Objective　To compare the effects of early and long-term treatment with captopril on clinical outcome between elder patients (65-75 years old) and younger patients (＜ 64 years old) suffering from acute myocardial infarction (AMI). 　Methods　In a randomized trial, 822 patients with a first AMI were treated with captopril at initial dosage of 6.25 mg and adjusted to 25 mg t.i.d according to blood pressure (209 younger patients, 269 elder patients) and conventional treatment (131 younger patients, 213 elder patients). Survival rate of the four groups was calculated with Kaplan-Meier method. 　Results　The survival of treatment group was correlated significantly with age during hospitalization (P=0.0002). Eight patients in younger treatment group and 10 patients in younger control group (3.83% vs 7.63%, P＞0.05), 25 patients in elder treatment group and 52 patients in elder control group (9.29% vs 24.41%, relative risk = 0.37, 95% CI 0.29-0.48, P＜0.0001) were died. During follow-up period, the survival was however not related to the age (P＞0.05), and both the elder and younger patients had better survival (all P＜0.01 ) and lower cardiac events (all P＜0.01) during captopril treatment. 　Conclusions　 Captopril exerts less effect on the younger patients but more effect on the elder patients during hospitalization after AMI. Long-term captopril had no difference between the youngers and the elders in prognosis.

Objective Myocardial blush grade (MBG) as a new angiographic parameter was used to describe the effectiveness of myocardial reperfusion in patients treated with thrombolysis for acute myocardial infarction (AMI) Methods Eighty nine patients received a small dose alteplase 50mg within 12 hours of acute infarction Coronary angiography was performed at 90 min after the initiation of thrombolytic therapy to evaluate infarct related artery (IRA) patency and myocardial reperfusion Cardiac events during a 6 month period were recorded Results There were 87 6% and 12 4% patients with and without successful clinical recanalization after thrombolysis respectively Coronary angiography showed that 82 6% patients with TIMI flow 2 or 3, 88 8% patients with MBG 2 or 3, and 40 4% patients with TIMI flow 3 and MBG 3 Mortality at follow up was 10 1% Multivariate analysis showed that the MBG and Killip grade at admission were major significant predictors of 6 month mortality Conclusion The primary objective of reperfusion therapies is not only restoration of blood flow in the epicardial coronary artery, but also complete reperfusion of the infarcted myocardium

Objective To evaluate the clinical efficacy of coroflex (BRAUN, Germany) intracoronary stent. Methods To retrospectively analyze the immediate angiographic and clinical follow-up outcomes of 81 patients (pts) receiving coroflex intracoronary stenting. Results 88 coroflex intracoronary stents were implanted in 81 pts. According to ACC/AHA classification, 38 lesions were type A-B 1, 50 lesions were type B 2-C. 52 lesions were de novo, 22 were suboptimal results after PTCA and 14 lesions were bailout for dissections. Stent deployment was successful in 82/88 (93.2%). High-pressure (16-18 atm) balloon was used for stent deployment in 3 lesions with severe calcification. Dissection was occurred at distal of stent in 2 lesions but no inducing flow reduction. Angiography showed TIMI 2 grade after intracoronary stenting in 1 diffused lesion. There were no adverse events occurred during hospital stay. Clinical follow-up of in 75 pts were conducted for 7.5?3.0 (3-13) months, there were no cardiac death or myocardial infarction reported. Complain of angina (CCS class Ⅰ) occurred in 17 pts (22.7%). Repeat angiography was performed in 7 pts, there were 2 in-stent restenosis with successful revascularization. Conclusion Coroflex intracoronary stenting appears to be safe and effective in the treatment of coronary lesions with favorable outcomes.

0.05). However, compared with group II, group I had higher cardiac event rates (34.6% vs 20.4%, P =0.020). Conclusion Coronary stenting in ostial lesions may have similar procedural success rate, but less late benefit, compared with that in nonostial lesions.

Objective To compare the effect of direct stenting (DS) and conventional post-dilation stenting (CS) on no-reflow phenomena in coronary artery disease (CAD) patients. Methods Demographic characters, final baloon dilation pressure instant angiographic results, and long term outcomes were compared between patients receiving DS (n=127) and patients receiving CS (n=127). Results Patients in DS group had less degree of stenosis (82%?6% vs 87%?11%,P

0.05) were of no significance between the 2 group. There was no difference in recurrent agina and improvement of blood pressure. But rates of re-admission (26.9% vs 7.3%) and comorbity of renal failure (23.1% vs 1.8%) in group Ⅰ were significantly higher than those in group Ⅱ ( P

Objective To evaluate the efficacy and safety of percutaneous stent implantation for native aortic coarctation. Methods Five patients with native coarctation of the aorta underwent percutaneous endovascular angioplasty and stenting. Immediate and long-term outcomes were assessed in terms of blood pressure changes, procedure complications, and medications. Results Compared before and after stenting, the pressure gradient associated with the stenotic segment was decreased immediately after stenting [(73?6) mm?Hg vs (8?2) mm?Hg, P

50% and was classified as in-stent if inside stent or in-segment if located within the stented segment plus the 5 mm segments distal or proximal to the stent margins. Results Among the 8 patients included in this analysis, 5 had in-segment restenosis and 3 had in-stent restenosis (2 were not real in-stent restenosis and were just due to underexpansion). IVUS showed all restenosis occurred as localized lesion. Conclusion Restenosis after drug-eluting stents implantation is frequently associated with local trauma outside the stented segment and incomplete lesion coverage by the drug-eluting stent. Restenosis usually occurs proximal to the stent and presents as a localized lesion.

0.05).Multivariate analysis showed that the recurrence was related to the number and diameter of the tumors,with the hazard ratios being 1.877(P=0.001)and 1.391(P=0.029 4),respectively;injection of MMC had no influence on the recurrence.There was no significant difference in the time of disease-free survival(DFS)between the 2 groups,with the median time of DFS of MMC injection group being 5 months and of control group being 3 months after the first operation(P=0.125 3).The recurrence rates in the MMC group and control group were 65.79% vs 68.57%(P=0.800 4) 6 months after operation,81.58% vs 94.29%(P=0.099 0)1 year after operation,89.47% vs 97.14%(P=1.679 55) 2 years after operation and 92.11% vs 97.14%(P=0.344 7)3 years after operation.Conclusion: Injection of 10mg MMC via great omentum vein during resection of IHCC may have no definite effect on the recurrence of IHCC;however,perspective study is needed to verify this finding.

Objective To compare the effects of early and long term treatment with captopril on clinical outcome between elder patients (65 75 years old) and younger patients (0 05), 25 patients in elder treatment group and 52 patients in elder control group (9 29% vs 24 41%, relative risk = 0 37, 95% CI 0 29 0 48, P 0 05), and both the elder and younger patients had better survival (all P