Objective To investigate the actions of beta blocker (atenolol) and ACE inhibitor (enalapril) for the secondary prevention of the main cardiac complications after acute myocardial infarction (AMI). Methods 1106 ...Objective To investigate the actions of beta blocker (atenolol) and ACE inhibitor (enalapril) for the secondary prevention of the main cardiac complications after acute myocardial infarction (AMI). Methods 1106 cases of AMI from 7 hospitals in the Beijing area were collected and were divided randomly into three groups: control (group C), atenolol (group A), and enalapril (group E). Drugs for investigation were administered 2 4 weeks after the onset of AMI, and the subjects were followed up for a median period of 19 months. All patients were given aspirin 50 mg/day. The end points of observation were cardiac events and non cardiac events. Cardiac events included sudden cardiac death (SCD), heart failure death, total cardiac deaths, and myocardial re infarction. Results The clinical conditions of the three groups were compatible. Sixty six cardiac events (6.0%) occurred. Comparing with group C, the rate of SCD decreased significantly by 68% in group A after atenolol treatment for 28 months. Both atenolol and enalapril significantly increased left ventricular ejection fraction (LVEF), whereas in group C the LVEF did not change during the follow up period. There was obvious decreasing tendency of the survival curve in group C, compared with the other two groups. Totally drugs decrease one cardiac death‰/month. But the rate of myocardial re infarction was the same in the three groups. No serious side effects on blood pressure or heart rate were observed. Conclusions Both atenolol and enalapril (domestic products) are beneficial to the secondary prevention of SCD and heart failure death after AMI, but not to re infarction. Both drugs should be continued for a prolonged period to be effective. Drugs given 2 4 weeks after acute stage are also effective, with no serious side effects.展开更多
Background: Drug-eluting stents (DESs) are associated with lower restenosis rates. However, minimal data on the follow up results of premature coronary artery disease (PCAD) treated with DESs exist. This study was to ...Background: Drug-eluting stents (DESs) are associated with lower restenosis rates. However, minimal data on the follow up results of premature coronary artery disease (PCAD) treated with DESs exist. This study was to evaluate clinical characteristics and one- year prognosis of PCAD implanted with DESs in a Chinese population. Methods: 282 patients with PCAD, of which 177 implanted with DESs and 105 prescribed medicine alone were enrolled and analyzed. Major adverse cardiovascular events (MACEs) and the use of medications for secondary prevention were collected and analyzed. Results: Compared with those receiving medicine alone, patients implanted with DESs had higher ratios of males than females, they also had acute coronary syndromes, multi-vessel disease, higher values of cardiac troponin I, longer hospital stays, higher aspirin and clopidogrel use (all P β-blockers and statins use during follow-up, they had higher ratios of recurrent angina and composite MACEs during one-year follow- up (all P y syndrome (OR 1.716, 95% CI: 1.011 - 2.913) and reduced left ventricular ejection fraction (OR 2.539, 95% CI: 1.180 - 5.463) predict MACEs in a one-year follow-up among patients with PCAD. Conclusions: PCAD patients implanted with DESs have more unstable clinical phenotypes and higher MACEs during a one-year follow-up period, though they were prescribed higher ratios of optimal therapeutic medicine. Further enhanced strategies should be made for secondary prevention.展开更多
目的观察肢体缺血预适应训练对脑血管高度狭窄或闭塞患者的短期疗效。方法共纳入16例脑动脉高度狭窄或闭塞的患者,随机纳入到预适应组和药物组,每组各8例。两组患者均接受规范卒中二级预防治疗;预适应组同时辅助短暂肢体缺血预适应训练...目的观察肢体缺血预适应训练对脑血管高度狭窄或闭塞患者的短期疗效。方法共纳入16例脑动脉高度狭窄或闭塞的患者,随机纳入到预适应组和药物组,每组各8例。两组患者均接受规范卒中二级预防治疗;预适应组同时辅助短暂肢体缺血预适应训练治疗,疗程半年。观察两组患者脑缺血事件发生率、症状改善率、mRS评分以及颈动脉超声和TCD的结果,并检测血清cAMP、HIF-1α和VEGF。结果两组患者均未出现脑缺血事件;预适应组症状改善率87.5%,药物组62.5%,无统计学差异(P>0.05);比较治疗前后两组血管狭窄程度,无统计学差异(P>0.05)。预适应组治疗后血清cAMP的水平较治疗前有显著升高(5.8±2.2 vs 8.9±2.7nmol/L,P<0.01),差异有统计学意义;药物组治疗前后血清cAMP的水平没有统计学差异;两组血清?HIF-1α和VEGF水平在治疗前后均无统计学差异。结论肢体缺血预适应训练可改善缺血性脑血管病患者的症状,其作用可能与血清cAMP增高有关。展开更多
文摘Objective To investigate the actions of beta blocker (atenolol) and ACE inhibitor (enalapril) for the secondary prevention of the main cardiac complications after acute myocardial infarction (AMI). Methods 1106 cases of AMI from 7 hospitals in the Beijing area were collected and were divided randomly into three groups: control (group C), atenolol (group A), and enalapril (group E). Drugs for investigation were administered 2 4 weeks after the onset of AMI, and the subjects were followed up for a median period of 19 months. All patients were given aspirin 50 mg/day. The end points of observation were cardiac events and non cardiac events. Cardiac events included sudden cardiac death (SCD), heart failure death, total cardiac deaths, and myocardial re infarction. Results The clinical conditions of the three groups were compatible. Sixty six cardiac events (6.0%) occurred. Comparing with group C, the rate of SCD decreased significantly by 68% in group A after atenolol treatment for 28 months. Both atenolol and enalapril significantly increased left ventricular ejection fraction (LVEF), whereas in group C the LVEF did not change during the follow up period. There was obvious decreasing tendency of the survival curve in group C, compared with the other two groups. Totally drugs decrease one cardiac death‰/month. But the rate of myocardial re infarction was the same in the three groups. No serious side effects on blood pressure or heart rate were observed. Conclusions Both atenolol and enalapril (domestic products) are beneficial to the secondary prevention of SCD and heart failure death after AMI, but not to re infarction. Both drugs should be continued for a prolonged period to be effective. Drugs given 2 4 weeks after acute stage are also effective, with no serious side effects.
文摘Background: Drug-eluting stents (DESs) are associated with lower restenosis rates. However, minimal data on the follow up results of premature coronary artery disease (PCAD) treated with DESs exist. This study was to evaluate clinical characteristics and one- year prognosis of PCAD implanted with DESs in a Chinese population. Methods: 282 patients with PCAD, of which 177 implanted with DESs and 105 prescribed medicine alone were enrolled and analyzed. Major adverse cardiovascular events (MACEs) and the use of medications for secondary prevention were collected and analyzed. Results: Compared with those receiving medicine alone, patients implanted with DESs had higher ratios of males than females, they also had acute coronary syndromes, multi-vessel disease, higher values of cardiac troponin I, longer hospital stays, higher aspirin and clopidogrel use (all P β-blockers and statins use during follow-up, they had higher ratios of recurrent angina and composite MACEs during one-year follow- up (all P y syndrome (OR 1.716, 95% CI: 1.011 - 2.913) and reduced left ventricular ejection fraction (OR 2.539, 95% CI: 1.180 - 5.463) predict MACEs in a one-year follow-up among patients with PCAD. Conclusions: PCAD patients implanted with DESs have more unstable clinical phenotypes and higher MACEs during a one-year follow-up period, though they were prescribed higher ratios of optimal therapeutic medicine. Further enhanced strategies should be made for secondary prevention.
文摘目的观察肢体缺血预适应训练对脑血管高度狭窄或闭塞患者的短期疗效。方法共纳入16例脑动脉高度狭窄或闭塞的患者,随机纳入到预适应组和药物组,每组各8例。两组患者均接受规范卒中二级预防治疗;预适应组同时辅助短暂肢体缺血预适应训练治疗,疗程半年。观察两组患者脑缺血事件发生率、症状改善率、mRS评分以及颈动脉超声和TCD的结果,并检测血清cAMP、HIF-1α和VEGF。结果两组患者均未出现脑缺血事件;预适应组症状改善率87.5%,药物组62.5%,无统计学差异(P>0.05);比较治疗前后两组血管狭窄程度,无统计学差异(P>0.05)。预适应组治疗后血清cAMP的水平较治疗前有显著升高(5.8±2.2 vs 8.9±2.7nmol/L,P<0.01),差异有统计学意义;药物组治疗前后血清cAMP的水平没有统计学差异;两组血清?HIF-1α和VEGF水平在治疗前后均无统计学差异。结论肢体缺血预适应训练可改善缺血性脑血管病患者的症状,其作用可能与血清cAMP增高有关。
