Objective This study was to investigate the role of trimetazidine in the prevention of contrast-induced nephropathy (CIN) in renal dysfunction patients undergoing coronary angiography. Methods A total of 151 patients with renal dysfunction who underwent coronary angiography were enrolled in our study and randomly divided into control group (n=77) and trimetazidine group (n=74). Standard hydration was administered in all the patients. In trimetazidine group, patients were administered trimetazidine orally for 48 hours before and 7 days after coronary angiography. Adverse events were observed in 12 months. Results (1) For 24 h and 48 h after the procedure:levels of SCr and CysC in the control group were significantly increased compared with baseline levels; levels of SCr and CysC in trimetazidine group were not increased, compared with baseline levels;levels of SCr and CysC were lower in trimetazidine group than the control group. (2)The incidence of CIN was reduced in trimetazidine group compared with control group (22.1%vs 9.5%,P=0.034). (3) Kaplan-Meier analysis showed that the incidence of adverse events in trimetazidine group was lower compared with the control group (P = 0.003). Conclusions Trimetazidine in combination with standard hydration is more effective than isotonic saline alone in protecting renal function in patients with renal dysfunction who undergo coronary angiography.

Objective:To explore influence of preoperative tirofiban usage and using time on blood flow of infarct re-lated artery (IRA) in patients with acute ST elevation myocardial infarction (ASTEMI ) undergoing emergency di-rect percutaneous coronary intervention (PCI ) .Methods:A total of 266 ASTEMI patients undergoing direct PCI from Jan 2009 to Oct 2012 ,were randomly divided into tirofiban group (n=134 ,received preoperative tirofiban us-age for PCI) and routine treatment group (n=132 ,didn't receive tirofiban during PCI) .According to percutaneous using time of tirofiban tirofiban group was divided into <3h group (n= 63) and ≥3h group (n= 71) ;TIMI blood flow of IRA ,before and after PCI were compared among different groups .Results:Compared with routine treat-ment group before PCI ,there were significant rise in percentages of TIMI grade 3 (10.6% vs .20.9% ) in tirofiban group ,P=0.028 ;after PCI ,percentage of TIMI grade 3 in tirofiban group was more significantly rose than that of routine treatment group (78.8% vs .92.5% ,P=0.001);in tirofiban group ,blood flow of IRA before PCI in <3h group was significantly improved compared with ≥3h group (TIMI grade 2 + 3 ,63.5% vs .29.6% , P<0.01) . Conclusion:Early tirofiban usage can improve TIMI blood flow of IRA before and after PCI in ASTEMI patients , the earlier it′s used ,the more significant effect it has .

Objective: To explore the impact of echocardiographic parameter of diastolic dysfunction (E/A) on the recurrence of atrial ifbrillation (AF) in patients after catheter ablation.
Methods: We retrospectively studied 277 consecutive AF patients with circumferential pulmonary vein ablation (CPVA) in our hospital. According to E/A ratio, the patients were divided into 3 groups: Normal group, the patients with 0.75< E/A<2, n=203, Mild abnormal group, E/A≤0.75, n=53 and Severe abnormal group, E/A>2, n=21. The late AF recurrent rates were compared among different groups. The patients were divided into another 2 groups upon AF recurrence after CPVA: Recurrent group, n=57 patients with atrial arrhythmia lasted more than 30 seconds at 3 months after CPVA and Non-recurrent group, n=220. The clinical conditions were compared between 2 groups.
Results: The patients were followed-up for (374 ± 276) days. The AF recurrent rate in Severe abnormal group was 33.3%, in Mild abnormal group was 23.5% and in Normal group was 18.5%, P>0.05. The E/A ratio in Recurrent group was 1.22 ± 0.54, in Non-recurrent group was 1.19 ± 0.49, P=0.653. Univariate analysis indicated that the risk factors for AF recurrence included LVEDD and gender, not E/A ratio (P=0.236). Cox multivariate analysis indicated that with adjusted gender, hypertension, diabetes, LVEDD and LVESD, abnormal E/A ratio was the predictor for late AF recurrence (HR 2.29, 95%CI 1.01-5.19, P=0.046). With further adjusted LVEDD and E/A, the severe abnormal E/A ratio was still the predictor for AF recurrence (HR 2.27, 95%CI 1.01-5.12, P=0.047).
Conclusion: E/A ratio was the important predictor for AF recurrence in patients after CPVA.

Objective To investigate the relationship between fasting blood glucose(FBG) with coronary arterial vulnerable plaque in civil airline pilots and its risk factors.Methods One hundred and twenty civil airline pilots with coronary heart disease were divided into the vulnerable plaque group and non-vulnerable plaque group based on the virtual histology intravascular ultrasound(VH-IVUS) results.Then the clinical data were collected.Logistic regression analysis was used to analyze the risk factors of vulnerable plaque.Results The FBG level in the vulnerable plaque group was much higher(P＜0.05);FBG,high-sensitivity C-reactive protein and low density lipoprotein were the risk factors for vulnerable plaque;FBG was positively correlated with the plaque necrosis core constituent ratio(r=0.44,P＜0.05).The area under curve of ROC curve efficiency for diagnosing vulnerable plaque was 0.72(95％CI:0.66-0.81),at FBG cut-off value of 6.39,the sensitivity was 71.35％ and specificity was 76.15％.Conclusion The FBG level is an independent risk factor of coronary arterial vulnerable plaque,which can assist in the identification of vulnerable plaque in civil airline pilots.