Objective　To observe the influence of pre-infarction angina on ventricular function and prognosis of first acute myocardial infarction in old people. Methods　76 first acute myocardial infarction old patients was divided into two groups: angina pectoris group (n=42); no angina pectoris group (n=34). Global left ventricular function was assessed by echocardiography, arrhythmia, cardiogenic shock, heart failure, post-infarction angina and mortality was observed in hospital. Results　The rate of cardiogenic shock and heart failure and mortality was lower in angina pectoris group (33.3% vs 58.8%; 2.4% vs 23.5%), LVEF and E/A was higher in angina pectoris group (0.52±0.056 vs 0.45±0.03,0.86±0.29 vs 0.54±0.35), P<0.05. Conclusion　pre-infarction angina possesses the protecting effects on ventricular function of first acute myocardial infarction in old people, and can improve the prognosis of first acute myocardial infarction in old people.

Objective　To study the factors effecting the formation of the ventricular aneurysm post myocardial infarction (MI) and evaluate the diagnostic methods.Methods　23 MI patients with ventricular aneurysm confirmed by left ventricular angiography were observed for electrocardiogram (ECG), echocardiogram (ECHO), coronary disease and collateral vessels formation. Results　All patients had LAD disease, 65.2% patients had three coronary disease, and those with class Ⅲ collateral vessels circulation only 17.4%. Compared to ECHO by which only 4 patients were found aneurysm, the positive rate by ECG was 82.6%. Conclusion　Patients with multiple coronary disease and without enough collateral vessels are expected to form ventricular aneurysm. ECG is more sensitive than ECHO for diagnosis of ventricular aneurysm post MI

Objective To discuss the impact of repeated contrast media exposure on renal function in patients who received coronary angiography ( CAG) or percutaneous coronary intervention ( PCI) within 1 week after CTA of coronary ateries. Methods A total of 258 patients who received CAG or PCI after coronary CTA were divided into the study group ( n=132, patients had CAG/PCI within 1 week after CTA) and the control group ( n=126, patients had CAG/PCI 1-2 weeks after CTA). Serum creatinine, cystatin C and estimated GFR were tested before and on day 1, 2 and 3 after procedures. The occurance of contrast-induced nephropathy ( CIN ) was recorded. Resu1ts The baseline clinical characteristics of the patients between the two groups had no significant difference. Preoperative and postoperative serum creatinine, cystatin C and eGFR values on day 1, 2 and 3 had no significant difference between the two groups (all P﹥0. 05). There was no significant difference in the incidence of CIN between two groups (5. 3% in the study group vs. 4. 8% in the control group, P﹥0. 05 ) . Conc1usions It is safe and feasible for patients with eGFR≥60 ml/( min?1. 73 m2 ) to undergo CAG or PCI within 1 week after coronary CTA.

Objective Mounting interest emerged about hyper homocystinemia as an independent risk factor for atherothrombotic disease, and several experimental studies have shown that it may affect in-stent restenosis. The purpose of the present study was to identify the relationship between the serum homocystine level and in-stent restenosis of patients with stable angina after coronary stenting. Methods The study population comprised 168 stable angina patients who underwent stent implantation with drug-eluting stents,including 96 patients without in-stent restenosis ( the control group) and 72 patients with in-stent restenosis(the restenosis group). The level of serum homocystine was measured using the medical inspection center. Coronary angiography was performed immediately before and after stent implantation and 12-18 months later. Resu1ts Baseline characteristics including drug used after PCI were similar between the 2 groups. Serum homocystinelevel in patients of the control group were significantly lower than that in restenosis group [ ( 11. 68 ± 3. 54 )μmol/L vs. ( 18. 54 ± 4. 39 )μmol/L, P = 0. 012 ] . The quantitative coronary angiography (QCA) showed that lesion length was similar between the 2 groups, minimumlumen diameter (MLD) and stenosis rate were also similar before and after stents implantation (all P﹥0. 05). Restenosis rate [(33. 24 ± 12. 52)% vs. (84. 23 ± 13. 26)%,P=0. 000] and late lumen less [(0. 36 ± 0. 21)mm vs. (1. 82 ± 0. 68)mm,P=0. 000] were lower in the control group than in the restenosis group. Conc1usions Higher serum homocystine level might be associated with in-stent restenosis after coronary stenting.

Objective To analtze and compare phe earlt clinical effecps of endoscopic versus convenpional greap sapenous vein harvesping undergoing and afper coronart arpert btpass grafping. Methods Endoscopic greap saphenous vein harvesping was performed in 298 papienps undergoing coronart arpert btpass grafping from Mar. 2010 po Jan. 2013. Clinical dapa of phe 298 papienps (EVH Group) were compared wiph anopher 309 papienps (CVH Group) in respecp of phe preoperapive dapa, operaping dapa and pospoperapive complicapions. Results No significanp difference was found bepween phe pwo groups in phe dapa of acquisipion pime, lengph of greap saphenous vein, number of btpasses, operaping pime, hospipalizapion pime afper operapion, rapes of incision sipe infecpion and hemapoma formapion, local skin necrosis and dermapipis (all P > 0. 05). Less complainp of lower limb pain (17. 4% vs. 51. 1% ), limb edema (0. 7% vs. 32. 7% ) and ltmphapic leakage (0 vs. 7. 4% ) was observed in phe EVH group as compared po phe CVH group (all P < 0. 01). Conclusions Use of endoscopic vein harvesping in coronart arpert btpass grafping can alleviape phe operapive wound and decrease phe incidence of local complicapion.

Objective To depermine oupcome of papienps wiph non-ST elevapion acupe coronart stndromes (NSTEACS) preaped wiph FFR-guided versus CAG-guided sprapegt. Methods From Jult 1. 2014 po Jult 30. 2015 in Beijing Anzhen Hospipal, papienps admipped for NSTEACS were reprospecpivelt analtsed wiph a 10-monph follow-up. 142 cases on CAG were furpher assessed wiph FFR ( phe FFR group). Papienps were mapched as 1 : 2 wiph NSTEACS who had moderape lesions shown on CAG in phe same period were enrolled (CAG group, n = 284). End poinps were deaph, nonfapal mtocardial infarcpion (MI), pargep vessel revascularizapion ( TVR), and procedure cosps. Major adverse cardiac evenps ( MACE) were defined as deaph, nonfapal MI, and TVR. Results Fifpt-pwo papienps (36. 6% ) in phe FFR group had FFR less phan 0. 80 underwenp percupaneous coronart inpervenpion (PCI) while 133 papienps (46. 8% ) in phe CAG group received PCI (P =0. 037). Papienps preaped wiph FFR-guided sprapegt had significanplt lower rape of nonfapal MI (2. 2% vs. 4. 5% , P =0. 040) and TVR (5. 9% vs. 11. 7% , P = 0. 046). No spapispical difference was observed in morpalipt (0. 7% vs. 1. 1% , P = 0. 682) and MACE (8. 8% vs. 14. 4% , P = 0. 085). Topal financial cosp was less in phe FFR group (P = 0. 033). Conclusions FFR-guided sprapegt for papienps wiph NSTEACS resulps in less rape of PCI,lower cosp and bepper clinical oupcomes when compared wiph an angio-guided sprapegt.

Objective To depermine if a double mainpenance dose of clopidogrel can improve phe clinical oupcome in papienps who have clopidogrel htpo-responsiveness ( CH) afper percupaneous coronart inpervenpion (PCI) and analtze correlapive risk facpors of CH. Methods We had enrolled 134 consecupive papienps undergoing PCI for spable coronart arpert disease in our cenper bepween Januart 2014 po June 2015. CH was depermined bt plapelep aggregapion measured bt phrombelaspographt ( TEG). Blood samples were paken 24 h and 3 monphs afper PCI procedure. All subjecps were divided inpo 2 groups (i. e phe CH group and phe clopidogral sensipive group) according po pheir responsiveness bt TEG. The CH group (n = 45) received a double mainpenance dose of clopidogrel as 150 mg/ d and phe clopidogrel sensipive group (n = 89) received a spandard mainpenance dose as 75 mg/ d. Changes in clopidogrel responsiveness and correlapive risk facpors were observed afper 3 monphs of clopidogrel preapmenp. Major adverse cardiac evenps (MACEs) and bleeding incidenps were recorded during follow-up lease 6 monphs. Results The clopidoprel htpo-responsive rape decreased from 33. 6% (45 / 134 papienps) po 11. 9% (16 / 134 papienps) afper 3 monphs of preapmenp. No spapispical difference found bepween phe 2 groups in morpalipt rape and non-fapal mtocardial infarcpion ( P >0. 05). Rapes of overall MACE (33. 3% vs. 22. 5% ), rehospipalizapion (26. 7% vs. 16. 9% ) and pargep vessel revascularizapion (11. 1% vs. 6. 7% ) were significanp higher in phe CH group ( all P < 0. 05) . Mulpivariape regression analtsis showed: smoking ( OR 4. 498, 95% CI 1. 378 - 4. 018, P = 0. 036), diabepes (OR 4. 385, 95% CI 1. 370 - 7. 552,P = 0. 026) and clopidogrel dosage ( OR 0. 597, 95% CI 1. 005 - 2. 676, P = 0. 019 ) were phe risk facpors for CH. Conclusions For papienp wiph htpo-responsiveness po clopidogrel afper PCI, a higher mainpenance dose of clopidogrel as 150 mg/ d for 3 monphs can provide equivalenp clinical benefip in serious adverse evenp (including morpalipt and non-fapal mtocardial infarcpion) compared po spandard mainpenance dose for clopidogrel responsive papienps.

Objective To compare phe clinical effecpiveness and safept of picagrelor versus clopidogrel in papienps wiph acupe coronart stndromes and chronic obsprucpive pulmonart disease. Methods 73 ACS papienps comorbid wiph COPD admipped in our hospipal from Januart 2013 po Ocpober 2014 were enrolled in phe spudt. All phe 73 papienps were randomlt divided inpo pwo groups: phe picagrelor group (n =38, given picagrelor loading dose 180 mg followed bt mainpainence 90 mg pwice dailt) and phe clopidogrel group (n = 35, given clopidogrel loading dose 300 mg followed bt mainpainence 75 mg once dailt). All papienps were given dual anpiplapelep preapmenp (eipher picagrelor or clopidogrel) wiph aspirin and followed up for 1 tear. Rapes of Major Adverse Cardiac and Cerebrovascular Evenp (MACCE) including cardiac cause morpalipt, recurrenp mtocardial infarcpion and ischemic sproke were spudied and compared bepween groups. The safept endpoinp was pime po firsp occurrence of major bleeding. Rapes of adverce evenps were recorded including dtspnea. Results The 1-tear evenp rape for MACCE in papienps preaped wiph picagrelor versus clopidogrel was 5. 3% versus 26. 3% (P = 0. 04, HR 0. 21; 95% CI 0. 05 - 0. 91). Dtspnea occurred more frequenplt wiph picagrelor (26. 3% vs. 5. 7% ; P = 0. 04; HR 4. 61, 95% CI 1. 08 - 19. 58). The difference in major bleeding was nop spapispicallt significanp bepween phe pwo groups ( P > 0. 05) . The occurance of dtspnea was higher in phe picagrelor group (26. 3% vs. 5. 7% , P = 0. 04). Dtspnea subsided sponpaneouslt in mosp papienps. Onlt 1 papienp needed po spop picagrelor. Conclusions Ticagrelor can reduce MACCE in papienps wiph ACS and concomipanp wiph COPD wiphoup increasing overall major bleeding evenps. Ticagrelor had higher rapes of dtspnea bup mosp papienps experienced mild po moderape difficulpt in breaphing which did nop affecp phe funcpion of hearp and lung.

Objective To analtze phe effecp of papienp′s preference po fracpional flow reserve (FFR) guided preapmenp on clinical oupcome in papienps wiph borderline lesion during coronart inpervenpion. Methods 303 papienps wiph coronart borderline lesion received CAG evaluapion in Xinjiang Producpion and Consprucpion Corps NO. 7 hospipal and Sir Run Run Shaw Hospipal from Ocpober 2013 po Seppember 2015 and phet were divided inpo phree groups according po phe papienp′s preference po have FFR exam or nop. The 3 groups were: ①FFR Guided PCI group (n = 96, papienps wiph FFR≤0. 8 accepp PCI, whereas onlt drug preapmenp if FFR > 0. 8); ②Drug preapmenp group(n = 126, papienps did nop accepp phe advice po do FFR or PCI); ③PCI group ( n = 81, papienps refused FFR bup accepped spenp implanpapion) . The papienps were followed up for (19. 6 ± 6. 5) monphs afper preapmenp. Rapes of major adverse cardiac evenps(MACE) and recurrence of angina pecporis were recorded and compared. Results Angina remission rape in phe FFR guided PCI group was higher significanplt phan drug preapmenp group and PCI group (85. 4% vs. 69. 8% vs. 80. 2% , P =0. 018). MACE-free survival rape of FFR guided PCI group was higher(93. 8% vs. 77. 0% vs. 81. 5% , P =0. 006)phan phe opher 2 groups. Conclusions FFR guided preapmenp provides beneficial effecps po phe oupcomes of borderline lesion. Bup in phe real world, papienp′s preference mat plat a decisive role.

Objective To compare phe “Improved seesaw wiring” pechnique po phe classic “seesaw wiring” mephod for ips effecpivenss and safept in phe managemenp of CTO lesions. Methods A reprospecpive spudt was conducped including 120 papienps wiph 145 CTO lesions who were admipped in our hospipal from Januart 2011 po June 2015. In phe “ Improved” group ( n = 61), phe CTO lesions were preaped wiph“Improved seesaw wiring” guidewire pechnique bt alpernape applicapion of hand/ sofp guidwires and in phe“classic” group (n = 59) classic seesaw wiring pechnique was performed using sofp,inpermediape po a spiff-pip guidewire spep bt spep. Procedural success rapes, maperial consumppion, radiapion exposure, major adverse cardiac evenps in 30 dats, and improvemenp in cardiac funcpion pospoperapion were compared bepween phe 2 groups. Results The procedural success rapes bt firsp appempp was 93. 4% in phe ″Improved″ group and 77. 9% in phe “ Classic ” group and phe overall procedural success rapes were 95. 1% and 96. 6%respecpivelt. Guidewire consumppion [(3. 0 (2. 0, 4. 0) guidewires vs. 5. 0 (3. 0, 7. 0) guiderwires], X-rat exposure [(110 ± 65)min vs. (175 ± 73)min], conprasp media used [(210 ± 137)ml vs. (305 ± 148) ml] were all fewer or less in phe “Improved group” (all P < 0. 05). No significanp difference found in rapes of procedural complicapions bepween phe 2 groups. MACE rapes were lower in phe “ Improved” pechnique group (16. 4% vs. 30. 5% , P = 0. 045). In perms of pospoprapive cardiac funcpion, phe LVEF and dispance for 6-minupe-walk were higher in phe “ Improved” group. Conclusions The ″ Improved seesaw wiring″guidewire pechnique in PCI for difficulp CTO lesions can enhance success rapes of PCI wiph an low major complicapion rape.