Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2017-12-07 Cooperative journals: 《南方医科大学学报》
Abstract： Objective To investigate peripheral blood apelin levels in patients with acute ST-elevation myocardial infarction (STEMI) and their correlation with the one-year outcome of the patients. Methods A total of 153 consecutive patients including 93 with acute STEMI undergoing primary percutaneous coronary intervention (PCI), 30 with acute STEMI and 30 with stable angina all undergoing elective PCI, and 10 healthy control subjects were examined for peripheral blood apelin levels and clinical parameters. The composite endpoints (CEPS) were determined at the one year follow-up. Results Apelin levels were significantly decreased in all the patients at admission, but increased following primary PCI. Apelin levels showed a negative correlation with glycosylated hemoglobin levels. At one year following PCI, the patients with a lower apelin level showed an increased risk for lowered left ventricular ejection fraction ratio, but further analysis failed to provide evidence that apelin levels were predictive of the one-year outcome. Conclusion Peripheral blood apelin levels might be useful for predicting the clinical outcomes of patients with acute STEMI.
Subjects: Nursing >> Nursing submitted time 2023-03-06
Abstract： to summarize a case of acute myocardial infarction (Ami) who was treated with emergency PCI after intravenous thrombolytic therapy. During the treatment, nursing intervention was carried out for the patients with severe pain due to myocardial ischemia, to enhance the patient""s own comfort. And the implementation of patients with cardiac rehabilitation care, so as to ease the patients during the treatment of excessive reaction to improve the treatment effect. This article reviews the first aid measures and nursing measures of 1 patient with acute myocardial infarction, and summarizes the relevant nursing experience.
Peer Review Status:
Awaiting Review
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2017-12-07 Cooperative journals: 《南方医科大学学报》
Abstract： Objective To evaluate the predictive value of serum iron level for in-hospital acute heart failure (AHF) after acute ST-elevated myocardial infarction (STEMI). Methods This retrospective study involved 287 patients with STEMI stratified by quartiles of admission serum iron concentration. The incidence of AHF was assessed by serum iron quartiles. We evaluated the association of serum iron levels with B-type natriuretic peptide (BNP), cardiac troponin I (cTnI), and high-sensitivity C-reactive protein (hs-CRP) levels on admission, and analyzed the correlation of serum iron levels with in-hospital AHF, death, and duration of hospital stay. Results The average serum iron level on admission of the 287 STEMI patients was 10.20 μmol/L (6.90-14.40 μmol/L), and the quartiles (Q) of serum iron levels were ≤6.90 μmol/L (Q1), 6.91-10.19 μmol/L (Q2), 10.20-14.39 μmol/L (Q3), and ≥14.40 μmol/L (Q4). The incidences of in-hospital AHF from Q1 to Q4 were 79.5% , 64.3% , 50.0% and 45.9% , respectively (P<0.001). Univariate logistic regression analysis showed that low admission serum iron level (Q1) was an independent predictor for in-hospital AHF (OR=3.358, 95% CI 1.791- 6.294, P<0.001), and multivariate logistic regression analysis showed a similar result (OR=2.316, 95%CI 1.205-4.453, P=0.012). Conclusion A lower admission serum iron level is an independent predictor of AHF in STEMI patients during hospitalization.
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2017-12-07 Cooperative journals: 《分子影像学杂志》
Abstract： Objective To investigate the interventional therapy and the long-term efficacy of conservative treatment of acutemyocardial infarction. Methods A total of 100 cases of patients with acute myocardial infarction in August 2013-August 2013at our hospital were retrospectively group studed. Conservative groups were performed with conservative treatment;intervention group were taken intervention treatment. We compared two groups of patients with anterior wall myocardialinfarction and inferior wall myocardial infarction, 1 year survival rate, incidence of cardiac events, and hospitalization rates;Before and after treatment 1 year cardiac function classification. Results In intervention group of patients with anterior wallmyocardial infarction, 1 year survival rate significantly higher than the conservative group, incidence of cardiac events, andhospitalization rates were significantly lower than the conservative group (P<0.05). In two groups of patients with inferior wallmyocardial infarction, 1 year survival rate, incidence of cardiac events, and hospitalization rates had no significant differences(P>0.05). Two groups before treatment in patients with cardiac function classification had no significant difference (P>0.05). Inintervention group of anterior wall myocardial infarction, cardiac function 1 year after treatment grade were significant betterthan the conservative group (P<0.05). In two groups of inferior wall myocardial infarction, cardiac function 1 year after treat-ment grading were significantly improved, with no significant difference between groups (P>0.05). Conclusion Interventionaltreatment and conservative treatment of acute inferior wall myocardial infarction, the long-term efficacy of similar, but thelong-term efficacy of anterior wall myocardial infarction, the effectiveness of interventional treatment is better.It can improvethe survival rate, reduce the incidence of adverse cardiac events and hospitalization rates.It improves cardiac function inpatients, which is worth promoting.
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2018-01-25 Cooperative journals: 《南方医科大学学报》
Abstract： Objective To investigate whether heart tissue-derived extracellular matrix (ECM) promotes the differentiation of cardiosphere-derived cells (CDCs) implanted in rat infracted myocardium to improve the cardiac structure and function. Methods Rat CDCs were cultured by cardiac explant methods, and ECM was prepared by decelluariztion method. In a Wistar rat model of acute myocardial infarction established by ligating the left anterior descending branch, IMDM solution, ECM suspension, 106 CDCs in IMDM solution, or 106 CDCs in ECM suspension were injected into the infracted rat myocardium (6 rats in each group). The cardiac function of the rats was evaluated by cardiac ultrasonography, and the percentage of positive heart fibrosis area after infarction was determined with Masson staining. The differentiation of implanted CDCs in the infarcted myocardium was detected using immunofluorescence assay for the markers of cardiac muscle cells (α-SA), vascular endothelial cells (vWF) and smooth muscle cells (α-SMA).Results Three weeks after acute myocardial infarction, the rats with injection of CDCs in ECM showed the highest left ventricular ejection fraction (LVEF) and percentage of fraction shortening with the lowest percentage of positive heart fibrosis area; implantation of CDCs with ECM resulted in significantly higher rates of CDC differentiation into cardiac muscle cells, vascular endothelial cells and smooth muscle cell (P<0.05). Conclusion Heart-tissue derived ECM significantly promotes the differentiation of CDCs implanted in the infracted myocardium into cardiac muscle cells, vascular endothelial cells and smooth muscle cells to improve the cardiac structure and cardiac functions inrats.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-07-26
Abstract： [Abstract] Objective To investigate the effect of daglizin on cardiovascular events in patients with acute myocardial infarction complicated with type 2 diabetes after percutaneous coronary intervention (PCI). Methods A total of 155 patients with acute myocardial infarction complicated with type 2 diabetes admitted to the cardiovascular department of our hospital from January 2021 to December 2022 were selected as the study objects, and were divided into experimental group (n=78) and control group (n=77) by random number method. The control group was given conventional treatment, and the experimental group was treated with dagaglizin on the basis of this treatment. The clinical related indicators, cardiac function indicators, treatment effectiveness and incidence of cardiovascular events were compared between the two groups after treatment. Results Before treatment, there were no significant differences in general conditions and clinical indicators between the two groups (p>0.05). After 6 months of treatment, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), hypersensitive C-reactive protein (hs-CRP) and lipoprotein-associated phospholipase A2(Lp-PLA2) in both groups were lower than before treatment (p<0.05), and all indexes in the experimental group were significantly lower than those in the control group (p<0.001). Before treatment, there was no significant difference in cardiac function indexes between the two groups. After treatment, left ventricular ejection fraction (LVEF) and 6-minute walking test (6MWT) in the experimental group were significantly higher than those in the control group. Left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), amino terminal brain natriuretic peptide precursor (NT-proBNP) and heart rate were significantly lower than those of control group, with statistically significant differences (p<0.001). The total effective rate of all patients was 92.90%, of which the total effective rate of the experimental group was 96.15%, which was significantly higher than that of the control group 89.61%, and the incidence of cardiovascular events in the experimental group (7.69%) was significantly lower than that of the control group (16.88%), with statistically significant differences (p<0.01). Conclusion Daglizin has significant efficacy in lowering blood sugar, improving heart function, improving treatment efficiency and reducing the incidence of cardiovascular events in patients with acute myocardial infarction complicated with type 2 diabetes after PCI, which is worthy of promotion and application in clinical treatment.
Peer Review Status:Awaiting Review
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2018-06-15 Cooperative journals: 《南方医科大学学报》
Abstract： Objective To explore the dynamic changes in brain natriuretic peptide (BNP) concentration and the diagnostic value of BNP for heart failure at different time points in the early phase of acute myocardial infarction (AMI). Methods AMI patients who were admitted in our department between January 1, 2016 and July 31, 2016 and underwent emergency percutaneous coronary intervention (PCI) within 12 h after onset were enrolled in this study. All the patients received bedside examinations of BNP concentration and clinical cardiac function within 1 h after PCI and at 12, 20, 24 and 48 h after the onset of AMI. According to the peak BNP concentration, the patients were divided into high peak BNP group (>400 pg/mL) and normal peak BNP group (≤400 pg/mL). Results Seventy patients were enrolled in the study. Within 48 h after AMI onset, BNP concentration variations followed a pattern of an initial increase till reaching the peak concentration at 20 to 24 h, with subsequent gradual decrease. BNP concentrations differed significantly among the indicated time points (χ2=141.7, P<0.05) except for those between 20 h and 24 h (χ2=0.173, P>0.05). Compared with those in normal peak BNP group, the patients in high peak BNP group had an older age, a lower BMI, a longer time to perfusion, and a higher likeliness of anterior myocardial infarction and pulmonary infection (P<0.05). Logistic regression analysis showed that age, BMI and anterior myocardial infarction were independently associated with the increase of peak BNP concentration. ROC curve analysis showed that BNP concentration within 1 h after emergency PCI was unable to diagnose heart failure at that time (P>0.05), while BNP concentrations at 12, 20, 24 and 48 h after AMI onset had significant diagnostic values for heart failure (P<0.05) with areas under ROC of 0.860, 0.786, 0.768 and 0.863, and optimal cutoff values of 156.5, 313.7, 240.9 and 285.9 pg/mL, respectively. Conclusions BNP concentration increases first and then decreases in the early phase of AMI, and the peak concentration occurs at 20-24 h after the onset. The diagnostic values of BNP concentrations at different time points also vary.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-04-03 Cooperative journals: 《中国全科医学》
MA Yiping
YUAN Yujuan
NIGERE Alimu
ABULAJIANG Aihemaiti
MA Qingyu
PALIDA Yushanjiang
MUYESAI Nijiati
Abstract： Background Acute myocardial infarction（AMI）is the leading cause of cardiovascular disease morbidity and mortality worldwide，and despite the widespread use of biomarkers for myocardial necrosis，morbidity and mortality of AMI remain high. Objective To investigate the expression levels and clinical significance of miR-126，mitochondrial components and adhesion molecules in endothelial microparticles（EMPs）. Methods A total of 50 patients with AMI，50 patients with stable coronary artery disease（SCAD）and 50 healthy subjects were enrolled in the People's Hospital of Xinjiang Uygur Autonomous Region from September 2021 to September 2022. AMI patients and SCAD patients were hospitalized in our hospital and received percutaneous coronary intervention（PCI），and all healthy subjects were evaluated by the physical examination center of our hospital. Peripheral blood samples and general data of three groups were collected. The morphology of the microparticles（MPs） was observed by transmission electron microscopy（TEM），the level of EMPs was identified by flow cytometry，and the expression of miR-126 in EMPs was detected by fluorescence quantitative PCR. ELISA was used to detect the levels of mitochondrial reactive oxygen species（ROS）and intracellular adhesion molecules ［vascular cell adhesion molecule-1 （VCAM-1），intercellular adhesion molecule-1（ICAM-1），E-selectin，and P-selectin］ in EMPs. Results As observed by TEM，the membrane structure of the isolated MPs was intact and its diameter ranged from 100 to 400 nm. Compared with the control group，the expression of miR-126 in plasma EMPs in the AMI group was significantly decreased（Z=4.979， P<0.001），the expression of ROS was significantly increased（Z=9.651，P<0.001），the expression of VCAM-1 was increased（Z=2.336，P=0.019），and the expression of ICAM-1（Z=5.894，P<0.001），E-selectin（Z=2.730，P=0.019） and P-selectin（Z=6.470，P<0.001） were increased. Multivariate Logistic regression analysis showed that the decreased expression of miR-126（OR=0.026，95%CI=0.003-0.210，P=0.001） was a protective factor for AMI，increased expression of ROS（OR=1.009，95%CI=1.005-1.013，P<0.001） and P-selectin（OR=1.063，95%CI=1.022-1.105，P=0.002）were risk factors for AMI. The receiver operator characteristic curve（ROC） showed that the area under the curve of miR-126 for the diagnosis of AMI was 0.816，the area under the curve of ROS for the diagnosis of AMI was 0.892，the area under the curve of P-selectin for the diagnosis of AMI was 0.728，and the area under the curve of miR-126，ROS and P-selectin combined diagnosis was 0.950. Conclusion In EMPs，miR-126，ROS，P-selectin and their combined indicators all have diagnostic value for AMI，and the combined indicators of the three have the highest diagnostic value，indicating that they may be potential diagnostic indicators for AMI patients.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-08-12 Cooperative journals: 《中国全科医学》
Abstract： Background Abnormal lipid metabolism is an important risk factor for the occurrence and development of acute myocardial infarction (AMI), but the occurrence of AMI is still common in some patients with normal blood lipid. There are few studies on the relationship between residual lipoprotein cholesterol (RLP-C) and plasma atherogenic index (AIP) as unconventional lipid indexes and AMI, and the relationship between the pathogenesis of AMI in young patients is not clear. Objective To investigate the correlation between RLP-C, AIP and young patients with initial acute myocardial infarction. Methods A total of 1201 patients aged 18-45 years old who were newly hospitalized and underwent coronary angiography from November 2014 to November 2021 in North Jiangsu People's Hospital were selected, including 627 patients with acute myocardial infarction as the study group and 574 patients without acute myocardial infarction as the control group. General information and triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) and other indicators of patients in the two groups were collected. RPL-C and AIP were calculated according to the formula for statistical analysis. All the researchers were divided into two groups according to the median age of 37 years, >37 years old was group A, and ≤37 years old was group B, and the risk factors of acute myocardial infarction at different ages were analyzed. Results The levels of RLP-C and AIP in the study group were significantly higher than those in the control group (P<0.05). Multivariate Logistic correlation analysis showed that smoking, TC, RPL-C and AIP were independent risk factors for acute myocardial infarction in young people (P<0.05), and HDL-C was independent protective factor for acute myocardial infarction. In the ROC curve of RLP-C and AIP to predict the incidence of acute myocardial infarction in the normal population, the RLP-C Yorden index was 0.547, the area under the ROC curve was 0.851（95%CI 0.83-0.873，P<0.001）, the sensitivity was 84.8%, the specificity was 69.9%. AIP Yorden index was 0.544, area under ROC curve was 0.813（95% CI 0.789-0.837, P<0.001）, sensitivity was 85.2%, specificity was 66%. The combined Yuden index of the two indexes was 0.587, the area under ROC curve was 0.861 (95%CI 0.840-0.882, P<0.001). The sensitivity was 83.1%, and the specificity was 75.6%. After stratification according to age, AIP and RLP-C were still independent risk factors for ACUTE myocardial infarction in the two groups of young patients of different ages, while HDL-C was independent protective factor for acute myocardial infarction in different ages. Conclusion RLP-C and AIP are independent risk factors for initial acute myocardial infarction in young people, and their predictive value increases with age. In addition, compared with the traditional lipid indexes, the two indexes and their combined indexes have more clinical predictive value for young people with acute myocardial infarction.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-05-04 Cooperative journals: 《中国全科医学》
Abstract： Background Early reperfusion therapy for acute myocardial infarction（AMI） is an effective approach to reduce mortality in AMI patients. Percutaneous coronary intervention（PCI） is one of the reperfusion therapy modalities，and contrast-induced acute kidney injury（CI-AKI） after PCI has become one of the common causes of AKI. Objective To investigate the risk factors for the development of CI-AKI in AMI patients after PCI，establish a risk prediction model for CI-AKI based on risk factors and evaluate its validity. Methods The clinical data of 1 274 patients who attended the Affiliated Hospital of Xuzhou Medical University diagnosed of AMI and treated with PCI were collected consecutively from 2019 to 2021. According to the chronological order of admission，the included patients were divided into the training group （January 2019 to March 2021，900 cases） and validation group（April 2021 to December 2021，374 cases） in a ratio of approximately 7：3；and divided into the CI-AKI and non-CI-AKI groups according to the diagnostic criteria of CI-AKI. Independent risk factors were screened using univariable Logistic regression analysis，Lasso regression，cross-validation，multivariable Logistic regression analysis，and a nomogram for predicting the risk of CI-AKI was plotted. Their discriminatory power，calibration ability，and clinical application value were evaluated by calculating concordance statistic（C-statistic），plotting calibration curve and decision curve. Results Among the 900 patients in the training group，109 patients（12.1%） developed CI-AKI after PCI；among the 374 patients in the validation group，27 patients（7.2%） developed CI-AKI. Multivariable Logistic regression analysis showed that LVEF〔OR=0.903，95%CI（0.873，0.934）〕，platelet distribution width〔OR=1.158，95%CI（1.053，1.274）〕，MPVLR〔OR=1.047，95%CI（1.016，1.079）〕，NHR〔OR=1.072，95%CI（1.021，1.124）〕，Scr〔OR=1.006，95%CI（1.002，1.011）〕，and diuretics〔OR=2.321，95%CI（1.452，3.709）〕 were independent influencing factors for CI-AKI after PCI in AMI patients（P<0.05）. A prediction model containing 6 risk factors of LVEF，platelet distribution width，MPVLR，NHR，Scr and diuretics was constructed and a nomogram for predicting the risk of CI-AKI was plotted. The C-statistic was 0.794〔95%CI（0.766，0.820）〕 for the training group and 0.799〔95%CI（0.774，0.855）〕 for the validation group，and the calibration plots showed good consistency between the predicted and actual results；the decision curve and clinical impact curve showed clinical application value of nomogram. Conclusion The CI-AKI risk prediction model including LVEF，platelet distribution width，MPVLR，NHR，Scr，and diuretics has good discrimination and accuracy，which can intuitively and independently screen high-risk population and has high predictive value for the development of CI-AKI after PCI in AMI patients.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-09 Cooperative journals: 《中国全科医学》
Abstract：
Background Studies have shown that neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have important predictive value for cardiovascular diseases. No studies have investigated whether the combination of NLR and PLR can enhance its predictive value for in-hospital mortality in patients with acute myocardial infarction. Objective To investigate whether the combined predictive model (NLR + PLR) constructed based on logistic regression algorithm can improve the predictive value of in-hospital mortality risk in patients with AMI. Methods A single-center, regression cohort study of 3246 AMI patients with complete medical history admitted to the Department of Cardiology of the Second Affiliated Hospital of Dalian Medical University from December 2015 to December 2021 was conducted. The outcome was defined as all-cause mortality during hospitalization. Results (1) The patients who died during hospitalization were matched according to the ratio of 1:1 based on Propensity Score Matching (PSM). All patients who died were successfully matched, resulting in 115 pairs of patients. There was no significant difference between the groups of patients who died during hospitalization (N = 115) and those who did not (N = 115) on the 20 independent variables already included in the matching (P > 0.05). (2) NLR + PLR (NLR combined with PLR) was superior to NLR (AUC = 0.754) and PLR (AUC = 0.731) alone in predicting the risk of in-hospital mortality, with a significant difference in the area under the ROC curve (P = 0.037, P < 0.001, respectively). (3) the optimal cut-off value for NLR + PLR was 0.5491 (Youden index = 0.4087, sensitivity = 85.22%, specificity = 55.65%).Cox regression analysis showed that patients with NLR + PLR > 0.549 had a higher risk of death (HR 2.936; 95% CI 1.963 – 4.392; P < 0.001) than patients with NLR + PLR ≤ 0.549. (4) NLR + PLR had a higher predictive ability for the risk of in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) (AUC = 0.797) than in patients with non-ST-segment elevation myocardial infarction (NSTEMI) (AUC = 0.739). Conclusions In this retrospective cohort study, we adjusted for multiple risk factors affecting in-hospital mortality in hospitalized AMI patients by propensity score matching.Our findings suggest that NLR combined with PLR can more accurately predict in-hospital mortality risk in AMI patients, especially in STEMI patients, than NLR or PLR alone.
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