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| 1 | Hyperbaric oxygen preconditioning induces neuroprotection against ischemia in transient not permanent middle cerebral artery occlusion rat model显示文摘This study was designed to determine if repeated hyperbaric oxygen (HBO) exposure induces ischemic tolerance in focal cerebral ischemia Methods Sixty male SD rats were used in this study Thirty animals underwent transient middle cerebral artery occlusion (MCAO) and the other thirty permanent MCAO model The rats were randomly allocated to 3 sub-groups: control group (n=10), HBO-3 group (n=10), and HBO-5 group (n=10) The animals in HBO-3 and HBO-5 groups received 1*!hour hyperbaric oxygenation at 2 5 atmosphere absolute (ATA) in 100% oxygen every day for 3 and 5 days, respectively The animals in the control group received sham treatments 24*!hours after the last HBO, transient MCAO (120 min) and permanent MCAO were induced by introducing a 3-0 nylon monofilament suture through internal carotid artery based on the Koizumi technique The neurological outcome was evaluated until 24*!hours after reperfusion in transient MCAO rats and ischemia in permanent MCAO rats The infarct volume was then assessed by TTC staining Results In transient MCAO rats, the neurological outcome in both the HBO-3 and HBO-5 groups was better than that of the control group ( P <0 05 and 0 001) The infarct volume decreased from 171 5±113*!mm 3 to 40 6±49 9*!mm 3 ( P <0 05) in the HBO-3 group and 16 2±28 8*!mm 3 ( P <0 01) in the HBO-5 group There were no significant differences in neurological outcome and infarct volume among the three groups in permanent MCAO rats Conclusions The present study demonstrated that HBO preconditioning can induce ischemic tolerance in transient not permanent MCAO rats in a “dose-dependent' | 熊利泽 朱正华 董海龙 胡文能 候立朝 陈绍洋 | 2000 | Chinese Medical Journal2000，，9： | 60 |
| 2 | Myocardial reperfusion injury and oxidative stress: Therapeutic opportunities显示文摘Acute myocardial infarction(AMI) is the leading cause of death worldwide. Its associated mortality, morbidity and complications have significantly decreased with the development of interventional cardiology and percutaneous coronary angioplasty(PCA) treatment, which quick-ly and effectively restore the blood flow to the area previously subjected to ischemia. Paradoxi-cally, the restoration of blood flow to the ischemic zone leads to a massive production of reactive oxygen species(ROS) which generate rapid and severe damage to biomolecules, generating a phenomenon called myocardial reperfusion injury(MRI). In the clinical setting, MRI is associated with multiple complications such as lethal reperfusion, no-reflow, myocardial stunning, and reperfusion arrhythmias. Despite significant advances in the understanding of the mechanisms accounting for the myocardial ischemia reperfusion injury, it remains an unsolved problem. Although promising results have been obtained in experimental studies(mainly in animal models), these benefits have not been translated into clinical settings. Thus, clinical trials have failed to find benefits from any therapy to prevent MRI. There is major evidence with respect to the contribution of oxidative stress to MRI in cardiovascular diseases. The lack- of consistency between basic studies and clinical trials is not solely based on the diversity inherent in epidemiology but is also a result of the methodological weak-nesses of some studies. It is quite possible that pharmacological issues, such as doses, active ingredients, bioavailability, routes of administration, co-therapies, startup time of the drug intervention,and its continuity may also have some responsibility for the lack- of consistency between different studies. Furthermore, the administration of high ascorbate doses prior to reperfusion appears to be a safe and rational therapy against the development of oxidative damage associated with myocardial reperfusion. In addition, the association with N-acetylcysteine(a glutathione donor) and deferoxamine(an iron chelator) could improve the antioxidant cardioprotection by ascorbate, mak-ing it even more effective in preventing myocardial reperfusion damage associated with PCA following AMI. | Jaime González-Montero Roberto Brito Abraham IJ Gajardo Ramón Rodrigo | 2018 | World Journal of Cardiology2018，10，9： | 56 |
| 3 | Influences of blood lipids on the occurrence and prognosis of hemorrhagic transformation after acute cerebral infarction: a case-control study of 732 patients显示文摘Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including intravenous recombinant human tissue plasminogen activator(r TPA), intensive lipid-lowering statins and anti-platelets, were not significantly related to either HT or long-term, post-ACI poor prognosis.Conclusions: For patients with large infarct sizes, especially those with cortex involvement, AF, or lower levels of TC, the risk of HT might increase after ACI. The risk of a long-term unfavorable outcome in these patients might increase with a reduction in LDL-C. | Gang Lv Guo-Qiang Wang Zhen-Xi Xia Hai-Xia Wang Nan Liu Wei Wei Yong-Hua Huang Wei-Wei Zhang | 2019 | Military Medical Research2019，6，3： | 60 |
| 4 | Effects of rh BNP after PCI on non-invasive hemodynamic in acute myocardial infarction patients with left heart failure显示文摘Objective: To investigate the effects of exogenous recombinant human brain natriuretic peptide(rh BNP) after primary percutaneous coronary intervention(PCI) on non-invasive hemodynamic in acute myocardial infarction patients with left ventricular failure. Methods: A number of 96 acute myocardial infarction patients accompanied with heart failure after PCI hospitalized in the People's Hospital of Sanya during February 2012 to October 2015 were selected. They were randomly divided into the therapy group(n = 50) and control group(n = 46). On the basis of routine treatment, patients in the therapy group were treated with intravenous rh BNP(1.5 μg/kg was intravenous injection with uniform speed of 3 min, followed by continuous infusion 0.007 5 μg/kg·min for 72 h), while the control group received conventional treatment. Bio Z-2011 non-invasive hemodynamic real-time monitoring system was used to monitor the hemodynamic parameters changes and the leves of plasma pro-BNP, serum creatinine, serum potassium, serum sodium and urine volume of each group before and after treating for 30 min, 1 h, 3 h, 6 h, 12 h, 24 h, 48 h, 72 h. Results: Patients in the therapy group showed no effect on heart rate, while after 30 min of intravenous injection of rh BNP, CO, CI, SV, and SI increased significantly and LVET and TFC reduced at the same time, which had certain effect on blood pressure(SBP/DBP). Compared with the control group, the therapy group showed a faster and more effective improvement on haemodynamics. Conclusions: Acute myocardial infarction patients complicated with left heart failure after primary PCI can significantly improve hemodynamics by treating with rh BNP. | Xi-Min He Lin Chen Jiang-Bin Luo Xu-Xia Feng Yun-Bo Zhang Qi-Jing Chen Xiao-Li Ji Tian-Song Wang | 2016 | Asian Pacific Journal of Tropical Medicine2016，9，8： | 52 |
| 5 | The efficacy and safety of endovascular recanalization of occluded large cerebral arteries during the subacute phase of cerebral infarction:a case series report显示文摘background Intravenous tissue plasminogen activator with or without mechanical thrombectomy during the acute phase are approved therapies for ischaemic stroke.Due to the short treatment time window(<6 hours)and often treatment failure,these patients would still have an intracranial arterial occlusion(IAO).It is unclear whether these patients can benefit from subsequent interventional recanalizationof their occluded artery in the subacute phase.In this retrospective study,we have examined the efficacy and safety in patients who have received either percutaneous transluminal angioplasty(PTA)or percutaneous transluminal angioplasty and stenting(PTAS)for IAO in the subacute phase of their stroke.Methods Patients with subacute symptomatic ischaemic stroke caused by IAO were assessed to identify the responsible artery and low perfusion areas by CT angiography,MR angiography or digital subtraction angiography.In eligible patients,a PTA or PTAS was performed to reopen the occluded artery.Regular antithrombotic therapy,use of statins,control of risk factors and rehabilitation therapy were prescribed after the procedure.All patients had regular follow-up up to 12 months.results PTA or PTAS was performed in 16 patients with cerebral infarction caused by IAO in the subacute phase.After the procedure,12 cases were recanalized,two were partially recanalized and two failed to open.One patient with left C6 segment occlusion of the carotid artery had a central retinal artery embolism after PTAS.The perioperative adverse events were 6.25%.At 3 months,the distribution of modified Rankin scale scores was 0(seven cases),1(three cases),2(five cases)and 3(one case).conclusion Selective PTA or PTAS could be performed in ischaemic stroke patients with a small infarct size and large area of hypoperfusion from an occluded large cerebral artery after the acute phase.It may improve neurological dysfunction and reduce the incidence of disability. | Kangning Chen Xianhua Hou Zhenhua Zhou Guangjian Li Qu Liu Li Gui Jun Hu Shugui Shi | 2017 | Stroke & Vascular Neurology2017，2，3： | 41 |
| 6 | Assessment of neovascularization within carotid plaques in patients with ischemic stroke显示文摘AIM:To assess neovascularization within human ca-rotid atherosclerotic soft plaques in patients with isch-emic stroke.METHODS:Eighty-one patients with ischemic stroke and 95 patients without stroke who had soft athero-sclerotic plaques in the internal carotid artery were studied.The thickest soft plaque in each patient was examined using contrast-enhanced ultrasound.Time-intensity curves were collected from 5 s to 3 min after contrast injection.The neovascularization within the plaques in the internal carotid artery was evaluated using the ACQ software built into the scanner by 2 of the experienced investigators who were blinded to the clinical history of the patients.RESULTS:Ischemic stroke was present in 7 of 33 patients(21%) with grade Ⅰ plaque,in 14 of 51 pa-tients(28%) with grade Ⅱ plaque,in 26 of 43 patients(61%) with grade Ⅲ plaque,and in 34 of 49 patients(69%) with grade Ⅳ plaque(P < 0.001 comparing grade Ⅳ plaque with grade I plaque and with grade Ⅱ plaque and P = 0.001 comparing grade Ⅲ plaque with grade Ⅰ plaque and with grade Ⅱ plaque).Analysis of the time intensity curves revealed that patients with ischemic stroke had a significantly higher intensity of enhancement(IE) than those without ischemic stroke(P < 0.01).The wash-in time(WT) of plaque was signifi-cantly shorter in stroke patients(P < 0.05).The sensi-tivity and specificity for IE in the plaque were 82% and 80%,respectively,and for WT were 68% and 74%,respectively.There was no significant difference in the peak intensity or time to peak between the 2 groups.CONCLUSION:This study shows that the higher the grade of plaque enhancement,the higher the risk of ischemic stroke.The data suggest that the presence of neovascularization is a marker for unstable plaque. | Wilbert S Aronow Chandra K Nair David Cosgrove | 2010 | World Journal of Cardiology2010，2，4： | 29 |
| 7 | Differences in symptoms and pre-hospital delay among acute myocardial infarction patients according to ST-segment elevation on electrocardiogram: an analysis of China Acute Myocardial Infarction (CAMI) registry显示文摘Background: Approximately 70% patients with acute myocardial infarction (AMI) presented without ST-segment elevation on electrocardiogram. Patients with non-ST segment elevation myocardial infarction (NSTEMI) often presented with atypical symptoms, which may be related to pre-hospital delay and increased risk of mortality. However, up to date few studies reported detailed symptomatology of NSTEMI, particularly among Asian patients. The objective of this study was to describe and compare symptoms and presenting characteristics of NSTEMI vs. STEMI patients. Methods: We enrolled 21,994 patients diagnosed with AMI from China Acute Myocardial Infarction (CAMI) Registry between January 2013 and September 2014. Patients were divided into 2 groups according to ST-segment elevation: ST-segment elevation (STEMI) group and NSTEMI group. We extracted data on patients' characteristics and detailed symptomatology and compared these variables between two groups. Results: Compared with patients with STEMI (N=16,315), those with NSTEMI (N=5679) were older, more often females and more often have comorbidities. Patients with NSTEMI were less likely to present with persistent chest pain (54.3% vs.71.4%), diaphoresis (48.6% vs.70.0%), radiation pain (26.4% vs.33.8%), and more likely to have chest distress (42.4% vs.38.3%) than STEMI patients (all P<0.0001). Patients with NSTEMI were also had longer time to hospital. In multivariable analysis, NSTEMI was independent predictor of presentation without chest pain (odds ratio: 1.974, 95% confidence interval:1.849-2.107). Conclusions: Patients with NSTEMI were more likely to present with chest distress and pre-hospital patient delay compared with patients with STEMI. It is necessary for both clinicians and patients to learn more about atypical symptoms of NSTEMI in order to rapidly recognize myocardial infarction. | Rui Fu Chen-Xi Song Ke-Fei Dou Jin-Gang Yang Hai-Yan Xu Xiao-Jin Gao Qian-Qian Liu Han Xu Yue-Jin Yang | 2019 | Chinese Medical Journal2019，，5： | 29 |
| 8 | Effects of intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction after emergency PCI显示文摘BACKGROUND:This study investigated the effects of the intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).METHODS:Seventy-eight STEMI patients with age>65 years who underwent emergency PCI were consecutively enrolled.These patients received conventional PCI and were randomly divided into a control group and a treatment group(n=39 per group).The control group received an intracoronary injection of tirofiban followed by a maintenance infusion for 36 hours after surgery.The treatment group received intracoronary injection of tirofiban and nicorandil,and then intravenous infusion of tirofiban and nicorandil 36 hours after surgery.The following parameters were measured:TIMI grade,corrected TIMI frame count(c TFC),TIMI myocardial perfusion grade(TMPG),STsegment resolution(STR)rate 2 hours post-operatively,resolution of ST-segment elevation(STR)at 2 hours postoperatively,peak level of serum CK-MB,left ventricular end diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)at 7–10 days postoperatively,and major adverse cardiac events(MACEs)in-hospital and within 30 days post-operatively.RESULTS:Compared with the control group,more patients in the treatment group had TIMI 3 and TMPG 3,and STR after PCI was significantly higher.The treatment group also had significantly lower c TFC,lower infarction relative artery(IRA),lower peak CK-MB,and no reflow ratio after PCI.The treatment group had significantly higher LVEDD and LVEF but lower incidence of MACEs than the control group.CONCLUSION:The intracoronary injection of nicorandil combined with tirofiban can effectively improve myocardial reperfusion in elderly STEMI patients after emergency PCI and improve shortterm prognoses. | Guo-xiong Chen Hong-na Wang Jin-lin Zou Xiao-xu Yuan | 2020 | World Journal of Emergency Medicine2020，11，3： | 27 |
| 9 | Cardiac remodeling and physical training post myocardial infarction显示文摘After myocardial infarction(MI), the heart undergoes extensive myocardial remodeling through the accumulation of fibrous tissue in both the infarcted and noninfarcted myocardium, which distorts tissue structure, increases tissue stiffness, and accounts for ventricular dysfunction. There is growing clinical consensus that exercise training may beneficially alter the course of post-MI myocardial remodeling and improve cardiac function. This review summarizes the present state of knowledge regarding the effect of post-MI exercise training on infarcted hearts. Due to the degree of difficulty to study a viable human heart at both protein and molecular levels, most of the detailed studies have been performed by using animal models. Although there are some negative reports indicating that post-MI exercise may further cause deterioration of the wounded hearts, a growing body of research from both human and animal experiments demonstrates that post-MI exercise may beneficially alter the course of wound healing and improve cardiac function. Furthermore, the improved function is likely due to exercise training-induced mitigation of reninangiotensin-aldosterone system, improved balance between matrix metalloproteinase-1 and tissue inhibitor of matrix metalloproteinase-1, favorable myosin heavy chain isoform switch, diminished oxidative stress, enhanced antioxidant capacity, improved mitochondrial calcium handling, and boosted myocardial angiogenesis. Additionally, meta-analyses revealed that exercise-based cardiac rehabilitation has proven to be effective, and remains one of the least expensive therapies for both the prevention and treatment of cardiovascular disease, and prevents re-infarction. | Michael A Garza Emily A Wason John Q Zhang | 2015 | World Journal of Cardiology2015，7，2： | 28 |
| 10 | Over-expression of VEGF in Marrow Stromal Cells Promotes Angiogenesis in Rats with Cerebral Infarction via the Synergistic Effects of VEGF and Ang-2显示文摘This study explored whether the transplantation of modified marrow stromal cells (MSCs) has angiogenic effects in a left middle cerebral artery occlusion infarction/reperfusion (MCAO I/R) rat model and preliminarily examined the mechanism of angiogenesis following cerebral infarction.MSCs were isolated by using a direct adherent method and cultured.Vascular endothelial growth factor (VEGF) was transfected into MSCs by employing the liposome transfection.The transfection efficiency was measured by the optical density method.The protein expression of VEGF gene before and after transfection was measured by Western blotting.SD rat model of transient occlusion of the left middle cerebral artery was established by using an approach of intra-luminal occlusion.Tetrazolium (TTC) and HE staining were performed to observe the cerebral infarction.ELISAs were used to measure the levels of VEGF in the rat cerebral tissues.The expression patterns of angiopoietin-2 (Ang-2) and CD34 in cells surrounding the area of infarction were immunohistochemistrically oserved.Ang-2 protein expression in the tissue surrounding the area of infarction was measured by Western blotting.VEGF expression in the MSCs increased after transfection at a rate of approximately 28%±3.4%.ELISA showed that the expression of VEGF in the cerebral tissue was significantly increased after induction of infarction,peaking on the 4th day and decreasing to the levels of the sham surgery group (normal) within 7 to 10 days.The VEGF level was significantly higher at each time point in the VEGF-MSC and MSC groups compared to the model group.Moreover,the VEGF level was higher in the VEGF-MSC group than in the MSC group and stayed relatively high until the 10th day.The immunohistochemical results showed that 10 days after the infarction,the number of Ang-2 and CD34-expressing cells in the area surrounding the infarction was significantly higher in the VEGF-MSC group and the MSC group compared to the model group.Moreover,the VEGF level was higher in the VEGF-MSC group than the MSC group.A similar trend in Ang-2 protein expression was revealed by Western blotting.In the MCAO rat model transfected with modified MSCs over-expressing VEGF,compared to the MSC transplantation group,the concentration of VEGF was significantly increased in the brain tissue after cerebral infarction.In addition,the level of Ang-2 was up-regulated,with angiogenesis promoted,the blood supply to the areas surrounding the cerebral infarction increased,and neurological function improved.We are led to speculate that the synergistic effects of VEGF and Ang-2 may be responsible for the angiogenesis following cerebral infarction. | 赖天宝 李嫚 郑丽芳 宋艳玲 徐小丽 郭远瑾 张远 张宗胜 梅元武 | 2012 | Journal of Huazhong University of Science and Technology(Medical Sciences)2012，32，5： | 26 |
| 11 | Effect and mechanism of salvianolic acid B on the myocardial ischemiareperfusion injury in rats显示文摘Objective:To investigate the effect of salvianolic acid B on rats with myocardial ischemiareperfusion injury.Methods:SD rats were randomly divided into five groups(n=10 in each group):A sham operation group,B ischemic reperfusion group model group,C low dose salvianolic acid B group,D median dose salvianolic acid B group,E high dose salvianolic acid B group.One hour after establishment of the myocardial ischemia-reperfusion model,the concentration and the apoptotic index of the plasma level of myocardial enzymes(CTnⅠ,CKMB),SOD,MDA,NO,ET were,measured.Heart tissues were obtained and micro-structural changes were observed.Results:Compared the model group,the plasma CTnⅠ,CK-MB,MDA and ET contents were significantly increased,NO,T-SOD contents were decreased in the treatment group(group C,D,and E)(P<0.05);compared with group E,the plasma CTnⅠ,CKMB,MDA and ET levels were increased,the NO,T-SOD levels were decreased in groups C and D(P<0.05).Infarct size was significantly reduced,and the myocardial ultrastructural changes were improved significantly in treatment group.Conclusions:Salvianolic acid B has a significant protective effect on myocardial ischemia-reperfusion injury.It can alleviate oxidative stress,reduce calcium overload,improve endothelial function and so on. | Ling Xue Zhen Wu Xiao-Ping Ji Xia-Qing Gao Yan-Hua Guo | 2014 | Asian Pacific Journal of Tropical Medicine2014，7，4： | 24 |
| 12 | Calpain system and its involvement in myocardial ischemia and reperfusion injury显示文摘Calpains are ubiquitous non-lysosomal Ca2+-dependent cysteine proteases also present in myocardial cytosol and mitochondria.Numerous experimental studies reveal an essential role of the calpain system in myocardial injury during ischemia,reperfusion and postischemic structural remodelling.The increasing Ca2+-content and Ca2+-overload in myocardial cytosol and mitochondria during ischemia and reperfusion causes an activation of calpains.Upon activation they are able to injure the contractile apparatus and impair the energy production by cleaving structural and functional proteins of myocytes and mitochondria.Besides their causal involvement in acute myocardial dysfunction they are also involved in structural remodelling after myocardial infarction by the generation and release of proapoptotic factors from mitochondria.Calpain inhibition can prevent or attenuate myocardial injury during ischemia,reperfusion,and in later stages of myocardial infarction. | Christiane Neuhof Heinz Neuhof | 2014 | World Journal of Cardiology2014，6，7： | 23 |
| 13 | A case of acute cerebral infarction caused by myxoma of the left atrium显示文摘To the Editor: The patient was a 42-year-old male with a height of 178cm and weight of 70kg. He was admitted to the emergency department on the 4th of July in 2018, due to dizziness accompanied by on-going left limb weakness for a total of 5 days. | Jia-Qi Zhang Cai-Jun Wu Li-Qiang Niu | 2019 | Chinese Medical Journal2019，，5： | 22 |
| 14 | Intracoronary arterial retrograde thrombolysis with percutaneous coronary intervention: a novel use of thrombolytic to treat acute ST-segment elevation myocardial infarction显示文摘Background Clearance of coronary arterial thrombosis is necessary in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing urgent percutaneous coronary intervention (PCI). There is currently no highly-recommended method of thrombus removal during interventional procedures. We describe a new method for opening culprit vessels to treat STEMI: intracoronary arterial retrograde thrombolysis (ICART) with PCI. Methods & Results Eight patients underwent ICART. The guidewire was advanced to the distal coronary artery through the occlusion lesion. Then, we inserted a microcatheter into the distal end of the occluded coronary artery over the guidewire. Urokinase (5–10 wu) mixed with contrast agents was slowly injected into the occluded section of the coronary artery through the microcatheter. The intracoronary thrombus gradually dissolved in 3–17 min, and the effect of thrombolysis was visible in real time. Stents were then implanted according to the characteristics of the recanalized culprit lesion to achieve full revascularization. One patient experienced premature ventricular contraction during vascular revascularization, and no malignant arrhythmias were seen in any patient. No reflow or slow flow was not observed post PCI. Thrombolysis in myocardial infarction flow grade and myocardial blush grade post-primary PCI was 3 in all eight patients. No patients experienced bleeding or stroke. Conclusions ICART was accurate and effective for treating intracoronary thrombi in patients with STEMI in this preliminary study. ICART was an effective, feasible, and simple approach to the management of STEMI, and no intraprocedural complications occurred in any of the patients. ICART may be a breakthrough in the treatment of acute STEMI. | Jin-Wen TIAN Mei ZHU Feng-Qi WANG Ke LI Chao-Fei ZHOU Bo LI Min WANG Jue-Lin DENG Bo JIANG Jing BAI Yi GUO Rong-Jie JIN Zhao ZHANG Ying LIN Ji-Hang WANG Shi-Hao ZHAO Ming-Zhi SHEN | 2019 | Journal of Geriatric Cardiology2019，16，6： | 22 |
| 15 | Clinical significance of diabetes on symptom and patient delay among patients with acute myocardial infarction——an analysis from China Acute Myocardial Infarction(CAMI) registry显示文摘Background Diabetes is frequently associated with poor prognosis among acute myocardial infarction(AMI)patients.Patients with these comorbidities often have atypical symptoms and subsequent delay in treatment.Few studies have reported detailed AMI symptoms in patients with diabetes.This study compared AMI symptoms and presentation characteristics between diabetics and non-diabetics.Methods We included patients from the China AMI registry diagnosed with AMI between January 2013 and September 2014.Baseline characteristics,symptomology,and delay in treatment were compared between diabetics and non-diabetics.Multivariable logistic regression analysis was used to explore independent predictors of atypical symptoms.Results A total of 4450(20.2%)patients had diabetes.They were older,more often women,higher in body mass index,and more likely to have non-ST segment elevation myocardial infarction.Fewer diabetic patients presented with persistent precordial chest pain(63.1%vs.68%,P<0.0001),diaphoresis(60.1%vs.65.6%,P<0.0001),fatigue(16.7%vs.18.3%,P=0.0123),and incontinence(0.4%vs.0.7%,P=0.0093).Time to hospital presentation was longer among patients with diabetes than those without.In multivariable analysis,diabetes was identified as an independent predictor of atypical symptoms(OR:1.112,95%CI:1.034?1.196).Conclusions Our study is the first large-scale study providing evidence that diabetics are less likely to present with typical chest pain and more likely to experience treatment delay when suffering from an AMI.Our results may increase clinician awareness of recognizing AMI patients rapidly to reduce diagnosis and treatment delay,particularly in the context of diabetes. | Rui FU Si-Dong LI Chen-Xi SONG Jing-Ang YANG Hai-Yan XU Xiao-Jin GAO Yi XU Jian-Ping ZENG Jun-Nong LI Ke-Fei DOU Yue-Jin YANG on behalf of the CAMI Registry study group Beijing,China | 2019 | Journal of Geriatric Cardiology2019，16，5： | 21 |
| 16 | Fabry disease with acute cerebral infarction onset in a young patient显示文摘To the Editor:Fabry disease (FD)is a recessive X-linked hereditary disease.The onset age of the disease is in children and adolescents mostly.The average time from the onset of symptoms to the definite diagnosis needs 13.7 years in male patients and 16.3 years in female patients.FD happens rarely and it is easy to cause diagnosis and treatment delay.Here,we report a case of FD in a 27-year-old man who developed clinical symptoms with acute cerebral infarction onset to improve doctors' understanding of FD. | Ya-Nan Zhang Zhen-Ni Guo Hong-Wei Zhou Ying-Ying Cheng Jia-Chun Feng Zan Wang | 2019 | Chinese Medical Journal2019，，4： | 21 |
| 17 | Risk factors for acute kidney injury in patients with acute myocardial infarction显示文摘Background:Acute kidney injury (AKI) is a serious and fatal complication of acute myocardial infarction (AMI).It has high shortand long-term mortality rates and a poor prognosis but is potentially preventable.However,the current incidence,risk factors,and outcomes of AKI in the Chinese population are not well understood and would serve the first step to identify high-risk patients who could receive preventative care.Methods:The medical data of 1124 hospitalized patients diagnosed with AMI from October 2013 to September 2015 were reviewed.AKI was defined according to the 2012 Kidney Disease Improving Global Outcomes criteria.All the patients were divided into either the AKI group or the non-AKI group.A univariate comparison analysis was performed to identify possible risk factors associated with AKI.A multiple logistic regression analysis was used to identify the independent risk factors for AKI in patients with AMI.Results:Overall,the incidence of AKI was 26.0%.The mortality rate of the AKI group was 20.5 %,and the mortality rate of the nonAKI group was 0.6%(P < 0.001).Logistic regression analysis showed that the independent risk factors for AKI in patients with AMI included:age (>60 years old)(odds ratio [OR] 1.04,95% confidence interval [CI] 1.02-1.05,P =0.000),hypertension (OR 2.51,95% CI 1.62-3.87,P =0.000),chronic kidney disease (OR 3.52,95% CI 2.01-6.16,P =0.000),Killip class ≥3 (OR 5.22,95% CI 3.07-8.87,P =0.000),extensive anterior myocardial infarction (OR 3.02,95% CI 1.85--4.93,P =0.000),use of furosemide (OR 1.02,95% CI 1.02-1.03,P =0.000),non-use of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker (OR 1.58,95% CI 1.04-2.40,P =0.032).These factors provided an accurate tool to identify patients at high risk of developing AKI.Contusions:Approximately 26.0% of patients undergoing AMI developed AKI,and the development of AKI was strongly correlated with in-hospital mortality.The risk factors for AKI in patients with AMI were determined to help identify high-risk patients and make appropriate clinical decisions. | Cong Wang Yuan-Yuan Pei Yun-Hui Ma Xiao-Lu Ma Zhi-Wei Liu Ji-Hong Zhu Chun-Sheng Li | 2019 | Chinese Medical Journal2019，，14： | 20 |
| 18 | A risk score model for predicting cardiac rupture after acute myocardial infarction显示文摘Background:Cardiac rupture (CR) is a major lethal complication of acute myocardial infarction (AMI).However,no valid risk score model was found to predict CR after AMI in previous researches.This study aimed to establish a simple model to assess risk of CR after AMI,which could be easily used in a clinical environment.Methods:This was a retrospective case-control study that included 53 consecutive patients with CR after AMI during a period from January 1,2010 to December 31,2017.The controls included 524 patients who were selected randomly from 7932 AMI patients without CR at a 1:10 ratio.Risk factors for CR were identified using univariate analysis and multivariate logistic regression.Risk score model was developed based on multiple regression coefficients.Performance of risk model was evaluated using receiveroperating characteristic (ROC) curves and internal validity was explored using bootstrap analysis.Results:Among all 7985 AMI patients,53 (0.67%) had CR (free wall rupture,n=39;ventricular septal rupture,n=14).Hospital mortalities were 92.5% and 4.01% in patients with and without CR (P<0.001).Independent variables associated with CR included:older age,female gender,higher heart rate at admission,body mass index (BMI)<25 kg/m^2,lower left ventricular ejection fraction (LVEF) and no primary percutaneous coronary intervention (pPCI) treatment.In ROC analysis,our CR risk assess model demonstrated a very good discriminate power (area under the curve [AUC]= 0.895,95% confidence interval:0.845–0.944,optimism-corrected AUC= 0.821,P<0.001).Conclusion:This study developed a novel risk score model to help predict CR after AMI,which had high accuracy and was very simple to use. | Yuan Fu Kui-Bao Li Xin-Chun Yang | 2019 | Chinese Medical Journal2019，，9： | 19 |
| 19 | Association of platelet to lymphocyte ratio with in-hospital major adverse cardiovascular events and the severity of coronary artery disease assessed by the Gensini score in patients with acute myocardial infarction显示文摘Background:The platelet to lymphocyte ratio(PLR)has recently emerged as a potential inflammatory biomarker and has been shown to be significantly associated with atherosclerotic coronary artery disease(CAD).Therefore,we aimed to explore the association of PLR with in-hospital major adverse cardiovascular events(MACEs)and the severity of CAD assessed by the Gensini score(GS)in patients with acute myocardial infarction(AMI)undergoing coronary angiography.Methods:A total of 502 patients with AMI consecutively treated at the Affiliated Hospital of Qingdao University(Qingdao,China)and underwent coronary angiography from August 2017 to December 2018 were recruited in this study.The demographic,clinical,angiographic characteristics,and laboratory parameters were collected.According to the presence of in-hospital MACEs,the included patients were divided into the MACE group(n=81)and the non-MACE group(n=421).Further,according to tertiles of the GS,the patients were classified into three groups:the low GS group(GS≤32 points,n=173),medium GS group(32 points | Xue-Ting Li Hao Fang Dong Li Feng-Qiang Xu Bin Yang Rui Zhang Yi An | 2020 | Chinese Medical Journal2020，，4： | 19 |
| 20 | Repeated measurement of growth-differentiation factor-15in Chinese Han patients with post-myocardial infarction chronic heart failure显示文摘Background Growth-differentiation factor-15(GDF-15)is a promising prognostic biomarker in patients with chronic heart failure (CHF).Comparatively little is known about the value of repeated measurement of GDF-15with CI-IF in Chinese Han population.This study sought to identify the clinical value of repeated measurement of GDF-15in Chinese Han patients with post-myocardial infarction CHF. Methods In total,232consecutive Chinese Hart patients with post-myocardial infarction CHF were enrolled prospectively from January 2014to June 2016.The plasma concentration of GDF-15was determined on admission and over 12months.Patients were followed up for all-cause death and a composite outcome of major adverse cardiac events (MACE)included all-cause death,myocardial infarction and first heart failure (HF)re-hospitalization.Association with other clinical variables and adverse outcomes of repeated measurement of GDF-15 was explored.Results The median baseline GDF-15level was 2025ng/L.Baseline GDF-15was moderately associated with baseline N-terminal pro-B type nalriuretic peptide (NT-proBNP)(coefficient 0.561,P <0.001).During a median follow-up of 20months,there were 53deaths and 100MACE.GDF-I5remained an independent predictor of all-cause death (adjusted hazard ratio 1.826per 1Ln U,95%CI: 1.037-8.360;P =0.037)and MACE (adjusted hazard ratio 2.243per I Ln U,95%CI:1.181-1.775;P <0.001)adjusted for established risk factors.Repeated measurement of GDF-15was performed in 173survivals over 12months.Increase of GDF-15over 12months was associ- ated with dilatation of left ventricle and acted as an independent predictor of subsequent all-canse death (adjusted HR =3.164,95%CI: 1.245~.041;P =0.015).In the joint model,GDF-15was also shown to be a risk factor for all-cause death (HR =2.749,95%CI: 1.667-3.831;P <0.001)and MACE (FIR =2.434,95%CI:1.425-3.443;P <0.001).Conclusions Repeated measurements of GDF-15 have promising prognostic value of the risk of all-cause death in Chinese Han patients with CI-IF post-myocardial infarction.GDF-15may influence the post-myocardial infarction CI-IF through the path physiological pathway of myocardial remodeling. | Ji-Xuan LIU Yan-Ping LI Bo-Han LIU Xiao-Jing ZHAO Ze-Yu ZHANG Jin-Da WANG Qian JIA Chun-Lei LIU Xiao-Jian GAO Zhen-Guo XU Hua-Wei ZHANG Lin-Nan SONG Zhi-Jun SUN Kun-Lun HE | 2018 | Journal of Geriatric Cardiology2018，15，10： | 19 |
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