Primary percutaneous coronary intervention in patients with acute myocardial infarction induced by left main artery occlusion or severe stenosis / 中华心血管病杂志

<p><b>OBJECTIVE</b>The effects of primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) induced by left main (LM) artery occlusion were analyzed retrospectively in this study.</p><p><b>METHODS</b>A total of 1343 consecutive AMI patients who underwent primary PCI between January 1995 and December 2004 were retrospectively studied.</p><p><b>RESULTS</b>LM occlusion or severe stenosis were found in 11 patients [all male, mean age (56.4 +/- 9.2) years (range 43-70 years)], cardiogenic shock was overt in 6 patients. Primary PCI were performed under the assistance of intra-aortic balloon pump (IABP) in these patients [8 stent implantation, 3 balloon dilation and 2 necessitating emergency CABG after balloon dilation]. In-hospital mortality was 45.5% (5/11). Three-month follow-up were made in all survivals (6/11). Analysis showed good collateral circulation flow from right coronary artery to left coronary artery was existed in all survival cases before PCI.</p><p><b>CONCLUSION</b>Prognosis of AMI patients with LM artery obstruction or severe stenosis was poor. Patients with pre-existed collateral circulation before primary PCI and IABP had a better clinical outcomes.</p>

The safety and efficacy of Cypher drug-eluting stent: results from a six months follow-up study in patients with ST-segment elevation myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the feasibility, safety and efficacy of Cypher drug-eluting stent implanted after the emergency percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).</p><p><b>METHODS</b>From Nov. 2002 to Dec. 2004, 186 patients with STEMI treated by emergency PCI were included into this study. The incidence of major adverse cardiovascular event (MACE), stent thrombosis and restenosis were evaluated during 6 months follow-up after PCI.</p><p><b>RESULTS</b>One hundred and sixty-eight patients were successfully treated by emergency PCI and there were no complication during the procedure. The rates of successful treatment were 100%. One hundred and seventy-five Cypher drug-eluting stents were successfully implanted into 171 target lesions. There was one case with acute stent thrombosis among 186 patients, and the MACE and mortality were 2.4% and 1.8%, respectively, during the first one month follow up. Six months later, the MACE was 4.2% and the mortality was 2.4%. The in-stent thrombosis and restenosis rates were 1.2% and 1.8%, respectively, when evaluated by angiography and clinic follow up at six months after PCI.</p><p><b>CONCLUSION</b>Implanting a Cypher drug-eluting stent in STEMI patients during emergency PCI is as safe and effective as a conventional bare stent. Cypher drug-eluting stent can reduce restenosis rate and MACE in STEMI patients treated with emergency PCI.</p>

Apolipoprotein E gene polymorphisms and risk for coronary artery disease in Chinese Xinjiang Uygur and Han population / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To examine the relationship between apolipoprotein E (Apo E) gene polymorphism and risk of coronary artery disease (CAD), analyzing association of polymorphism with classical risk factors.</p><p><b>METHODS</b>A total of 124 patients (including 84 Han population and 40 Uygur population) with angiographically verified CAD or myocardial infarction were prospectively evaluated. Data referring to hypertension, diabetes, and tobacco consumption were recorded. The levels of total cholesterol (TC), high density lipoprotein (HDL) cholesterol, Apo A1 and B, and triglycerides (TG) were determined. DNA was obtained from 124 patients and 70 controls. In order to determine Apo E genotypes, DNA was PCR amplified and digested with HhaI. The genetic polymorphism of Apo E is due to three common alleles, epsilon (epsilon) 2, epsilon3, epsilon4, at a single autosomal gene locus. These alleles determine the six phenotypes E2/2, E3/3, E4/4, E4/2, E4/3, and E3/2.</p><p><b>RESULTS</b>In Uygur population, the frequency of the epsilon2, epsilon3, and epsilon4 was 0.155, 0.648, and 0.197 respectively. In Han population, the frequency of the epsilon2, epsilon3, and epsilon4 was 0.081, 0.772, and 0.146 respectively. In the patient group, the frequency of the epsilon2, epsilon3, and epsilon4 was 0.060, 0.758, and 0.182 respectively. In the control group, the frequency of the epsilon2, epsilon3, and epsilon4 was 0.193, 0.671, and 0.136 respectively. epsilon2 frequency of Uygur' patients and controls was 0.050 and 0.290 respectively. Serum low density lipoprotein (LDL) cholesterol, TC, and TG values tended to decrease from the Apo E-4 phenotypes to Apo E-2 phenotypes. When deletion polymorphism of epsilon2 was compared with the common risk factors for CAD, its risk ratio (RR) is 4.38.</p><p><b>CONCLUSIONS</b>These studies confirm and find that Apo E phenotype distribution in Uygur population differs significantly from that in Han population in Xinjiang. CAD patients have significantly lower epsilon2 allele and slightly higher epsilon3 or epsilon4 allele frequency than controls, especially in Uygur population. It shows protective effects of epsilon2 on CAD.</p>