Objective To compare the characteristics of coronary artery lesions and ventricular systolic, diastolic and synchronous function of non-ST-segment elevation (NSTEMI) with those of ST-segment elevation myocardial infarction (STEMI) in Chinese. Methods One hundred and sixty-eight consecutive patients with NSTEMI 116 and STEMI 52 were enrolled into this study. Coronary angiography (CAG) was performed within 72 hours in all patients, while the parameters of left ventricular function were measured by equilibrium radionuclide angiography (ERNA) with ventricular phase analysis (PA) within 1 week after acute myocardial infarction. Results (1) The incidences of patients associated with diabetes and old myocardial infarction in NSTEMI group were higher than those in STEMI group (30.77% vs 10.34%; 34.62% P

Objective To investigate the extablishment of minipigs no-reflow models after percutaneous coronary intervention of AMI. Methods A total of 20 wuzhishan minipigs (9?1 months old with body weight of 25?5 kg) were chosen. Left ventriculography and coronary angiography (CAG) were performed sequentially by femoral approach,AMI and no-reflow was set up by diliating balloon to occlude the coronary coronary and reperfusion after the injection of microthrombus into the left anterior descending artery. At the same time, left ventricular hemodynamics parameters were recorded. Changes in ECG and IC-ECG were monitored. Results (1) Sixteen animals survived after the procedures and fourteen of them reached the criterion of AMI with no-reflow (TIMI≤2, CTFC≥36.2). The model extablishment success rate was 70%. (2)The hemodynamics parameters including heart rate, PRI, LVEDP, and PCWP increased, but blood pressure decreased at the time no-reflow was formed compared with those before LAD was occluded. (3) During the experiment, the changes in ECG and IC-ECG were similar to those observed in human in AMI. Conclusion Minipig is an ideal species for the establishment of animal no reflow model reperfusion after microthombus injection and balloon occlusion of LAD.

Objective To explore the protection for ischemic myocardium with warm-up phenomenon and KATP channel blocker interventional effect on it. Methods Patients with chronic stable angina who came into the study were divided into three groups according to the presence of diabetes and its treatment ways: 25 patients without diabetes came into a NDM group, 22 patients with diabetes treated with glibenclamide came into a DMG group and 25 patients with diabetes but on diet only came into a DMD group. All the patients underwent sequential bicycle ergnmeter exercise test twice (EX1, EX2)with a time interval of 15 min. Parameters including exercise duration (ED), time for 1 mm ST-segment depression (T-STD), maximum STD (mm) and corresponding heart-rate systolic blood pressure product (RPP) were observed respectively. The parameters obtained during EX2 were compared with those obtained during EX1.Results In the group NDM,ED and T-STD were prolonged [(546. 04±103.78)s vs (617.52±106. 96) s, P < 0.05 and (378.64±92.34)s vs (436.84±91.25)s, P<0.05], STDmax was shortened [(2.06± 0.37) mm vs(1.75±0.41)mm,P<0.01]and RPP was increased[(173.77±34.73) beats±min~(-1)·nun Hg~(-2) vs (199.23±37.07 beats·min~(-1)·mm Hg~(-2), p<0.05]as the parameters during EX2 were compared with those during EX1. In the group DMG, there was no difference in these analysed parameters except that T-STD was prolonged [(328.45±64.66)s vs (363.00±81.48)s, P<0.01]when these of EX2 and EX1 were compared. In the group DMD,all the analysed parameters improved significantly during the second test (EX2) in comparison with the first test (EX1) as the results in the group NDM. Conclusions Exercise test can induce warm-up phenomenon in patients with chronic stable angina poctoris.The KATP channel blocker glibenclamide can block the warm-up phenomenon.

0.05). The mortality in group A was obviously higher than that in group AI ( P

OBJECTIVE: To explore the mechanism of Sanqi Qiancao Recipe (SQR) in treating metrorrhagia caused by copper intrauterine device (IUD) in rabbits and to provide experimental evidence for preventing and treating this disease. METHODS: Fifty-six rabbits were randomly divided into seven groups, which were normal control group, sham-operation group, untreated group, indomethacin-treated group, low-dose SQR-treated group, medium-dose SQR-treated group and high-dose SQR-treated group. Copper IUD insertion was operated in rabbits of the last five groups. Rabbits in the last four groups were treated orally with indomethacin and low-, medium- and high-dose SQR respectively for a week. Rabbits in the untreated group, normal control group and sham-operation group were given distilled water orally. Hematocrit, blood viscosity at low, medium and high shear rate, plasma viscosity and blood sedimentation were examined after treatment. RESULTS: The hematocrit, blood viscosity at low, medium and high shear rate and plasma viscosity were higher in the untreated group than those in the normal control group with significant differences (P<0.01) while those indexes in low-, medium- and high-dose SQR-treated groups were significantly lower than those in the untreated group (P<0.05 or P<0.01). CONCLUSION: SQR can lead to a decrease in blood viscosity and improve the blood flow, which may be one of the mechanisms of SQR in treating metrorrhagia after copper IUD insertion.

Objective To establish a bedside available risk scoring system of no-reflow in the acute stage of STEMI.Methods Data from STEMI patients treated with PCI divided into model group and validation group were analyzed.Multivariable binary logistic regression analysis was used to identify independent no-reflow predictors of the model group.Finally,a score according to the odds ratio on logistic regression analysis was designed,and then risk stratification was established,and no-reflow high-risk patients with myocardial infarction were selected.The authenticity and reliability of the logistic regression courses were validated using receiver operator characteristic curve (ROC)and Hosmer-Lemeshow goodness-of-fit.Results Multivariate logistic regression analysis demonstrated that female (OR =0.587,P =0.019),Killip class of myocardial infarction≥2 (OR =3.656,P <0.01),TIMI flow ≤2 before primary PCI (OR =0.774,P =0.013),thrombus burden score ≥4 on baseline angiography (OR =2.629,P <0.01),pain to balloon time ≥ 6 h (OR =1.485,P =0.083)were independent correlate predictors of no-reflow phenomenon in the STEMI after PCI.The risk score system demonstrated a good risk prediction in the model group with AUC of 0.716 (95%CI:0.671 -0.761)based on ROC analysis.There was no significant discrepancy between multivariate logistic regression analysis and Hosmer-Lemeshow goodness-of-fit (χ2 =1.027,P =0.994).In risk stratification,total value <2 was assigned into low risk level,and 2-5 was put into the medium risk level,and >5 was arranged into high risk level.The risk score system demonstrated a good risk prediction in the validation group with AUC of 0.891 (95%CI:0.822 -0.959)based on ROC analysis.ROC analysis in the validation group was applied to Killip class,thrombus burden,score and risk stratification in the validation group ,and the no-reflow score was more accurate,with a larger area under the curve (AUC = 0.851,95% CI:0.776 -0.927 ).Conclusions Establishment of no-reflow scoring system with STEMI patients undergoing PCI was benefit to select high risk patients with no-reflow.

Objective: To explore the impact of ticagrelor on myocardial microcirculation in patients of non-ST elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI). Methods: A total of 80 NSTEMI patients treated in our hospital from 2015-03 to 2015-12 were enrolled. All patients received coronary angiography (CAG) and PCI, they were randomly divided into 2 groups: ticagrelor (TA) group and clopidogrel (CA) group, n=40 in each group. The baseline condition, PCI related parameters, plasma levels of SOD, MDA at pre- and 24h, 72h post-PCI were compared, the incidence of major adverse cardiac events (MACE) within 30 days after PCI was also compared between 2 groups. Results: The baseline condition, proportion of infarction-related vessels, average length and diameter of implanted stents were similar between 2 groups, all P>0.05. Compared with CA group, TA group had the less post-operative CTFC in LAD and RCA, P<0.05; while CTFC in LCX was similar between 2 groups, P>0.05. The ratios of acute pre-operative, post-operative TIMI grade 3 and slow flow incidence were similar between 2 groups, P>0.05. The peak values of CK-MB and cTnI in TA group were lower than CA group, P<0.05. Compared with baseline condition, MDA levels at 24h and 72h post-operation were increased in both groups, all P<0.001; compared with CA group, TA group had the lower MDA level at 24h post-operation, P=0.023, MAD was further reduced at 72h post-operation in TA group, P=0.043. Compared with baseline condition, SOD levels at 24h and 72h post-operation were decreased in both groups, all P<0.001; compared with CA group, TA group had the higher SOD level at 24h post-operation, P=0.013, SOD was elevated at 72h post-operation in both groups, the elevation was more obvious in TA group, P=0.049. The incidence of MACE was similar between 2 groups within 30 days of PCI,. Conclusion: Ticagrelor could improve myocardial microcirculation in NSTEMI patients after PCI; it was safe and without obvious adverse effects.

Objective To investigate the effects of simvastatin on membrane ionic currents in left ventricular myocytes after acutemyocardial infarction(AML.so as to explore the ionic mechanism of statin treatment for antiarrhythmia.Methods Fourty-five NewZeland rabbits were randomly divided into three groups:AMI group,simvastatin intervention group(statin group)and sham-operatedcontrol group (CON).Rabbits were infarcted by ligation of the left anterior descending coronary artery after administration of oralisolated enzymatically from the epicardial zone of the infractcd region.Whole cell patch clamp technique was used to record mmbranewas significantly decreased in AMI group(-23.26+5.1 8)compared with CON(-42.78±5.48,P＜0.05),while it was significantlyincreased in Stating roup(-39.23±5.45)compared with AMI group(P＜0.01);The peak Ica-L current density(at 0 mV) was significantlydecreased in AMI group(-3.23±0.91)compared with CON(-4.56±1.01,P＜0.05),while it was significantly increased in Statin group(-4.18±0.95)compared with AMI group(P＜0.05);The Ito current density(at+60 mV)was significantly decreased in AMI group(10.41±1.93)compared with CON(17.41±3.13,P＜0.01),while it was significantly increased in Statin group(16.21±2.42)compared withattenuate this change without lowering the serum cholesterol level,suggesting that simvastatin reverse this electrical remodeling thuscontributing to the ionic mechanism of statin treatment for antiarrhythmia.

ObjectiveTo investigate the effect and medical cost of different revascularization strategies for acute myocardial infarction (AMI) patients with multi-vessel disease (MVD).Methods A prospective randomized controlled trial (RCT) was conducted. From January 2009 to June 2012, patients with AMI and MVD undergoing primary percutaneous coronary intervention (PCI) were enrolled. They were randomly assigned to group A [staged PCI for non-infarction related artery (non-IRA) within 7-10 days after AMI] and group B (subsequent PCI for non-IRA recommended only for those with evidence of ischemia). All of patients were given optimized medical therapy according to clinical guideline, and they were followed up for 24 months at regular intervals. Major adverse cardiovascular events(MACE) including recurrence of myocardial infarction and death due to cardiac ailments were recorded. Meanwhile, re-hospitalization from cardiac causes, recurrence of angina, heart failure, and re-PCI, number of stents, total hospital stay days, and total medical expenditure were recorded.Results A total of 428 patients accomplished the 24-month follow up. All the patients underwgennt PCI for non-IRA in group A (215 patients), while 62 patients in group B (213 patients) undergone PCI for myocardial ischemia, and 51 patients received non-IRA treatment. There was no significant difference in MACE incidence between group A and group B [8.4% (18/215) vs. 10.8% (23/213),χ2= 0.727,P = 0.394]. The difference of death rate due to cardiac causes (5.1% vs. 6.6%), recurrence of myocardial infarction (4.2% vs. 6.6%), and heart failure (4.2% vs. 7.0%) were not significantly different between groups A and B (allP> 0.05). The rate of recurrence of angina (14.4 % vs. 32.9%), re-hospitalization from cardiac causes (14.4% vs. 33.8%), and re-treatment of implanting stents (12.6% vs. 29.1%) were significantly lower in group A than group B (allP< 0.01), and the rate of revascularization was significantly higher in group A than group B (10.7% vs. 5.2%,P< 0.05). The total number of stents (610 vs. 366), mean number of stents per patient (2.83±0.91 vs. 1.72±0.91,t = 12.725,P = 0.000), and total cost per patient (kRMB: 63.7±12.6 vs. 51.5±12.3,t = 10.107,P = 0.000) in group A were significantly higher than those in group B. Total hospital stay days in group A was significantly less than group B (days: 8.21±2.45 vs. 9.89±3.23, t = 6.071,P = 0.000). Because non-IRA-vascular reconstruction rate was low in group B, the rate of usingβ-blocker and anti-anginal agents during the 24-month follow up in group B was significantly higher than group A [59.2% (126/213) vs. 47.0% (101/215),χ2= 6.371,P = 0.012; 56.3% (112/213) vs. 17.6% (36/215),χ2 = 64.704,P = 0.000]. Conclusions In patients with AMI and MVD undergone emergency PCI, staged PCI within 7-10 days for non-IRA cannot decrease the incidence of myocardial infarction and death due to cardiac causes, recurrence of angina and rehospitalization for cardiac causes was diminished, and it may increase the number of stents and medical cost significantly.

Objective: To evaluate the impact of intracoronary administration of eptifibatide oncoronary no-reflow and myocardium perfusion in patients with ST-elevation myocardial infarction (STEMI) at percutaneous coronary intervention (PCI). Methods: A total of 80 STEMI patients with emergent PCI were randomly divided into 2 groups: Eptifibatide group, the patients received intracoronary administration of eptiifbatide and Control group, the patients received the same volume of normal saline.n=40 in each group. The baseline condition, post-operative vascular recanalization, changes of platelet aggression at pre- and post-medication were compared between 2 groups. Echocardiography was examined at immediately and 24 weeks after operation;myocardial infusion imaging was examined at l week after operation. All patients were followed-up for 24 weeks to observe the incidence of major adverse cardiovascular events (MACE). Results: Compared with Control group, Eptifibatide group showed increased ratios of post-operative TIMI grade 3 (72.5%vs 92.5%) and myocardium perfusion (70.0% vs 90.0%), bothP<0.05; decreased post-operative and 2h post-medicinal platelet aggression and they were both lower than Control group at the same period, allP<0.05. Eptiifbatide group had obviously improved LVEDD and LVEF at 24-week than 1-week after PCI and they were both superior to Control group, allP<0.05. There were 7 (17.5%) patients in Eptiifbatide group and 7 (7.5%) in Control group suffering from small bleeding events, P>0.05; no severe bleeding eventand no in-hospital thrombocytopeniaoccurred. MACE occurrence rates during 24-week follow-up period were 12.5% vs 22.5%, P>0.05. Conclusion: Intracoronary administration of eptiifbatide in STEMI patients at emergent PCI could effectively improve coronary blood lfow,increase myocardium perfusion and enhance cardiac function without severe bleeding events.