Background Corrected thrombolysis in myocardial infarction(TIMI)frame count(CTFC)was a simple and sensitive prognostic method that could reflect the perfusion status.Contemporary data on the relationship between CTFC ...Background Corrected thrombolysis in myocardial infarction(TIMI)frame count(CTFC)was a simple and sensitive prognostic method that could reflect the perfusion status.Contemporary data on the relationship between CTFC and the prognosis for patients with ST-elevation myocardial infarction are not available.Methods Between January 2013 and December 2019,183 STEMI patients who attended in our center were retrospectively analyzed.All of the patients underwent primary percutaneous coronary intervention(PCI)and were with final TIMI grade 3 flow.Those patients were divided into high CTFC group(CTFC≥23 frames,n=76)and low CTFC group(CTFC<23 frames,n=107).The primary endpoint was the incidence of major adverse cardiovascular events(MACEs)after 12 months.Univariate and multivariate cox regression analysis was performed to figure out prognostic factors.Results A total of 183 individuals were included in this study.MACE rate was significantly higher in those patients with high CTFC(32.9%vs.15.7%,P=0.012),especially the revascularization rate(18.4%vs.2.8%,P=0.012).Multivariate Cox regression analysis showed that CTFC was the independent predictors of worse prognosis[risk ratio(RR):0.75,95%confidence interval(CI)0.67-0.82,P<0.001].Conclusions CTFC is feasible to identify the high-risk group after primary PCI for STEMI patients.High CTFC was associated with poor short-term clinical outcome.[S Chin J Cardiol 2021;22(1):7-12]展开更多
BACKGROUND Bivalirudin,a direct thrombin inhibitor,is used in anticoagulation therapies as a substitute for heparin,especially during cardiovascular procedures such as percutaneous coronary intervention.AIM To explore...BACKGROUND Bivalirudin,a direct thrombin inhibitor,is used in anticoagulation therapies as a substitute for heparin,especially during cardiovascular procedures such as percutaneous coronary intervention.AIM To explore the effect of bivalirudin on myocardial microcirculation following an intervention and its influence on adverse cardiac events in elderly patients with acute coronary syndrome(ACS).METHODS In total,165 patients diagnosed with acute myocardial at our hospital between June 2020 and June 2022 were enrolled in this study.From June 2020 to June 2022,elderly patients with ACS with complete data were selected and treated with interventional therapy.The study cohort was randomly divided into a study group(n=80,administered bivalirudin)and a control group(n=85,administered unfractionated heparin).Over a 6-mo follow-up period,differences in emergency processing times,including coronary intervention,cardiac function indicators,occurrence of cardiovascular events,and recurrence rates,were analyzed.RESULTS Significant differences were observed between the study cohorts,with the observation group showing shorter emergency process times across all stages:Emergency classification;diagnostic testing;implementation of coronary intervention;and conclusion of emergency treatment(P<0.05).Furthermore,the left ventricular ejection fraction in the observation group was significantly higher(P<0.05),and the creatine kinase-MB and New York Heart Association scores were CONCLUSION In elderly patients receiving interventional therapy for ACS,bivalirudin administration led to increased activated clotting time achievement rates,enhanced myocardial reperfusion,and reduced incidence of bleeding complications and adverse cardiac events.展开更多
目的:测定冠状动脉慢血流现象(CSFP)患者血清同型半胱氨酸(Hcy)、一氧化氮(NO)水平,评价两者与CSFP的相关性,分析两者对CSFP的预测价值。方法:选取华润武钢总医院2020年8月至2021年8月,心内科因胸痛住院、心电图提示ST-T改变,行经皮冠...目的:测定冠状动脉慢血流现象(CSFP)患者血清同型半胱氨酸(Hcy)、一氧化氮(NO)水平,评价两者与CSFP的相关性,分析两者对CSFP的预测价值。方法:选取华润武钢总医院2020年8月至2021年8月,心内科因胸痛住院、心电图提示ST-T改变,行经皮冠状动脉造影未见心外膜冠状动脉有狭窄或明显狭窄(<50%)患者92例,通过校正TIMI血流计帧法(CTFC)计算各冠状动脉血流帧数,将冠状动脉血流平均帧数> 27帧定义为CSFP,将92例患者分为慢血流现象组(CSFP组)43例及非慢血流现象组(NCSFP)49例,收集两组患者的一般临床资料、测定Hcy、NO、TG、TC等血清学指标,应用多因素Logistic回归分析确定CSFP的危险因素,通过受试者工作曲线(ROC)进一步分析Hcy及NO对CSFP的预测价值。结果:CSFP组Hcy水平明显高于NCSFP组[(20.39±1.70)vs.(17.57±1.57),P<0.05],CSFP组NO水平明显低于NCSFP组[(21.96±2.68)vs.(27.00±3.95),P <0.05],Logistic回归分析结果表明Hcy是CSFP的危险因素(OR=2.981, P <0.0001),NO是CSFP的保护因素(OR=0.588, P <0.000);ROC分析结果表明Hcy曲线下面积为0.880,预测CSFP的灵敏度为93.02,特异度为69.39,NO曲线下面积为0.853,预测CSFP的灵敏度为88.4,特异度为73.5。结论:血清NO水平降低及Hcy水平升高是CSFP的危险因素,两者对CSFP有较高的预测价值。展开更多
基金supported by The Second Batch of Shantou Medical and Health Science and Technology Plan(self-financing)projects in 2019[shanfuke(2019)No.70]
文摘Background Corrected thrombolysis in myocardial infarction(TIMI)frame count(CTFC)was a simple and sensitive prognostic method that could reflect the perfusion status.Contemporary data on the relationship between CTFC and the prognosis for patients with ST-elevation myocardial infarction are not available.Methods Between January 2013 and December 2019,183 STEMI patients who attended in our center were retrospectively analyzed.All of the patients underwent primary percutaneous coronary intervention(PCI)and were with final TIMI grade 3 flow.Those patients were divided into high CTFC group(CTFC≥23 frames,n=76)and low CTFC group(CTFC<23 frames,n=107).The primary endpoint was the incidence of major adverse cardiovascular events(MACEs)after 12 months.Univariate and multivariate cox regression analysis was performed to figure out prognostic factors.Results A total of 183 individuals were included in this study.MACE rate was significantly higher in those patients with high CTFC(32.9%vs.15.7%,P=0.012),especially the revascularization rate(18.4%vs.2.8%,P=0.012).Multivariate Cox regression analysis showed that CTFC was the independent predictors of worse prognosis[risk ratio(RR):0.75,95%confidence interval(CI)0.67-0.82,P<0.001].Conclusions CTFC is feasible to identify the high-risk group after primary PCI for STEMI patients.High CTFC was associated with poor short-term clinical outcome.[S Chin J Cardiol 2021;22(1):7-12]
文摘BACKGROUND Bivalirudin,a direct thrombin inhibitor,is used in anticoagulation therapies as a substitute for heparin,especially during cardiovascular procedures such as percutaneous coronary intervention.AIM To explore the effect of bivalirudin on myocardial microcirculation following an intervention and its influence on adverse cardiac events in elderly patients with acute coronary syndrome(ACS).METHODS In total,165 patients diagnosed with acute myocardial at our hospital between June 2020 and June 2022 were enrolled in this study.From June 2020 to June 2022,elderly patients with ACS with complete data were selected and treated with interventional therapy.The study cohort was randomly divided into a study group(n=80,administered bivalirudin)and a control group(n=85,administered unfractionated heparin).Over a 6-mo follow-up period,differences in emergency processing times,including coronary intervention,cardiac function indicators,occurrence of cardiovascular events,and recurrence rates,were analyzed.RESULTS Significant differences were observed between the study cohorts,with the observation group showing shorter emergency process times across all stages:Emergency classification;diagnostic testing;implementation of coronary intervention;and conclusion of emergency treatment(P<0.05).Furthermore,the left ventricular ejection fraction in the observation group was significantly higher(P<0.05),and the creatine kinase-MB and New York Heart Association scores were CONCLUSION In elderly patients receiving interventional therapy for ACS,bivalirudin administration led to increased activated clotting time achievement rates,enhanced myocardial reperfusion,and reduced incidence of bleeding complications and adverse cardiac events.
文摘目的:测定冠状动脉慢血流现象(CSFP)患者血清同型半胱氨酸(Hcy)、一氧化氮(NO)水平,评价两者与CSFP的相关性,分析两者对CSFP的预测价值。方法:选取华润武钢总医院2020年8月至2021年8月,心内科因胸痛住院、心电图提示ST-T改变,行经皮冠状动脉造影未见心外膜冠状动脉有狭窄或明显狭窄(<50%)患者92例,通过校正TIMI血流计帧法(CTFC)计算各冠状动脉血流帧数,将冠状动脉血流平均帧数> 27帧定义为CSFP,将92例患者分为慢血流现象组(CSFP组)43例及非慢血流现象组(NCSFP)49例,收集两组患者的一般临床资料、测定Hcy、NO、TG、TC等血清学指标,应用多因素Logistic回归分析确定CSFP的危险因素,通过受试者工作曲线(ROC)进一步分析Hcy及NO对CSFP的预测价值。结果:CSFP组Hcy水平明显高于NCSFP组[(20.39±1.70)vs.(17.57±1.57),P<0.05],CSFP组NO水平明显低于NCSFP组[(21.96±2.68)vs.(27.00±3.95),P <0.05],Logistic回归分析结果表明Hcy是CSFP的危险因素(OR=2.981, P <0.0001),NO是CSFP的保护因素(OR=0.588, P <0.000);ROC分析结果表明Hcy曲线下面积为0.880,预测CSFP的灵敏度为93.02,特异度为69.39,NO曲线下面积为0.853,预测CSFP的灵敏度为88.4,特异度为73.5。结论:血清NO水平降低及Hcy水平升高是CSFP的危险因素,两者对CSFP有较高的预测价值。
