RESUMO
Objective To investigate the long-term safety and efficacy of the domestic biodegradable drug-eluting cor?onary stents (BuMA) in treating coronary heart disease (CHD). Methods Patients (n=440) who received BUMA stents were designated as observation group while patients (n=460) received Resolutestents were designated as control group. The base?line clinical characteristics, extend of pathological change shown by Coronary Arteriography (CAG),the procedure of percu?taneous coronary intervention were similar between these two groups. The patients were followed up for a mean of 24 ± 4 months;the primary endpoint was the occurrence of definite or probable stent thrombosis;secondary endpoint was major ad?verse cardiac events (MACEs) including complex end such as recurrent angina, acute non-fatal myocardial infarction, death, target vessel revascularization (TVR); other endpoints include all- cause mortality, cardiac death, myocardial infarc?tion (MI), target lesion revascularization (TLR), non-target vessel revascularization and stroke. Some patients were lost dur?ing follow up, which include 5 in observation group and 26 in control group. Results Patients in observation groups were in?serted with 615 stents while patients in control group were implanted with 614 stents, both groups with average of implanting 1.41 stent/case. There are no statistical significance differences in the primary endpoint [1.4%(6/435) vs 1.8%(8/434), χ2=0.087], secondary endpoint [12.3%(54/435) vs 10.8%(47/434),χ2=0.524] and other endpoints between the two groups. Con?clusion These data suggest that domestic biodegradable drug-eluting coronary stents (BuMA) are with good long-term safe?ty and efficacy.
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Objective To investigate the preventive effect of N-acetylcysteine (NAC) on contrast-induced nephropa-thy (CIN) in patients undergoing elective percutaneous coronary intervention (PCI). Methods A total of 521 patients under-went PCI in Tianjin were randomly divided into conventional treatment group (n=261) and NAC treatment group (n=260). NAC treatment group was given oral NAC (600 mg twice daily) for 48 h and 72 h before PCI plug hydration therapy, and the conventional treatment group was given only hydration therapy. The serum levels of creatinine(Scr), urea nitrogen(BUN), creatinine clearance rate (Ccr), C-reactive protein (CRP),β2-microglobulin(β2-MG), tumor necrosis factor-α(TNF-α), inter-leukin-6 (IL-6), superoxide dismutase (SOD), glutathione peroxidase (GPX) and incidence of CIN were detected at admission and 72 h after the procedure. Results (1) There was no significant difference in the incidence of CIN between NAC treat-ment group (6.2%) and conventional treatment group (3.8%,χ2=1.48, P>0.05). (2) There were no significant differences in se-rum levels of Scr, BUN, Ccr, CRP,β2-MG, TNF-α, IL-6, SOD and GPX before PCI ( P>0.05). (3) The serum levels of CRP, SOD and GPX were significantly higher 72 h after the procedure in two groups ( P＜0.05). There were significantly lower se-rum levels in CRP, SOD and GPX in NAC treatment group than those of conventional treatment group ( P＜0.05). There were no significant differences in serum levels of Scr, BUN,β2-MG and Ccr between NAC treatment group and conventional treat-ment group ( P >0.05). Conclusion N-acetylcysteine may have no beneficial effect on the prevention of CIN after PCI.
RESUMO
Objective To evaluate the clinical effectiveness of a new and easy-to-use thrombus-aspirating device for primary percutaneous trans-radial coronary intervention (PCI). Method From March 2006 to June 2008, fifty acute myocardial infarction (AMI) patients with angiographic evidence of high-burden coronary throm-bus treated with thrombus aspiration were enrolled in a single center retrospective study. Thrombotic clot was aspi-rated before stent was implanted in the infarct-related coronary artery. Thrombolysis in myocardial infarction(TIMI) flow, corrected TIMI frame count (cTFC), TIMI myocardial perfusion grade(TMPG), and rate of no-reflow were observed with coronary augiography. Acute thrombosis and subacute thrombosis in stent during hospital stay were investigated. Myocardial ischemic events, revascularization and mortality during the following period were also in-vestigated. Paired t -test was used for statistical analysis. Results Thrombus was completely removed in 35 pa-tients (70%) and partially removed in 15 patients (30%) seen immediately after thrombus aspiration. There were significant improvements both in postoperative TIMI flow (0 vs. 2.7±0.5, P <0.01) and TMPG (0 vs. 2.6±0.8, P <0.01), while cTFC was 20.2±16.8 after the thrombus aspiration. No severe complication occurred during and after operation. Conclusions Trans-radial thrombas-aspiration in primary PCI is clinically safe and feasible. The use of aspiration catheter (ZEEK) is a simple and effective approach to the treatment of coronary artery stenosis associated with thrombus because it elevates the successful rate of treatment,reduces the incidence of no-reflow,and results in better prolonged-term outcome.