a diagnosis of ACS and CKD between 1 January 2011 and 30 May 2014. Patients were divided into two groups: PCI group who received PCI treatment during hospitalization (n = 135) and non-PCI group who did not receive PCI treatment (n = 200). Multivariable logistic regression analysis was performed to evaluate the connection between PCI and in-hospital death and acute renal insufficiency.</p><p><b>RESULTS</b>The median GFR level of 335 patients was 36.26 (25.09-47.65) ml · min⁻¹ · 1.73 m⁻². GFR level was similar between the two groups (P = 0.205). Multivariable logistic regression analysis showed that PCI did not increase the risk of in-hospital death (OR = 0.465, 95% CI: 0.190-1.136, P = 0.093) and in-hospital acute renal insufficiency (OR = 0.830, 95% CI: 0.375-1.836, P = 0.669). In patients of 45 ml · min⁻¹ · 1.73 m⁻² ≤ GFR < 60 ml · min⁻¹ · 1.73 m⁻², 30 ml · min⁻¹ · 1.73 m⁻² ≤ GFR < 45 ml · min⁻¹ · 1.73 m⁻² and GFR < 30 ml · min⁻¹ · 1.73 m⁻², the OR of in-hospital death in PCI group were 0.235 (95% CI: 0.024-2.301, P = 0.213), 0.640 (95% CI: 0.112-3.649, P = 0.616) and 0.919 (95% CI: 0.159-5.307, P = 0.925), and the OR of in-hospital acute renal insufficiency were 0.436 (95% CI: 0.120-1.587, P = 0.208), 2.209 (95% CI: 0.394-12.391, P = 0.368) and 0.724 (95% CI: 0.127-4.117, P = 0.716) indicating that PCI did not increase above events in ACS patients complicating CKD.</p><p><b>CONCLUSION</b>PCI does not increase the risk of in-hospital death and in-hospital acute renal insufficiency in ACS patients complicating CKD.</p>

Concentration of plasma vascular endothelial growth factor and related factors in patients with unstable angina pectoris / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe plasma vascular endothelial growth factor(VEGF) levels and related factors in patients with unstable angina pectoris(UAP).</p><p><b>METHODS</b>A total of 108 consecutive patients with chest pain hospitalized in our department from October to December 2014 were included. They were divided into UAP (n=78) and non-CHD group (n=30) by the result of coronary angiography(CAG). Coronary artery lesion was assessed according to the Gensini score, serum lipids, homocysteine(Hcy) levels and other biochemical indicators were also determined. The peripheral arterial tonometry was evaluated by reactive hyperemia index(RHI) measured by Endo-PAT2000 Noninvasive Diagnostic System.The level of plasma VEGF was detected in patients with unstable angina pectoris. Multiple linear regression analysis was used to analyze the correlations between VEGF and various related factors.</p><p><b>RESULTS</b>Percent of male gender, triglyceride (TG) and Hcy levels were significantly higher in UAP group than in no-CHD group(all P<0.05). VEGF values was significantly higher ((102.1 ± 55.7)ng/L vs.(80.9 ± 38.1)ng/L, P<0.05), while RHI was significantly lower (1.53 ± 0.27 vs.1.65 ± 0.32, P<0.05) in UAP group than in no-CHD group. Multiple linear regression analysis showed that VEGF value was significantly correlated with degree of coronary artery stenosis, Gensini score and RHI (β=38.03, P<0.01; β=0.51, P<0.01; β=-69.30, P=0.03; respectively).</p><p><b>CONCLUSION</b>VEGF levels are significantly increased in patients with unstable angina pectoris, and VEGF level is significantly associated with the degree of coronary artery stenosis, Gensini score and RHI. V EGF level might serve as a new biochemical indicator for coronary artery lesion in patients with UAP.</p>