Analysis of the Nursing Effect of Continuity of Care on Elderly Patients with Coronary Heart Disease Unstable Angina and its Impact on Quality of Life

Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.

Identifying Metabolite and Protein Biomarkers in Unstable Angina In-patients by Feature Selection Based Data Mining Method

Unstable angina（UA） is the most dangerous type of Coronary Heart Disease（CHD） to cause more and more mortal and morbid world wide. Identification of biomarkers for UA at the level of proteomics and metabolomics is a better avenue to understand the inner mechanism of it. Feature selection based data mining method is better suited to identify biomarkers of UA. In this study, we carried out clinical epidemiology to collect plasmas of UA in-patients and controls. Proteomics and metabolomics data were obtained via two-dimensional difference gel electrophoresis and gas chromatography techniques. We presented a novel computational strategy to select biomarkers as few as possible for UA in the two groups of data. Firstly, decision tree was used to select biomarkers for UA and 3-fold cross validation was used to evaluate computational performanees for the three methods. Alternatively, we combined inde- pendent t test and classification based data mining method as well as backward elimination technique to select, as few as possible, protein and metabolite biomarkers with best classification performances. By the method, we selected 6 proteins and 5 metabolites for UA. The novel method presented here provides a better insight into the pathology of a disease.

Plasma Levels of the Anti-inflammatory Cytokine IL-10 and Inflammatory Cytokine IL-6 in Patients with Unstable Angina

The plasma levels of inflammatory cytokine interleukin-6 （IL-6） and anti-inflammatory cytokine interleukin-10 （IL-10） in the patients with unstable angina or stable angina were determined and compared. In 30 patients with unstable angina and 22 patients with stable angina, plasma levels of IL-10 and IL-6 were detected by ELISA and plasma lipid parameters by lipid research clinical methods respectively. The results showed plasma levels of IL-10 were significantly lower in unstable angina group than in stable angina group （P=0. 005）, while those of IL-6 were significantly increased in unstable angina group as compared with those in stable angina group （P= 0. 039）. There was a significantly negative correlation between IL-10 and IL-6 in patients with unstable angina （r=-0.41, P=0. 003）. In the unstable angina group, IL-6 levels were obviously positively correlated with TC （r=0. 314, P=0. 023）, but not with TG and HDL. There were no significant correlations between IL-10 and plasma lipid parameters. It was suggested that the decreased IL-10 and increased IL-6 might be associated with the atheromatous plaque stability and progression of coronary heart diseases. IL-10 may play an important role in preventing coronary vascular lesions.

Study on Effect of Zhixinkang Capsule(脂欣康胶囊)in TreatingUnstable Effort Angina and Hyperlipidemia and Its Function in Vascular Endothelium Protection

Objective:To observe the clinical effect and protection of vascular endothelium of Zhixin-kang Capsule (ZXKC) in middle-aged and old people with unstable effort angina and hyperlipidemia. Methods: Sixty-five patients with unstable effort angina were randomly divided into ZXKC group (34 cases) and control group (31 cases). Conventional western medical therapy was given to both groups, with ZXKC group receiving additional ZXKC treatment. Data of 20 healthy persons were taken as normal group. Forty-eight patients with hyperlipidemia were divided into ZXKC group treated with ZXKC (31 cases) and control group treated with Yixintong (17 cases). The changes of clinical symptoms and laboratory indexes in all the patients were observed before and after treatment. Results: In patients with unstable effort angina, the efficacy of treatment of ZXKC, the withdrawal rate of nitroglycerin, the relieving of symptoms, the improvement of the electrocardiogram, the counts of circulating endothelial cells, the content of platelet P-selectin, the content of plasma endothelin (ET), the activity of superoxide dismutase (SOD) and the activity of malonyldialdehyde (MDA) were all better than those in the control group. In patients with hyperlipidemia, there was no significant difference in lipids reduction between ZXKC group and the control group. In both groups, the total cholesterol (TC), triglyceride (TG), low density lipo-protein-cholesterol (LDL-C), lipoprotein(a) [Lp(a)] , ET, oxidized low density lipoprotein, MDA, arte-riosclerotic index (AI) all lowered obviously, while the SOD, HDL-C and calcitonin gene-related peptide (CGRP) were all elevated markedly. In the ZXKC group, the nitric oxide(NO) increased significantly whereas the ET/CGRP and ET/NO decreased markedly. The total effective rate in symptom relieving, the markedly effective rate, the reduction of TC, ET and ET/CGRP, and the elevation of SOD in ZXKC group were all superior to those in the control group. Conclusion: ZXKC could effectively resist myocardial ischemia, relieve angina, reduce blood lipids, protect vascular endothelial cells, inhibit the activation of platelets, and resist lipid peroxidation.

Mean Platelet Volume and Prognosis of Unstable Angina

Objective: Clopidogrel therapy is the standard of care in patients with unstable angina. However, a percentage of subjects are nonresponders to clopidogrel and this leads to increased adverse outcome. On the other way round, some responsive patients are exposed to bleeding complications. Detection of both in daily practice is important in order to tailor the treatment protocol. In this study we aimed to estimate the cutoff value of mean platelet volume (MPV) for both platelet responsiveness and bleeding risks. Methods: The study was planned as a prospective cohort study. A total number of 230 patients admitted to our CCU with unstable angina over a period of one year (from June 2013 to May 2014) were enrolled. Exclusion criteria were: severe anemia, throm-bocytopenia, myelodysplastic syndrome, coagulopathy and recent blood transfusion. In all patients clopidogrel was initially started and maintained during the hospital stay. Blood (2 ml) was collected in dipotassium EDTA tubes from all patients on the first day of admission by a clean puncture. Samples for MPV analysis were drawn on admission, and analyzed within 1 hour of admission after sampling by Beckman Caulter LH 780 Analyzer. Grouping was then done according to MPV of the patients into group (I) who had a low MPV less than or equal to 7.00 fl, and group (II) with MPV equal to or higher than 9.00 fl. Demographical and clinical variables of the patients were recorded. Routine laboratory parameters were also recorded. Clinical manifestations during the admission period were meticulously reported. Major complications as bleeding or, urgent need for percutaneous coronary intervention (PCI) were also studied. Results: Among the 230 patients analyzed, 175 patients (76%) were found to have MPV ≤7.00 fl (group (I)) and 55 patients (24%) had MPV ≥9.00 fl (group (II)) with mean ± SD MPV (8.4 ± 1.5 fl, vs 11.7 ± 1.2 fl respectively) (p < 0.001). Observation of clinical course during admission period revealed a statistically more significant clinical deterioration in group (II) than group (I) and the presence of more frequent AMI cases in group (II) having a high MPV. A high cutoff value of 9.7 fl for MPV was detected in prediction of clopidogrel nonresponsiveness (group (II)) with a sensitivity of 78.2% and specificity of 66.8%, and a low cutoff value for bleeding tendency lower than 6.3 fl was detected in group (I) with a sensitivity of 71.4% and specificity of 62.5%. Conclusion: This study showed that MPV can be used as a simple bedside predictor for detection of clopidogrel response in patients with unstable angina. And a cutoff value for both platelet responsiveness and risk of bleeding is now reached. This may lead to enhancement in our decision for early intervention and attention for bleeding risk during clopidogrel therapy.

Management of unstable angina in a patient with Haemophilia A

Hemophilia A is an X-linked recessive disorder characterized by a deficiency of coagulation factor Ⅷ(FⅧ) and therefore by a greater risk of bleeding during percutaneous interventional procedures and during the dual antiplatelet therapy(DAPT) in patients with ischemic heart disease. Information regarding safe percutaneous procedures in hemophiliacs is limited. Since the introduction of FVⅧ concentrates, the life expectancy of hemophiliac patients has improved and consequently, the rate of ischemic heart disease in this population is increased. Frequently the replacement therapy can trigger the onset of an acute coronary syndrome. We report a case of a patient with mild Hemophilia A, who presents with unstable angina, treated successfully with coronary angioplasty and drug eluting stent implantation without replacement of FVⅧ, treated with long term DAPT without major bleeding after six months of follow up.

Effects of Ginkgo Leaf Extract on Function of Dendritic Cells and Th1/Th2 Cytokines in Patients with Unstable Angina Pectoris

Objective： To investigate the effects of Ginkgo leaf extract （GLE） on function of dendritic cells （DO） and Th1/Th2 cytokines in patients with unstable angina pectoris（UAP）. Methods： Fifty-four patients with UAP were equally assigned into two groups, the treated group and the control group, both treated with conventional Western medicine, but with GLE given additionally to the treated group. Blood of all patients was taken before and 4 weeks after treatment to prepare the peripheral mononuclear cells, then which were incubated in the completed medium containing granulocyte-macrophage colony stimulatory factor （GMCSF） and interleukin-4 （IL-4） to induce mature DO. The expression of co-stimulating factor CD86 （B7-2） on the surface of DC was detected by flow cytometry, and the stimulating capacity of DC was determined by mixed lymphocyte reaction （MLR）. The blood levels of cytokines, interferon-γ （IFN-γ）, and IL-4, were analyzed by ELISA, and blood C-reactive protein （CRP） level by turbidimetry. Moreover, the direct effect of Ginkgolide B on CD86 expression on DO were also tested in vitro. Results： After treatment, CD86 expression on DO, the stimulating capacity of DO as well as levels of IFN-γ and ORP were lowered in both groups （P〈0.05 or P〈0.01）, but the changes were much more significant in the treated group than those in the control group. Ginkgolide B showed a direct inhibitory effect on the CD86 expression on DO. Conclusion： The inhibition of GLE on DO and thereby the suppression on inflammatory reaction may be one of the mechanisms of GLE in treating patients with UAP.

Effect of Gualou Xiebai Banxia decoction combined with Danshen Decoction on clinical efficacy of unstable angina with phlegm and blood stasis syndrome

Objective:To observe the clinical efficacy and safety of Gualou Xiebai Banxia decoction combined with Danshen decoction on unstable angina(UA)with phlegm and blood stasis syndrome.Method:Eighty patients with UA were randomly divided into treatment group(40 cases)and control group(40 cases)by random number table.The control group was given conventional western medicine treatment,and the experimental group was given Gualou Xiebai Banxia decoction and Danshen decoction on the basis of the control group.Both groups were treated for 4 weeks.Before and after treatment,the angina attacks,dosage of nitroglycerin,traditional Chinese medicine syndrome score,quality of life score,blood lipid,coagulation index and clinical total efficacy were observed and recorded.Results:After 4 weeks of treatment,the attack times and duration of angina in the two groups were both decreased compared with those before treatment.And the treatment group was more significantly reduced than the control group,the difference was statistically significant(p<0.05);the consumption of nitroglycerin of the treatment group was 90.0%,which was better than 67.5%of the control group,the difference was statistically significant(p<0.05);the total effective rate of the treatment group was 90%,which was better than 65%of the control group,the difference was statistically significant(p<0.05);the traditional Chinese medicine(TCM)syndrome score of the experimental group was lower than that of the control group,the differences was significant(p<0.05).The improvement of low density lipoprotein(LDL-C),total cholesterol(TC)and prothrombin time(PT)in the experimental group was better than that in the control group(p<0.05).During the study,there were no obvious adverse reactions in both groups.Conclusion:Gualou Xiebai Banxia decoction combined with Danshen decoction can effectively relieve the attack of angina and the consumption of nitroglycerin,improve clinical symptoms,regulate blood lipid and blood flow state,and improve the quality of life of patients with UA,with good clinical efficacy and safety.

Antithrombotic efficacy of MV1 serine protease in a canine model of unstable angina

Objective To determine the antiplatelet and antithrombotic efficacies of MV1 serine protease on coronary arterial thrombosis in a canine model of unstable angina.Methods Pentobarbital-anesthetized Beagles(total of 30)were used in which acute damage of the proximal left circumflex coronary artery,together with mechanical stenosis,produced the phenomenon of cyclic flow reduction(CFR)in the Folts model of unstable angina.When the platelet plug was removed by rubbing the vessel,the occlusion returned reproducibly for at least 3 hours in control studies.To evaluate the antithrombotic efficacy of MV1,CFR was first established over a period of one hour,thereafter,MV1(0.3,0.6 mg·kg-1 i.v.bolus),Batroxobin(0.3 BU·kg-1 i.v.bolus),Tirofiban(40 μg·kg-1,i.v.bolus),or vehicle was administered and observations continued for two additional hours.Platelet aggregation induced by adenosine diphosphate(ADP),arachidonic acid(AA),collagen(CG)was measured by the method of born,and thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(Fbg)were measured using coagulation methods,bleeding time was measured according to previous described methods.Results MV1 dramatically inhibited the frequency of CFR dose-dependently and the frequency of CFR decreased by 65%,80% respectively at 1 h than that in control group's after MV1 0.3,0.6 mg·kg-1 administration,further more the frequency decreased by 75%,90% respectively at 2 h.MV1 eliminated thrombus formation in 5 of 6 dogs at 0.6 mg·kg-1,and the time for CFR absolute disappearances of MV1 at a dose of 0.6 mg·kg-1 was shortened to 5±2 min(the time was more than 120 min in all dogs of control group).Platelet aggregation induced by ADP,AA,CG was inhibited effectively by MV1 0.3,0.6 mg·kg-1 TT,PT prolonged gently after MV1 administration,and MV1 produced an approximate 40% degradation of Fbg,but MV1 did not have any effects on APTT.There was a tendency for prolonged bleeding time with MV1 administration.Conclusions These studies showed that as a novel serine protease,MV1 provides favorable antithrombotic activity in vivo with inhibition of platelet aggregation and fibrinogenolytic activity.The results indicated that MV1 has reliable therapeutical efficacy on unstable angina pectoris.

EFFECTS OF EXERCISE ON THE FIBRINOLYTIC ACTIVITY INPATIENTS WITH UNSTABLE ANGINA PECTORIS

Objective The purpose of this study was to evaluate the fibrinolytic response to exercise in patients with unstable angina pectoris(UAP) compared with an age - matched control group. Methods We measuredtissure- type plasminogen activator (t- PA) activity and plasminogen activator inhibitor 1(PAI- 1) activitybefore and after treadmill exercise test in 20 healthy subjects and 25 patients with UAP. ResultsResting t - PA activities were similar between two groups, but resting PAI- 1 activity was higher in UAP groupthan in control. Although both groups showed significant increase in t- PA activity with exercise, post - exerciset - PA activity was significantly lower in patients with UAP than in control (0.96± 0.45IU/ml vs 1.89± 0.68I U/ml,P<0.01), Post - exercise PAI- 1 activity was still much higher in UAP group than in control (8.20±2.28A U/ml vs4.21± 0.68A U/ml, P<0.01). Conclusion There existed impaired fibrinolysis in patients with UAP not only at restbut also alter exercise loading.

Comparative Study on the Effects of Small Dose of Aspirin Combined with Ginkgo-damole Injection(银杏达莫注射液) and the Effects of Conventional Dose of Aspirin in Treating Senile Unstable Angina Pectoris

Objective: To evaluate the therapeutic and adverse effect of small dose of aspirin (Asp) combined with Ginkgo-damole injection (GDI,银杏达莫注射液) in treating senile unstable angina pectoris (UA). Methods: One hundred and twenty old in-patients of coronary heart disease with UA were randomly divided into two groups. The 60 patients in the treated group were treated with oral administration of enteric soluble 50 mg Asp once a day and GDI 20 ml per day by intravenous dripping, with 14 days as one therapeutic course, while the other 60 in the control group were treated with enteric soluble Asp 100 mg alone once a day orally. Besides, isosorbide-5-mononitrate 20 mg twice a day was applied to both groups, and the β-ad-renoceptor blocker, blood lipids regulatory agents and nitroglycerin (10 mg by intravenous dripping) were given accordingly. The angina total improving rate, hemorrheologic indexes (whole blood viscosity, plasma viscosity, fibrinogen, platelet aggregation rate), comprehensive clinical terminal event and the total occurrence rate of adverse reaction in the two groups were observed. Results: After treatment, comparison between the two groups showed insignificant difference in aspects of angina total improving rate (75.00% vs 65.00%), hemorrheological indexes and comprehensive clinical terminal event rate (25.00% vs 31.67%), P>0.05, and the hemorrheological indexes were improved in both groups (P<0.05), but the total occurrence rate of adverse reaction in the treated group was lower than that in the control group (6. 67% vs 25.00%), showing significant difference (P<0.05). Conclusion: In treatment of senile UA, small dose of Asp combined with GDI showed therapeutic effect similar to that of conventional dose of Asp, but it has lower adverse reaction.

Functional Role of Dendritic Cells in Patients with Unstable Angina

Summary： To investigate the function of dendritic cells （DC） in patients with unstable angina, 10 mL of blood was drawn from 30 subjects. 15 patients diagnosed as having unstable angina and 15 healthy subjects were included in an observation and a control groups respectively. The mononuclear cells were separated from the peripheral blood and cultured in RPMI1640 supplemented with recombinant human granulocyte/macrophage-colony stimulating factor （rh GM-CSF） and recombinant human interleukin-4 （rh IL-4） to induce dendritic cells. The shape and ultrastructure of DC was examined with electronic microscope. The phenotype of DC was analyzed with FACS and the alloantigen presenting capacity of DC was evaluated by mixed lymphocyte reaction （MLR）. The expression tale of CD86 of DC in patients with unstable angina was （40. 7±3. 6）%, which was obviously higher than thai of normalDC （29.6±2.5 %） （P〈0.001）. The capacity of the DCs in unstable angina patients to induce allogenic T cells （OD 2.73±1. 10）, was significantly higher than that of the normal DC （OD：0.9±0.21） （P〈0.005）. It is suggested thai the function of DC in patients with unstable angina is increased, which may play an important role in the initiation of immune reaction in the plaque.

Effect of Chinese Herbs for Activating Blood Circulation,Removing Stasis and Supplementing Qi on the Circulating Endothelial Cells in Patients with Unstable Angina Pectoris

Objective: To observe the effect and clinical significance of circulating endothelial cells (CEC) in the pathogenesis of coronary heart disease with unstable angina pectoris (CHD-UAP), and to explore the protective effect of Chinese herbs for activating blood circulation, removing stasis and supplementing Qi (CH) on CHD-UAP patient's CEC. Methods: Sixty patients with diagnosis of CHD-UAP confirmed and differentiated to be Qi-deficiency and blood stasis by TCM were randomly divided into two groups and treated, on the basis of Western drug-therapy, with Tongxinluo capsule (通心络胶囊, TXL) and Huoxue Tongmai capsule (活血通脉胶囊, HXTM) respectively by way of oral taking three times a day, 3 capsules every time, with 1 month as one therapeutic course. The number of CEC in patients' blood circulation was counted before and after treatment. Besides, the number of CEC in 30 healthy persons was also counted for control. Results: The number of CEC in CHD-UAP patients was significantly higher than that in the healthy persons (P<0.01). After the patients were treated with CH, either TXL or HXTM, it significantly decreased (P<0.01)with insignificant difference between the two treated groups. Conclusion: CEC in CHD-UAP patients is severely damaged and endothelial function in disorder, Chinese herbs have protective effect on patients' CEC.

Case management does not decrease mortality of patients with myocardial infarction or unstable angina:Evidence from a systematic review

Objective:To objectively assess the impact of case management on patients with myocardial infarction or unstable angina.Methods:PubMed,EMBASE,Web of Science,Cochrane Library,China National Knowledge Infrastructure(CNKI),and Chinese Biomedical Literature Database were searched for relevant randomized controlled trials(RCTs)published through February 2015.The quality of eligible studies was independently assessed by two investigators.The primary outcome assessed from included studies was all-cause mortality,with total cholesterol,systolic and diastolic blood pressures,smoking cessation rates and cost-effectiveness as secondary outcomes.The pooled effect sizes were expressed as relative risk,odds risk,and standard mean difference with 95%confidence intervals.Heterogeneity among studies was assessed using Cochrane Q and determined with an I2 statistic.Results:After the initial search,a total of four studies divided into six RCTs that included 1293 participants met the inclusion criteria and were analyzed.The results of meta-and descriptive analyses failed to identify any significant differences in all-cause mortality during the follow-up period of up to 36 months.Furthermore,a definitive conclusion for remaining indicators could not be drawn due to limited evidence.Conclusion:Case management is not beneficial to all-cause mortality after myocardial infarction or unstable angina compared to routine care.Additional,prospective RCTs of high quality and large scale are warranted to verify these results.

Clinical analysis of heart rate variability in 32 cases with Unstable angina pectoris

Abstract Heart rate variability was evaluated in 32 patients with unstable angapectons and 32 control subjects using 24 hour ambulatory ECG.The resuitsshowed that indexes of time-ranged analysis and frequency-ranged analysisin angina pectoris group were significantly different,compared with the controlgroup(p【0.01)This indicates disturbance in autonomic nervous activity inpatients with unstable angina

Correlation of Coronary Angiographic Morphology and Clinical Presentation in Unstable angina

Objective:To seek the relation between clinical presentation(Braunwaldclassification)or electrocardiogram(ECG)and angiographic morphology inpatients with unstable angma(UA),and to determine which clitoral markerscould reliably predict unstable lesions and cardiac eventsMethods:120 hospdalized patients with a clinical diagnosis of UA and anabonrmal angiograms(≥50% diameter stenosis)were selected The lesionmorphology included sunple lesion,complex lesion and inracoronarythrombus(ICT)In-hospital events included acute myocardialinfarction,cardiac death and prompt revasculan-zation Logistic regressionwas used to evaluate the ability of clinical markers to predict unstable lesionsand cardiac events.Results:There were more complex lesion in class Ⅲ group(61%,or 20 of33)than in class 1 group(30%,or 13 of 43,P【0.05)and more ICT in class Ⅲgroup(18%.or 6 of 33)than in class Ⅱ group(2%,or 1 of 44,P【0.05)Thetare of cardiac events was higher m class Ⅲ patients(58%,or 19 of 33)thanin class 1 patients(19%,or 8 of 43,P=0.01)or in class Ⅱ patients(25%,or Ⅱof 44,P【0.01)Logistic regrassion analysis demonstrated that an abnormalST segment of ECG or Braunwald class Ⅲ were highly predictive of thepresence of complex lesion morphology(P【0.01,OR 4.9,P【001,OR3.3,respectively)An abnormal ECG was the single predictive clintcalindicator of triple coronary disease(P【0.01.OR 3.9)and cardiacevents(P【0.001,OR 4.8).Conclusion:Complex lesion can be best identified by the clinical featureof recent onset refractory angina at rest and abnormal ECG Patients withabnormal ST segment represents a high rate of triple coronary disease anda high risk of cardiac events.

Levels of Soluble P-Selectin in Patients With Unstable Angina

Background Unstable angina occurs when atherosclerotic plaquerupture.Recent evidence suggests a role for inflammation in this process.Leukocyte-endothelial cell interactions are important in inflammationand are regulated by cell adhesion melecules.As a kind of cell adhesionmelecules,P-selectin in platelets and endothelial cells mediates adhesiveinteraction with leukocytes to form thrombi.The purpuru of this studywar to invvstigate plasma levels of soluble P-selectin in patients withunstable angina and in health volunteers.Methods and Results Plasma P-selectin levels were determinedby a monoclonal antibody-bared enzyme immunoassay on plasma samplestaken from 27 patients with unstable angina,46 healthy volunteers.Patientswith unstable angina had angina at rest associated with ECG changes.Blood sample(2ml)was collected within 3 hours after the attack .Inpatiants with unstable angina,plasma P-seleatin levels(23.2±7.5ng/ml)were significently(P【0.005)higher than those in volunteers(10.12±7.61ng/ml)Conclusions our data indicate that soluble P-selectin released intothe blood after the attack of unstable angina and the levels of P-selectin inpatients with unstable angina were increased significantly.Our data indicatethat measur-ements of plasma P-selectin may help us to understandthe pathophysiology of unstable angina and may be clinically usefulas a new molecular marker of platelet aggregation and thrombus fomationin acute coronary syndrom.

Effects of Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy on platelet function, inflammatory response and lipid metabolism in patients with unstable angina pectoris

Objective: To study the effects of Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy on platelet function, inflammatory response and lipid metabolism in patients with unstable angina pectoris. Methods: A total of 96 patients who were diagnosed with unstable angina pectoris for the first time in Beijing Shunyi District Hospital of Traditional Chinese Medicine between February 2015 and January 2018 were chosen and randomly divided into two groups, the observation group received Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy, and the control group only accepted antiplatelet drug and statin therapy. Platelet function parameters, inflammatory response parameters and lipid metabolism parameters were determined before treatment and after 2 months of treatment. Results: Compared with those of same group before treatment, PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of both groups of patients were decreasing whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were increasing after treatment, and PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of observation group after treatment were lower than those of control group whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were higher than those of control group. Conclusion: Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy for unstable angina pectoris can more effectively inhibit the platelet aggregation and improve the inflammatory response and lipid metabolism.

Comparison of Results of Coronary Angioplasty in Patients with Unstable vs. Stable Angina

Objectives To compare the short and mid - term outcomes in cases of percutaneous transluminal coronary angioplasty (PTCA) in patients with unstable v stable angina. Methods Patients selected for PTCA/stenting were divided in to two groups, one with stable angina pectoris (SA group, n = 92) and one with unstable angina pectoris (UA group, n = 112). The outcomes of coronary an giographies (CAG), initial (30-d) success of the procedure, and follow - up status in the two groups were compared. Results Baseline characteristics were similar, although the patients with unstable symptoms more females ( P< 0. 05), and had a higher average CCS class (P< 0. 05) and a higher incidence of postinfarction angina ( P< 0. 01). The frequency of ' complex stenosis in patients with unstable angina was higher than that of patients with stable angina, 33% v 20% ( P< 0. 01). A total of 309 vessels ac cepted the procedure; including 210 stents were sue cessfully delivered to 156 patients. 143 and 67 stents were implanted in the UA and SA group, respectively ( P< 0. 01 ) . No major complication occurred in the two groups, except 12 patients experienced reoccur ring chest pain initially, 9 in UA group v 3 in SA group ( P< 0. 05). The averaged six - month follow -up status was compared too. Only 3 cases developed myocardial infarction, including 2 patients with unsta ble angina. 12 and 16 reoccurring chest pains were found in the two groups, respectively ( 13% in SA group vs 14% in UA group). There were no signifi cant differences between groups in rates of clinical restenosis, follow - up angina class, or overall clinical success. Conclusions Patients with unstable angina receiving PTCA/stenting have similar complication, restenosis, and initial and midterm success rate as compared to patients with stable symptoms with strict cases select and careful preparation.

The Study of hemodynamics and coronary arteriography of Patients with Different Types of Unstable Angina Pectoris

Objectives To explore the basic heart functional state and cardiac reserve function of patients with different types of unstable angina pectoris (UAP) and observe the relations between the heart function and severity of coronary arterial disease. Methods 70 cases with UAP were enrolled including 25 patients with angina decubitus (AD), 23 patients with mixed angina (MA) , and 22 patients with accelerated effort angina (AEA). All patients underwent a series of examination such as UCG, ECT, hemodynamics and volume-loading test. The patients were divided into three groups in light of the results of the hemodynamic examination: ① diastolic dysfunction group ② systolic dysfunction group ③ normal heart function group. We assessed the basic heart function and cardiac reserve function of patients with different types of UAP and also observed the relations between coronary arteriography and heart function. Results ① Under basic conditions, patients with angina decubitus suffered from the systolic (36%) or diastolic dysfunction (48%). 43 percent of the patients with mixed angina had systolic dysfunction and other 43 percent of them had normal cardiac function. However, patients with accelerated effort angina (AEA) were characterized by diastolic dysfunction (31%) or normal heart function (60%). ② In hemodynamic examination, the pulmonary capillary wedge pressure of positive patients rose, at the same time cardiac index fell to the extreme instantaneously after loading in volume-loading test and then they restored to the basic level until 60 minutes. However, both PCWP and CI of the negative patients reach the peak momentarily after loading. They returned to the basic level within 30 minutes. ③ coronary arteriography show: there are 41% of patient with three-vessel disease, 50% with two-vessel disease, 9% single vessel disease and left main narrowing 22. 7% in AEA. There are separately 76%, 24%, 0% and 36% in AD; and 26.1% , 43.4% , 21.7% , 43.4% in MA. ④ Constituent ratio of the AEA and MA were separately compared with AD, AEA/AD: P < 0.05(P = 0.031); MA/AD: P < 0.01 (P = 0.000313). Conclusions Most of patients with the above three types of unstable angina pectoris suffered from the basic heart dysfunction and cardiac reserve dysfunction which might participate in the occurrence and development of unstable angina pectoris. In angiography, there are the most three-vessel diseases in AD that are, therefore, the most severe UAP.