Atherosclerosis ; pathology ; C-Reactive Protein ; metabolism ; Dendritic Cells ; metabolism ; Glycation End Products, Advanced ; metabolism ; Humans ; Inflammation

Coronary Aneurysm ; complications ; pathology ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications

Adult ; Aneurysm, False ; complications ; diagnosis ; Coronary Aneurysm ; complications ; diagnosis ; Coronary Angiography ; methods ; Coronary Vessels ; injuries ; Humans ; Male ; Myocardial Infarction ; etiology ; Tomography, X-Ray Computed ; methods ; Ultrasonography, Interventional ; methods

Adult ; Female ; Graft Occlusion, Vascular ; Humans ; Stents ; Takayasu Arteritis ; surgery

Objective To assess the safety and efficacy of domestic sirolimus-eluting stent(SES)compared with bare metal stent(BMS)in the primary percutaneous coronary intervention(PCI)for patients with ST-segment elevation AMI in a real-world scenario.Method From January 2005 to March 2006,a total of 143 patient with ST-segment elevation AMI were enrolled in this study,and all of them underwent primary percutaneous coronary intervention(PCI).Among the 143 patients,74 were treated with domestic SESs(Firebird stent)and 69 with BMSs.The incidence of major adverse cardiovascular events(MACE:death,reinfarction,and target vessel revascularization[TVR])was evaluated at 30 days and 180 days.Continuous variables were compared using Student's unpaired t test.Categorical variables were compared using Fisher's test.Cox proportional hazard survival models were used to assess risk reduction of adverse events.P value

Aged ; Fatal Outcome ; Heart Rupture ; etiology ; Humans ; Male ; Myocardial Infarction ; therapy

BACKGROUNDIncomplete stent apposition (ISA) has been demonstrated to be more common after drug-eluting stent (DES) implantation than after bare metal stent (BMS) implantation. Clinical outcomes of ISA remain controversial and the predictive accuracy of previous studies was limited by the short follow-up period of only 12-18 months. In the present study, we present the outcomes of a more than 2-year follow-up in patients with ISA after DES implantation.

METHODSFrom the clinical and core intravascular ultrasound (IVUS) database of the hospital, we identified 76 patients who had undergone DES implantation in de novo lesions between January 2004 and June 2005 and had received IVUS examination at a scheduled 6-month follow-up. A total of 13 (17.1%) patients had documented ISA at the follow-up by IVUS. Clinical follow-up was available up to 41 months after DES implantation and up to 33 months after identification of ISA.

RESULTSOver a mean follow-up of (34+/-5) months (range 24-41 months), 3 of the 13 patients (23.1%) suffered from ST elevated myocardial infarction with one death. Angiography confirmed the very late stent thrombosis (ST) in the area with ISA. All the 3 patients were implanted with sirolimus eluting stents in left anterior descending artery (LAD) and the very late ST occurred at 29, 31 and 32 months after DES implantation, and separately at 20, 23 and 23 months after the identification of ISA. All of the 3 patients had antiplatelet therapy continued before suffering from ST, and had been apparently stable on antiplatelet monotherapy with aspirin for a long period following dual antiplatelet therapy with aspirin and clopidogrel for more than 12 months.

CONCLUSIONISA of DES may be associated with a high incidence of very late stent thrombosis, even in clinically stable patients with dual antiplatelet therapy of at least 12 months after the procedure.

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Drug-Eluting Stents ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Thrombosis ; etiology ; Ultrasonography, Interventional

OBJECTIVETo estimate the feasibility of 16-multidetector spiral computed tomography (16-MDCT) on detecting coronary plaques in comparison with intravascular ultrasound (IVUS).

METHODSSixty-eight patients suspected of coronary heart diseases were examined by 16-MDCT, quantitative coronary angiography (QCA) and IVUS. Coronary stenosis was defined as lumen diameter reduction (DS) >or= 50%. Hounsfield units (HU) were used to determine different types of plaques: soft plaque (or= 120 HU).

RESULTSCompared to QCA, the sensitivity and the specificity for patients with DS >or= 50% were 91.8% (112/122) and 97.8% (556/568) respectively, the positive and negative predictive value were 90.3% (112/124) and 98.2% (556/566) respectively. In 96 plaques evaluated both by 16-MDCT and IVUS, 20 and 21 soft plaques, 37 and 36 fibrous plaques, 39 and 38 calcified plaques were identified by 16-MDCT and IVUS respectively. HU value of soft (11 +/- 36), fibrous (83 +/- 20), and calcified (292 +/- 80) plaques were significantly different (P < 0.05).

CONCLUSIONSNoninvasive 16-MDCT could correctly estimate coronary stenosis and coronary plaques compositions.

Aged ; Atherosclerosis ; diagnostic imaging ; Coronary Angiography ; Female ; Humans ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods ; Ultrasonography, Interventional

Aged ; Angioplasty, Balloon, Coronary ; methods ; Coronary Angiography ; Coronary Occlusion ; diagnostic imaging ; therapy ; Humans ; Male ; Middle Aged ; Stents

Adult ; Coronary Angiography ; Coronary Vessels ; diagnostic imaging ; pathology ; Humans ; Male ; Myocardial Infarction ; pathology ; therapy ; Sirolimus ; administration & dosage ; Stents ; adverse effects ; Ultrasonography