ObjectiveTo study the effect of platelet aggregation rate (PAR) level on the prognosis of percutaneous transluminal coronary angioplasty (PCI).MethodsFour hundred and one patients who performed PCI were divided into 4 groups:group 1 (PAR≤30％,103 cases),group 2 (PAR 31％ - 40％,102 cases),group 3 (PAR 41％ - 49％,103 cases ) and group 4 (PAR ＞ 49％,93 cases ).All the patients were followed up.The survival analysis was performed in 4 groups.ResultsThe data of survival table were tested by 3 methods among 4 groups:statistic was 0.612,degree of freedom was 3,P =0.894 in Log-rank (Mantel-Cox) test,statistic was 0.567,degree 9f freedom was 3,P =0.904 in Wilcoxon test and statistic was 0.586,P =0.900 in Tarone-Ware test.There was no significant difference among them.The mean follow-up duration was 2.2 years,and there was no significant difference in survival function among 4 groups (P ＞0.05).ConclusionPreoperative and postoperative measurement of PAR levels may not improve the prognosis.

Objective To investigate the correlation between the levels of placenta growth factor (PLGF),soluble angiopoietin receptor-2 (sTie-2) and critical coronary artery plaque imaging morphology of coronary borderline lesions in patients with coronary heart disease (CHD).Methods In three consecutive years from April 2007 to September 2009,a cohort of 719 patients with borderline coronary lesions with stenosis in three main vessels with lumen diameter reduction varied all the way from more than 20％ to less than 70％ and with greater than 2.25 mm of the inner diameter were selected in this study from 4 teaching hospitals of tertiary class A in Beijing.These patients fell into three categories:unstable angina pectoris (UAP,n =292),stable angina pectoris (SAP,n =219) and coronary arteriosclerosis (AS,n =208).The vessels involved were analyzed using quantitative coronary angiography (QCA).Plasma levels of PLGF and sTie-2 were measured by using protein chip.The relationship between plasma levels of vascular factors,sTie-2,PLGF and coronary artery plaque imaging morphology among three groups were analyzed.Results (1) Plasma level of PLGF was 80.33 ng/L in the UAP group,which was significantly higher than 54.29 ng/L in the SAP group and 45.16 ng/L in AS group (both P ＜0.05).Plasma level of sTie-2 was 1353.06 ng/L in the UAP group,which was significantly higher than 1308.28 ng/L in the AS group (P =0.008).(2) There was significantly statistical differences in QCA between the SAP group and the UAP group as well as the AS group (both P ＜ 0.05) in terms of the minimal lumen diameter,diameter stenosis rate,minimal lumen cross-sectional area and cross-sectional area of stenosis.The plaque area in the UAP group was larger than that in the AS group (P =0.013).(3) The relationship between vascular factors and plaque imaging morphology was analyzed.There was significantly statistical difference in the involved lesions among the three groups (P ＜ 0.01).(4) There was a positive correlation between plasma level of PLGF and minimal lumen cross-sectional area (r =0.493,P =0.009).Conclusions The plasma levels of PLGF and sTie-2 reflect the level of neo-vascularization in the plaque,and could be taken as predictive factors for potential pathogenesis of coronary plaque.

ObjectiveTo investigate the clinical characteristics of patients with acute coronary syndrome suffering hemorrhage during hospitalization. MethodsThe clinical symptoms,diagnostic and therapeutic characteristics and in-hospital outcome of 3807 inpatients who were recruited into SINO-GRACE study in China due to acute coronary syndrome from March,2001 to December,2007 were collected.Statistical methods were adopted to compare the differences in clinical data between hemorrhage group and non-hemorrhage group.ResultsHemorrhage had happened in 57 out of 3807 inpatients with the incidence of 1.50％. Five patients, which accounted for 9.6％of the overall hemorrhage cases, were fatal hemorrhage.Nine patients were intracranial hemorrhage with the incidence of 0.24％. There were 155 deaths among the 3807 patients,with an overall mortality rate of 4.1％. The mortality of hemorrhage accounted for 3.2％in overall mortality. Patients with one of the following factors were more apt to hemorrhage:＞ 70 years old,previous hemorrhage history,renal failure history,heart failure history and clopidogrel and glycoprotein (GP)Ⅱ b/Ⅲ a receptor antagonist administration for coronary artery bypass grafting.Patients who developed hemorrhage might need prolonged hospitalization and were liable to develop heart-related adverse events,including re-infarction and sustained ventricular tachycardia/fibrillation after they were admitted in hospital over 24 hours. ConclusionPatients with acute coronary syndrome who underwent coronary artery bypass grafting,with advanced age,previous hemorrhage history,renal failure history,heart failure history or treated with clopidogrel and GPⅡ b/Ⅲ a receptor antagonist are more vulnerable to hemorrhage.

Objective ST segment elevation in adult patients with acute myocarditis is rare in adult.The purpose of this study was to report the outcome of ST segment elevation in adult patients with acute myocarditis in our hospital,in order to provide reference for clinical diagnosis and treatment.Methods A retrospective analysis of Beijing Anzhen Hospital during January 2002 to December 2015 for the diagnosis of acute myocarditis were 105 cases,divided into two groups,one group of ST elevation (ST elevation group) total 57 cases,another group of non ST elevation (non ST elevation group) total 48 cases.The clinical features,laboratory examination,treatment and prognosis were compared between the two groups.The composite primary endpoint of major cardiovascular events (MACE) during hospitalization included:mortality,cardiac shock and ventricular fibrillation.Results The average onset age of patients with ST segment elevation group and non ST segment elevation group were similar [(27.7 ± 10.1) years vs.(28.7 ± 10.0) years,P =0.603].There was a significant difference between the two group in patients of heart rate [(89 ± 22) beats/min vs.(80 ± 23) beats/min,P =0.028],systolic blood pressure on admission [(105 ± 17) mmHg vs.(115 ± 17) mmHg,P =0.003],diastolic blood pressure on admission [(66 ± 11) mmHg vs.(74 ± 11) mmHg,P =0.000],and total number of acute fulminant myocarditis [20 (35.1％) vs.7 (14.6％),P =0.024)].ST segment elevation acute myocarditis patients were significantly more at risk for MACE than non ST segment elevation acute myocarditis patients during hospitalization (P =0.04).Conclusion ST segment elevation acute myocarditis has acute onset and rapid progression.The incidence of MACE during hospitalization was significantly high.Mechanical support can be ve,ry favourable.ST segment elevation acute myocarditis is associated with excellent short-term prognosis.

Objective To study the changes of plasma cystatin C level (PcyC),and evaluate the effects of the joint use of atorvastatin and probucol on PcyC and severity of coronary lesion in patients with borderline lesion of coronary artery.Methods One hundred and thirty consecutive patients with borderline coronary lesion assessed by quantitative coronary angiography were enrolled into borderline coronary lesion group (BCL),and another 136 subjects without coronary lesion were enrolled as controls (CTR).And in the meantime,the subjects in BCL group were randomized (closed envelope method) into routine treatment subgroup ( RTT,n =60),and combined treatment subgroup in which patients were treated with atorvastatin 20 mg plus probucol 1.0 g daily in addition to routine medication ( CBT,n =70) for 6 months.There were no statistical differences in basic clinical features between two subgroups.PcyC,high-sensitive C-reactive protein (hs-CRP),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol ( HDL-C ) and triglycerides (TG) were determined.Of them,104 patients in BCL group rechecked by coronary angiography.Comparison of biomarkers carried out between two groups by using a number of independent-sample t-test and analysis of variance.For enumeration data,chi-square test was used to compare mean values of biomarkers between groups. P ＜ 0.05 was considered statistically significant.Results PcyC levels were significantly higher in BCL group than those in CTR group ( P ＜ 0.05 ).Compared with RTT subgroup,levels of PcyC,TC,LDL-C,TG and hs-CRP were more significantly decreased in CBT subgroup (P ＜ 0.05,P ＜ 0.01 ).Moreover,there was a trend of slight decrease in the mean percent of stenosis (MPS) of coronary artery with borderline lesion in RTT subgroup treated for 6 months,whereas more marked decrease in the MPS of coronary artery with borderline coronary lesion in CBT subgroup treated for 6 months ( P ＞ 0.05 ; P ＜ 0.05 ).Conclusions Cystatin C plays an important role in the pathogenesis of coronary artery,and PcyC is associated with severity of coronary lesion,the combination of atorvastatin and probucol decreases the PcyC level,and it may be the treatment of choice for borderline lesion of coronary artery.

Objective To explore whether ultrasound-mediated microbubbles destruction could enhance anti-sense RNA transfection and expression. Methods Phospholamban antisense RNA eukaryon vector PcDNA 4. 1-asPLB was successfully constructed and it was transfected into cardiac myocytes by various methods including calcium phosphate precipitation, ultrasound exposure and ultrasound-mediated microbubbles destruction. The expression of PLB and sarcoplasmic retculum Ca2+ ATPase (SERCA2a) in cardiac myocytes was tested by RT-PCR and western blot. Results The transfection and expression of PcDNA 4. 1-asPLB increased significantly in cells treated with ultrasound-mediated microbubbles destruction compared to other transfer groups( P ＜0.05). The expression of PLB was inhibited specifically after cardiac myocytes were transfected with PcDNA 4. 1-asPLB. There was no change of PLB expression after cardiac myocytes transfected with PcDNA 4. 1 ( P ＜0.05). Though the expression of SERCA2a never exhibited any changes after PcDNA 4. 1-asPLB transfection, the PLB/SERCA2a ratio decreased markedly. Conclusions As a highly effective antisense RNA transfer method, ultrasound-mediated microbubbles destruction can enhance the transfection and expression of the PcDNA 4. 1-asPLB significantly. The PcDNA4. 1-asPLB transfection inhibits the expression of PLB and result in decrease of PLB/SERCA2a ratio in cardiac myocytes.

OBJECTIVEThe purpose of this registry is to collect data on percutaneous coronary interventions (PCI) performed in various provinces in mainland China in 2005.

METHODSQuestionnaires were send to all hospitals in China and data on PCI, PCI case numbers and type of stents were collected.

RESULTS(1) PCI is available in 754 hospitals among the 30 provinces and there are more than 50 hospitals performing PCI in 4 provinces: Shandong (70), Beijing (60), Guangdong (60) and Shanghai (50); (2) A total of 95 912 PCIs were performed among the 30 provinces and about 50% of these procedures were finished in five provinces (Beijing: 20%, Shanghai: 8.9%, Shandong: 7.6%, Liaoning: 6.1% and Shanxi 6.0%; (3) PCI numbers were more 1000 in 7 hospitals, between 500 - 999 in 13 hospitals, between 300 - 499 in 41 hospitals, between 100 - 299 in 149 hospitals and less than 100 in more than 50% of all hospitals; (4) In several regions with higher GDP such as Jiangsu Province, Zhejiang Province, Guangdong Province, Shandong Province and Hainan Province, the rate of PCI/total population is significantly lower than other regions with comparable GDP and there is a potential for higher PCI numbers in the future; (5)Around 60% stents implanted were drug eluting stents.

CONCLUSIONPCI procedures is popular in mainland China now, especially in regions with higher GDP. Around 60% implanted stents were drug eluting stents.

Angioplasty, Balloon, Coronary ; statistics & numerical data ; China ; epidemiology ; Drug Delivery Systems ; Humans ; Registries ; statistics & numerical data ; Stents

Objective To evaluate the relationship between plasma cystatin C concentration (PcyC) and coronary artery diseases (CAD). Method A total of 126 subjects with CAD evidenced by coronary angiography admitted from April 2007 to March 2009 were divided into three groups: stable angina pectoris (SAPs, n = 34),unstable angina pectoris (UAPs, n = 56) and acute myocardial infarction (AMIs, n = 36), according to the diag-nostic criteria of CAD set by WHO. Another 34 subjects without CAD were taken as controls. There were no statis-tical differences in demographics among four groups. Serum lipids profile, uric acid (UA), PcyC and high-sensi-tive C-reactive protein (hs-CRP) were determined. And in the meantime, all patients were followed up for six months and adverse cardiovascular events were recorded. Comparisons were made between groups with a number of independent-sample t -tests. Data were processed with analysis of variance to test the differences in means among four groups, and the means were compared with chi-square test. Statistical significance was established at a P val-ue of less than 0.05. Results Cystatin C levels were significantly higher in UAPs than that in SAPs and in controls (P < 0.05), but were much lower than that in AMIs (P < 0.05). And much higher concentration of hs-CRP was found in UAPs (P < 0.05) and in AMIs (P < 0.01). Cystatin C was positively and significantly corre-lated with age, hs-CRP, WBC, creatinine and UA (r > 0, P < 0.05), whereas a significantly negative correla-tion with high-density lipoprotein cholesterol was found (r = - 0.227, P < 0.05). These coefficients were obvi-ously high for creatinine (r = + 0. 612), and WBC (r = + 0.459). During the period of six-month follow-up, 26 patients with adverse cardiovascular events were found, and had significantly higher cystatin C levels than 22 con-trols at admission (P < 0.01). Conclusions Cystatin C plays a pivotal role in the course of CAD, and the PcyC is a strong predictor for the risk of cardiovascular events.

OBJECTIVETo collect data on percutaneous coronary intervention (PCI) performed in inland of China.

METHODSQuestionnaires on PCI were distributed to all hospitals capable of performing PCI through national society of cardiology. Data from 2006 and 2007 were reported in this report.

RESULTS(1) In 2007, 144,673 PCI were performed in 870 hospitals compared to 112,580 PCI performed in 1078 hospitals in 2006. Number of PCI in 2007 increased more rapidly compared to 2006 in three provinces (Fujian 327.3%; Anhui 115.1% and Guangdong 86.9%). (2) In 2007, the number of PCI performed in ten provinces accounted for 66.7% of total PCI in inland of China (Beijing 15.4%; Guangdong 8.0%; Liaoning 6.9%; Shandong 6.9%; Shanghai 6.1%; Henan 5.8%; Zhejiang 4.7%; Jiangsu 4.4%; Shanxi 4.4% and Hebei 4.2%). (3) There were 299 (34.4%) hospitals with PCI number more than 100 in 2007 compared with 290 (29.6%) hospitals in 2006; there were 507 hospitals with PCI numbers less than 50 in 2006. (4) In 2006, there were 86,974 patients received PCI in 672 hospitals and 135,658 stents were implanted and 97.8% of implanted stents were drug eluting stents (DES).

CONCLUSIONFrom 2006 to 2007, number of PCI increased significantly in inland of China, there were about 50% hospitals with PCI number less than 50 per year and 1.56 stents per patient were implanted and 97.8% implanted stents were DES.

Angioplasty, Balloon, Coronary ; statistics & numerical data ; China ; Coronary Restenosis ; Humans ; Registries

OBJECTIVETo analyse the effects of different therapies on coronary artery disease (CAD).

METHODSA total of 1055 patients who suffered from CAD diagnosed by coronary angiography were divided into three groups, namely pure drug therapy, percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) groups. Follow up was carried out from March to May in 2001, and the major adverse cardiac events (MACEs) including death, no-lethal myocardial infarction (MI) and revascularization were observed. In long-term observation, angina reoccurred, and their improvement was evaluated. The short-term period was defined as the duration of 30 days after discharge, and the long term period was defined as the duration from 30 days after discharge.

RESULTSIn the long-term period, the recurrences of angina both in PCI group and CABG group were lower than pure drug group (P 0.018, 0.002 respectively). No differences about long-term endpoint events were observed among these three groups (P > 0.05). Forty-two patients suffering from left main coronary disease were intervened by the three therapies, and there was no death or MI both in PCI and CABG groups, three patients died and suffered from AMI in pure drug therapy group (P = 0.015). In the short-term period, mortality in CABG group (5.77%) was higher than those in the other two groups (1.91% for PCI, and 1.40% for medical therapy, P = 0.002), and no obvious difference observed in the latter two groups. No significance was concluded about the recent MI among this three groups (P = 0.357). There were no differences on revascularization in these three groups.

CONCLUSIONSPercutaneous coronary interventions can not only reduce the attack of angina but also improve the life quality of patients, however it can not improve the long-term existence but left main CAD.

Adult ; Aged ; Angina Pectoris ; etiology ; Angioplasty, Balloon ; Coronary Artery Bypass ; Coronary Disease ; drug therapy ; surgery ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; etiology ; Treatment Outcome