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Objective To evaluate the clinical outcomes of patients complicated with major bleeding after primary coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI). Methods During the period of January 2004-January 2008, primary PC1 was performed in 412 consecutive patients with acute STEMI at Shanghai Ruijin Hospital. The clinical data were retrospectively analyzed. Major adverse cardiac events (MACE), including death, reoccurrence of myocardial infarction and target vessel revascularization, in patients with major bleeding were compared with that in patients without major bleeding. Results Compared to patients without bleeding, the patients with bleeding were older (70.0 ± 8.9 years vs 64.9 ± 12.7 years, P = 0.04), mainly the females (51.9% vs 23.1%, P = 0.001) and treated more often with glycoprotein (GP) Ⅱb/Ⅲa receptor inhibitor (88.9% vs 69.4%, P = 0.03) or intra-aortic balloon pump (7.4% vs 1.3%, P = 0.02). In-hospital and one-year MACE rate in the patients with bleeding was 18.5% and 37.0% respectively, which were significantly higher than that in the patients without bleeding (5.7% and 14.3%, with P = 0.008 and P = 0.002, respectively). Multivariate analysis indicated that patient aged over 70 years, feminine gender and use of GP Ⅱb/Ⅲa receptor inhibitor were independent predictors for the occurrence of major bleeding. The occurrence of major bleeding after primary PCI was significantly correlated with MACE occurred within one year after the procedure (OR 2.79, 95% CI: 2.21-5.90, P < 0.001). Conclusion In patients with acute STEMI, the occurrence of major bleeding after primary PCI is closely linked to the increased MACE rate within one year after the treatment. Feminine gender, aged patient and use of GP Ⅱb/Ⅲa receptor inhibitor are independent predictors to increase the danger of major bleeding.

8.Role of computer aided design for treating coronary atherosclerotic heart disease

Hongchao ZHANG ; Guorong ZHANG ; Xiangyang ZHANG ; Longsong PIAO ; Li LI ; Chaozhong LIU

Chinese Journal of Tissue Engineering Research 2009;13(48):9597-9600

OBJECTIVE: Computer has become an important tool in medical works. However, application ability of clinical physicians is imbalanced with the fast development of information technology (IT) system. Therefore, it is necessary to explore a bridge between researchers and integrate decentralized IT resources. Based on this survey, we provide some views concerning IT applying in medical procedures. METHODS: The correlated computer information was collected from a patient with coronary heart disease from early diagnosis, interventional therapy to coronary bypass surgery, until rehabilitation. The medical staffs were investigated from the general status, computer skills, knowledge structure, as well as the acceptance degree of computer application to measure computer skills. RESULTS: The correlated computer information was characterized by large soft variability, a large time span, and various date categories with more dynamic data or three-dimensional data. The investigation of computer knowledge demonstrated that the lack of IT knowledge resulted in poor outcome in their appointed tasks. From the view of self-assessment of IT knowledge, nursing staff and technician exhibited deficiency IT knowledge than doctors, who learned from department training, self-study or internet. Resident physicians and attending physicians were familiar with office system, so they were satisfied with IT skills. In contrary, nurses and majority of high-ranking professor or chief physicians were found difficult to study IT skills. However, most nurses were fond of their office system. The results also demonstrated that people aged 31 -40 years were easy to receive IT system. CONCLUSION: It is very important to enhance the cooperation between computer researchers and medical users for the treatment of coronary atherosclerotic heart disease.