Background Studies have shown that staged percutaneous coronary intervention （PCI） for non-culprit lesions is beneficial for prog- nosis of ST-segment elevation myocardial infarction （STEMI） patients with multives...Background Studies have shown that staged percutaneous coronary intervention （PCI） for non-culprit lesions is beneficial for prog- nosis of ST-segment elevation myocardial infarction （STEMI） patients with multivessel disease. However, the optimal timing of staged re- vascularization is still controversial. This study aimed to find the optimal timing of staged revascularization. Methods A total of 428 STEMI patients with multivessel disease who underwent primary PCI and staged PCI were included. According to the time interval between primary and staged PCI, patients were divided into three groups （〈 1 week, 1- weeks, and 2-12 weeks after primary PCI）. The primary endpoint was major adverse cardiovascular events （MACE）, a composite of all-cause death, non-fatal re-infarction, repeat revascularization, and stroke. Cox regression model was used to assess the association between staged PCI timing and risk of MACE. Results During the follow-up, 119 participants had MACEs. There was statistical difference in MACE incidence among the three groups （〈 1 week： 23.0%; 1-2 weeks： 33.0%; 2-12 weeks： 40.0%; P = 0.001）. In the multivariable adjustment model, the timing interval of staged PCI ≤ 1 week and l-2 weeks were both significantly associated with a lower risk of MACE [hazard ratio （HR）： 0.40, 95% confidence intervals （CI）： 0.24-4）.65; HR： 0.54, 95% CI： 0.3 lq3.93, respectively], mainly attributed to a lower risk of repeat revascularization （HR： 0.41, 95% CI： 0.24-0.70; HR： 0.36, 95% CI： 0.18-0.7）, compared with a strategy of 2-12 weeks later of primary PCI. Conclusions The optimal timing of staged PCI for non-culprit vessels should be within two weeks after primary PCI for STEMI patients.展开更多
Objective To analyze the effect of age on the ECG QT interval, an important predictor of cardiovascular mortality and drug-induced cardiac arrhythmias, and determine whether QT-heart rate correction formulae （QTc） h...Objective To analyze the effect of age on the ECG QT interval, an important predictor of cardiovascular mortality and drug-induced cardiac arrhythmias, and determine whether QT-heart rate correction formulae （QTc） have differential relationships with age and sex. Methods Data were examined from the US National Health and Nutrition Examination Survey （NHANES） II and III, civilian population aged 25 to 90 years. QT weighted means and standard deviations were calculated for all ages. The QTc were evaluated for six QTc： proposed by Bazett （QTcBZT）, Fridericia （QTcFRD）, Hodges （QTcHDG）, Dmitrienko （QTcDMT）, Rautaharju （QTcRTHa） and Framingham （QTcFRM）. Results QTc was strongly related to age and gender, for all formulae except for QTcBZT for women. The relationship between QTc and age was significant regardless of whether the relationship was approximated by a linear or non-linear （quadratic or cubic spline） model. QTc increased more dramatically with age in men. There was a significant （P 〈 0.001） positive relationship between QTc variance and age for each QTc formula for both men and women. There were a greater proportion of individuals with longer QTc with older ages especially age 80 years and above. Conclusion QTc and its variance increase with age. Prolonged QTc is more prevalent in older individuals, especially men.展开更多
文摘Background Studies have shown that staged percutaneous coronary intervention （PCI） for non-culprit lesions is beneficial for prog- nosis of ST-segment elevation myocardial infarction （STEMI） patients with multivessel disease. However, the optimal timing of staged re- vascularization is still controversial. This study aimed to find the optimal timing of staged revascularization. Methods A total of 428 STEMI patients with multivessel disease who underwent primary PCI and staged PCI were included. According to the time interval between primary and staged PCI, patients were divided into three groups （〈 1 week, 1- weeks, and 2-12 weeks after primary PCI）. The primary endpoint was major adverse cardiovascular events （MACE）, a composite of all-cause death, non-fatal re-infarction, repeat revascularization, and stroke. Cox regression model was used to assess the association between staged PCI timing and risk of MACE. Results During the follow-up, 119 participants had MACEs. There was statistical difference in MACE incidence among the three groups （〈 1 week： 23.0%; 1-2 weeks： 33.0%; 2-12 weeks： 40.0%; P = 0.001）. In the multivariable adjustment model, the timing interval of staged PCI ≤ 1 week and l-2 weeks were both significantly associated with a lower risk of MACE [hazard ratio （HR）： 0.40, 95% confidence intervals （CI）： 0.24-4）.65; HR： 0.54, 95% CI： 0.3 lq3.93, respectively], mainly attributed to a lower risk of repeat revascularization （HR： 0.41, 95% CI： 0.24-0.70; HR： 0.36, 95% CI： 0.18-0.7）, compared with a strategy of 2-12 weeks later of primary PCI. Conclusions The optimal timing of staged PCI for non-culprit vessels should be within two weeks after primary PCI for STEMI patients.
文摘Objective To analyze the effect of age on the ECG QT interval, an important predictor of cardiovascular mortality and drug-induced cardiac arrhythmias, and determine whether QT-heart rate correction formulae （QTc） have differential relationships with age and sex. Methods Data were examined from the US National Health and Nutrition Examination Survey （NHANES） II and III, civilian population aged 25 to 90 years. QT weighted means and standard deviations were calculated for all ages. The QTc were evaluated for six QTc： proposed by Bazett （QTcBZT）, Fridericia （QTcFRD）, Hodges （QTcHDG）, Dmitrienko （QTcDMT）, Rautaharju （QTcRTHa） and Framingham （QTcFRM）. Results QTc was strongly related to age and gender, for all formulae except for QTcBZT for women. The relationship between QTc and age was significant regardless of whether the relationship was approximated by a linear or non-linear （quadratic or cubic spline） model. QTc increased more dramatically with age in men. There was a significant （P 〈 0.001） positive relationship between QTc variance and age for each QTc formula for both men and women. There were a greater proportion of individuals with longer QTc with older ages especially age 80 years and above. Conclusion QTc and its variance increase with age. Prolonged QTc is more prevalent in older individuals, especially men.
