Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,t...Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.展开更多
BACKGROUND The outbreak of the coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 has been the most important clinical challenge worldwide since January 2020.COVID-19 inact...BACKGROUND The outbreak of the coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 has been the most important clinical challenge worldwide since January 2020.COVID-19 inactivated vaccines play a crucial role in reducing the rates of morbidity and mortality.CASE SUMMARY We presented a 48-year-old woman from Haidian District,Beijing,China who developed ischemic colitis after receiving the second dose of COVID-19 inactivated vaccine.Computed tomography of the abdomen showed edema and bowel wall thickening with hypodensity in the sigmoid colon and descending colon.Colonoscopy revealed hyperemia,edema and erosion of the mucosa with superficial ulceration and a yellow-white coating at the descending colon and sigmoid colon.The symptoms were relieved after 1 wk of receiving pinaverium bromide(50 mg,tid)and aspirin enteric-coated tablets(0.1 g,qd).CONCLUSION The possible occurrence of ischemic colitis should be considered after administration of the COVID-19 inactivated vaccines.展开更多
Diabetes mellitus(DM) is a major risk factor for cardiovascular events, including ischemic stroke. Moreover, ischemic stroke appears to be more severe in these patients and to be associated with less favorable outcome...Diabetes mellitus(DM) is a major risk factor for cardiovascular events, including ischemic stroke. Moreover, ischemic stroke appears to be more severe in these patients and to be associated with less favorable outcomes. However, strict glycemic control does not appear to reduce the risk of ischemic stroke. On the other hand, newer glucose-lowering agents(glucagon-like peptide 1 receptor agonists and sodiumglucose cotransporter 2 inhibitors) reduced the risk of cardiovascular events in recent randomized, placebocontrolled trials. Semaglutide also reduced the risk of ischemic stroke. These benefits are independent of glucose lowering and might be due to the favorable effects of these agents on body weight and blood pressure. Pioglitazone also reduced the risk of recurrent stroke in patients with insulin resistance or type 2 DM but the unfavorable safety profile limits its use. In contrast, sulfonylureas and dipeptidyl peptidase 4 inhibitors have a neutral effect on cardiovascular morbidity and might be less attractive options in this high-risk population.展开更多
目的探讨脑小血管(cerebral small vessel disease,CSVD)负担评分对短暂性脑缺血发作(transient ischemic attack,TIA)患者复发性脑血管事件(recurrence cerebrovascular events,RCVEs)的预测价值。材料与方法回顾性分析2019年10月至202...目的探讨脑小血管(cerebral small vessel disease,CSVD)负担评分对短暂性脑缺血发作(transient ischemic attack,TIA)患者复发性脑血管事件(recurrence cerebrovascular events,RCVEs)的预测价值。材料与方法回顾性分析2019年10月至2022年12月期间于安徽省第二人民医院就诊的182例TIA患者病例资料,依据MRI检查计算CSVD总体负担评分,根据随访1个月内有无发生RCVEs分为RCVEs组(n=46)和未RCVEs组(n=136)。比较两组临床资料和CSVD总体负担评分,采用多因素logistic回归分析模型分析RCVEs的独立危险因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析CSVD影像特征得分及总负担评分对TIA患者RCVEs的预测价值。结果RCVEs组和未RCVEs组TIA发作次数、症状持续时间、既往高血压病史、CSVD总负担评分及分级情况比较差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示:TIA发作次数、症状持续时间、CSVD总负担评分是TIA患者发生RCVEs的独立危险因素(P<0.05)。ROC曲线分析结果显示:CSVD影像特征评分及总负担评分预测TIA患者发生RCVEs的曲线下面积(areas under the curve,AUC)分别为0.771(95%CI:0.673~0.869,P<0.001)、0.745(95%CI:0.655~0.835,P<0.001)、0.664(95%CI:0.549~0.780,P=0.009)、0.845(95%CI:0.766~0.924,P<0.001)、0.945(95%CI:0.896~0.994,P<0.001),其中CVSD总负担评分预测的AUC最高,当最佳截断值为2分时,敏感度为86.05%,特异度为83.02%。结论CSVD总负担评分对TIA患者发生RCVEs的预测价值良好,有助于临床评估TIA患者的短期预后。展开更多
目的:探讨主动强化风险干预联合抚触对新生儿缺氧缺血性脑病(Hypoxic-Ischemic encephalopathy,HIE)患儿风险事件及发育的影响。方法:选取2020年1月至2023年1月本院新生儿科收治的70例HIE患儿作为研究对象,根据随机数字表法分为对照组...目的:探讨主动强化风险干预联合抚触对新生儿缺氧缺血性脑病(Hypoxic-Ischemic encephalopathy,HIE)患儿风险事件及发育的影响。方法:选取2020年1月至2023年1月本院新生儿科收治的70例HIE患儿作为研究对象,根据随机数字表法分为对照组和研究组,各35例。对照组采用常规护理联合抚触干预,研究组实施主动强化风险干预联合抚触干预。分析比较两组风险事件,体格生长指标、精神运动及智力发育情况。结果:干预期间,研究组风险事件发生率明显低于对照组(P<0.05)。研究组身高、体重、头围增长值均明显高于对照组(P<0.05)。干预后,两组精神运动发育指数(Psychomotor development index,PDI)、智力发育指数(Mental development index,MDI)评分均较干预前升高,且研究组高于对照组(P<0.05)。结论:主动强化风险干预联合抚触能减少新生儿HIE护理风险事件的发生,还能促进患儿体格发育、改善精神运动及智力发育。展开更多
Background Aspirin and clopidogrel resistance plays a significant role in the development of cardiovascular ischemic events for ninety patients undergoing percutaneous coronary intervention.Recent studies have indicat...Background Aspirin and clopidogrel resistance plays a significant role in the development of cardiovascular ischemic events for ninety patients undergoing percutaneous coronary intervention.Recent studies have indicated that increasing the dose of antiplatelet drugs maybe a potent method to improve the inhibition of platelet aggregation.Methods Thrombelastograph （TEG） determinations were used to evaluate the effect of antiplatelet therapy.According to the results,90 patients were divided into three groups and given different doses of aspirin and clopidogrel.Thirty patients with both an inhibition rate of aspirin 〉50% and an inhibition rate of clopidogrel 〉50% were defined as the control group.Sixty patients with an inhibition rate for aspirin 〈50% and an inhibition rate for clopidogrel 〈50% were defined as the resistance group.Patients in resistance group were randomly assigned to be given a routine dose （100 mg aspirin plus 75 mg clopidogrel per day,which we called a resistance plus routine dose group,R＋R） and a loading dose （200 mg aspirin and 150 mg clopidogrel per day,which we called resistance plus loading dose group,R＋L） of antiplatelet therapy.A 12-month follow-up was observed to examine the change of inhibition rate of antiplatelet therapy and to estimate the relationship between inhibition rate and the occurrence of cardiovascular ischemic events.Results After 6 months of antiplatelet therapy,the inhibition rate of aspirin in the R＋L group increased from （31.4±3.7）% to （68.6±7.1）%,which was significantly higher than that in R＋R group,（51.9±8.2）% （P 〈0.01）.The inhibition rate of clopidogrel in the R＋L group increased from （22.1±3.8）% to （60.2±7.4）%,which was significantly higher than in the R＋R group,（45.9±4.3）% （P 〈0.01）.The occurrence rates of cardiovascular ischemic events,stent thrombosis,recurrent unstable angina and myocardial infarction in the R＋R group were 20%,36% and 17%,respectively.Occurrence was significantly increased compared with that in the control group,3%,10% and 1%,respectively （P 〈0.01）.In contrast,the occurrence rates in the R＋L group （10%,23% and 6%,respectively） were attenuated compared with those in the R＋R group （P 〈0.01 ）,although still higher than in the control group （P 〈0.01）.Conclusions Almost all of the cardiovascular ischemic events occurred in the first six months after percutaneous coronary intervention.According to the result of TEG determinations,earlier application of a loading dose of aspirin and clopidogrel can decrease the rate of recurrent cardiovascular ischemic events.展开更多
Background:High on-treatment platelet reactivity (HTPR) has been suggested as a risk factor for patients with ischemic vascular disease.We explored a predictive model of platelet reactivity to clopidogrel and the rela...Background:High on-treatment platelet reactivity (HTPR) has been suggested as a risk factor for patients with ischemic vascular disease.We explored a predictive model of platelet reactivity to clopidogrel and the relationship with clinical outcomes.Methods:A total of 441 patients were included.Platelet reactivity was measured by light transmittance aggregometry after receiving dual antiplatelet therapy.HTPR was defined by the consensus cutoff of maximal platelet aggregation >46% by light transmittance aggregometry.CYP2C19 loss-of-function polymorphisms were identified by DNA microarray analysis.The data were compared by binary logistic regression to find the risk factors.The primary endpoint was major adverse clinical events (MACEs),and patients were followed for a median time of 29 months.Survival curves were constructed with Kaplan-Meier estimates and compared by logrank tests between the patients with HTPR and non-HTPR.Results:The rate of HTPR was 17.2%.Logistic regression identified the following predictors of HTPR:age,therapy regimen,body mass index,diabetes history,CYP2C19^*2,or CYP2C19^*3 variant.The area under the curve of receiver operating characteristic for the HTPR predictive model was 0.793 (95% confidence interval:0.738–0.848).Kaplan-Meier analysis showed that patients with HTPR had a higher incidence of MACE than those with non-HTPR (21.1% vs.9.9%;χ^2 = 7.572,P = 0.010).Conclusions:Our results suggest that advanced age,higher body mass index,treatment with regular dual antiplatelet therapy,diabetes,and CYP2C19^*2 or CYP2C19^*3 carriers are significantly associated with HTPR to clopidogrel.The predictive model of HTPR has useful discrimination and good calibration and may predict long-term MACE.展开更多
Background Prior randomized trials have shown reduced bleeding with bivalirudin compared with unfractionated heparin （UFH） in patients undergoing percutaneous coronary intervention （PCI）. However, it is not known ...Background Prior randomized trials have shown reduced bleeding with bivalirudin compared with unfractionated heparin （UFH） in patients undergoing percutaneous coronary intervention （PCI）. However, it is not known if this benefit is also present when UFH doses are more tightly controlled （as measured by activated clotting time, ACT）.展开更多
Background Creatine kinase-MB （CK-MB） elevation after been associated with increased risk for mortality. Although most infarction （pMI） as an elevation in CK-MB 〉 3 × upper limit of and variation in site-spe...Background Creatine kinase-MB （CK-MB） elevation after been associated with increased risk for mortality. Although most infarction （pMI） as an elevation in CK-MB 〉 3 × upper limit of and variation in site-specific definitions of the ULN may limit the percutaneous coronary intervention （PCI） has studies have defined periprocedural myocardial normal （ULN）, use of different CK-MB assays value of such relative thresholds.展开更多
ABSTRACT The intensity of antiplatelet therapy during percutaneous coronary intervention （PCI） is an important deter- minant of PCI-related ischemic complications. Cangrelor is a potent intravenous adenosine diphos...ABSTRACT The intensity of antiplatelet therapy during percutaneous coronary intervention （PCI） is an important deter- minant of PCI-related ischemic complications. Cangrelor is a potent intravenous adenosine diphosphate （ADP）- receptor antagonist that acts rapidly and has quickly reversible effects.展开更多
基金supported by the Youth Fund of Fundamental Research Fund for the Central Universities of Jinan University,No.11622303(to YZ).
文摘Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.
文摘BACKGROUND The outbreak of the coronavirus disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 has been the most important clinical challenge worldwide since January 2020.COVID-19 inactivated vaccines play a crucial role in reducing the rates of morbidity and mortality.CASE SUMMARY We presented a 48-year-old woman from Haidian District,Beijing,China who developed ischemic colitis after receiving the second dose of COVID-19 inactivated vaccine.Computed tomography of the abdomen showed edema and bowel wall thickening with hypodensity in the sigmoid colon and descending colon.Colonoscopy revealed hyperemia,edema and erosion of the mucosa with superficial ulceration and a yellow-white coating at the descending colon and sigmoid colon.The symptoms were relieved after 1 wk of receiving pinaverium bromide(50 mg,tid)and aspirin enteric-coated tablets(0.1 g,qd).CONCLUSION The possible occurrence of ischemic colitis should be considered after administration of the COVID-19 inactivated vaccines.
文摘Diabetes mellitus(DM) is a major risk factor for cardiovascular events, including ischemic stroke. Moreover, ischemic stroke appears to be more severe in these patients and to be associated with less favorable outcomes. However, strict glycemic control does not appear to reduce the risk of ischemic stroke. On the other hand, newer glucose-lowering agents(glucagon-like peptide 1 receptor agonists and sodiumglucose cotransporter 2 inhibitors) reduced the risk of cardiovascular events in recent randomized, placebocontrolled trials. Semaglutide also reduced the risk of ischemic stroke. These benefits are independent of glucose lowering and might be due to the favorable effects of these agents on body weight and blood pressure. Pioglitazone also reduced the risk of recurrent stroke in patients with insulin resistance or type 2 DM but the unfavorable safety profile limits its use. In contrast, sulfonylureas and dipeptidyl peptidase 4 inhibitors have a neutral effect on cardiovascular morbidity and might be less attractive options in this high-risk population.
文摘目的:探讨远端缺血预处理(remote ischemic preconditioning,RIPC)对髋部骨折老年患者术后1年发生心血管不良事件(major adverse cardiovascular events,MACEs)的影响。方法:2015年4月至2020年5月经手术治疗髋部骨折老年患者314例,男116例,女198例;年龄60-76岁;均为美国麻醉医师协会(American Society of Anesthesiologists,ASA)Ⅱ-Ⅲ级。所有患者进行常规麻醉,根据是否进行RIPC将患者分为两组,157例在常规麻醉基础上应用RIPC为干预组,男56例,女101例,年龄(68.12±7.13)岁;另157例为对照组,男60例,女97例,年龄(68.24±7.05)岁。对比分析两组患者术后1年的MACEs事件。结果:应用RIPC髋部骨折患者术后1年发生心肌梗死、心力衰竭、脑卒中、非致命性心搏停止、冠状动脉血运重建术、严重心律失常、周围动脉血栓形成、心血管疾病再住院、术后1年全因死亡影响的OR值分别是1.269、1.304、0.977、1.089、1.315、1.335、0.896、0.774、1.191,但差异均无统计学意义(P>0.05)。结论:髋部骨折术后1年内,RIPC并未明显影响改变主要心血管不良事件的发生。非心脏手术中RIPC对临床心血管结局的长期影响需要在适当的随机临床试验中得到证实。
文摘目的探讨脑小血管(cerebral small vessel disease,CSVD)负担评分对短暂性脑缺血发作(transient ischemic attack,TIA)患者复发性脑血管事件(recurrence cerebrovascular events,RCVEs)的预测价值。材料与方法回顾性分析2019年10月至2022年12月期间于安徽省第二人民医院就诊的182例TIA患者病例资料,依据MRI检查计算CSVD总体负担评分,根据随访1个月内有无发生RCVEs分为RCVEs组(n=46)和未RCVEs组(n=136)。比较两组临床资料和CSVD总体负担评分,采用多因素logistic回归分析模型分析RCVEs的独立危险因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析CSVD影像特征得分及总负担评分对TIA患者RCVEs的预测价值。结果RCVEs组和未RCVEs组TIA发作次数、症状持续时间、既往高血压病史、CSVD总负担评分及分级情况比较差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示:TIA发作次数、症状持续时间、CSVD总负担评分是TIA患者发生RCVEs的独立危险因素(P<0.05)。ROC曲线分析结果显示:CSVD影像特征评分及总负担评分预测TIA患者发生RCVEs的曲线下面积(areas under the curve,AUC)分别为0.771(95%CI:0.673~0.869,P<0.001)、0.745(95%CI:0.655~0.835,P<0.001)、0.664(95%CI:0.549~0.780,P=0.009)、0.845(95%CI:0.766~0.924,P<0.001)、0.945(95%CI:0.896~0.994,P<0.001),其中CVSD总负担评分预测的AUC最高,当最佳截断值为2分时,敏感度为86.05%,特异度为83.02%。结论CSVD总负担评分对TIA患者发生RCVEs的预测价值良好,有助于临床评估TIA患者的短期预后。
文摘目的:探讨主动强化风险干预联合抚触对新生儿缺氧缺血性脑病(Hypoxic-Ischemic encephalopathy,HIE)患儿风险事件及发育的影响。方法:选取2020年1月至2023年1月本院新生儿科收治的70例HIE患儿作为研究对象,根据随机数字表法分为对照组和研究组,各35例。对照组采用常规护理联合抚触干预,研究组实施主动强化风险干预联合抚触干预。分析比较两组风险事件,体格生长指标、精神运动及智力发育情况。结果:干预期间,研究组风险事件发生率明显低于对照组(P<0.05)。研究组身高、体重、头围增长值均明显高于对照组(P<0.05)。干预后,两组精神运动发育指数(Psychomotor development index,PDI)、智力发育指数(Mental development index,MDI)评分均较干预前升高,且研究组高于对照组(P<0.05)。结论:主动强化风险干预联合抚触能减少新生儿HIE护理风险事件的发生,还能促进患儿体格发育、改善精神运动及智力发育。
文摘Background Aspirin and clopidogrel resistance plays a significant role in the development of cardiovascular ischemic events for ninety patients undergoing percutaneous coronary intervention.Recent studies have indicated that increasing the dose of antiplatelet drugs maybe a potent method to improve the inhibition of platelet aggregation.Methods Thrombelastograph （TEG） determinations were used to evaluate the effect of antiplatelet therapy.According to the results,90 patients were divided into three groups and given different doses of aspirin and clopidogrel.Thirty patients with both an inhibition rate of aspirin 〉50% and an inhibition rate of clopidogrel 〉50% were defined as the control group.Sixty patients with an inhibition rate for aspirin 〈50% and an inhibition rate for clopidogrel 〈50% were defined as the resistance group.Patients in resistance group were randomly assigned to be given a routine dose （100 mg aspirin plus 75 mg clopidogrel per day,which we called a resistance plus routine dose group,R＋R） and a loading dose （200 mg aspirin and 150 mg clopidogrel per day,which we called resistance plus loading dose group,R＋L） of antiplatelet therapy.A 12-month follow-up was observed to examine the change of inhibition rate of antiplatelet therapy and to estimate the relationship between inhibition rate and the occurrence of cardiovascular ischemic events.Results After 6 months of antiplatelet therapy,the inhibition rate of aspirin in the R＋L group increased from （31.4±3.7）% to （68.6±7.1）%,which was significantly higher than that in R＋R group,（51.9±8.2）% （P 〈0.01）.The inhibition rate of clopidogrel in the R＋L group increased from （22.1±3.8）% to （60.2±7.4）%,which was significantly higher than in the R＋R group,（45.9±4.3）% （P 〈0.01）.The occurrence rates of cardiovascular ischemic events,stent thrombosis,recurrent unstable angina and myocardial infarction in the R＋R group were 20%,36% and 17%,respectively.Occurrence was significantly increased compared with that in the control group,3%,10% and 1%,respectively （P 〈0.01）.In contrast,the occurrence rates in the R＋L group （10%,23% and 6%,respectively） were attenuated compared with those in the R＋R group （P 〈0.01 ）,although still higher than in the control group （P 〈0.01）.Conclusions Almost all of the cardiovascular ischemic events occurred in the first six months after percutaneous coronary intervention.According to the result of TEG determinations,earlier application of a loading dose of aspirin and clopidogrel can decrease the rate of recurrent cardiovascular ischemic events.
文摘Background:High on-treatment platelet reactivity (HTPR) has been suggested as a risk factor for patients with ischemic vascular disease.We explored a predictive model of platelet reactivity to clopidogrel and the relationship with clinical outcomes.Methods:A total of 441 patients were included.Platelet reactivity was measured by light transmittance aggregometry after receiving dual antiplatelet therapy.HTPR was defined by the consensus cutoff of maximal platelet aggregation >46% by light transmittance aggregometry.CYP2C19 loss-of-function polymorphisms were identified by DNA microarray analysis.The data were compared by binary logistic regression to find the risk factors.The primary endpoint was major adverse clinical events (MACEs),and patients were followed for a median time of 29 months.Survival curves were constructed with Kaplan-Meier estimates and compared by logrank tests between the patients with HTPR and non-HTPR.Results:The rate of HTPR was 17.2%.Logistic regression identified the following predictors of HTPR:age,therapy regimen,body mass index,diabetes history,CYP2C19^*2,or CYP2C19^*3 variant.The area under the curve of receiver operating characteristic for the HTPR predictive model was 0.793 (95% confidence interval:0.738–0.848).Kaplan-Meier analysis showed that patients with HTPR had a higher incidence of MACE than those with non-HTPR (21.1% vs.9.9%;χ^2 = 7.572,P = 0.010).Conclusions:Our results suggest that advanced age,higher body mass index,treatment with regular dual antiplatelet therapy,diabetes,and CYP2C19^*2 or CYP2C19^*3 carriers are significantly associated with HTPR to clopidogrel.The predictive model of HTPR has useful discrimination and good calibration and may predict long-term MACE.
文摘Background Prior randomized trials have shown reduced bleeding with bivalirudin compared with unfractionated heparin （UFH） in patients undergoing percutaneous coronary intervention （PCI）. However, it is not known if this benefit is also present when UFH doses are more tightly controlled （as measured by activated clotting time, ACT）.
文摘Background Creatine kinase-MB （CK-MB） elevation after been associated with increased risk for mortality. Although most infarction （pMI） as an elevation in CK-MB 〉 3 × upper limit of and variation in site-specific definitions of the ULN may limit the percutaneous coronary intervention （PCI） has studies have defined periprocedural myocardial normal （ULN）, use of different CK-MB assays value of such relative thresholds.
文摘ABSTRACT The intensity of antiplatelet therapy during percutaneous coronary intervention （PCI） is an important deter- minant of PCI-related ischemic complications. Cangrelor is a potent intravenous adenosine diphosphate （ADP）- receptor antagonist that acts rapidly and has quickly reversible effects.
