Objective:To investigate the effects of contrast-induced nephropathy (CIN) and/or perioperative myocardial injury (PMI) on the short-term prognosis of patients after percutaneous coronary intervention (PCI).Method:The study was designed as a prospective cohort study. The subjects were selected from patients with acute coronary syndrome (ACS) who underwent PCI in the Department of Cardiology, the First Medical Center, General Hospital of Chinese people′s Liberation Army from August to October 2015. According to the occurrence of CIN and PMI after operation, the patients were divided into 4 groups: no injury group, CIN group, PMI group, and CIN+PMI group. The patients were followed up for 12 months, and the end point was the main adverse cardiovascular events (MACE). The differences in basic characteristics (sex, age, ACS type, underlying diseases, past medical history, etc.), the preoperative levels of serum creatinine, triglyceride, low density lipoprotein cholesterol, fasting blood glucose, high sensitivity troponin T (hs-cTnT), creatine kinase (CK) MB, C-reactive protein, and N terminal pro-B type natriuretic peptide (NT-proBNP), levels of serum creatinine, hs-cTnT, CK-MB, and NT-proBNP within 48 hours after operation, and the occurrence of MACE were compared in patients among the 4 groups. The effects of CIN and/or PMI on the occurrence of MACE within 12 months after operation were analyzed using COX multivariate regression model.Results:A total of 299 patients were included in the cohort study, including 216 males (72.2%) and 83 females (27.8%), with an average age of 60 years (range, 26-84 years). Of them, 125 patients (41.8%) were with ST segment elevation myocardial infarction (STEMI). One hundred and eighty-two patients (60.9%), 18 patients (6.0%), 79 patients (26.4%), and 20 patients (6.7%) were included in the non-injury group, CIN group, PMI group, and CIN+PMI group, respectively. The incidence of CIN in all patients was 12.7% (38/299) and that of PMI was 33.1% (99/299). No subjects were lost during the 12-month follow-up. Of the 299 patients, 24 subjects had 26 times of MACE [cardiogenic death, nonfatal myocardial infarction (NF-MI), target vessel revascularization (TVR), and stroke occurred 3, 5, 5, and 13 times, respectively] and the incidence of MACE was 8.0%. The incidences of MACE in the no injury group, CIN group, PMI group, and CIN+PMI group were 1.6% (3/182), 11.1% (2/18), 11.4% (9/79), and 50.0% (10/20), respectively, and the difference among groups was statistically significant ( P<0.001). The results of COX multivariate regression analysis showed increased risk of MACE in the other 3 groups [hazard risk ( HR)=6.897, 95%confidence interval ( CI): 1.152-41.281, P=0.034; HR=7.623,95 %CI: 2.063-28.167, P=0.002; HR=43.087, 95 %CI: 11.817-157.098, P<0.001) compared with the non-injury group. Conclusion:Both CIN and PMI can increase the risk of MACE in patients within 12 months after PCI treatment, which can be further increased in the coexistence of them.

Objective:To investigate the effects of contrast-induced nephropathy (CIN) and/or perioperative myocardial injury (PMI) on the short-term prognosis of patients after percutaneous coronary intervention (PCI).Method:The study was designed as a prospective cohort study. The subjects were selected from patients with acute coronary syndrome (ACS) who underwent PCI in the Department of Cardiology, the First Medical Center, General Hospital of Chinese people′s Liberation Army from August to October 2015. According to the occurrence of CIN and PMI after operation, the patients were divided into 4 groups: no injury group, CIN group, PMI group, and CIN+PMI group. The patients were followed up for 12 months, and the end point was the main adverse cardiovascular events (MACE). The differences in basic characteristics (sex, age, ACS type, underlying diseases, past medical history, etc.), the preoperative levels of serum creatinine, triglyceride, low density lipoprotein cholesterol, fasting blood glucose, high sensitivity troponin T (hs-cTnT), creatine kinase (CK) MB, C-reactive protein, and N terminal pro-B type natriuretic peptide (NT-proBNP), levels of serum creatinine, hs-cTnT, CK-MB, and NT-proBNP within 48 hours after operation, and the occurrence of MACE were compared in patients among the 4 groups. The effects of CIN and/or PMI on the occurrence of MACE within 12 months after operation were analyzed using COX multivariate regression model.Results:A total of 299 patients were included in the cohort study, including 216 males (72.2%) and 83 females (27.8%), with an average age of 60 years (range, 26-84 years). Of them, 125 patients (41.8%) were with ST segment elevation myocardial infarction (STEMI). One hundred and eighty-two patients (60.9%), 18 patients (6.0%), 79 patients (26.4%), and 20 patients (6.7%) were included in the non-injury group, CIN group, PMI group, and CIN+PMI group, respectively. The incidence of CIN in all patients was 12.7% (38/299) and that of PMI was 33.1% (99/299). No subjects were lost during the 12-month follow-up. Of the 299 patients, 24 subjects had 26 times of MACE [cardiogenic death, nonfatal myocardial infarction (NF-MI), target vessel revascularization (TVR), and stroke occurred 3, 5, 5, and 13 times, respectively] and the incidence of MACE was 8.0%. The incidences of MACE in the no injury group, CIN group, PMI group, and CIN+PMI group were 1.6% (3/182), 11.1% (2/18), 11.4% (9/79), and 50.0% (10/20), respectively, and the difference among groups was statistically significant ( P<0.001). The results of COX multivariate regression analysis showed increased risk of MACE in the other 3 groups [hazard risk ( HR)=6.897, 95%confidence interval ( CI): 1.152-41.281, P=0.034; HR=7.623,95 %CI: 2.063-28.167, P=0.002; HR=43.087, 95 %CI: 11.817-157.098, P<0.001) compared with the non-injury group. Conclusion:Both CIN and PMI can increase the risk of MACE in patients within 12 months after PCI treatment, which can be further increased in the coexistence of them.

Objective To explore the effects of sleep situation on circadian rhythm of blood pressure in elderly hypertension patients.Methods Two hundred and thirty patients (aged ≥ 60 years) with hypertension treated in the Department of Geriatric Cardiology of PLA General Hospital were enrolled in the study from October 2016 to December 2016.After admission,the clinical and laboratory tests data and examinations of the patients were collected and analyzed.The patients' sleep was investigated by Pittsburgh sleep quality index (PSQI).The ambulatory blood pressure rhythm was divided into three groups:reverse-dipper group (n=110),non-dipper group (n=86),and dipper group (n=34).The clinical data and sleep situation of different blood pressure rhythm groups were compared,and the effects of sleep situation on different blood pressure rhythm were analyzed.Results The total PSQI score with six domains[P＜0.01,except hypnotic drug (P＞0.05)]was significantly lower in dipper group than in reverse-and non-dipper group.The sleep situation was significantly better in dipper group than in reverse-and non-dipper group (P＜0.05).Multiple linear regression analysis showed a significant negative correlation between total PSQI score and nocturnal blood pressure drop after adjusting for risk factors of hypertension (β =-0.651,P ＜0.01).Furthermore,after further adjusting for the seven domains of the PSQI score,the negative correlation remained between the sleep time score and the nocturnal blood pressure drop (β=-1.926,P =0.031).The elderly hypertension patients with shorter sleep duration had a lower rate of nocturnal blood pressure decline,and were prone to present the reverse-dipper and non-dipper blood pressure rhythm.Conclusions The elderly hypertension patients with poor sleep quality,especially with short sleep duration,are prone to present the reverse-dipper and non-dipper blood pressure rhythm.Short sleep duration can be used as a predictor for abnormal blood pressure rhythm.