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Objective To analyze the influence of liraglutide intervention combined percutanous coronary intervention(PCI) therapy on acute myocardial infarction( AMI) with type 2 diabetes( T2DM) patients'myocardial injury, ventricular remodeling( VR), and cardiac function. Methods Eighty patients with AMI and T2DM were included in the study, and they were randomly divided into observation group and control group according to the random number table, each with 40 patients. The patients in the control group received metformin and conventional insulin combined PCI treatment, and the patients in the observation group received metformin and liraglutide combined PCI treatment. The changes in the values of ventricular remodeling indexes, cardiac function and serum related indexes were compared after 3 months treatment between the two groups. Results ( 1) The body weight and fasting blood glucose levels of the observation group were significantly lower than those of the control group( P＜0.05), and fasting insulin levels were significantly higher than those of the control group(P＜0.01). (2)The levels of N-terminal-pro-B- type natriuretic peptide ( NT-proBNP ), creatine kinase isoenzymes-MB ( CK-MB), and troponin I ( TnI) in the observation group 3 months after treatment were significantly lower than those in the control group(P＜0.05). (3)The levels of serum hypersensitive C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) in the observation group were significantly lower than those in the control group 3 months after treatment( P＜0. 05). ( 4) The values of left ventricular end systolic diameter ( LVESD ), left ventricular end diastolic diameter (LVEDD), interventricular septum thickness ( IVST), left ventricular posterior wall thickness ( LVPWT), left ventricular mass index ( LVMI), left ventricular end systolic volume ( LVESV), and left ventricular end diastolic volume(LVEDV) in the observation group were lower than those in the control group; the values of left ventricular fraction shortening(LVFS), left ventricular ejection fraction(LVEF), and mitral valve early diastolic blood flow rate (VE)/atrial systolic flow velocity ( VA), all were higher than those of the control group ( P＜0. 05). Conclusion Lraglutide intervention combined with PCI therapy on AMI with T2DM patients may reduce myocardial injury, induce ventricular remodeling, enhance cardiac function, and improve prognosis.
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[Abstrct] In 2008, Beijing Chaoyang Hospital of Capital Medical University was certified as cardiovascular interventional therapy tralning base of National Health and Family Planning Commission (former Ministry of Health). In accordance with the requirements of the measures for the management of tralning base, and according to the characteristics of tralning students in combination with the clinical teaching experience, skills of teaching for tralning base were summed up as the following: in strict accordance with the syllabus requirements , systematic and standardized tralning were emphasized . Emphasis on theoretical study which combined closely with actual operation was also established. After the tralning, all students who received tralning can do coronary angiography and PCI for simple lesion in accordance with the requirements of the syllabus. All tralnees passed unified national exam organized by the Ministry of Health and got the qualification for interventional therapy.
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Objective To investigate the effects of fruit potassium supplement on hypokalemia at in the perioperative period of percutanous coronary intervention(PCI)? Methods Ninety cronary herat disease patients with hypokalemia undergoing PCI during July to December 2011 involved the study? Since admission,the patients were administered with oranges and bananas each 500 g daily until the third day after PCI,on the basis of oral administration of potassium? Serum potassium was assessed in all patients at time points of the day at PCI,the first day and third day after PCI? Results The time range for the patients to take potassium supplement by eating fruits was 12-45 hours,averaged(28?84 ± 11?70)hours? The serum potassium levels on days 1 and 3 were significantly higher than that on the day for the admission(P < 0?05 for both)and even maintained at the normal level? Conclusion The oral complement of potassium by eating bananas and oranges can help patients to correct and prevent hypokalemia during the perioperative period of PCI?
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Objective To explore clinical characteristics of chronic total occlusion(CTO) in population with routine coronary angiography,and to cumulate therapeutic experience.Methods Retrospective analysis was performed on clinical data of 57 cases with CTO selected from 825 patients undergone coronary angiography.Results Among 57 cases,the percentage of male,myocaridial infarction,diabetes mellitus,hyperlipidermia and left ventricular dysfunction was 73.7%,84.2%,22.8%,73.7% and 22.8%,respectively.The types of lesions included single branch(n=11),double branches(n=29) and three branches(n=17).Of 70 branches lesion vessels,44 were TIMI 0 of blood flow classification and 26 were TIMI1.The position of lesions occurred at left anterior descending branch(n=32),left circumflex branch(n=16),right coronary artery(n=22).The occlusion time was less than three months(n=41) and more than three months(n=29).The lengths of lesion was divided into less than 20 mm(n=43) and more than 20 mm(n=27).The shapes of terminal lesion looked like rat-tail(n=42) and blaze knife-edge(n=28).The coronary stents were performed at 57 lesions among 70 branches and the successful rate of operation was 82.9%.Conclusions Timely coronary angiography and selecting suitable treatment on different kinds of lesions for male patients with myocardial infraction,especially complicated with diabetes mellitus,might play important roles in prevention of CTO and in improvement of the successful rate of percutanous coronary intervention for the complex lesion.
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Objective To investigate the effect of persistent ST-segment elevation after successful direct percutanous coronary intervention (PCI) on the late phase of left ventricular (LV) systolic function in acute anterior wall myocardial infarction.Methods Serial electrocardiograms were record before PCI and 1 hour after reperfusion in 72 patients with acute anterior wall myocardial infarction. The reduction of ST-segment elevation after successful PCI more than 50% was defined as ST-segment resolution (ST reduction group). Persistent ST-segment elevation was defined as ≥50% of peak ST elevation (ST elevation group). Echocardiography was performed on 2 to 3 weeks (early phase) and 5 to 6 months(late phase)after PCI to evaluate the LV function and ventricular wall motion abnormality (VWMA). Results Fifty-three patients (74%) had early ST segment elevation resolution and 19 patients (26%) did not. The LV function and VWMA were similar in two groups during early phase. But during the late phase, ST elevation group patients had lower LVEF and higher LVEDVI, LVESVI, VWMA index compared with ST reduction group (P
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Objective To investigate the effects of rehabilitation and exercise training on endothelial func- tion and collateral circulation in patients with coronary heart disease(CHD)who underwent PCI.Methods Sixty- three cases were divided into three groups:group A undertook rehabilitation protocol with three stages,group B with additional extracorporeal counterpulsation in addition to the intervention of group A,group C acted as control.The Bruce submaximal treadmill,coronary angiography and Doppler were conducted for evaluation of the functional per- formance,lateral branching and endothelium function.Results(1)The value of RPP and RPE of groups A and B were significantly higher than those of the control group as quantified by exercise test alter the third stage of rehabilita- tion(P
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BACKGROUND: Previous reports have mentioned the increased mortality of percutaneous coronary intervention (PCI) in elderly female patients compared with elderly male. The purpose of this study was to evaluate the clinical characteristics, coronary lesion, characteristics and differences of success rate of PCI between male and female elderly patients. METHODS: Three hundred sixty six elderly patients (454 lesions), including 210 male (255 cases, 73.4+/-2.45 year-old) and 156 female (199 cases, 73.5+/-2.55 year-old) who underwent PCI at Chonnam National University Hospital between Jan '96 and Dec '98 (out of 3,030 patients during same period). We compared clinical characteristic, coronary artery lesion morphology, success and complication rates of PCI in elderly male and female patients. RESULTS: Clinical diagnosis and risk factors for atherosclerosis were not different between two groups. Right coronary lesions were more common in female and left circumflex artery lesion less common in female patients. The success rate of balloon angioplasty was 93.2% (110/118) in male and 93.3% in (98/105) in female patients, and the success rates of stenting were 99.2% (136/137) in male and 100% (94/94) in female. Success rates of PCI were not different between two groups. Procedure-related mortality was one cardiac death (1/255, 0.39%) in male group only. Complications of elderly male were two occlusive dissection (OD: 2/255, 0.8%), three thrombotic occlusion (TO: 3/255, 1.2%) and two ventricular arrhythmia (VA) with shock (2/255, 0.8%). In 199 female patients, three OD (3/199, 1.5%), three TO (3/199, 1.5%) and two VA (2/199, 1.0%) developed. The complications rates were not different two groups. CONCLUSION: PCI in female patients older than 70 years can be performed with comparable success and complication rates to those of elderly male patients.
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Idoso , Feminino , Humanos , Masculino , Angioplastia com Balão , Arritmias Cardíacas , Artérias , Aterosclerose , Vasos Coronários , Morte , Diagnóstico , Mortalidade , Intervenção Coronária Percutânea , Fatores de Risco , Choque , StentsRESUMO
BACKGROUND: Previous reports have mentioned the increased mortality of percutaneous coronary intervention (PCI) in elderly female patients compared with elderly male. The purpose of this study was to evaluate the clinical characteristics, coronary lesion, characteristics and differences of success rate of PCI between male and female elderly patients. METHODS: Three hundred sixty six elderly patients (454 lesions), including 210 male (255 cases, 73.4+/-2.45 year-old) and 156 female (199 cases, 73.5+/-2.55 year-old) who underwent PCI at Chonnam National University Hospital between Jan '96 and Dec '98 (out of 3,030 patients during same period). We compared clinical characteristic, coronary artery lesion morphology, success and complication rates of PCI in elderly male and female patients. RESULTS: Clinical diagnosis and risk factors for atherosclerosis were not different between two groups. Right coronary lesions were more common in female and left circumflex artery lesion less common in female patients. The success rate of balloon angioplasty was 93.2% (110/118) in male and 93.3% in (98/105) in female patients, and the success rates of stenting were 99.2% (136/137) in male and 100% (94/94) in female. Success rates of PCI were not different between two groups. Procedure-related mortality was one cardiac death (1/255, 0.39%) in male group only. Complications of elderly male were two occlusive dissection (OD: 2/255, 0.8%), three thrombotic occlusion (TO: 3/255, 1.2%) and two ventricular arrhythmia (VA) with shock (2/255, 0.8%). In 199 female patients, three OD (3/199, 1.5%), three TO (3/199, 1.5%) and two VA (2/199, 1.0%) developed. The complications rates were not different two groups. CONCLUSION: PCI in female patients older than 70 years can be performed with comparable success and complication rates to those of elderly male patients.