Coronary angiographic features and in-hospital outcome of patients with coronary artery disease and rheumatoid arthritis / 中国介入心脏病学杂志

Objective To report the coronary angiographic features and in-hospital outcome in coronary artery disease(CAD) patients with rheumatoid arthritis(RA) who underwent percutaneous coronary intervention(PCI)with stent implantation.Methods The study group comprised 69 consecutive patients with RA who underwent PCI in Beijing Friendship Hospital between January 2009 and June 2017. Medical records were analyzed retrospectively including clinical basic material, coronary angiogram data, and the incidence of major adverse events in hospital.Results Fifty five patients(79.7％) had one or more traditional CAD risk factors. Multivessel disease was present in 73.9％ of the patients, and the average SYNTAX score was(31.6±7.2). Two bare metal stents and 143 drug eluting stents were implanted. 50 cases(72.4％) required implantation of long stents(stent length>30 mm) .There were 25 patients developed major adverse events(36.2％) during hospitalization, including 1 case of cardiac death, 2 cases of stent thrombosis, 5 cases of PCI related MI, 5 cases of heart failure, 5 cases of gastrointestinal bleeding and 10 cases of contrast induced nephropathy(2 cases comorbided acute heart failure).Conclusions Patients with RA and CAD may have severe coronary lesions.PCI in these patients tends to result in an increased rate of major adverse events in-hospital. Hence there is a need of early identification and early prevention in these patients during perioperative period.

Short- and Long-term Outcomes in Patients with Connective Tissue Diseases Undergoing Percutaneous Coronary Intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Coronary artery disease (CAD) is a leading cause of morbidity and mortality in patients with connective tissue diseases (CTDs). Risk factors and clinical characteristics in these patients are not equivalent to those in traditional CAD patients. The objective of this study was to report short- and long-term clinical outcomes in a consecutive series of patients with CTD who underwent percutaneous coronary intervention (PCI) with stent implantation.</p><p><b>METHODS</b>The study group comprised 106 consecutive patients with CTD who underwent PCI in Beijing Friendship Hospital between January 2009 and June 2012. Medical records were analyzed retrospectively including clinical basic material, coronary angiogram data, and the incidence of major adverse cardiac events (MACEs) during the short- and long-term (median 3 years) follow-up.</p><p><b>RESULTS</b>Ninety-two of the patients (86.8%) had one or more traditional CAD risk factors. Multivessel disease was present in more than 2/3 of patients (73.6%). The left anterior descending coronary artery was the most commonly affected vessel (65.1%). Five bare-metal stents and 202 drug-eluting stents were implanted. After a median follow-up period of 36 months, thirteen patients (12.3%) died from cardiac causes, the rate of stent thrombosis was 9.4%, and the rate of target vessel revascularization (TVR) was 14.2%. Multivariate analysis revealed that hypertension (hazard ratio [HR] = 3.07, 95% confidence interval [CI]: 1.30-7.24, P = 0.041), anterior myocardial infarction (HR = 2.77, 95% CI: 1.06-7.03, P = 0.04), longer duration of steroid treatment (HR = 3.60, 95% CI: 1.43-9.08, P = 0.032), and C-reactive protein level >10 mg/L (HR = 3.98, 95% CI: 1.19-12.56, P = 0.036) were independent predictors of MACEs.</p><p><b>CONCLUSIONS</b>Patients with CTD and CAD may have severe coronary lesions. PCI in these patients tends to result in an increased rate of stent thrombosis and TVR during long-term follow-up, which may be influenced by traditional and nontraditional risk factors.</p>

1-[5-(Anthracen-9-yl)-3-(4-nitro-phen-yl)-4,5-dihydro-1H-pyrazol-1-yl]ethan-1-one.

In the title compound, C(25)H(19)N(3)O(3), steric repulsion between the methine H atom and one of the anthryl H atoms seems to be concomitant with the considerable distortion of the anthryl fragment from planarity. The side rings of the anthryl subtend an angle of 9.57 (8)°, which is an extreme value among the known reliably determined structures. This angle correlates with the length of the bond by which the anthryl is attached to the rest of the mol-ecule. In the anthryl fragment, the maximum deviation of one of the C atoms from the mean plane is 0.126 (3) Šand regards the carrier C atom involved in the repulsion between the anthryl and the methine H atoms. The inter-planar angle between the pyrazoline ring and the anthryl fragment is 88.36 (5)° and that between the pyrazoline and 4-nitro-phenyl rings is 8.80 (15)°. Weak inter-molecular C-H⋯N, C-H⋯π and π-π inter-actions [centroid-centroid distances of 3.7659 (17), 3.9477 (15) and 3.8972 (15) Å] are pesent in the structure.

Predictors and long-term prognosis of angiographic slow/no-reflow phenomenon during emergency percutaneous coronary intervention for ST-elevated acute myocardial infarction.

OBJECTIVE: Angiographic slow/no-reflow during emergency percutaneous coronary intervention (PCI) in patients with ST-elevated acute myocardial infarction (AMI) may result in unfavorable outcomes. The aim of our study was to investigate the clinical factors and angiographic findings that predict slow/no-reflow phenomenon and the long-term prognosis of AMI patients with angiographic slow/no-reflow. METHODS: A total of 210 consecutive AMI patients, who underwent primary PCI within 12 hours of symptom onset were divided into a normal flow group (thrombolysis in myocardial infarction [TIMI] flow grade 3, n = 169) and a slow/no-reflow group (≤TIMI flow grade 2, n = 41), based on cineangiograms performed during PCI. RESULTS: A total of 41 patients (19.5%) developed slow/no-reflow phenomenon. Univariate analysis showed that delayed reperfusion, high thrombus burden on baseline angiography, and acute hyperglycemia all correlated with slow/no-reflow (P < 0.05 for all). Multivariate analysis revealed that hyperglycemia on admission (≥10 mmol/L; odds ratio [OR]: 1.7, 95% confidence interval [CI]: 1.423-2.971, P = 0.012), reperfusion time (≥6 h; OR:1.4, 95% CI: 1.193-1.695, P = 0.040), and high thrombus burden (OR: 1.6, 95% CI: 1.026-2.825, P = 0.031) were significant and independent predictors of angiographic slow/no-reflow. The 6-month mortality and incidence of major adverse cardiac and cerebrovascular events (MACCE) were significantly higher in the slow/no-reflow group than in the normal flow group. Angiographic slow/no-reflow was independently predictive of MACCE (hazard ratio [HR]: 2.642, 95% CI: 1.304-5.932, P = 0.028). CONCLUSION: Delayed reperfusion, high thrombus burden on baseline angiography, and blood glucose level on admission can be used to stratify AMI patients into a lower or higher risk for angiographic slow/no-reflow during PCI. In addition, angiographic slow/no-reflow predicts an adverse outcome in AMI patients.

1-[5-(Anthracen-9-yl)-3-phenyl-4,5-dihydro-1H-pyrazol-1-yl]ethanone.

In the title compound, C(25)H(20)N(2)O, the pyrazoline ring is nearly planar [maximum atomic deviation = 0.0254 (17) Å]; but the anthracene ring system is distorted from a coplanar structure [maximum atomic deviation = 0.181 (3) Å], the dihedral angle between the outer benzene rings being 10.68 (13)°. The pyrazoline ring is almost perpendicular to the mean plane of the anthracene ring system [dihedral angle = 76.94 (8)°], but nearly coplanar with the phenyl ring [dihedral angle = 1.63 (7)°]. π-π stacking is observed between parallel benzene rings of adjacent anthracene units, the face-to-face distance being 3.27 (3) Å. Weak intra-molecular C-H⋯N hydrogen bonding also occurs.

5-(Anthracen-9-yl)-3-(4-nitro-phen-yl)-1-phenyl-4,5-dihydro-1H-pyrazole.

In the title compound, C(29)H(21)N(3)O(2), the five-membered pyrazoline ring is nearly planar, the maximum deviation being 0.037 (3) Å. The anthracene ring system is approximately perpendicular to the central pyrazoline ring, making a dihedral angle of 86.55 (16)°, whereas the two attached benzene rings are oriented at smaller dihedral angles of 12.9 (2) and 14.7 (2)°with respect to the pyrazoline ring. An intra-molecular C-H⋯N hydrogen bond is observed.

Predictors and short-term prognosis of angiographically detected distal embolization after emergency percutaneous coronary intervention for ST-elevation acute myocardial infarction.

OBJECTIVE: Distal embolization after percutaneous coronary intervention (PCI) is one of the major mechanisms of no-reflow. The aim of the study was to investigate clinical, angiographic predictors of distal embolization on angiography in patients with ST-elevation acute myocardial infarction (AMI) after PCI, and to assess the short-term prognosis of patients with distal embolization. METHODS: There were 318 consecutive AMI patients, who underwent primary PCI within 12 h of symptom onset, and were divided into distal embolization group (N = 97) and non-distal embolization group (N = 221), based on cineangiograms performed during PCI. RESULTS: Distal embolization was present in 97 patients (30.5%), and more often observed in female sex (29.9 vs. 16.3%, P = 0.006), in patient with right coronary artery of infarct-related artery (IRA) (44.3 vs. 28.1%, P = 0.017), pre-revascularization thrombolysis in myocardial infarction (TIMI) flow

Association between inflammatory mediators and angiographic morphologic features indicating thrombus formation in patients with acute myocardial infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Inflammatory mechanisms had played an important role in the occurrence and prognosis of acute myocardial infarction, inflammatory mediators was associated with adverse outcomes of acute myocardial infarction. This study tested the hypothesis that in the acute phase of myocardial infarction with ST-segment elevation, neutrophil count and high-sensitivity C-reactive protein are predictive of angiographic morphologic features that indicate thrombus formation in the infarct-related artery.</p><p><b>METHODS</b>This retrospective study included 182 consecutive patients with acute myocardial infarction and ST-segment elevation. Patients were assigned to a thrombus-formation group (n = 77) and a non-thrombus-formation group (n = 106). All patients had a Killip's classification <or= 3 and onset < 12 hours prior to presentation. All the cases were going to undergo coronary angiography, including primary percutaneous coronary intervention, simple coronary angiography, or thrombolysis in a coronary artery (or arteries) or coronary artery bypass graft(s). Blood samples for measurement of high-sensitivity C-reactive protein and for routine blood laboratory studies were collected prior to coronary angiography.</p><p><b>RESULTS</b>The levels of high-sensitivity C-reactive protein, total leukocyte counts, neutrophil counts, and neutrophil/ lymphocyte ratios were substantially higher in the thrombus-formation group than in the non-thrombus-formation group patients (for each, P < 0.05). Stepwise Logistic regression analyses identified high-sensitivity C-reactive protein, neutrophil count, and neutrophil/lymphocyte ratio as independent predictors of thrombus formation in the infarct-related artery (for each, P < 0.05).</p><p><b>CONCLUSIONS</b>In patients with acute myocardial infarction, higher neutrophil counts, neutrophil/lymphocyte ratio, and levels of high-sensitivity C-reactive protein are predictors to indicate thrombus formation.</p>

Research on Change of Inflammatory Factors in Obstructive Sleep Apnea Syndrome with Hypertension / 中华高血压杂志

20 beats/ h);⑤ normal control group(n=20):healthy person without OSAS or hypertension.The serum level of IL-6, sCD40L,hsCRP,sICAM-1,VACM-1 are determined by ELISA method.Results The serum level of IL-6, sCD40L,hsCRP,sICAM-1,VCAM-1 in patients of OSAS alone group or HT alone group is higher than that of normal control group;whereas,the serum level of IL-6,sCD40L,hsCRP,sICAM-1,VCAM-1 in patients with hy- pertension co-existed OSAS are furthermore higher than that of OSAS alone group,hypertension alone group(P