BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.Howeve...BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.展开更多
Atherosclerotic coronary artery disease(CAD) comprises a broad spectrum of clinical entities that include asymptomatic subclinical atherosclerosis and its clinical complications, such as angina pectoris, myocardial in...Atherosclerotic coronary artery disease(CAD) comprises a broad spectrum of clinical entities that include asymptomatic subclinical atherosclerosis and its clinical complications, such as angina pectoris, myocardial infarction(MI) and sudden cardiac death. CAD continues to be the leading cause of death in industrialized society. The long-recognized familial clustering of CAD suggests that genetics plays a central role in its development, with the heritability of CAD and MI estimated at approximately 50% to 60%. Understanding the genetic architecture of CAD and MI has proven to be difficult and costly due to the heterogeneity of clinical CAD and the underlying multi-decade complex pathophysiological processes that involve both genetic and environmental interactions. This review describes the clinical heterogeneity of CAD and MI to clarify the disease spectrum in genetic studies, provides a brief overview of the historical understanding and estimation of the heritability of CAD and MI, recounts major gene discoveries of potential causal mutations in familial CAD and MI, summarizes CAD and MIassociated genetic variants identified using candidate gene approaches and genome-wide association studies(GWAS), and summarizes the current status of the construction and validations of genetic risk scores for lifetime risk prediction and guidance for preventive strategies. Potential protective genetic factors against the development of CAD and MI are also discussed. Finally, GWAS have identified multiple genetic factors associated with an increased risk of in-stent restenosis following stent placement for obstructive CAD. This review will also address genetic factors associated with in-stent restenosis, which may ultimately guide clinical decision-making regarding revascularization strategies for patients with CAD and MI.展开更多
Objective: To study the correlation of serum Hcy and UA contents with coronary plaque property changes in diabetic patients with coronary heart disease. Methods: Patients who were diagnosed with type 2 diabetes mellit...Objective: To study the correlation of serum Hcy and UA contents with coronary plaque property changes in diabetic patients with coronary heart disease. Methods: Patients who were diagnosed with type 2 diabetes mellitus in Dongguan Branch of Yan'an University Affiliated Hospital between May 2013 and June 2017 were selected and divided into the CHD+DM group who were complicated by coronary heart disease and the DM group who were not complicated by coronary heart disease according to the results of coronary CTA, and the healthy subjects who received physical examination in Dongguan Branch of Yan'an University Affiliated Hospital during the same period were selected as control group. The contents of homocysteine (Hcy), uric acid (UA), platelet activation indexes and protease indexes in serum were measured. Results: Serum Hcy, UA, sSema4D, sP-selectin, sE-selectin, MMP1, MMP3, CatK and ADAMTS4 contents of DM group and CHD+DM group were greatly higher than those of control group whereas Klotho and TIMP2 contents were greatly lower than those of control group;serum Hcy, UA, sSema4D, sP-selectin, sE-selectin, MMP1, MMP3, CatK and ADAMTS4 contents of CHD+DM group were greatly higher than those of DM group whereas Klotho and TIMP2 contents were greatly lower than those of DM group;serum sSema4D, sP-selectin, sE-selectin, MMP1, MMP3, CatK and ADAMTS4 contents of CHD+DM group were positively correlated with Hcy and UA contents while Klotho and TIMP2 contents were negatively correlated with Hcy and UA contents. Conclusion: The abnormal increase of serum Hcy and UA contents in diabetic patients with coronary heart disease can promote the activation and aggregation of platelet, the degradation of plaque fibrous cap and the decrease of plaque stability.展开更多
Background: Patients who underwent percutaneous coronary intervention in left main coronary artery (LMCA) requires special concern, being high risk and increasing patient population. The aim of this study was to asses...Background: Patients who underwent percutaneous coronary intervention in left main coronary artery (LMCA) requires special concern, being high risk and increasing patient population. The aim of this study was to assess the clinical profile, angiographic status, and prevalence of restenosis in patients who underwent percutaneous transluminal coronary angioplasty (PTCA) in LMCA. Materials and Methods: This observational cohort study included 17 patients who underwent PTCA in LMCA during one-year study period at tertiary care centers in Government Medical College, Kozhikode, India. Data including various risk factors, clinical and angiographic details, stent used, procedural complications and outcomes including rate of restenosis were analyzed. Results: A total of 17 patients (mean age 53.88 ± 9.80 years) with 76.47% of males were included in the study. Smoking and hypertension were the most common risk factors presented in 52.94% and 47.06% of patients respectively. Single vessel disease (SVD) of LMCA was the most common pattern observed in 47.10%;the rate of restenosis was observed in 11.76% patients. Revascularization was performed in one patient (5.88%) with coronary artery bypass graft and in one patient (5.88%) with PTCA using drug eluting stent (DES). The overall procedural success was 88.24% in this study. Survival rate was 100% at one-year follow-up period. Conclusion: Our study involved patients who underwent PTCA in LMCA, showed smoking as a most prevalent risk factor for coronary artery disease and SVD as a most common pattern, comparatively low rate of restenosis and 100% of survival rate at one-year follow-up period.展开更多
Purpose: The aim of this study was to determine the influence of lesion preparation using the dual wire scoring balloon on stent expansion and long-term outcomes. Methods: Forty-six consecutive de novo lesions treated...Purpose: The aim of this study was to determine the influence of lesion preparation using the dual wire scoring balloon on stent expansion and long-term outcomes. Methods: Forty-six consecutive de novo lesions treated with a single >2.5 mm drug-eluting stent under intravascular ultrasound guidance, using two implantation strategies, were randomly assigned to: 1) pre-dilation with a non-compliant balloon (NC group;n = 23) or 2) pre-dilation with a dual wire scoring balloon (DS group;n = 23). Results: Although the balloon size and the maximal dilation pressure for pre-dilatation was larger (3.33 ± 0.28 vs 3.09 ± 0.33 mm, p = 0.01) and higher (11.6 ± 3.2 vs 8.6 ± 2.7 atm,展开更多
Objectives To evaluate the effectiveness of firebird stent for the treatment of coronary de novo lesion compared with cypher stent. Methods Ninety-one consecutive patients with 156 lesions who underwent coronary cyphe...Objectives To evaluate the effectiveness of firebird stent for the treatment of coronary de novo lesion compared with cypher stent. Methods Ninety-one consecutive patients with 156 lesions who underwent coronary cypher (n = 68 lesions) and firebird (n = 88 lesions) implantation, quantitative coronary angiography (QCA) was performed at the time of stent implantation and subsequently at 8 months post-stenting. Small vessel disease was defined as ≤2.5 mm of reference vessel diameter measured by QCA. Major adverse cardiac events (MACE) including death, thrombosis, nonfatal myocardial infarction and target lesion revascularization (TLR) were compared between the two groups. Results Baseline clinical characteristics and angiographic parameters were similar between the two groups. Seven-month angiographic follow-up, the late loss was not different between the two groups (0.14 ± 0.38 mm vs 0.13 ± 0.17 mm, P > 0.05). Similarly, overall thrombosis rate were similar in both groups (1.5% vs 1.1%, P > 0.05). However, in-stent restenosis as well as in-segment restenosis rate were significantly higher in cypher group than that in firebird group (4.4% vs 0% and 19.1% vs 3.4%, P = 0.047 and P = 0.001 respectively). TLR was also higher in the cypher group (10.3% vs 2.3%, P = 0.033) compared with firebird group. Conclusions In this small sample size, non-randomized study, the data indicated that implantation of firebird stent for the treatment of small coronary lesion showed more favorable results in respective of restenosis compared with cypher stent implantation. A multi-center, large-sample size, randomized study, therefore, may be warranted.展开更多
Background Many studies have shown that the serum uric acid(SUA) level is one of the cardiovascular risk factors. The aim of the study is to evaluate the relationship between SUA levels and the severity of coronary ar...Background Many studies have shown that the serum uric acid(SUA) level is one of the cardiovascular risk factors. The aim of the study is to evaluate the relationship between SUA levels and the severity of coronary artery disease(CAD) assessed by angiography and the Syntax score in patients with obstructive CAD.Methods Participants who visited our hospital for a coronary angiography, from December 2007 to September 2012, were eligible for this analysis. SUA and other blood parameters after at least 12-hour fast were determined. First, the patients were divided into tertiles according to their Syntax scores(low Syntax score group: Syntax score ≤10.0; moderate Syntax score group: 10.0 <Syntax score ≤18.0; high Syntax score group: Syntax score >18.0). Second, to clarify the association between SUA levels and major adverse cardiovascular events(MACEs), all patients were divided into two subgroups on the basis of SUA levels. The cutoff value of SUA was defined by diagnostic criteria of hyperuricemia. Patients were separated into normal SUA group(n=251, with SUA <416 μmol/L for men and SUA <357 μmol/L for women) and high SUA group(n=96, with SUA ≥416 μmol/L for men and SUA ≥357 μmol/L for women). All participants were followed for a mean of 22.0 months(1–75 months, interquartile range: 28 months) for major adverse cardiovascular events(MACEs), including all-cause death, recurrent nonfatal myocardial infarction(re-MI) and recurrent percutaneous coronary intervention(re-PCI). Results A total of 347 patients were registered for the study. The SUA levels in the high Syntax score group were significantly higher than that of the moderate Syntax score group and the low Syntax score group((392.3±81.6) μmol/L vs.(329.9±71.0) μmol/L, P <0.001;(392.3±81.6) μmol/L vs.(311.4±64.7) μmol/L, P <0.001). The SUA level was positively correlated not only with the Syntax score(r=0.421, P <0.001; 95% CI: 0.333–0.512), but also with the number of diseased vessels(r=0.298, P <0.001; 95% CI: 0.194–0.396). After multiple linear regression analysis, SUA levels were identified to be independently correlated with a high Syntax score(B=0.033, 95% CI 0.023–0.042, P <0.001). Compared with the normal SUA subgroup, the high SUA subgroup tended to have a higher Syntax score(19.9±8.7 vs. 13.6±7.5, P <0.001) and more multi-vessel disease(70.8% vs. 46.6%, P <0.001). Follow-up data showed a higher incidence of MACE in the high SUA subgroup(20.8% vs. 6.0%, P <0.001). Binary Logistic regression analysis indicated that the elevated SUA can predict the long-term prognosis of patients with obstructive CAD(OR=2.968, 95% CI 1.256–7.011, P=0.013). KaplanMeier analysis showed a significantly lower event-free survival rate in patients with high SUA levels than in the normal SUA subgroup(79.2% vs. 94.0%, Log rank=17.645, P <0.001). Conclusions SUA levels were independently associated with the severity of CAD in patients with obstructive CAD. An elevated SUA is associated with cardiovascular events and may be useful as a biomarker of the severity of CAD.展开更多
Objectives To explore therisk of uric acid (UA) resulting in carotid atheroscle-rosis. Methods With a cross sectional study, 643subjects (aged 41-83 yrs, male 552 and female 91)were surveyed in 1999 in Guangdong Provi...Objectives To explore therisk of uric acid (UA) resulting in carotid atheroscle-rosis. Methods With a cross sectional study, 643subjects (aged 41-83 yrs, male 552 and female 91)were surveyed in 1999 in Guangdong Province, China.The main research variables were uric acid (UA), oc-currence and the size of carotid artery plaque. Re-sults There was no statistical significance betweenthe UA means of plaque occurrence and no - occur-rence groups (t=0.60, df=242, P=0.5495). It seemedUA was not a possible risk factor of carotid atheroscle-rosis (OR=1.060, P=0.8448>0.05, n=244) based on thelogistic regression analysis. Conclusions Our resultsare not consistent with serum UA being an indepen-dent risk factor for atherosclerosis and coronary heartdisease (CHD). It is necessary to do more research toleam the risk degree of UA during the progress ofatherosclerosis/CHD.展开更多
Objective:To explore the relationship between blood lipids and serum uric acid(UA)in the elderly patients with coronary heart disease(CHD).Method:Quartered patients according to their uric acid level.Systematic review...Objective:To explore the relationship between blood lipids and serum uric acid(UA)in the elderly patients with coronary heart disease(CHD).Method:Quartered patients according to their uric acid level.Systematic review and compare lipid level among this four groups.Polynary logistic stepwise regression analysis were employed to analyze independent risk factor of coronary heart disease.Results:Serum level of triglycerides(TAG)and very low density lipoprotein cholesterol(VLDL-C)increase significantly(F=7.42,p<0.01;F=5.42,p<0.01 respectively)while high density lipoprotein cholesterol(HDL-C)and Apolipoprotein A1(Apo A1)decrease(F=5.03,p<0.01;F=7.03,p<0.01)upon elevated serum uric acid level among coronary heart disease patients.Gender(OR=0.16,95%CI 0.078~0.315,p=0.001),Ccr(OR=0.95,CI=0.935~0.969,p=0.001),associated hypertension(OR=2.23,CI=1.156~4.285,p=0.017)or DM(OR=2.44,CI=1.154~5.168,p=0.02),TC(OR=1.56,CI=1.119~2.186,p=0.009),HDL-C(OR=0.02,CI=0.004~0.076,p=0.001),UA(OR=1.09,1.086~1.094,p=0.001)are all independent risk factors for coronary heart disease.Conclusion:TAG,VLDL-C were positively related to UA while HDL-C and Apo A1were negatively linked to UA among CHD patients.Gender,Ccr,Hypertension,DM,TC,HDL-C and UA are independent risk factors for CHD while BMI,TAG,LDL-C were not.展开更多
Objective To investigate the relationship between baseline serum uric acid and the severity of coronary artery disease(CAD)in the first-degree relatives or nonfirst-degree relatives of men with type 2 diabetes.Methods...Objective To investigate the relationship between baseline serum uric acid and the severity of coronary artery disease(CAD)in the first-degree relatives or nonfirst-degree relatives of men with type 2 diabetes.Methods Three hundred and eighty-one men with negative coronary angiography for the first time were divided into diabetes and non-diabetes groups and followed-up for展开更多
The application of drug-eluting stent (DES), either sirolimus-eluting stent (Cypher, Cordis, USA) or paclitaxel-eluting stent (Taxus, Boston Scientific, USA), in treatment of patients with coronary artery disea...The application of drug-eluting stent (DES), either sirolimus-eluting stent (Cypher, Cordis, USA) or paclitaxel-eluting stent (Taxus, Boston Scientific, USA), in treatment of patients with coronary artery disease (CAD) has achieved great success. The high cost of imported DES (either Cypher or Taxus) gave the birth to a China-made, polymer-based, sirolimus-eluting stent (Firebird, Microport Company,展开更多
文摘BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.
基金NC TraC S to Dai XNo.550KR91403+1 种基金NIH T32 to Wiernek SNo.HL083828-04
文摘Atherosclerotic coronary artery disease(CAD) comprises a broad spectrum of clinical entities that include asymptomatic subclinical atherosclerosis and its clinical complications, such as angina pectoris, myocardial infarction(MI) and sudden cardiac death. CAD continues to be the leading cause of death in industrialized society. The long-recognized familial clustering of CAD suggests that genetics plays a central role in its development, with the heritability of CAD and MI estimated at approximately 50% to 60%. Understanding the genetic architecture of CAD and MI has proven to be difficult and costly due to the heterogeneity of clinical CAD and the underlying multi-decade complex pathophysiological processes that involve both genetic and environmental interactions. This review describes the clinical heterogeneity of CAD and MI to clarify the disease spectrum in genetic studies, provides a brief overview of the historical understanding and estimation of the heritability of CAD and MI, recounts major gene discoveries of potential causal mutations in familial CAD and MI, summarizes CAD and MIassociated genetic variants identified using candidate gene approaches and genome-wide association studies(GWAS), and summarizes the current status of the construction and validations of genetic risk scores for lifetime risk prediction and guidance for preventive strategies. Potential protective genetic factors against the development of CAD and MI are also discussed. Finally, GWAS have identified multiple genetic factors associated with an increased risk of in-stent restenosis following stent placement for obstructive CAD. This review will also address genetic factors associated with in-stent restenosis, which may ultimately guide clinical decision-making regarding revascularization strategies for patients with CAD and MI.
文摘Objective: To study the correlation of serum Hcy and UA contents with coronary plaque property changes in diabetic patients with coronary heart disease. Methods: Patients who were diagnosed with type 2 diabetes mellitus in Dongguan Branch of Yan'an University Affiliated Hospital between May 2013 and June 2017 were selected and divided into the CHD+DM group who were complicated by coronary heart disease and the DM group who were not complicated by coronary heart disease according to the results of coronary CTA, and the healthy subjects who received physical examination in Dongguan Branch of Yan'an University Affiliated Hospital during the same period were selected as control group. The contents of homocysteine (Hcy), uric acid (UA), platelet activation indexes and protease indexes in serum were measured. Results: Serum Hcy, UA, sSema4D, sP-selectin, sE-selectin, MMP1, MMP3, CatK and ADAMTS4 contents of DM group and CHD+DM group were greatly higher than those of control group whereas Klotho and TIMP2 contents were greatly lower than those of control group;serum Hcy, UA, sSema4D, sP-selectin, sE-selectin, MMP1, MMP3, CatK and ADAMTS4 contents of CHD+DM group were greatly higher than those of DM group whereas Klotho and TIMP2 contents were greatly lower than those of DM group;serum sSema4D, sP-selectin, sE-selectin, MMP1, MMP3, CatK and ADAMTS4 contents of CHD+DM group were positively correlated with Hcy and UA contents while Klotho and TIMP2 contents were negatively correlated with Hcy and UA contents. Conclusion: The abnormal increase of serum Hcy and UA contents in diabetic patients with coronary heart disease can promote the activation and aggregation of platelet, the degradation of plaque fibrous cap and the decrease of plaque stability.
文摘Background: Patients who underwent percutaneous coronary intervention in left main coronary artery (LMCA) requires special concern, being high risk and increasing patient population. The aim of this study was to assess the clinical profile, angiographic status, and prevalence of restenosis in patients who underwent percutaneous transluminal coronary angioplasty (PTCA) in LMCA. Materials and Methods: This observational cohort study included 17 patients who underwent PTCA in LMCA during one-year study period at tertiary care centers in Government Medical College, Kozhikode, India. Data including various risk factors, clinical and angiographic details, stent used, procedural complications and outcomes including rate of restenosis were analyzed. Results: A total of 17 patients (mean age 53.88 ± 9.80 years) with 76.47% of males were included in the study. Smoking and hypertension were the most common risk factors presented in 52.94% and 47.06% of patients respectively. Single vessel disease (SVD) of LMCA was the most common pattern observed in 47.10%;the rate of restenosis was observed in 11.76% patients. Revascularization was performed in one patient (5.88%) with coronary artery bypass graft and in one patient (5.88%) with PTCA using drug eluting stent (DES). The overall procedural success was 88.24% in this study. Survival rate was 100% at one-year follow-up period. Conclusion: Our study involved patients who underwent PTCA in LMCA, showed smoking as a most prevalent risk factor for coronary artery disease and SVD as a most common pattern, comparatively low rate of restenosis and 100% of survival rate at one-year follow-up period.
文摘Purpose: The aim of this study was to determine the influence of lesion preparation using the dual wire scoring balloon on stent expansion and long-term outcomes. Methods: Forty-six consecutive de novo lesions treated with a single >2.5 mm drug-eluting stent under intravascular ultrasound guidance, using two implantation strategies, were randomly assigned to: 1) pre-dilation with a non-compliant balloon (NC group;n = 23) or 2) pre-dilation with a dual wire scoring balloon (DS group;n = 23). Results: Although the balloon size and the maximal dilation pressure for pre-dilatation was larger (3.33 ± 0.28 vs 3.09 ± 0.33 mm, p = 0.01) and higher (11.6 ± 3.2 vs 8.6 ± 2.7 atm,
文摘Objectives To evaluate the effectiveness of firebird stent for the treatment of coronary de novo lesion compared with cypher stent. Methods Ninety-one consecutive patients with 156 lesions who underwent coronary cypher (n = 68 lesions) and firebird (n = 88 lesions) implantation, quantitative coronary angiography (QCA) was performed at the time of stent implantation and subsequently at 8 months post-stenting. Small vessel disease was defined as ≤2.5 mm of reference vessel diameter measured by QCA. Major adverse cardiac events (MACE) including death, thrombosis, nonfatal myocardial infarction and target lesion revascularization (TLR) were compared between the two groups. Results Baseline clinical characteristics and angiographic parameters were similar between the two groups. Seven-month angiographic follow-up, the late loss was not different between the two groups (0.14 ± 0.38 mm vs 0.13 ± 0.17 mm, P > 0.05). Similarly, overall thrombosis rate were similar in both groups (1.5% vs 1.1%, P > 0.05). However, in-stent restenosis as well as in-segment restenosis rate were significantly higher in cypher group than that in firebird group (4.4% vs 0% and 19.1% vs 3.4%, P = 0.047 and P = 0.001 respectively). TLR was also higher in the cypher group (10.3% vs 2.3%, P = 0.033) compared with firebird group. Conclusions In this small sample size, non-randomized study, the data indicated that implantation of firebird stent for the treatment of small coronary lesion showed more favorable results in respective of restenosis compared with cypher stent implantation. A multi-center, large-sample size, randomized study, therefore, may be warranted.
文摘Background Many studies have shown that the serum uric acid(SUA) level is one of the cardiovascular risk factors. The aim of the study is to evaluate the relationship between SUA levels and the severity of coronary artery disease(CAD) assessed by angiography and the Syntax score in patients with obstructive CAD.Methods Participants who visited our hospital for a coronary angiography, from December 2007 to September 2012, were eligible for this analysis. SUA and other blood parameters after at least 12-hour fast were determined. First, the patients were divided into tertiles according to their Syntax scores(low Syntax score group: Syntax score ≤10.0; moderate Syntax score group: 10.0 <Syntax score ≤18.0; high Syntax score group: Syntax score >18.0). Second, to clarify the association between SUA levels and major adverse cardiovascular events(MACEs), all patients were divided into two subgroups on the basis of SUA levels. The cutoff value of SUA was defined by diagnostic criteria of hyperuricemia. Patients were separated into normal SUA group(n=251, with SUA <416 μmol/L for men and SUA <357 μmol/L for women) and high SUA group(n=96, with SUA ≥416 μmol/L for men and SUA ≥357 μmol/L for women). All participants were followed for a mean of 22.0 months(1–75 months, interquartile range: 28 months) for major adverse cardiovascular events(MACEs), including all-cause death, recurrent nonfatal myocardial infarction(re-MI) and recurrent percutaneous coronary intervention(re-PCI). Results A total of 347 patients were registered for the study. The SUA levels in the high Syntax score group were significantly higher than that of the moderate Syntax score group and the low Syntax score group((392.3±81.6) μmol/L vs.(329.9±71.0) μmol/L, P <0.001;(392.3±81.6) μmol/L vs.(311.4±64.7) μmol/L, P <0.001). The SUA level was positively correlated not only with the Syntax score(r=0.421, P <0.001; 95% CI: 0.333–0.512), but also with the number of diseased vessels(r=0.298, P <0.001; 95% CI: 0.194–0.396). After multiple linear regression analysis, SUA levels were identified to be independently correlated with a high Syntax score(B=0.033, 95% CI 0.023–0.042, P <0.001). Compared with the normal SUA subgroup, the high SUA subgroup tended to have a higher Syntax score(19.9±8.7 vs. 13.6±7.5, P <0.001) and more multi-vessel disease(70.8% vs. 46.6%, P <0.001). Follow-up data showed a higher incidence of MACE in the high SUA subgroup(20.8% vs. 6.0%, P <0.001). Binary Logistic regression analysis indicated that the elevated SUA can predict the long-term prognosis of patients with obstructive CAD(OR=2.968, 95% CI 1.256–7.011, P=0.013). KaplanMeier analysis showed a significantly lower event-free survival rate in patients with high SUA levels than in the normal SUA subgroup(79.2% vs. 94.0%, Log rank=17.645, P <0.001). Conclusions SUA levels were independently associated with the severity of CAD in patients with obstructive CAD. An elevated SUA is associated with cardiovascular events and may be useful as a biomarker of the severity of CAD.
文摘Objectives To explore therisk of uric acid (UA) resulting in carotid atheroscle-rosis. Methods With a cross sectional study, 643subjects (aged 41-83 yrs, male 552 and female 91)were surveyed in 1999 in Guangdong Province, China.The main research variables were uric acid (UA), oc-currence and the size of carotid artery plaque. Re-sults There was no statistical significance betweenthe UA means of plaque occurrence and no - occur-rence groups (t=0.60, df=242, P=0.5495). It seemedUA was not a possible risk factor of carotid atheroscle-rosis (OR=1.060, P=0.8448>0.05, n=244) based on thelogistic regression analysis. Conclusions Our resultsare not consistent with serum UA being an indepen-dent risk factor for atherosclerosis and coronary heartdisease (CHD). It is necessary to do more research toleam the risk degree of UA during the progress ofatherosclerosis/CHD.
文摘Objective:To explore the relationship between blood lipids and serum uric acid(UA)in the elderly patients with coronary heart disease(CHD).Method:Quartered patients according to their uric acid level.Systematic review and compare lipid level among this four groups.Polynary logistic stepwise regression analysis were employed to analyze independent risk factor of coronary heart disease.Results:Serum level of triglycerides(TAG)and very low density lipoprotein cholesterol(VLDL-C)increase significantly(F=7.42,p<0.01;F=5.42,p<0.01 respectively)while high density lipoprotein cholesterol(HDL-C)and Apolipoprotein A1(Apo A1)decrease(F=5.03,p<0.01;F=7.03,p<0.01)upon elevated serum uric acid level among coronary heart disease patients.Gender(OR=0.16,95%CI 0.078~0.315,p=0.001),Ccr(OR=0.95,CI=0.935~0.969,p=0.001),associated hypertension(OR=2.23,CI=1.156~4.285,p=0.017)or DM(OR=2.44,CI=1.154~5.168,p=0.02),TC(OR=1.56,CI=1.119~2.186,p=0.009),HDL-C(OR=0.02,CI=0.004~0.076,p=0.001),UA(OR=1.09,1.086~1.094,p=0.001)are all independent risk factors for coronary heart disease.Conclusion:TAG,VLDL-C were positively related to UA while HDL-C and Apo A1were negatively linked to UA among CHD patients.Gender,Ccr,Hypertension,DM,TC,HDL-C and UA are independent risk factors for CHD while BMI,TAG,LDL-C were not.
文摘Objective To investigate the relationship between baseline serum uric acid and the severity of coronary artery disease(CAD)in the first-degree relatives or nonfirst-degree relatives of men with type 2 diabetes.Methods Three hundred and eighty-one men with negative coronary angiography for the first time were divided into diabetes and non-diabetes groups and followed-up for
文摘The application of drug-eluting stent (DES), either sirolimus-eluting stent (Cypher, Cordis, USA) or paclitaxel-eluting stent (Taxus, Boston Scientific, USA), in treatment of patients with coronary artery disease (CAD) has achieved great success. The high cost of imported DES (either Cypher or Taxus) gave the birth to a China-made, polymer-based, sirolimus-eluting stent (Firebird, Microport Company,