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Objective To investigate the correlation ofchemokine CX3CL1 and the major adverse cardiovascular events (MACCE) within 1 year in patients with ST elevation myocardial infarction (STEMI).Methods Five hundred patients with STEMI were continuously selected from the Department of Emergency,General Hospital of Shenyang Command,and 5ml venous blood was extracted at the time of admission.Plasma CX3CL1 levels were detected by ELISA.The median of CX3CL1 plasma concentration of all selected patients (2108.3pg/ml) was used to assign the patients to low expression group (＜2108.3pg/ml) and high expression group (≥ 2108.3pg/ml).The baseline information and the medical history of patients were recorded and followed up by telephone inquiry for 1 year.The endpoint events were defined as MACCE (including cardiac death,heart failure,nonfatal stroke and nonfatal myocardial infarction).Based on the MACCE in 1 year following up,patients were assigned into MACCE group and non-MACCE group.Multivariable Cox regression analysis was performed to analyze the correlation between CX3CL1 level and MACCE in STEMI patients.Results The plasma CX3CL1 level significantly increased in MACCE group compared with that in Non-MACCE group,the difference was statistically significant (P＜0.01).Kaplan-Meier and Cox regression analysis showed that the plasma concentration of CX3CL1 was independently associated with the occurrence of MACCE within 1 year (HR=1.124,95％CI:1.032-1.217,P=0.003).Conclusion Chemokine CX3CL1 concentration in plasma is positively correlated with the prognosis of patients with STEMI,and can be used in the prognosis assessment of STEMI patients.
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Objective To evaluate the efficacy of bivalirudin on reperfusion of coronary artery in patients with acute myocardial infarction undergoing percutaneous coronary intervention. Methods In our study, we evaluated 245 patients with acute myocardial infarction who underwent percutaneous coronary intervention between April 2012 to May 2015. Based on the therapy during operation, bivalirudin were used in 122 patients and heparin was used in 123 patients. Study outcomes included immediate TIMI(thrombolysis in myocardial infarction)flow and CTFC(Corrected TIMI Frame Count)by angiogrophy once the target lesion was opened rates of ,in-hospital thrombocytopenia, bleeding events myocardial infarction, repeat revascularization and the incidence of MACE(major adverse cardiac events)in 30 days and 1 year. Results The mean heart rate was higher in the bivalirudin group(P=0.034). There was no significant difference between the two groups in laboratory results or interventional data(P>0.05). After the target vessel was opened, the effect of bivalirudin on slow/no-reflow in primary PCI has no difference between heparin in terms of TIMI blood evaluation or CTFC (P>0.05). Hospitalization data analysis showed that bivalirudin was able to obtain a higher activated whole blood coagulation time(ACT)value(P<0.001)with lower decrease in the number of platelets. Follow-up data of 30 days and 1 year showed no difference in the incidence of MACE and net adverse clinical events(NACE)between the two groups(P>0.05). Conclusions Bivalirudin has well efficacy and safety in patients with acute myocardial infarction in patients with acute myocardial infarction undergoing PPCI without increasing the incidence of slow/no-reflow.