Objective:To investigate the current situation of insomnia in patients with acute coronary syndrome (ACS), and analyze the influencing factors of insomnia in the ACS patients, so as to provide information on the development of new strategies for the treatment of insomnia in ACS patients.Methods:This is a multicenter and prospective observational study. A total of 771 ACS patients who met the criteria were selected from March 2013 to June 2015. The baseline social demographic information, sleep quality questionnaire, general anxiety disorder scale-7(GAD-7),patient health questionnaire-9(PHQ-9), short-form 12 health survey questionnaire(SF-12), and enhancing recovery in coronary heart disease patients social inventory(ESSI) were completed within 7 days after admission. Logistic regression analyses were used to analyze the influencing factors of insomnia in ACS patients.Results:A total of 741 subjects with valid questionnaires were collected, including 510 males (68.8%) and 231 females (31.2%). Among them, 487 (65.7%) subjects had at least one insomnia symptom: 308 (41.6%) subjects had difficulty in falling asleep, 369 (49.8%) subjects were easy to wake at night, 116 (15.7%) subjects woke up earlier than they expected, 74 (10.0%) subjects experienced both woke up earlier and difficulty in falling asleep, and 53 (7.2%) subjects woke up earlier, woke up at night and had difficulty in falling asleep at the same time. Logistic regression analyses showed that before admission physical activity ( OR =0.636, 95% CI 0.411-0.984), depression ( OR=1.908, 95% CI 1.101-3.305) and low social support ( OR=0.278, 95% CI 1.198-3.301) were independent factors of insomnia in ACS patients. Conclusions:Nearly 2/3 ACS patients have symptoms of insomnia. Difficulty in falling asleep and easy to wake up at night are the most common manifestations. Physical activity, depression and social support independently are associated with insomnia.

Objective To investigate the safety and effectiveness of left internal mammary artery (LIMA) angiography via right transradial approach with 5F universal coronary angiography catheter. Methods Left internal mammary artery (LIMA) angiography via right transradial approach with 5F universal coronary angiography catheter was performed following coronary angiography in 86 patients.The success rate of the procedure, the result of LIMA angiography, the time to LIMA, the volume of contrast, the incidence of complications and bypass vessels in patients who received coronary artery bypass grafting (CABG) were recorded and analysed. Results The success rate was 97.6%(84/86), and the result of LIMA angiography was satisfied; the time to LIMA was (6.5 ± 2.8) min, and the volume of contrast was (17.6 ± 11.1) ml;the incident of complications was 4.7%(4/86);56 patients received CABG. LIMA was harvested in all cases and left radial artery in 53 cases. Conclusions LIMA angiography via right transradial approach with 5F universal coronary angiography catheter is safe and effective, and it has significant sense to patients who will receive CABG.

Objectives: To investigate the social support status, related influential factors and the impact on one year outcome in patients with acute coronary syndrome (ACS), our data might be helpful to provide basis for making new treatment strategy aimed at improving social support for patients with ACS. Methods: From January 2013 to June 2014, a total of 778 hospitalized patients with ACS were enrolled in the study. All patients completed enhancing recovery in coronary heart disease patients social support inventory(ESSI), general anxiety disorder scale(GAD-7), patient health questionnaire(PHQ-9), short-form 12 health survey questionnaire(SF-12), sleep questionnaire and demographic questionnaire within 7 days after admission and at 6 months and one year post discharge. Multiple linear regressions were performed to analyze factors that influenced the social support. Results: The total score of social support was 17.08±3.61, 17.72±3.04, and 17.76±3.05 respectively in patients with ACS at baseline, 6 months and 12 months after discharge. Patients had a higher point of social support at 6 months (t=-2.69, P<0.01) and 12 months (t=-2.86, P<0.01) after discharge than at baseline. Multiple regression analysis for baseline data identified five significant predictors of low social support status: workers or farmers (t=2.82, P<0.01), low family monthly income (t=2.42, P<0.05), anxiety (t=-3.66, P<0.01), depression (t=-3.22, P<0.01) and low quality of life (t=4.38, P<0.01). Conclusions Social support of patients with ACS is lower in China, and there are significant relationships between low social support and occupation, economic status, anxiety, depression, quality of life of ACS patients.

Objective To summarize the experience and technique of complex transradial percutaneous coronary intervention ( PCI) using a 4F KIWAMI ST01 catheter with Mother-Child technique for patients with coronary heart disease. Methods Retrospectively analyzed the data from 30 patients who had received PCI using a 4 F catheter with Mother-Child method. Results PCI were performed on a total of 30 patients with complex lesions. Angiographic success was achieved in 100% of lesions. 19 patients were found to have moderate-to-severe calcified lesions, 13 patients had chronic total occlusion ( CTO ) , 11 patients had moderate-to-severe tortuous lesions, and 6 patients had moderate-to-severe angulated lesions. Four patients suffered from in-stent restenosis. 4 F catheter with Mother-Child method was used in all patients, and all 4F catheters successfully passed through the target lesions with all stents implanted in place along the 4 F catheter. There were no 4 F catheter-related complications in all patients. Conclusions Use of 4F catheter with Mother-Child method is safe and effective for patients where stent delivery is difficult by the conventional method.

Objective To investigate the coronary characteristics and interventional treatment results of coronary artery patients on dialysis due to uremia.Methods Twenty-five cases coronary artery disease patients,including 3 cases with stable coronary disease,7 cases with ST elevation myocardial infarction,and 15 cases with non-ST elevation myocardial infarction,who were treated with uremia dialysis from January 2001 to December 2014 in Friendship Hospital of Beijing Affiliated to Capital Medical University were selected.Emergency or regular coronary angiography was done after admission,and coronary angiography characteristics of vascular lesions and interventional treatment outcomes,clinical results during hospitalization and 12-month follow-up were observed.Results (1) The proportion of three-vessel disease of 19 cases,moderate and severe calcification of 20 cases,and diffuse disease of 11 cases were observed in coronary artery disease with dialysis.No differences were found in the proportion of three-vessel disease(x2=1.08,P=0.58),moderate and severe calcification(x2 =0.48,P =0.79),and diffuse disease (x2 =4.52,P =0.11) among the groups of stable coronary disease,ST elevation myocardial infarction and non-ST elevation myocardial infarction.(2) The interventional therapy in 24 patients with coronary heart disease complicated with uremia was successful,and the average total operation time was (55.3±7.1) min,the average contrast volume was (126.0±12.6) ml.There was 1 case with complication of side branch occlusion.(3) Cardiovascular events rates during hospitalization and after 12-month follow-up were 20.0％ (5/25) and 48.0％ (12/25),respectively.Conclusion In coronary artery patients with uremic on dialysis,the proportion of three-vessel disease,moderate and severe calcification,and diffuse disease are relatively high.The success rate of intervention therapy is high and safe but with a relatively high cardiac events during hospitalization and 12-month follow-up.

Objective To summarizes the experiences and technique of complex transradial percutaneous coronary intervention (PCI) using sheathless guide catheter (Sheathless Eaucath, ASAHI) for 60 patients with coronary heart disease. Methods Retrospectively analyzed the data from 60 patients received PCI using sheathless guide catheter. Results PCI were performed on a total of 60 patients with complex lesions. Angiographic success was achieved in 95.0%and failed in three patients with CTO. 7 patients were with left main lesions, and 32 patients were with bifurcation lesions(including 7 patients with left main lesions and 2 patients with CTO), and 13 patients were with CTO, and the other 17 patients were with tortuous and calcified lesions. Sheathless guide catheters of 7.5Fr were used for PCI in all patients, and all catheters successfully passed through the radial artery and were put in place. No other vascular complications associated with the use of the catheter occurred. Sheathless guide catheters were respectively JL(8 patients), PB(2 patients), AL(2 patients), and JR(1 patient) in 13 patients with CTO, and were respectively JL(8 patients), JR(6 patients), SPB(2 patients), AL(1 patient) in 17 patients with tortuous and calcified lesions. JL or JR were used in all 32 patients with bifurcation. Conclusions Use of the Sheathless of 7.5 Fr is safe and feasible, and allows complex interventions to be undertaken transradially with a high success rate.

Background To document the pharmacotherapy of chronic heart failure (CHF) and to evaluate the adherence to treatment guidelines in Australian population.Methods The pharmacological management of 677 patients (female 46.7%,75.5±11.6 years) with CHF was retrospectively analyzed.Results The use of angiotensin converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARB) and fl-blockers were 58.2%and 34.7%,respectively.Major reasons for non-use of ACE inhibitors/ARBs were hyperkalemia and elevated serum creatimne level.For patients who did not receive β-blockers,asthma and chronic obstructive pulmonary disease were the main contraindications.Treatment at or above target dosages for ACE inhibitors/ARBs and β-blockers was low for each medication (40.3% and 28.9%,respectively).Conclusions Evidenced-based medical therapies for heart failure were under used in a rural patient population.Further studies are required to develop processes to improve the optimal use of heart failure medications.

Objective To investigate the risk factors,clinical and coronary angiographic characteristics in women less than 50 years with coronary heart disease(CHD).Methods One hundred and twenty-six women less than 50 years were divided into CHD group and non-CHD group according to the result of coronary angiography(CAG).Risk factors,clinical and coronary angiographic characteristics were investigated retrospectively.Results In 6395 cases who were given CAG in the corresponding time period,126(1197%)women were less than 50 years,and 44 cases were confirmed as having CHD by CAG[CHD group,mean age(46.8±3.6)years)].Meanwhile 82 cases were in non-CHD group[mean age(45.4±4.3)years)].The incidence rate of hypertension[77.3%(34/44)vs 26.8%(22/82)],diabetes mellitus[34.1%(15/44)vs 4.9%(4/82)],hyperlipidemia[43.2%(19/44)vs 7.3%(6/82)],family history of CHD[43.2%(19/44)vs 7.3%(6/82)],and risk factors of family history of CHD[52.3%(23/44)vs 12.2%(10/82)]had significant difference between CHD group and non-CHD group(P<0.01).88.6%(39/44)CHD palients were acute coronary syndrome,50.0%(20/44)lesion was one-vessel lesion.Left anterior descending coronary was involved most easily.The degree of calcification was lighter.The type.of lesion was mostly localized and segmented.Conclusions Hypertension,hypedipidemia,diabetes mellitus,family history of CHD,and risk factors of family history of CHD are the major risk faetom in women less than 50 years with CHD. The possibility of CHD is higher when having classical angina and multiple risk faetom.

Objective To evaluate the clinical effectiveness of a new and easy-to-use thrombus-aspirating device for primary percutaneous trans-radial coronary intervention (PCI). Method From March 2006 to June 2008, fifty acute myocardial infarction (AMI) patients with angiographic evidence of high-burden coronary throm-bus treated with thrombus aspiration were enrolled in a single center retrospective study. Thrombotic clot was aspi-rated before stent was implanted in the infarct-related coronary artery. Thrombolysis in myocardial infarction(TIMI) flow, corrected TIMI frame count (cTFC), TIMI myocardial perfusion grade(TMPG), and rate of no-reflow were observed with coronary augiography. Acute thrombosis and subacute thrombosis in stent during hospital stay were investigated. Myocardial ischemic events, revascularization and mortality during the following period were also in-vestigated. Paired t -test was used for statistical analysis. Results Thrombus was completely removed in 35 pa-tients (70%) and partially removed in 15 patients (30%) seen immediately after thrombus aspiration. There were significant improvements both in postoperative TIMI flow (0 vs. 2.7±0.5, P <0.01) and TMPG (0 vs. 2.6±0.8, P <0.01), while cTFC was 20.2±16.8 after the thrombus aspiration. No severe complication occurred during and after operation. Conclusions Trans-radial thrombas-aspiration in primary PCI is clinically safe and feasible. The use of aspiration catheter (ZEEK) is a simple and effective approach to the treatment of coronary artery stenosis associated with thrombus because it elevates the successful rate of treatment,reduces the incidence of no-reflow,and results in better prolonged-term outcome.

Objective To evaluate the effectiveness of immediate quantitative coronary angiography (QCA) analysis in percutaneous coronary intervention (PCI). Methods The parameters of QCA and conventional methods before and after PCI were compared and statistics was performed by using t test or ANOVA methods. Results One hundred and two patients were enrolled in our study. Significant differences between QCA and conventional methods were found in evaluation of lesion length [ ( 22.9 ± 8.9 ) mm vs (24. 8 ± 10. 6) mm,t = 9. 63, P < 0. 05 ], stenosis diameter [ (3.0 ± 0.4 ) mm vs (2. 9 ± 0. 7) mm, t = 6. 31, P < 0. 05 ] and stenosis area [ ( 87. 8 ± 10. 7 ) mm2 vs ( 85.0 ± 12.9 ) mm2, t = 2. 54, P < 0.05 ], and also in different vessels. Stenosis diameter and stenosis area after stenting in target lesion were lower than the international standards. Conclusion Immediate QCA analysis can be effective in directing stent implantation.