Objective To identify the factors influencing the response to clopidogrel.Methods Seventy-two patients with acute coronary syndrome who were treated at Beijing Tongren Hospital from September,2005 to April,2006 were eligible for this study.10 ?mol/L ADP induced platelet aggregation was measured before and 7 days after clopidogrel treatment by the traditional optical aggregometry.According to the inhibition of platelet aggregation(?A),the population was divided into low response group and normal response group.Then some factors possibly influencing the response to clopidogrel were analyzed by specific statistical methods.Results Baseline characteristic showed that compard with that of normal response group,the body mass index and the percentage of obesity and STEMI were lower in low response group,while its percentage of hypertension and diabetes were higher(P

Objective To investigate the long-term clinical outcomes in patients with anterior wall acute myocardial infarction ( AW-AMI) and non AW-AMI ( NAW-AMI) referred to primary percutaneous coronary intervention (P-PCI). Methods 287 patients with AMI who consecutively underwent primary PCI were divided into AW-AMI group (142 cases) and NAW-AMI group (145 cases) according to different location of myocardial infarction. The baseline characteristics and coronary artery lesions of patients were analysed. The primary end points were in-hospital mortality and the major cardiovascular events (MACE) during a mean 17.3?9.8 month follow-up including the occurrences of non-fatal myocardial infarction, non-fatal congestive heart failure, revascularization of target vessels and overall cardiac-related death. Results The peak value of CK and CK-MB were significantly higher (3 533?2 888) U/L vs (2 322 ? 1 638)U/L, (158 ? 197) U/L vs (95 ? 64) U/L, all P

Objective To explore the incidence and risk factor of renal artery stenosis in patients with coronary artery disease and essentiality of renal arteriography while performing coronary artery angiography. Methods Renal arteriography was performed immediately after coronary artery angiography in 114 patients with suspected coronary artery disease. Results Incidence of renal artery stenosis was 18.4% (21/114) in 114 patients and 26% (20/77) in patients with coronary artery disease who were identified by coronary artery angiography. Only one case with renal artery stenosis was found in 37 cases whose coronary arteries were normal (2.7%, 1/37). Incidence of renal artery stenosis in patients with coronary artery disease was higher than that in patients with normal coronary artery (26% vs 2.7%, P

Objective To compare the clinical outcomes of immediate PTCA and elective PTCA on infarct related artery after spontaneous recanalization. Methods One hundred and eighteen patients with SR between January 1996 and March 2001 were enrolled. According to TIMI flow, the patients were divided into 2 study populations. The two study populations were divided into 2 groups according to immediate PTCA or elective PTCA, respectively. Results Mortality and reinfarction were similar between the 2 groups two weeks after heart attack. However, recurrent ischemic events were more frequent in elective PTCA group than in immediate PTCA group according to TIMI flow grade 2 (1/24 vs 4/12,P=0.034). Furthermore, heparin or low molecular weight heparin was prescribed more frequently in elective PTCA (4/24 vs 11/12, 3/45 vs 34/37,P

Objective: To study the correlation of blood stasis syndrome or its accompanied syndromes with Gensini score in patients with coronary heart disease (CHD) in stable condition. Methods: The syndrome types of traditional Chinese medicine (TCM) and blood stasis score in 131 CHD patients confirmed by coronary angiography were recorded. Gensini score was calculated according to the coronary pathological characteristics showed by angiography. The correlations of blood stasis syndrome and its accompanied syndromes with coronary lesion and Gensini score were analyzed. Results: Among the TCM syndrome types, blood stasis, turbid phlegm and qi deficiency were the most common syndromes, revealed in 85 patients (64.9%), 83 patients (63.4%) and 85 patients (64.9%), respectively. The coronary lesion length and Gensini score in the patients with blood stasis syndrome were much higher than those in the patients with non-blood stasis syndrome (P<0.05 or P<0.01). In the subtypes of blood stasis, the coronary lesion length and Gensini score in the patients with blood stasis accompanied by turbid phlegm syndrome were higher than those in the patients with non-blood stasis syndrome (P<0.05). And in the patients whose blood stasis syndrome score was more than 9 points, the coronary lesion length was higher than that in the patients whose blood stasis syndrome score was less than 9 points (P<0.05). Besides, with bivariate analysis, the blood stasis syndrome score showed no correlation with Gensini score (Pearson correlation coefficient was 0.104, P=0.241). Conclusion: Blood stasis syndrome is the most common TCM syndrome in CHD patients in stable condition. The blood stasis syndrome score is proportional to coronary lesion length, and reflects the severity of coronary lesion.

Objective To determine the correlation of cardiovascular MRI with cardiac biomarkers and electrocardiography(ECG)in acute myocardial infarction(MI).Methods Nineteen patients with first acute MI were selected to undergo MRI on a 1.5 T system within 3-7 days after the onset of symptoms.A first-pass perfusion scan was performed with the administration of Gd-DTPA at a speed after cine MRI for global left ventricle(LV)funotions.Delay-enhanced MRI was performed by using an ECG-gated inversionrecovery fast-gradient echo-pulse sequence 5 to 10 minutes later with second bolus injection at a s peed.Infarct mass(IM),percentage size of infarction(PSI)and LV functions were compared with peak troponin T (peak TnT)and peak ereatine kinase-MB fraction (peak CK-MB).The 12-lead ECG was analysed for STelevation on admission.Pearson and Spearman correlation test and independent-Sample t test wel-e used for statistics.Results The IM (median 6.3 g) was correlated with peak TnT(median 0.8μg/L,r=0.487,P=0.0340)and left ventricle end-systolic volume index(LVESVI)(median 23.4 ml/m2,r=0.480,P=0.038).IM showed a negative correlation with left ventricle ejection fraction(LVEF)(54.1±15.4)/(r=-0.563.P:0.012).The PSI(median 6.0/)was correlated with peak TnT(r=0.583,P=0.009),peak CK.Mn(median 43.0 U/L,r=0.470,P=0.042)and LVSV[(57.6 ±15.0)ml,r=-0.482,P=0.036],peak TnT was also correlated with LVSV(r=-0.524,P=0.021).There were more involved segments(IS)(t=2.972,P=0.009),higher peak TnT(t=2.245,P=0.041)and peak CK-MB(t=2.508,P=0.024)in ST-elevation MI(STEMI)than in non ST-elevation MI(NSTEMI).Conclusions IM directly influences LV functions in acute MI.Peak TnT was a better biomarker reflecting PSI and LV functions.There were more involved segments in STEMI than in NSTEMI.

Objective The sirolimus-eluting stent (SES) has dramatically reduced the rate ofrestenosis in comparison to that with the bare-metal stent (BMS).This study aimed to evaluate the short-term efficacy and safety of Firebird stent implantation for patients with coronary heart disease (CHD). Methods From Apri12006 through July 2007, 155 patients (mean age 58.93～10.27 years) with CHD were implanted with Firebird stent or Cypher select stent at Daxing Hospital. Patients were followed up for one year. All-cause mortality, major adverse cardiac events (MACE, including cardiac death, myocardial infarction, recurrence of angina pectoris, heart failure, revascularization, and adverse arrhythmia) and stent thrombosis were compared between the 2 groups. Results Of the 155 consecutive patients, 147 patients were revascularized completely. Of these patients, 48 (with 59 lesions) were treated with Firebird stent, 59 patients (with 75 lesions) with Cypher select stent. The demographic characteristics were similar in the 2 groups. All the angiographic and procedural results were not significantly different between the 2 groups. All-cause mortality, myocardial infarction, recurrence of angina pectoris, MACE and stent thrombosis were almost identical between the 2 groups before discharge, at 6 months and at one year .Conclusion The short-term efficacy and safety of Firebird stent are similar to that of the cypher select stent for the treatment of patients with CHD.

Objective To assess the feasibility,safety and efficacy of primary PCI in elderly patients with AMI.Methods Three hundred and sixty-four AMI patients were divided into ≥75 years old group (n=90) and ＜75 years old group (n=274).The successful operation rate,preoperative complication rate,mortality and incidence of major adverse cardiovascular events (MACE) were recorded during their hospital stay time.Results The successful operation rate was 94.4％,the postoperative TIMI 3 blood flow rate was 87.8％,and the preoperative complication rate was 10.0 ％ in ≥75 years old group.The mortality and incidence of MACE were significantly higher in ≥75 years old group than in＜75 years old group during the hospital stay time (12.2％ vs 2.9％,P =0.001;16.7 ％ vs 5.1％,P =0.000).Conclusion Transradial primary PCI is a safe,feasible and effective therapy for ≥75 years old AMI patients.

Objective To study the clinical characteristics and risk factors of elderly female CHD patients.Methods A total of 1223elderly CHD patients(493females and 730males)were included in this study.Their general clinical data and inhospital mortality were retrospectively analyzed and the risk factors for their inhospital mortality were analyzed.Results The age was significantly older,the incidence of DM,hyperlipidemia,sleep apnea sysdrome and the ratio of divorce and widowhood were significantly higher while the number of smokers and alcohol drinkers was significantly smaller in female patients than in male patients.The serum levels of LDL-C,TC,TG,FPG,apoA-Ⅰ,apoB were significantly higher,the specific volume of RBC was significantly larger while the number of RBC was significantly smaller,the serum Hb,CK-MB,EOS,Hcy,TBA,TBIL,APTT levels were significantly lower in female patients than in male patients.No significant difference was detected in inhospital mortality between female and male patients(6.7％vs 5.9％,P＞0.05).The low glomerular filtration rate was an independent predictor of inhospital mortality in elderly female patients(HR=0.894,95％CI:0.808-0.990,P=0.031)while age and serum creatine kinase isozyme level were the risk factors for inhospital mortality in elderly male patients( HR=1.169,95％CI:1.013-1.350,P=0.033;HR=1.008,95％CI:1.002-1.013,P=0.006).Conclusion The age of elderly female CHD patients is older than that of elderly male CHD patients.The spectrum of risk factors is significantly different between elderly female and male CHD patients.It is thus necessary to further study its prognostic value.

Objective To study the different therapeutic proportion of the patient populations undergone coronary angiography (CAG) in the era of development in multislice spiral computed tomography(MSCT).Methods Two hundred and fifty four consecutive patients(mean age 59.24±10.65),who underwent CAG at Daxing Hospital from February 2007 through October 2007,were enrolled,160 patients were male and 94 were female.By evaluating from the coronary angiogram,the patients were not diagnosed to have coronary heart disease(CHD) with less than 50% diameter stenosis of coronary artery;the patients to have CHD with more than or equal to 50% stenosis of coronary artery;the patients were performed the procedure of percutaneous coronary intervention(PCI) with more than or equal to 70% stenosis;the patients were proposed to have coronary aortic bypass graft(CABG) surgery with left main coronary artery lesions or diffuse triple coronary artery lesions.Results In the 254 consecutive patients,59 patients(23.2%) had not been diagnosed to have CHD;195(76.8%)to have CHD,of these patients with CHD,49 patients(19.3%)were not indicated for PCI (including the patients receiving follow-up coronary angiography after stenting),81(31.9%)had been performed the procedure of stent implantation,57(22.4%)proposed to have CABG,8(3.1%)the procedure of PCI had not been successful,or had not been performed because of patients opposing to this therapy.Conclusion Multislice spiral computed tomography can be applied as a non-invasive screening tool to exclude the presence of CHD,to increase the positive proportion of the populations with CHD in all patients receiving coronary angiograhpy,to avoid the use of CAG in a subset of patients.