Objective To investigate the effects of probiotics combined with sacubitril valsartan and amiodarone on short-term and long-term efficacy of patients with atrial fibrillation after radiofre-quency ablation.Methods A total of 90 patients with atrial fibrillation after radiofrequency ablation in the First Hospital of Zhangjiakou City from June 2021 to June 2022 were selected and randomly di-vided into three groups,with 30 cases in each group.Control group was treated with amiodarone,sacubitril valsartan group was treated with amiodarone and sacubitril valsartan,and probiotics group was treated with probiotics,amiodarone and sacubitril valsartan.The recurrence situation,atrial struc-ture indexes[left atrial diameter(LAD),left ventricular ejection fraction(LVEF),left ventricular end systolic volume index(LVESVI),left atrial volume(LAV),left ventricular end diastolic volume index(LVEDVI)],myocardial fibrosis indexes[galactin-3(Gal-3),soluble growth stimulation expression gene 2 protein(sST2)],inflammatory response indexes[intercellular adhesion mole-cule-1(ICAM-1),C reactive protein(CRP),interleukin-6(IL-6)],neuroendocrine hormone in-dexes[aldosterone,norepinephrine(NE),angiotensin Ⅱ(Ang Ⅱ)],metabolites of gut microbiota[total bile acids,trimethylamine oxide(TMAO)]and incidence of adverse events were compared among the three groups.Results At 12 months after treatment,the recurrence rate of the probiotics group was significantly lower than that of the sacubitril valsartan group and the control group(P＜0.05);after 3,6 and 12 months of treatment,the LAD,LAV,LVESVI,LVEDVI,sST2 and Gal-3 in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group(P＜0.05),and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group(P＜0.05);after 3,6 and 12 months of treatment,the LVEF of the probiotics group was significantly higher than that of the sacubitril valsartan group and the con-trol group(P＜0.05),and the LVEF of the sacubitril valsartan group was also significantly higher than that of the control group(P＜0.05);after 3,6 and 12 months of treatment,the CRP,IL-6,ICAM-1,NE,aldosterone and Ang Ⅱ in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group,and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group(P＜0.05);after 3,6 and 12 months of treatment,the TMAO and total bile acids in the probiotics group were significantly lower than those in the control group and the sacubitril valsartan group(P＜0.05);there was no significant difference in the incidence of adverse events among the three groups(P＞0.05).Conclusion Pro-biotics combined with sacubitril valsartan and amiodarone can improve atrial structure after radiofre-quency ablation of atrial fibrillation,inhibit myocardial fibrosis,reduce inflammatory response,reg-ulate neuroendocrine hormones and metabolites of gut microbiota,prevent long-term recurrence of atrial fibrillation,and have a high safety.

Objective To investigate the effects of probiotics combined with sacubitril valsartan and amiodarone on short-term and long-term efficacy of patients with atrial fibrillation after radiofre-quency ablation.Methods A total of 90 patients with atrial fibrillation after radiofrequency ablation in the First Hospital of Zhangjiakou City from June 2021 to June 2022 were selected and randomly di-vided into three groups,with 30 cases in each group.Control group was treated with amiodarone,sacubitril valsartan group was treated with amiodarone and sacubitril valsartan,and probiotics group was treated with probiotics,amiodarone and sacubitril valsartan.The recurrence situation,atrial struc-ture indexes[left atrial diameter(LAD),left ventricular ejection fraction(LVEF),left ventricular end systolic volume index(LVESVI),left atrial volume(LAV),left ventricular end diastolic volume index(LVEDVI)],myocardial fibrosis indexes[galactin-3(Gal-3),soluble growth stimulation expression gene 2 protein(sST2)],inflammatory response indexes[intercellular adhesion mole-cule-1(ICAM-1),C reactive protein(CRP),interleukin-6(IL-6)],neuroendocrine hormone in-dexes[aldosterone,norepinephrine(NE),angiotensin Ⅱ(Ang Ⅱ)],metabolites of gut microbiota[total bile acids,trimethylamine oxide(TMAO)]and incidence of adverse events were compared among the three groups.Results At 12 months after treatment,the recurrence rate of the probiotics group was significantly lower than that of the sacubitril valsartan group and the control group(P＜0.05);after 3,6 and 12 months of treatment,the LAD,LAV,LVESVI,LVEDVI,sST2 and Gal-3 in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group(P＜0.05),and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group(P＜0.05);after 3,6 and 12 months of treatment,the LVEF of the probiotics group was significantly higher than that of the sacubitril valsartan group and the con-trol group(P＜0.05),and the LVEF of the sacubitril valsartan group was also significantly higher than that of the control group(P＜0.05);after 3,6 and 12 months of treatment,the CRP,IL-6,ICAM-1,NE,aldosterone and Ang Ⅱ in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group,and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group(P＜0.05);after 3,6 and 12 months of treatment,the TMAO and total bile acids in the probiotics group were significantly lower than those in the control group and the sacubitril valsartan group(P＜0.05);there was no significant difference in the incidence of adverse events among the three groups(P＞0.05).Conclusion Pro-biotics combined with sacubitril valsartan and amiodarone can improve atrial structure after radiofre-quency ablation of atrial fibrillation,inhibit myocardial fibrosis,reduce inflammatory response,reg-ulate neuroendocrine hormones and metabolites of gut microbiota,prevent long-term recurrence of atrial fibrillation,and have a high safety.

Objective To investigate the effect of interaction between serum neutrophil gelatinase-associat-ed lipid carrier protein(NGAL)and complications after percutaneous coronary intervention(PCI)on poor prognosis in patients with ST-segment elevation myocardial infarction(STEMI),and to provide reference for improving prognosis.Methods From January 2017 to January 2020,a total of 400 STEMI patients admitted to this hospital were selected and divided into good prognosis group(n=378)and poor prognosis group(n=22)according to their 2-year prognosis.Logistic regression equations were used to analyze the prognostic fac-tors of STEMI patients,and multiplicative and additive effects were established to analyze the effect of the in-teraction between serum NGAL and post-PCI complications on poor prognosis.Results Gender,age,heart rate,Gensini score,number of lesions ≥2,Killip grade,complications after PCI and NGAL level after PCI were associated with poor prognosis in STEMI patients(P＜0.05).Gender(female),age,heart rate,Gensini score,number of lesions ≥2,Killip grade,complications after PCI and NGAL level after PCI were all inde-pendent influencing factors of poor prognosis in STEMI patients(P＜0.05).There was interaction between serum NGAL after PCI and complications after PCI,both of which had an adverse effect on the prognosis of STEMI patients(P＜0.05).There was no multiplicative interaction between serum NGAL and complications after PCI(P＞0.05).When serum NGAL and complications after PCI were exposed at the same time,the risk of poor prognosis in STEMI patients was higher than the sum of the two exposures alone,and the interaction was 2.611 times the sum of the effects of the two exposures alone.Conclusion Serum NGAL and postopera-tive complications after PCI are independent factors influencing poor prognosis in STEMI patients.There is a additive interaction between the two factors,and exposure can increase the risk of poor prognosis.