Relationship between platelet-leukocyte aggregation and myocardial perfusion in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention.

OBJECTIVE: To explore the relationship between inflammation, oxidative stress and poor myocardial perfusion in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). BACKGROUND: Risk factors and mechanisms of poor reperfusion in patients with STEMI after primary PCI remain unclear. METHODS: A total of 143 patients who underwent primary PCI after STEMI were divided into good and poor perfusion groups according to sum-ST-segment resolution (sumSTR) and TIMI myocardial perfusion grade (TMP) results. Aortic sinus arterial blood was collected after primary PCI. The platelet-leukocyte aggregation (PLA), platelet-neutrophil aggregation (PNA), platelet-monocyte aggregation (PMA) and platelet-lymphocyte aggregation (PLyA) were measured by flow cytometry. The malondialdehyde (MDA) and superoxide dismutase (SOD) levels were measured by chemical colorimetry. RESULTS: The leukocyte count, neutrophil ratio and high-sensitivity C-reactive protein were significantly higher in the poor perfusion group than the good perfusion group (p < 0.05). Multiple linear regression analysis showed that neutrophil ratio was an independent risk factor of sumSTR in STEMI patients after primary PCI (p < 0.01). The poor myocardial perfusion group had higher levels of PLA, PNA, PMA and MDA (p < 0.05). There were no differences in PLyA and SOD levels between the good and poor myocardial perfusion groups (p > 0.05). CONCLUSION: Inflammation and oxidative stress were related to poor myocardial perfusion in patients with STEMI after primary PCI.

[An epidemiological study on carotid atherosclerosis among veterans in Beijing].

OBJECTIVE: To investigate the prevalence and risk factors of carotid atherosclerosis (CAS) among veterans in Beijing. METHODS: 820 individuals, aged 60 or above, were randomly selected out from 8202 individuals, 21 military cadre retirement centers in Beijing. Each individual answered a questionnaire and received Doppler ultrasonic examination for an observation of the Internal-Media Thickness and structure of the carotid. A logistic regression analysis was also made to identify possible risk factors and their powers on the prevalence of CAS. RESULTS: The prevalence of carotid atherosclerosis by ultrasonic examinations among the veterans in Beijing was 44.0%, of which males taked 53.8% and females taked 33.5%. The prevalence rised with the increase of age. Among them, the prevalence ratio of CAS for ages of 60-69, 70-79, and 80 or above were 30.4%, 51.8%, 65.27%, respectively. Logistic regression was done to provide the following results: CAS risk factors include the age, sex, obesity, smoking, hypertention and diabetes mellitus. CONCLUSION: The prevalence of CAS among the veterans in Beijing rises with the increase of age. CAS risk factors include age, sex, obesity, smoking, hypertention and diabetes mellitus.

[An epidemiological study on degenerated heart valvular diseases among military elderly population in Beijing].

OBJECTIVE: To investigate the prevalence and possible risk factors of senile degenerated heart valvular disease (SDHVD) among military elderly in Beijing. METHODS: 820 individuals, aged 60 or above,are randomly selected from 8202 individuals, in 21 military retirement centers in Beijing. Each individual answers a questionnaire and receives Doppler echocardiographic examination for an observation of the cardiac structure, function and valve condition. A logistic regression analysis is also made to identify possible risk factors and their powers on the prevalence of SDHVD. RESULTS: The prevalence ratio of SDHVD by means of ultrasonic checks among military elderly in Beijing is 13.4%. Among them, the prevalence ratio of SDHVD for age groups of 60-, 70-, and 80 or above are 7.7%, 16.1%, 25.7% respectively. Data from logistic regression shows the following results that SDHVD risk factors include age, hypertention, hyperlipemia, stroke and cadiovascular family history. CONCLUSION: The prevalence of SDHVD among the military elderly in Beijing rises with the increase of age. SDHVD risk factors include age, hypertention, hyperlipemia, stroke and cadiovascular family history.

[Pulse pressure and prevalence of stroke and myocardial infarction in Chinese population].

OBJECTIVE: To explore the characteristics of distribution of pulse pressure (PP) in Chinese population and its relationship to major cardiovascular diseases in them. METHODS: Data from the Third National Blood Pressure Survey involved 882,681 subjects aged over 18 in 1991 were reanalysed for the relationship between PP and risks of major cardiovascular diseases, with t-test, chi2 test and logistic regression model. PP is defined as the difference between systolic and diastolic blood pressure. RESULTS: (1) Overall mean PP was (44.61 +/- 13.59) mm Hg for the subjects aged over 18, higher in men [(44.92 +/- 12.72) mmHg] than that in women [(44.34 +/- 14.32) mmHg]. PP increased progressively with age, and its increase accelerated significantly at age over 50 but higher in women than in men. Proportion of the subjects with PP equal to or greater than 60 mmHg was more in those aged 60 or over than that in younger ones. (2) Prevalence of stroke and myocardial infarction (MI) increased with PP and age, whether in the normotensives, or in the hypertensives or in the isolated systolic hypertensives. (3) Results of multivariate logistic regression analysis revealed that risks of stroke in the subjects with PP of (45-59) mmHg, (60-74) mmHg and over 75 mmHg were 1.9, 3.5 and 5 times as in those with PP less than 45 mm Hg, respectively, adjusted for other risk factors, and their risks of myocardial infarction (MI) were 1.2, 1.5 and 1.7 times, respectively. Furthermore, PP was significantly and independently related to the risks of stroke and MI, even adjusted for systolic and diastolic pressures. CONCLUSIONS: Prevalence of stroke and MI increased with the breadth of PP and age. Broader PP may be an important and independent predictor of risks of stroke and MI, especially in the aged people.

[Prevalence, awareness, treatment and control of hypertension in Chinese adults].

OBJECTIVE: To identify the prevalence, distribution, current status of awareness and control of hypertension in Chinese adult population. METHODS: A cross-sectional survey was conducted in mainland of China in 2000 - 2001 as a part of work coordinated with InterASIA Program. A total of 15,838 nationally representative subjects aged 35 to 74 were selected with multistage cluster sampling. Measurement of blood pressure was taken for all of them with three readings in a mercuric-column sphygmomanometer after resting for five minutes. Standard structured questionnaire was used to collect their histories and treatment and prevention for hypertension. A case of hypertension was defined as any person with systolic blood pressure equal to or greater than 140 mmHg, or with diastolic blood pressure equal to or greater than 90 mmHg, or being administered with antihypertensive agents. RESULTS: A total of 15,838 adults aged 35 - 74 years were included in this survey. Overall, the prevalence of hypertension was 27.2%, representing 130 million persons with hypertension nationwide as estimated. Age-specific prevalence of hypertension was 10.7%, 26.8%, 38.9% and 50.2% for women and 17.4%, 28.2%, 40.7% and 47.3% for men aged 35 - 44, 45 - 54, 55 - 64 and 65 - 74 years, respectively. Among hypertensive patients, 44.7% were aware of their high blood pressure, 28.2% were taking antihypertensive medication, and 8.1% achieved their blood pressure under control (< 140/90 mm Hg). All these data indicated that percentages of awareness, treatment and control of hypertension increased by 86.2%, 92.6% and 145.4%, respectively in the past ten years, as compared with the data in 1991. CONCLUSIONS: In the past ten years, percentages of awareness, treatment and control of hypertension in Chinese adults increased significantly, who had a relatively high prevalence of hypertension, but lower awareness and much lower percentages of treatment and control of hypertension. It is urgently needed to improve prevention, detection and treatment for hypertension in adults.