Objective To investigate the long-term clinical outcomes in patients with anterior wall acute myocardial infarction ( AW-AMI) and non AW-AMI ( NAW-AMI) referred to primary percutaneous coronary intervention (P-PCI). Methods 287 patients with AMI who consecutively underwent primary PCI were divided into AW-AMI group (142 cases) and NAW-AMI group (145 cases) according to different location of myocardial infarction. The baseline characteristics and coronary artery lesions of patients were analysed. The primary end points were in-hospital mortality and the major cardiovascular events (MACE) during a mean 17.3?9.8 month follow-up including the occurrences of non-fatal myocardial infarction, non-fatal congestive heart failure, revascularization of target vessels and overall cardiac-related death. Results The peak value of CK and CK-MB were significantly higher (3 533?2 888) U/L vs (2 322 ? 1 638)U/L, (158 ? 197) U/L vs (95 ? 64) U/L, all P

Objective To explore the incidence and risk factor of renal artery stenosis in patients with coronary artery disease and essentiality of renal arteriography while performing coronary artery angiography. Methods Renal arteriography was performed immediately after coronary artery angiography in 114 patients with suspected coronary artery disease. Results Incidence of renal artery stenosis was 18.4% (21/114) in 114 patients and 26% (20/77) in patients with coronary artery disease who were identified by coronary artery angiography. Only one case with renal artery stenosis was found in 37 cases whose coronary arteries were normal (2.7%, 1/37). Incidence of renal artery stenosis in patients with coronary artery disease was higher than that in patients with normal coronary artery (26% vs 2.7%, P

Objective To compare the clinical outcomes of immediate PTCA and elective PTCA on infarct related artery after spontaneous recanalization. Methods One hundred and eighteen patients with SR between January 1996 and March 2001 were enrolled. According to TIMI flow, the patients were divided into 2 study populations. The two study populations were divided into 2 groups according to immediate PTCA or elective PTCA, respectively. Results Mortality and reinfarction were similar between the 2 groups two weeks after heart attack. However, recurrent ischemic events were more frequent in elective PTCA group than in immediate PTCA group according to TIMI flow grade 2 (1/24 vs 4/12,P=0.034). Furthermore, heparin or low molecular weight heparin was prescribed more frequently in elective PTCA (4/24 vs 11/12, 3/45 vs 34/37,P

Objective To investigate the association between glucose metabolism status and brachial-ankle pulse wave velocity(baPWV)in Chinese patients with coronary artery disease(CAD).Methods baPWV values were measured in 198 CAD patients.Plasma glncose,serum lipids,hsCRP and other baseline data were obtained in all the patients.According to the glucose level,the participants were divided into 3 groups:normal glucose tolerance(NGT)group,impaired glucose regulation(IGR)group and diabetes mellitus(DM)group.ResultsbaPWV values in the DM group(1807±381)cm/s were significantly higher than those in the NGT group[(1615±248)cm/s,P=0.000]and IGR group[(1674±277)cm/s.P=0.035].Multiple stepwise linear regression analyses indicated that higher baPWv values were associated with aging and hsCRP levels in 198 patients.In DM group,higher baPWV values were independently associated with aging and HbA1 C levels.Conclusions In patients with coronary artery disease.baPWV values increase with different glucose metabolism status from NGT to IGR then DM.baPWV values in the patients with DM were significantly higher than those in the other two groups.Glycemic control may ameliorate arterial stiffness.

Objective To investigate epidemiological characteristics and differences in anklebrachial index (ABI) among the natural population in Shanghai and Inner Mongolia,and to observe the prevalence of lower extremity peripheral arterial disease (PAD).Methods A total of 2604 volunteers from Shanghai and Inner Mongolia were selected by stratified cluster random sample.ABI was measured and related data were collected.Results The A BI value in Shanghai was 1.074 ± 0.095,while it was 1.062 ±0.075 in Inner Mongolia (P ＜ 0.001).The prevalence of lower extremity PAD in Shanghai was 4.2％,while it was 1.9％ in Inner Mongolia (P ＜ 0.01).For males,the ABI value in Shanghai was 1.078 ±0.105,and it was 1.075 ± 0.080 in Inner Mongolia (P ＞ 0.05).For females,the ABI value in Shanghai was 1.073 ±0.089,while it was 1.052 ±0.070 in Inner Mongolia (P ＜0.001).For males,the prevalence of lower extremity PAD of the in Shanghai was 4.7％,while it was 2.0％ in Inuer Mongolia (P ＜ 0.05).For females,the prevalence of lower extremity PAD of in Shanghai was 4.0％,while it was 1.8％ in Inner Mongolia (P ＜ 0.05).The ABI values in age group of ＜ 50 years in Shanghai and Inner Mongolia were 1.037 ± 0.082 and 1.055 ± 0.068,respectively (P ＜ 0.05).The prevalences of lower extremity PAD in age group of ＜50 years in Shanghai and Inner Mongolia were 7.6％ and 1.2％,respectively (P ＜0.001).There were no significant differences in ABI value and the prevalence of lower extremity PAD between Shanghai and Inner Mongolia in both age group of 50-69 years and ≥70 years (all P values ＞ 0.05).Conclusions The ABI value in Shanghai is higher than that in Inner Mongolia and the prevalence of lower extremity PAD in both males and females in Shanghai is significantly higher than that in Inner Mongolia.But they are lower than the level of western countries.In different age groups,the difference of the prevalence of lower extremity PAD between Shanghai and Inner Mongolia is only displayed in the age group of ＜ 50 years,which may be related to the limited sample size.The natural population in Shanghai exposed artery atherosclerotic disease risk factors may increase and we need to pay more attention to the lower extremity PAD.

Objective To compare the epidemiological characteristics and differences in brachialankle pulse wave velocity (baPWV)among middle-aged residents between Shanghai and Inner Mongolia autonomous region (Inner Mongolia),and to observe the prevalence of arterial stiffness in the two populations.Methods A total of 922 volunteers aged between 45 and 59 from Shanghai and Inner Mongolia were selected by stratified cluster random sample method.BaPWV was measured and related data were collected.Results A total of 903 cases were enrolled in this study,including 441 from Shanghai and 462 from Inner Mongolia.The baPWV value of middle-aged residents in Inner Mongolia was higher than that in Shanghai [(1 548 ± 281) cm/s and (1 476 ± 254) cm/s,P ＜ 0.001].The abnormal rate of baPWV (baPWV ≥ 1 400 cm/s) in Inner Mongolia was also higher than that in Shanghai [67.5 ％ (312) and 57.4％ (253),P ＜0.001].The baPWV value of middle-aged men in Inner Mongolia was (1 568 ±299) cm/s,while it was (1 508 ± 260) cm/s in Shanghai,no statistical difference was found (P ＞ 0.05).The baPWV value of middle-aged women in Inner Mongolia was (1 534 ± 268) cm/s,which was higher than that of Shanghai [(1 468 ±252)cm/s,P ＜0.01].The abnormal rate of baPWV of middle-aged men in Inner Mongolia and Shanghai was 67.0％ (126/188) and 60.8％ (59/97),respectively (P ＞ 0.05).The abnormal rate of baPWV of middle-aged women in Inner Mongolia and Shanghai was 67.9％ (186/274) and 56.4％(194/344),respectively.Conclusions The difference of baPWV value and abnormal rate of baPWV of middle-aged residents between Inner Mongolia and Shanghai exists.Middle-aged people in Inner Mongolia should be more alert to the incidence of arteriosclerosis and cardio-cerebrovascular diseases.

Objective To investigate the relationship between brachial-ankle pulse wave velocity (baPWV)and different stage of cardiac dysfunction.Methods 253 consecutive patients with coronary atherosclerotic heart disease were enrolled from August 2006 to February 2007.Patients were grouped according to the functional classification of New York Heart Association(NYHA).The baPWV was measured non-invasively with a VP1000 automated PWV/ABI analyzer(PWV/ABI,Colin CO.Ltd.,Komaki.Japan).At the sanle time,BNP,EF,LAEDV and LVESV were measured in all the patients.Results Brachial-ankle PWV was significantly correlated with cardiac function classification of NYHA(r=0.444.P＜O.001),BNP(r=0.394,P＜0.001)and left ventriculat end diastolic volume(r=-0.130,P＜0.05),The under area of receiver operating charachateistic(ROC)curve was 73.9%.The ROC curve demonstrated that when the value of brachial-ankle PWV was equal to or larger than 1717 cm/s(≥1717 cm/s),the sensitivity of diagnosing mild cardiac dysfunction was 72.9%and specifity 61.8%.When its value was equal to or larger than 1900 cm/s(≥1900 cm/s),the sensitivity and specificity were 61.5%and 81.9% respectively.Conclusion Brachial-ankle PWV is significantly correlated to the NYHA classification of heart failure and it may be a prospective index to diagnose early stage of cardiac dysfunction.

Objective To investigate the perception of anticoagulant treatment for atrial fibrillation (AF) in physicians from county-level hospitals.Methods Two hundred and ninety two physicians from 9 hospitals of Jiangsu,Henan,Zhejiang,Jiangxi provinces were enrolled in this cross-sectional survey from June to November 2013.A standard questionnaire was used in the survey,which consisted of questions on knowledge,awareness and concerns of physicians regarding the diagnosis of atrial fibrillation and administration of warfarin.Results Total 292 questionnaires were returned and 208 of them were finally analyzed.According to the reports of the physicians,the percentage of anticoagulant treatment was 30.0％ (10.0％-60.0％) in patients with rheumatic valvular AF,20.0％ (10.0％-50.0％) in patients with non-valvular AF and 80.0％ (40.0％-100.0％) in those with mechanical heart valve replacement.The most common concerns of prescribing warfarin were worries about the bleeding related to warfarin (74.0％,154),the necessary of monitoring INR (65.4％,136) and advanced age (44.7％,93).A half of physicians (51.0％,106) thought that ECG was the main means for diagnosis of AF and only 28.3％ (59) used both ECG and Holter as diagnosis procedure.Among the physicians who reported to use INR for monitoring warfarin administration,62.5％ (130) reported a target ranging 2-3 and one third reported a target INR ＜ 2.The proportion of the physicians who were aware of CHADS2 score and CHA2DS2-VASc score was 51.0％ (106) and 41.3％ (86),but only 15.4％ (32) and 6.3％ (13) of them knew the correct answer of the risk factors,respectively.Although 34.6％ (72) physicians were aware of HAS-BLED score,only 5.3％ (11) selected the 9 parameters correctly.68.3％ (142) physicians reported that vitamin K is the antidote for warfarin.Conclusion This study reveals the concerns and deficits in perception of anticoagulant treatment for AF patients in physicians of county-level hospitals,suggesting that education programs are needed to increase the prevalence of warfarin use in patients with AF.

Denervation ; Humans ; Renal Artery

Objective:To define impact of spontaneous TIMI-3 flow before angioplasty on outcomes of percutaneous coronary intervention strategy and the prognosis in patients with acute myocardial infarction (AMI ). Methods: The consecutive 301 patients enrolled in the ongoing register of emergent coronary angioplasty within 12 hours from symptoms who were diagnosed as having ST elevation AMI in our hospital from 2000 to 2006 were analyzed, they were followed up for one year and the clinical characteristics and survival rates were analysed. Results: Among the 301 patients enrolled in the ongoing register of emergent coronary angioplasty, spontaneous reperfusion (TIMI-3 flow) was present in 14.6% at initial angiography. Compared with patients without TIMI-3 flow, those with TIMI-3 flow before coronary intervention were less likely to present in new-onset heart failure(2.3% versus 16%, P=0.016), Patients with initial TIMI-3 flow had significantly lower 30-day mortality (0% versus 9.3%, P=0.035) , and cardiogenic shock (0%versus 8.6%, P=0.044) and had a shorter hospital stay (P=0.008). Cumulative 1-year mortality was 0% in patients with initial TIMI-3 flow, 11.3% with TIMI 0-2 flow (P=0.019). By COX regression analysis, postprocendural TIMI-3 flow was an independent determinant of survival (OR=0.285,P=0.004) , however,TIMI-3 flow before coronary intervention was not found as an independent determinant of survival significantly. The lenitive symptoms and current smoking were the independent determinants of TIMI-3 flow before coronary intervention (P=0.005, P=0.048, respectively).Conclusion: Patients undergoing primary percutaneous transluminal coronary intervention in whom TIMI-3 flow is present before angioplasty may present with greater clinical and angiographic evidence of myocardial salvage, be less likely to develop complications related to left ventricular failure, and improve early and late survival.