We present the case of a 74-year-old man with diabetes and hypertension who had to be rescued owing to a near-drowning syndrome at sea.When he was rescued,he complained of dyspnea and chest pain.An electrocardiogram(E...We present the case of a 74-year-old man with diabetes and hypertension who had to be rescued owing to a near-drowning syndrome at sea.When he was rescued,he complained of dyspnea and chest pain.An electrocardiogram(ECG)suggested acute coronary syndrome(ACS)affecting the left main coronary artery.Therefore,he was referred to our hospital for urgent coronary angiography.展开更多
Objective To investigate whether patients, who are at risk of major acute coronary events, are safe to undergo and benefit from early intervention after using simvastatin.Methods The study was a randomized, open, two-...Objective To investigate whether patients, who are at risk of major acute coronary events, are safe to undergo and benefit from early intervention after using simvastatin.Methods The study was a randomized, open, two-dosage-controlled trial to evaluate the safety and benefits of simvastatin administered to 197 patients (10 mg group, n =98 and 20 mg group, n =99), within 48 hours of hospitalization for a diagnosis of unstable angina or acute myocardial infarction (Ml), with total cholesterol (TC)≥180 mg/dL or low-density lipoprotein cholesterol (LDL-C) 3≥100 mg/dL. Lipid levels were measured immediately, followed by the 3rd, 6th and 12th month after admission and all adverse events were recorded during follow-up.Results TC levels fell by 10.15% and 14. 52% in the 10 mg and 20 mg groups (P<0. 05), and LDL-C levels fell 13. 87% and 19. 38% in the 10 mg and 20 mg groups, respectively (P<0. 01), 12 months after using simvastatin. The rates of achieving target TC reached 26. 3% and 36. 5% in the 10 mg and 20 mg groups (P<0. 01), and that of LDL-C reached 28. 2% and 40. 3% in the 10 mg and 20 mg groups, respectively (P<0. 01). There were higher rates of Ml and re-hospitalization resulting from angina pectoris and revascularization in the 10 mg group compared with the 20 mg group.Conclusions The results suggest that early intervention with the HMG-CoA reductase inhibitor, simvastatin, in acute coronary syndromes is possible and safe. It also indicates that the clinical dosage of simvastatin are relatively smaller than that for satisfactory lipid control in patients with acute coronary syndromes.展开更多
Coronary artery bypass grafting (CABG) is considered as a more complete means of revascularization than percutaneous coronary intervention (PCI). However, acute coronary syndrome (ACS) can still occur after CABG. The ...Coronary artery bypass grafting (CABG) is considered as a more complete means of revascularization than percutaneous coronary intervention (PCI). However, acute coronary syndrome (ACS) can still occur after CABG. The culprit vessel can be the graft vessel or the native vessel. Many questions remain unanswered in the Chinese literature regarding this topic: what are the short- and long-term pathological changes that induce ACS? Is there any difference between arterial and venous grafts with respect to the frequency of restenosis? Are there any patterns of ACS-related vessels in different periods after CABG? We aim to answer these fundamental questions by analyzing coronary angiographies of patients with recurrent ACS following CABG and provide evidence for reducing post-CABG restenosis.展开更多
文摘We present the case of a 74-year-old man with diabetes and hypertension who had to be rescued owing to a near-drowning syndrome at sea.When he was rescued,he complained of dyspnea and chest pain.An electrocardiogram(ECG)suggested acute coronary syndrome(ACS)affecting the left main coronary artery.Therefore,he was referred to our hospital for urgent coronary angiography.
文摘Objective To investigate whether patients, who are at risk of major acute coronary events, are safe to undergo and benefit from early intervention after using simvastatin.Methods The study was a randomized, open, two-dosage-controlled trial to evaluate the safety and benefits of simvastatin administered to 197 patients (10 mg group, n =98 and 20 mg group, n =99), within 48 hours of hospitalization for a diagnosis of unstable angina or acute myocardial infarction (Ml), with total cholesterol (TC)≥180 mg/dL or low-density lipoprotein cholesterol (LDL-C) 3≥100 mg/dL. Lipid levels were measured immediately, followed by the 3rd, 6th and 12th month after admission and all adverse events were recorded during follow-up.Results TC levels fell by 10.15% and 14. 52% in the 10 mg and 20 mg groups (P<0. 05), and LDL-C levels fell 13. 87% and 19. 38% in the 10 mg and 20 mg groups, respectively (P<0. 01), 12 months after using simvastatin. The rates of achieving target TC reached 26. 3% and 36. 5% in the 10 mg and 20 mg groups (P<0. 01), and that of LDL-C reached 28. 2% and 40. 3% in the 10 mg and 20 mg groups, respectively (P<0. 01). There were higher rates of Ml and re-hospitalization resulting from angina pectoris and revascularization in the 10 mg group compared with the 20 mg group.Conclusions The results suggest that early intervention with the HMG-CoA reductase inhibitor, simvastatin, in acute coronary syndromes is possible and safe. It also indicates that the clinical dosage of simvastatin are relatively smaller than that for satisfactory lipid control in patients with acute coronary syndromes.
文摘Coronary artery bypass grafting (CABG) is considered as a more complete means of revascularization than percutaneous coronary intervention (PCI). However, acute coronary syndrome (ACS) can still occur after CABG. The culprit vessel can be the graft vessel or the native vessel. Many questions remain unanswered in the Chinese literature regarding this topic: what are the short- and long-term pathological changes that induce ACS? Is there any difference between arterial and venous grafts with respect to the frequency of restenosis? Are there any patterns of ACS-related vessels in different periods after CABG? We aim to answer these fundamental questions by analyzing coronary angiographies of patients with recurrent ACS following CABG and provide evidence for reducing post-CABG restenosis.