Effectiveness and safety of fibrinolytic therapy combined with clopidogrel for patients with acute st segment elevation myocardial infarction / 中国实用内科杂志

Objective To observe the effectiveness and safety of clopidogrel combined with fibrinolytic therapy for acute ST segment elevation myocardial infarction(STEMI).Methods From January 2004 to December 2006,a total of 158 STEMI patients in our hospital were treated with fibrinolytic agents combined with or without clopidogrel.There were 84 patients in clopidogrel group,including 66(78.6%)male,18(21.4%)female and 45(53.6%)elderly patients(aged ≥ 60 years);74 patients were in control group,including 58(78.4%)male,16 female(21.6%)and 40(54.1%)elderly patients.Clinical characteristics,patency of infarct-related artery(IRA),30 d major adverse cardiac events(MACE),recurrent angina and hemorrhage events of the two groups were retrospectively analyzed.Efficacy and safety of fibrinolytic therapy combined with clopidogrel in elderly patients(≥60 years old)subgroup were also estimated.Results Baseline clinical characteristics between the two groups were comparable.Clopidogrel therapy was associated with a higher proportion of patent IRA(69.1% vs 51.4%,P=0.035)and lower rates of cardiac death(0 vs 6.8%,P=0.047)and MACE(2.4% vs 12.2%,P=0.036).There was no significant difference in the incidence of recurrent angina(3.6% vs 2.7%,P=0.885),slight and severe hemorrhage events(7.1% vs 9.5%,P=0.811;1.2% vs 1.4%,P=0.533)between the two groups.In elderly patients,clopidogrel therapy was associated with a higher proportion of patent IRA(68.9% vs 45.0%,P=0.045),the declining tendency in MACE(2.2% vs 12.5%,P=0.155),but no significant differences in the other indexes.There were no significant differences in above-mentioned indexes between the elderly and younger patients in clopidogrel group.Conclusion Addition of clopidogrel to fibrinolytic therapy is safe and effective for both the elderly and younger STEMI patients.

Long-term clinical effectiveness in old female patients with multi-vessel coronary artery disease treated with percutaneous coronary intervention / 解放军医学杂志

Objective To evaluate long-term clinical effectiveness in old female patients with multi-vessel coronary artery disease (≥65 years) treated with percutaneous coronary intervention (PCI). Methods 601 female patients with multi-vessel coronary artery disease underwent PCI were divided into the elder group (≥65 years, n=354) and the younger group (0.05). Conclusion PCI can be performed in old female patients with multi-vessel coronary artery disease with high success rate and few complications. Long-term clinical outcomes of PCI in old females with multi-vessel disease are similar to younger females.

Clinical investigation of drug-eluting stent in treatment of elderly female patients with multi-vessel coronary artery disease / 解放军医学杂志

Objective To retrospectively analyze the effectiveness and safety of drug-eluting stents (DES) on prevention of restenosis in old female patients (≥65 years) with multi-vessel coronary artery disease. Methods 387 old female patients with multi-vessel coronary artery disease underwent percutaneous coronary intervention (PCI) were divided into the DES group (n=139) and the metallic stent (BMS) group (n=248). Acute and long-term outcomes were compared between the two groups. Results The ratio of patients with diabetic disease was higher in DES group than that in BMS group (P0.05). The rates of restenosis shown by angiography and major adverse cardiac events (MACE) were significantly lower in the DES group compared with BMS group (4.2% vs 15.8%, 7.5% vs 17.3%, P