ABSTRACT
BACKGROUND: It is clinically important to identify high-risk patients with acute coronary syndrome (ACS) who may require repeat revascularization. This retrospective study identified risk factors for repeat revascularization among ACS patients after first-time successful percutaneous coronary interventions (PCIs). The predictive value of the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio for repeat revascularization was also evaluated. METHODS: We enrolled consecutive ACS patients who had coronary angiography performed during the period from 6 to 12 months after a first-time successful PCI. The primary outcome of the study was to identify the risk factors of repeat revascularization. The subjects were stratified based on repeat PCI events. After comparing various clinical characteristics, univariate and multivariate Cox proportional hazard model analyses were adopted to evaluate the effects of risk factors on repeat revascularization. RESULTS: The patients (n=271) were divided into the event (+) group (n=101) and the event (-) group (n=170). In the event (+) group, target lesion revascularization (TLR) accounted for 20.79% and target vessel revascularization (TVR) accounted for 50.49% of the patients. In contrast, 52.47% of the patients required de novo vessel revascularization (DVR). After adjustment for confounding factors, the TG/HDL-C ratio [hazard ratio (HR) =1.206, 95% confidence interval (CI): 1.016-1.431, P=0.032 for each higher TG/HDL-C ratio unit] and the Gensini score (HR =1.012, 95% CI: 1.005-1.018, P<0.001 for each higher Gensini score unit) were independent risk factors for a repeat PCI. Subgroup analyses showed that higher TG/HDL-C ratios were associated with a significantly higher risk of repeat PCIs in the male, hypertensive, and diabetes mellitus subgroups. CONCLUSIONS: The TG/HDL-C ratio and Gensini score could serve as risk factors for repeat revascularization in ACS patients after a first-time successful PCI.
ABSTRACT
OBJECTIVE: To investigate the effects of recombinant human growth hormone (rhGH) on the changes in serum insulin-like growth factor-I (IGF-I), IGF binding protein 3 (IGFBP-3) and blood sugar in severely burned patients, so as to validate the optimal time of rhGH administration. METHODS: Forty severely burned patients were enrolled in the study and were randomly divided into control (C), treatment 1 (rhGH given from 7 - 9 PBD, T1) and treatment 2 (rhGH from 10 - 14 PBD, T2) groups. The dynamic changes in serum IGF-I, IGFBP-3 and blood sugar on the 1, 3, 5, 7, 10, 14 and 21 PBDs in all 3 groups of burn patients were determined, analyzed and compared with one another. RESULTS: The serum IGF-I, IGFBP-3 and blood sugar levels in T1 and T2 groups were higher than those in C group after the use of rhGH, especially the IGFBP-3 and blood sugar (P < 0.05). There was no difference of all the indices between T1 and T2 groups. CONCLUSION: It might be optimal to give rhGH to severely burned patients during 7-9 PBDs.
