高龄急性冠状动脉综合征患者的介入治疗

冠心病主要发生在老年人,其中高龄急性冠状动脉综合征(acute coronary syndrome,ACS)的患者临床表现更为危重.本研究旨在探讨对高龄ACS患者进行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI),现报道如下.     

急性冠状动脉综合征外周血妊娠相关血浆蛋白A水平变化及其临床意义

急性冠状动脉综合征(acute coronary syn-dromes,ACS)的药物治疗在近几年取得了巨大进展,但其患病率和死亡率在全球仍居首位.因此,早期诊断ACS及准确预测ACS的预后仍然是未来几年心血管领域的研究热点.现在已经有越来越多的研究致力于寻找在ACS进展前就升高的生化标记物.     

急性冠状动脉综合征血小板表面P-选择素的变化及意义

急性冠状动脉综合征(acute coronary syndrome,ACS)主要病因是冠状动脉(冠脉)粥样斑块破裂诱发血栓形成.P-选择素作为选择素家族中的一个粘附分子,其介导的细胞间粘附在ACS发病中的作用越来越引起广泛重视.研究P-选择素及其介导的细胞粘附可进一步认识ACS的发病机制,为有效治疗ACS提供新思维、新方法.     

急性冠脉综合征研究的新进展

急性冠脉综合征(acute coronary syndromes ACS)是冠心病(coronary hear disease,CHD)致死和致残的主要原因之一。近年来的研究使人们对ACS从概念更新到深入认识,随着CHD药物治疗的进展和急诊技术的成熟和广泛开展,ACS的治疗效果和预后显著改善。该文对ACS的最新进展作一综述。     

急性冠状动脉综合征抗凝治疗的获益与瓶颈及亟待优化的问题

<正>冠状动脉斑块形成、破裂和血栓形成是急性冠状动脉综合征(acute coronary syndrome,ACS)缺血事件发生的关键机制。抗凝和抗血小板治疗是ACS药物治疗的基石~([1-3])。目前,欧美及中国指南均推荐,ACS急性期和经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)中应给予抗凝治疗     

平均血小板体积及中性粒细胞/淋巴细胞比值与急性冠状动脉综合征相关性的研究进展

<正>急性冠状动脉综合征(acute coronary syndrome,ACS)是在动脉粥样硬化性疾病的基础上发生不稳定斑块破裂出血,血栓形成.继发冠状动脉痉挛或阻塞,导致心肌缺血或坏死的综合征。ACS主要包括不稳定型心绞痛(unstable angina pectoris,UAP)和急性心肌梗死(acute myocardial infarction,AMI)以及心脏性猝死(sudden cardiacdeath,SCD)。已有研究证实.血小板和炎症在动脉粥样硬化和血栓形成中起重要作用.是触发ACS的重要因素。平均血小板体积(mean platelet volume.MPV)作为血小板活化的生物学指标,与ACS     

Acute coronary syndromes: more or less antithrombotic medi-cation for the elderly?

The treatment of elderly patients with acute coronary syndromes (ACS) remains challenging. About two thirds of patients with ACS and four fifth of patients who died from ACS are older than 65 years.1……     

The effect of aortic valve calcification on the clinical characteristics and prognosis of patients with acute coronary syndrome undergoing percutaneous coronary intervention

<正>Objective To investigate the effect of aortic valve calcification (AVC) on the clinical characteristics and prognosis of patients with acute coronary syndrome(ACS) undergoing percutaneous coronary intervention(PCI). Methods A total of 68 ACS inpatients with echocardiographic AVC and 106 ACS controls without AVC     

欧美出血学术研究会(BARC)关于出血的统一定义

抗栓治疗进展及早期介入治疗策略的应用,已经显著减少了急性冠状动脉综合征(acute coronary syndrome,ACS)患者缺血事件的复发和死亡.随着ACS抗栓力度增强,缺血事件减少,出血及大出血患者明显增加,而发生严重出血并发症患者的临床预后不良,心血管事件发生率明显升高.因此,在提高抗栓治疗效果的同时,如何面对出血风险,增加患者临床净获益变得十分重要[1].ACS或接受经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)患者的出血问题备受关注.     

γ-谷氨酰转移酶与急性冠状动脉综合征患者心血管事件关系的研究

正γ-谷氨酰转移酶(gamma-glutamyl transferase,GGT)对急性冠状动脉综合征(acute coronary syndromes,ACS)患者的预后价值尚不清楚。研究人员针对这一临床相关问题,连续入选行经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的ACS患者2534例,进行调查。所有受试者在PCI前     

Relationship between interleukin-18 levels and characterization of atherosclerotic plaque and percutaneous coronary intervention

Background lnterleuldn-18(IL- 18) plays a key role in the development,progression and outcome of coronary artery disease and its complications.However,its variability relation to the characterization of atherosclerotic plaque and percutaneous coronary intervention are still unknown.Methods Fifty four patients with coronary artery disease [22 patients with stable angina (SA) and 32 patients with acute coronary syndrome (ACS)] were enrolled in this study.All patients underwent percutaneous coronary intervention (PCI).The stability of the plaques at the criminal vessels was assessed with analogical IVUS.Serum IL-18 levels were measured at the time points of 5 rain before PCI,and Oh,6h,24h and lmonth after PCI in all patients.Results ACS group consisted mainly of lipidic unstable plaques while SA group of fibrous stable plaques.Moreover,compared with those in SA group,eccentricity index (EI) and remodeling index (RI) were significantly higher in ACS group.Positive remodeling was seen in ACS group while negative or no remodeling in SA group.Further,serum IL-18 levels were significantly elevated in patients with ACS than those in SA group before PCI,increased at Oh,6h,24h after PCI (P＜0.05)and were not significant different at 1 month after PCI from those before PCI.Conclusions There is significant difference in the composition and structural characteristics of atherosclerotic plaques between ACS and UA groups.PCI triggersd and enhances the inflammatory response in a short time.Serum levels of IL- 18 are the predictors of progression of unstable plaque in atherosclerosis.Post-operative complications of PCI might be reduced by inhibiting IL- 18.(J Geriatr Cardiol 2008;5:21-24)     

Risk factors and coronary angiography characteristics of female patients with acute coronary syndrome

Objective To assess the risk factors and coronary angiography characteristics of female patients with acute coronary syndrome(ACS). Methods A total of consecutive 986 inpatients with ACS who had undergone coronary angiography from March 2009 to August 2010 in our hospital were enrolled in this study.     

Clinical correlation between myeloperoxidase and acute coronary syndrome

Objective To study whether myeloperoxidase (MPO) can provide prognostic information in patients with acute coronary syndromes (ACS). Methods The study population consisted of 274 consecutive patients with ACS. All patients underwent coronary angiography which showed significant coronary artery disease and blood samples were collected at admission. Follow-ups were scheduled at 1, 3, and 6 months.The end point included cardiac death, acute myocardial infarction (MI), percutaneous or surgical revascularization. Results Patients with elevated MPO serum levels (MPO ≥ 72.2 AUU/L) were more likely to have diabetics and had a history of coronary events. Kaplan-Meier event rate curves with accumulative incidence of end point at 6-month follow-up in the MPO ≥ 72.2 AUU/L group was significantly higher than in MPO<72.2 AUU/L group. Conclusions MPO may be a powerful predictor of adverse outcome in patients with ACS.(J Geriatr Cardiol 2007;4:209-212)     

IMA、h-FABP联合检测在急性冠脉综合征诊断中的意义

急性冠脉综合征(acute coronary syndrome,ACS)是由于急性心肌缺血导致胸部不适和其他症状的一大类病症,其临床表现多样而复杂,危险性存大较大差别.筛查潜在的高危ACS患者并对其进行及时快速有效的诊断治疗极其重要.     

急性冠状动脉综合征患者经皮冠状动脉介入治疗术后抗栓与出血风险评估

正随着新型抗栓药物和经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的进展,急性冠状动脉综合征(acute coronary syndrome,ACS)患者PCI术后缺血事件发生率显著降低,但是出血发生率明显上升,并且已经成为ACS患者PCI术后发生率最高的并发症之一[1]。近年来越来越多的研究证实,ACS患者PCI术后不同阶段(围     

高血糖与急性冠脉综合征

急性冠脉综合征(acute coronary syndromes, ACS)患者入院时常伴有高血糖,无论有无糖尿病,都是生存率和院内并发症风险增加的强预测因子.     

解读急性冠状动脉综合征他汀类药物治疗作用的临床证据(一)

急性冠状动脉综合征(aute coronary syndromes,ACS)是指由于冠状动脉内血栓形成导致的严重心脏缺血事件,包括不稳定型心绞痛(unstable angina,UA)、非ST段抬高心肌梗死及ST段抬高心肌梗死[1].ACS是在冠状动脉粥样斑块溃疡或者斑块破裂基础上血栓形成的结果,高胆固醇血症是冠状动脉粥样硬化的直接原因.     

Relationship between maximal amplitude of thrombelastography and intracoronary thrombus in patients with acute coronary syndrome

正Objective Thrombelastography(TEG)has been widely used for real-time monitoring of coagulation and bleeding systems.We want to investigate the relationship between intracoronary thrombotic lesion and TEG parameters in acute coronary syndrome(ACS)patients or guiding antithrombotic therapy.Methods A total of 328 ACS     

进一步提高急性冠状动脉综合征的介入疗效

急性冠状动脉综合征(acute coronary syndrome,ACS)仍然是广大临床心脏病学医师感兴趣的研究课题,在本期就有三篇关于ACS的发生机制、治疗策略和二级预防的章。     

急性冠状动脉综合征患者外周血单个核细胞核因子-κB蛋白表达水平与冠状动脉病变特征的关系

Objective To explore the correlation between expression of nuclear factor kappa B (NF-kappa B) in peripheral blood monouclear cells(PBMC) and the severity of coronary artery lesion in patients with acute coronary syndrome(ACS). Methods The 81 patients were diagnosed with coronary heart disease, and all of them underwent immediate or selective coronary angiography(CAG) The nuclear protein level of activated NF-B was detected by Western blot and semi-quantity image analysis was done. Coronary angiograms were scored according to Gensini integration. The relationship between NF-κB and Gensini score was analyzed. Results The protein expression of NF-κB in PBMC in ACS group was significantly higher than that in stable angina group and control group (0.85±0.18 vs. O.75±0.21 and 0.71±0.23, F=3.72, P<0.05). The protein expression of NF-κB was not correlated with Gensini score(r=0.07, P>0.05). Conclusions The ACS patients have the activation of NF-κB in PBMC. The protein expression of NF-κB is not correlated with Gensini score, which does not suggest an implication of the severity of coronary artery.