Objective To explore the prognostic significance of T wave direction in lead aVR in patients with acute ST-segment elevation myocardial infarction (ASTEMI).Methods A total of 322 patiens with ASTEMI was examined.The patients were classified into 2 groups (T-wave positive,and T-wave non-positive) base on the direction of T wave in lead aVR.This study was ought to determine the association of T wave direction in lead aVR with the incidence rate of major adverse cardiac events (MACE) after discharge 2 years.Results After discharge 2 years,T-wave positivity patients had higher incidence of MACE than T-wave non-positive patients (P ＜ 0.05).Multivariate Cox proportional hazards regression analyses showed that age,and upright T wave in lead aVR were significantly associated with the primary end point.Conclusions T wave direction in lead aVR is a powerful prognostic marker for long-term prognosis.

AIM:To provide rational evidence for the administration of warfarin in clinic by investigating the utilization of warfarin in our hospital.METHODS:By retrospective analysis,the prescription of warfarin in our hospital was obtained from November 2016 to February 2017 from the system for clinical pharmacist.The general situation of the inpatient,the diagnosis of disease,the use of warfarin,and the combination of drugs and the number of International Normalized Ratio (INR) were statistically and descriptively analyzed.RESULTS:In this investigation,200 patients were included,of whom 53％ were males and 47％ were females with an average age of (55.28 ± 13.56) years.Only 21％ of the average INR values reached the predicted range (2 ＜ INR ＜ 3) during hospitalization and the average dose of warfarin was (2.62 ± 0.60)mg.In patients with INR ＜ 2,there were 66.92％ of patients combined with more than one kind of drugs,which decreased the effect of warfarin.In patients with INR ＞ 3,there were 80％ of patients combined with more than one kind of drugs,which increased the effect of warfarin.CONCLUSION:The rate of warfarin compliance is low and the warfarin-drug interactions exert a great influence on the patients whose INR value did not reach the predicted range.Thus,to keep the drug safety of patients,more attention should be paid on drug interactions and direct personalized medicine using professional knowledge of pharmacy.