青年乳腺癌与中老年乳腺癌超声影像学对比研究

目的 探讨青年乳腺癌与中年、老年乳腺癌在超声影像学、病理及免疫组化表现方面的差异.方法 共收集乳腺癌患者162例,按年龄分为青年组(≤40岁)、中年组(41 ～ 59岁)和老年组(≥60岁)各54例.回顾分析三组乳腺癌在超声影像学、病理及免疫组化表现方面的差异.结果 青年组超声恶性征象“边缘毛刺征”、“周围高回声晕环”、“微小钙化灶”、“后发回声衰减”、“腋窝异常肿大淋巴结”的比率均高于中年组和老年组(JP＜0.05).青年组浸润性非特殊性癌Ⅲ级、肿瘤大小T3+T4、腋下淋巴结转移的比率均高于中年组和老年组(P＜0.05).青年组ER、PR阳性表达比率均低于中年组和老年组(P＜0.05).结论 青年乳腺癌与中老年乳腺癌相比具有恶性度高、侵袭性强及超声典型恶性征象发生率高的特点.     

宁夏某院不同年龄大肠息肉检出率及临床特征分析

目的 探讨宁夏医科大学总医院不同年龄组大肠息肉特点,为临床诊治提供客观依据.方法 收集2002～2012年该院收治的经内镜及病理证实的大肠息肉患者837例,按患者年龄不同分为青年组(＜45岁)、中年组(45～59岁)、老年组(≥60岁),回顾性分析各组检出率、性别结构、临床表现、内镜特征、病理类型.结果 各组检出率均呈逐年上升趋势且老年组高于青、中年组,发病年龄向年轻化发展,差异有统计学意义(P＜0.05);青、中年组男性大肠息肉检出率明显高于女性,老年组性别构成差异无统计学意义(P＞0.05),青、中组男性检出率高于老年组男性,老年组女性检出率高于青、中年组女性,差异有统计学意义(P＜0.05);青年组临床表现以无症状为主,中、老年组以大便性质改变为主;老年组大于或等于1 cm、无蒂、多发息肉的构成比显著高于青、中年组,差异有统计学意义(P＜0.05);3组均非腺瘤性息肉多于腺瘤性息肉,青、中年组非腺瘤性息肉构成比高于老年组,老年组腺瘤性息肉构成比、癌变率均高于青、中年组,差异有统计学意义(P＜0.05).结论 老年人患大肠息肉、发生癌变风险均高于青、中年,近年大肠息肉的发病有年轻化趋势,临床上应根据不同年龄组大肠息肉的特点制订筛查策略.     

高龄冠状动脉性心脏病患者经皮冠状动脉介入治疗的临床特点及预后

目的观察≥75岁高龄冠状动脉性心脏病患者经皮冠状动脉介入治疗(PCI)的临床特点及其预后.方法回顾性分析2005年6月-2007年6月间所有于上海交通大学附属胸科医院行PCI的老年患者,分为高龄组(年龄≥75岁,115例)和老年组(年龄≥60岁且<75岁,294例),观察高龄组患者行PCI的临床特点及其住院期间和远期的预后.结果高龄组的平均年龄为(78.1±3.7)岁,显著高于老年组的(68.0±4.3)岁.平均随访时间为(964±254)d.与老年组相比,高龄组的糖尿病、高血压、高血脂的构成比无明显增加(P值均>0.05),脑卒中、陈旧性心肌梗死、心力衰竭的构成比显著增加(P值均<0.05).高龄组在住院期间及远期的主要不良心脏事件、死亡和心源性死亡的发生率均显著高于老年组(P值均<0.05).多因素分析提示,左心室射血分数(LVEF)≤0.40、多支血管病变及急性冠状动脉综合征是影响预后的独立因素,而年龄≥75岁不是独立危险因素.结论尽管高龄冠状动脉性心脏病患者的一般情况较差,远期临床预后较差,然而年龄≥75岁并不是影响预后的独立因素,LVEF低和急性冠状动脉综合征才是导致临床预后较差的主要因为.     

青年与老年结直肠癌临床病理特征的对比分析

目的 探讨青年与老年结直肠癌的临床病理特征及其与预后的关系.方法 回顾性分析1993年7月至2003年7月收治的68例35岁以下青年结直肠癌患者与322例65岁以上老年患者的临床资料,比较分析其临床表现、病理特征、肿瘤分期、误诊比例和随访结果.结果 青年组患者以腹痛为主,占69.1%(47/68);而老年组则以便血或黏液血便为主,占53.7%(173/322).青年组的肿瘤低分化比例为48.5%,明显高于老年组的20.5%(P＜0.01).青年组的肿瘤中晚期(Dukes分期C期 D期)比例为80.9%,明显高于老年组的50.3%(P＜0.01).青年组和老年组的误诊率分别为64.7%和14.O%,差异非常显著(P＜0.01).青年组3年生存率33.9%,明显低于老年组的67.3%(P＜0.01);其中肿瘤低分化患者的3年生存率在青年组和老年组分别为15.6%和43.4%,组间差异显著(P＜0.05);中晚期患者的3年生存率在青年组和老年组分别为25.0%和51.2%,差异非常显著(P＜0.01).结论 与老年患者相比,青年结直肠癌分化更差,侵袭性更强,且易贻误诊断,预后不良.因此,应充分加强青年结直肠癌的早期诊断.     

食管癌临床病理学特征与年龄的关系

目的:探讨不同年龄段食管癌患者的临床和病理学特点.方法:对174例食管癌患者临床资料进行回顾性分析.174例患者中≤40岁(青年组)、41～46岁(中年组)、＞60岁(老年组)患者分别为26、74、74例,分析比较各组的一般临床及病理学特点.结果:各年龄组食管癌患者的性别、民族构成及发病部位差异均无统计学意义(P＞0.05).老年组术前合并症及术后并发症发生率均明显高于青年组和中年组(P＜0.05),随着年龄的增长,高、中分化所占的比例呈上升趋势,而低分化所占比例呈下降趋势,各组差异有统计学意义(P＜0.05);青年组区域淋巴结转移率明显高于老年组(P＜0.05);随着年龄的增长,临床TNM分期Ⅲ期以上者呈下降趋势,各组差异有统计学意义(P＜0.05).结论:不同年龄段食管癌临床、病理学特点存在明显差异,青年食管癌病情发展快,肿瘤分化程度低,区域淋巴结转移率高,TNM分期晚;而老年食管癌术前合并症多,术后并发症发生率高,但病情发展较慢,肿瘤分化程度高,区域淋巴结转移率低,TNM分期较早;中年食管癌居中.     

老年与青年胃溃疡临床特点对比研究

目的 探讨分析老年与青年胃溃疡临床特点.方法 随机抽取158例胃溃疡患者,按照年龄分为老年组与青年组,各79例;比较两组临床表现及病因等.结果 老年组和青年组胃溃疡患者临床症状表现不同,黑便与呕血、贫血及消瘦的比例差异均有统计学意义(均P＜ 0.05),反酸嗳气、上腹部疼痛及牙痛的比例差异均无统计学意义(均P＞ 0.05).两组长期吸烟比例差异无统计学意义(P＞0.05);青年组不规律饮食与不合理作息比例明显高于老年组(P＜0.05).老年组幽门螺杆菌感染与服用非甾体抗炎药物比例明显高于青年组(P＜0.05).青年组溃疡部位多发生于胃窦部,直径一般＜2cm,而老年组溃疡部位同样好发于胃窦部,但胃底部与胃体部溃疡发生率明显高于青年组,胃窦部发生率明显低于青年组患者(P＜0.05),直径一般＞2cm,差异均有统计学意义(均P＜0.05).结论 青年组胃溃疡患者在不规律饮食与不合理作息方而更显著,而老年组患者在幽门螺杆菌感染与服用非甾体抗炎药物方面比例多于青年组,青年组溃疡部位多发生于胃窦部,直径一般＜ 2cm,而老年组胃底部与胃体部溃疡发生率明显高于青年组,直径一般＞ 2cm.     

青年急性ST段抬高型心肌梗死的临床特点及冠状动脉病变特征分析

目的:探讨青年急性ST段抬高型心肌梗死(STEMI)的临床特点以及冠状动脉病变特征。方法:选择首次发病的STEMI患者112例,按年龄分青年组43例(年龄18⁴4岁)、老年组69例(年龄≥60岁),对两组患者间的主要危险因素,临床特点和冠状动脉病变特征进行对比分析。结果:青年组患者腹型肥胖、吸烟史、饮酒史、早发冠心病家族史及血脂异常程度均高于老年组(P<0.05);青年组患者以男性为主。青年组患者发病前多伴有过度劳累、情绪异常、暴食酗酒等诱发因素(P<0.05)。青年组患者多为前降支病变(P<0.05),单支冠脉病变比例明显高于老年冠心病组(P<0.05),ACC/AHA冠脉病变分类低危组占多数。结论:患者腹型肥胖、吸烟、饮酒、早发心血管疾病家族史及血脂异常,主要是青年STEMI患者的危险因素,青年组发病前多伴有过度劳累、情绪异常、暴食酗酒等诱发因素。冠状动脉造影示青年组以单支血管病变为主,大多累及前降支近段,病变多为低危组。     

青年急性心肌梗死患者的临床及冠状动脉造影特点

①目的 探讨青年急性心肌梗死(AMI)患者的临床、冠状动脉造影及预后特点.②方法 回顾性分析40例靑年(年龄＜45岁)AMI患者的临床资料,并与40例老年(年龄≥60岁)AMI患者进行比较.③结果 两组患者性别、典型心绞痛、吸烟史、心血管病家族史、高血压、糖尿病构成比,差异均有统计学意义(P＜0.01).与老年组AMI患者比较,青年AMI患者冠状动脉病变以单支病变多见(P＜0.01),心力衰竭、心源性休克、心律失常及病死率均较低(P＜0.05).④结论 青年AMI患者临床表现典型,冠心病危险因素多,冠状动脉狭窄程度轻,并发症少,预后好.     

174例右肺中叶综合征病因分析

目的:分析中叶综合征的常见病因以及分布规律.方法:回顾性分析174 例临床诊断中叶综合征患者的纤维支气管镜、病理检查结果, 并按不同年龄组、吸烟严重程度等分组进行比较.结果:病因组成中炎症占44.8%, 肿瘤占25.3%, 结核占24.7%,其他病因占5.2%.炎症构成比在青年组与中、老年组有显著性差异(P＜0.05);肿瘤构成比中年组最高,而青年组和老年组没有显著性差异.结核构成比在中年组最高,老年组与青年组构成比有显著性差异.炎症、肿瘤构成比在不吸烟组和中、重度吸烟组间有显著性差异(P均＜0.05),结核构成比中中、重度吸烟组构成比有显著性差异(P＜0.05).结论:纤支镜检查发现右中叶综合征最常见的病因依次为炎症、肿瘤和结核, 肺癌有年轻化的趋势,对于中年组(年龄40-60岁)和重度吸烟组(≥400年支)的中叶综合征患者应高度警惕肺癌的可能.纤支镜检查对于明确右中叶综合征的病因诊断有不可替代的作用.     

105例中年与老年急性心肌梗死危险因素及冠脉病变对比分析

目的：分析中年与老年急性心肌梗死危险因素及冠脉病变特点，以提高AMI防治效果。方法：将105例AMI患者按年龄分为中年组(40-59岁)50例和老年组(≥60岁)75例，比较两组间发病的危险因素及心肌梗死的部位及程度。结果：危险因素：中年组冠心病阳性家族史者、吸烟者、饮酒者分别为76．67％、83．33％、50％，明显高于老年组的38．67％、54．67％、12％。(P值分别＜0．01、＜0．05、＜0．01)。冠脉造影：中、老年组三支病变分别为16．67％、50．94％。(P＜0．05)。心肌梗死面积广泛者分别为10％、34．67％。(P＜0．05)。结论：中年组AMI的主要危险因素是冠心病阳性家族史、吸烟、饮酒，冠状动脉病变单支较多，病变程度较轻；老年组AMI的主要危险因素是高血压、糖尿病，冠脉病变三支多，狭窄程度明显。     

Outcomes of primary percutaneous coronary intervention for acute ST-elevation myocardial infarction in patients aged over 75 years

Background The optimal reperfusion strategy in elderly patients with ST-elevation myocardial infarction （STEMI） remains unclear. The purpose of this study was to evaluate the safety, in-hospital and one-year clinical outcomes for patients 〉75 years of age with STEMI receiving primary percutaneous coronary intervention （PCI）, compared with those treated by conservative approach. Methods One hundred and two patients 〉75 years of age with STEMI presented 〈12 hours were randomly allocated to primary PCI （n=50） or conservative therapy only （n=52）. The baseline characteristics, in-hospital outcome and major adverse cardiac events （MACE）, including death, non-fatal myocardial infarction and target vessel revascularization at one-year clinical follow-up were compared between the two groups. Results Age, gender distribution, risk factors for coronary artery disease, infarct site and clinical functional status were similar between the two groups, but the patients in primary PCI group received less low-molecular- weight heparin during hospitalization. Compared with conservative group, the patients in primary PCI group had significantly lower occurrence rate of re-infarction and death and shortened hospital stay. The composite endpoint for in-hospital survivals at 30-day follow-up was similar between the two groups, but one-year MACE rate was significantly lower in the primary PCI group （21.3% and 45.2%, P=0.029）. Left ventricular ejection fraction was not significantly changed in both groups during follow-up. Multivariate analysis revealed that primary PCI （OR=0.34, 95% CI： 0.21-0.69, P =0.03） improved MACE-free survival rate for STEMI patients aged 〉 75 years. Conclusion Our results indicated that primary PCI was safe and effective in reducing in-hospital mortality and one-year MACE rate for elderly patients with STEMI.     

Age-based clinical and angiographic outcomes after sirolimus-eluting stent implantation in patients with coronary artery disease

Background Advanced age independently predicts early and late mortality and major adverse cardiac events （MACE） after percutaneous coronary intervention （PCI）. Randomized clinical trials indicate that siroUmus-eluting stent （SES） implantation reduces target lesion revascularization （TLR）, but there are limited data on the impact of age on outcomes following SES implantation in patients with coronary artery disease （CAD） in real-world practice. Methods A total of 333 CAD patients with 453 lesions were enrolled in this study. Subjects were divided into two groups according to age： a young group （〈65 years old, 244 patients with 369 lesions） and elderly group （≥65 years old, 89 patients with 113 lesions）. Clinical follow-up and quantitative coronary angiography （QCA） were performed seven months after PCh Results Baseline clinical, demographic, angiographic, and procedural chararcteristics were similar in both groups, except that there were more female patients in the elderly group （21.3% vs 9.8%, P=-0.006）. Primary success rate was similar in both groups （96.5% in young group vs 95.7% in elderly group, P〉0.05）. During angiographic follow-up at 7 months, binary in-stent restenosis and in-segment restenosis rates were not significantly different between the two groups （4.7% vs 1.8%; 9.7% vs 8.8%, P〉0.05 respectively）. Both sub-acute and late thrombosis rates were similar in the two groups （0.3% vs 0.9% and 1.2% vs 0.9%, P〉0.05 respectively. TLFI was not significantly different between the two groups （6.5% vs 3.5%;P=-0.246）. The rates of bleeding, stroke, angina rehospitalization during the, follow-up period were also similar in both groups （P〉0.05 respectively）. Conclusion Despite a high-risk clinical profile, coronary SES implantation can be safely and effectively performed in elderly patients with a similar procedural success rate, a low complication rate, and excellent 7-month outcomes.     

老老年急性心肌梗死患者介入治疗的疗效及近期安全性评价

目的评价老老年(≥80岁)急性心肌梗死(AMI)患者行急诊与择期经皮冠状动脉介入治疗术(PCI)的有效性和近期安全性。方法将120例老老年冠心病患者分为急性心肌梗死组(AMI组)和非心肌梗死组(对照组),其中AMI组发病12h内行直接PCI的患者为AMI急诊组,其他AMI患者(AMI择期组)和对照组患者均行择期PCI,两组合称为非急诊组,对各组的临床资料及冠脉介入特点进行回顾性分析。结果 AMI急诊组PCI即刻成功率(72.2%)低于非急诊组(92.2%),差异有统计学意义(P=0.036)。AMI急诊组并发症比非急诊组和AMI择期组高,差异有统计学意义(P<0.001,P=0.039),AMI组并发症及主要不良心脏事件发生率、院内死亡率均比对照组高(P<0.05)。结论在老老年AMI患者中,急诊与择期PCI手术成功率均较高,虽然急诊PCI术发生并发症的风险较高,但两者在院内死亡率和主要不良心脏事件发生率方面差异无统计学意义。     

慢性肾功能不全对ST段抬高型心肌梗死患者经皮冠状动脉介入治疗预后的影响

目的评价慢性肾功能不全对ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)预后的影响。方法回顾性收集因STEMI在北京安贞医院接受急诊PCI的患者743例。将肾小球滤过率(eGFR)<60 mL·min-1·1.73 m-2的患者作为肾功能不全组,eGFR≥60 mL·min-1·1.73 m-2的患者作为对照组,比较2组患者的临床特点、病变特点和预后情况。结果与对照组比较,肾功能不全组患者年龄大、男性少、并发高血压和糖尿病者多、既往心肌梗死病史及多支病变者多、心功能不全(Killip分级≥2)者多(P<0.05);住院期间及随访2 a时主要心血管不良事件及病死率明显升高(P<0.05);Logistic多因素回归分析显示,eGFR<60 mL·min-1·1.73 m-2、年龄≥70岁、Killip分级≥2、糖尿病、既往心肌梗死病史、多支病变均为患者2 a内死亡的独立预测因子(P<0.05),其中eGFR<60 mL·min-1·1.73 m-2校正的相对危险度为1.93(95%可信区间:1.24～4.56,P=0.01)。结论 STE-MI接受急诊PCI治疗患者中,并发肾功能不全患者临床预后较差,而eGFR<60 mL·min-1·1.73 m-2是接受急诊PCI治疗STEMI患者预后不良的最重要危险因素。     

左心室收缩功能对经皮冠状动脉介入治疗的急性下壁ST段抬高型心肌梗死患者预后的影响

目的 探讨左心室收缩功能对经皮冠状动脉介入(percutaneous coronary intervention, PCI)治疗的急性下壁ST段抬高型心肌梗死(ST-segment elevation myocardial infarction, STEMI)患者预后的影响。方法 对161例PCI治疗的急性下壁STEMI患者按左心室收缩功能分为2组:左心室收缩功能障碍[左心室射血分数(left ventricular ejection fraction, LVEF)<50%]组和左心室收缩功能正常(LVEF≥50%)组。本研究的主要终点主要不良心脏事件(major adverse cardiac events, MACE)包括所有全因死亡、再发性心肌梗死、缺血驱动的血管血运重建和卒中。结果 两组患者在年龄、性别、病史、Killip分级以及症状发作时间方面比较,差异均无统计学意义(P>0.05);左心室收缩功能障碍组具有更高的病变血管支数和血栓负荷(P<0.05),其他冠状动脉造影结果和介入治疗特征,两组间差异均无统计学意义(P>0.05)。两组在1年预期MACE发生率方面比较,差异均无统计学意义(Log-rank P>0.05)。结论 在接受直接PCI治疗的急性下壁STEMI患者中,左心室收缩功能障碍的患者与左心室收缩功能正常的患者具有相似的1年临床不良事件发生率。     

外周血MPO、NLR、hs-CRP对ST段抬高型心肌梗死患者PCI术后主要不良心脏事件的预测价值

目的 探讨外周血髓过氧化物酶（MPO）联合中性粒细胞/淋巴细胞比值（NLR）、高敏C反应蛋白（hs-CRP）对ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入术（PCI）术后主要不良心脏事件（MACE）的预测价值。方法 选取2016年5月—2020年8月南阳医学高等专科学校第一附属医院收治的178例STEMI患者行PCI治疗,术后随访1年。收集患者临床资料,测定PCI术前外周血MPO、NLR、hs-CRP,分析患者冠状动脉病变狭窄程度。分析不同病情严重程度STEMI患者外周血MPO、NLR、hs-CRP,统计患者术后1年MACE发生情况,分析影响STEMI患者PCI术后发生MACE的因素,分析外周血MPO、NLR、hs-CRP对STEMI患者PCI术后发生MACE的预测价值。结果 重度狭窄组MPO、NLR、hs-CRP均高于轻、中度狭窄组（P <0.05）,中度狭窄组均高于轻度狭窄组（P <0.05）。逐步多因素Logistic回归分析结果显示：Cys C[■=3.662(95%CI:1.507,8.899)]、MPO[■=3.725(95%CI:1.533,9.05...     

Prospective multicenter randomized trial comparing physician versus patient transfer for primary percutaneous coronary intervention in acute ST-segment elevation myocardial infarction

Background Primary percutaneous coronary intervention （PCI） has been identified as the first therapeutic option for patients with acute ST-segment elevation myocardial infarction （STEMI）. The strategy of transferring patient to a PCI center was recently recommended for those with acute STEMI who were present to PCI incapable hospitals, which include lack of facilities or experienced operators. In China, some local hospitals have been equipped with PCI facilities, but they have no interventional physicians qualified for performing primary PCI. This study was conducted to assess the feasibility, safety and efficacy of the strategy of transferring physician to a PCI-equipped hospital to perform primary PCI for patients with acute STEMI. Methods Three hundred and thirty-four consecutive STEMI patients with symptom presentation 〈12 hours in five local hospitals from November 2005 to November 2007 were randomized to receive primary PCI by either physician transfer （physician transfer group, n=165） or patient transfer （patient transfer group, n=169） strategy. Door-to-balloon time, in-hospital and 30-day major adverse cardiac events （MACE, including death, non-fatal re-infarction, and target vessel revascularization） were compared between the two groups. Results Baseline characteristics between the two groups were comparable. Thrombolysis in myocardial infarction （TIMI） 3 flow was revealed in more patients in the physician transfer group at initial angiography （17.6% vs 10.1%, P〈0.05）. The success rate of primary PCI （96.3% vs 95.4%, P〉0.05） and length of hospital stay were similar between the two groups （（15±4） days vs （14±3） days, P〉0.05）. In the physician transfer group, door-to-balloon time was significantly shortened （（95±20） minutes vs （147±29） minutes, P〈0.0001） and more patients received primary PCI with door-to-balloon time less than 90 minutes （21.2% vs 7.7%, P〈0.001）. During hospitalization, MACE occurred in 6.7% and 11.2% of patients     

后扩张对老年冠状动脉钙化病变介入治疗的疗效观察

目的:观察后扩张应用于老年冠状动脉钙化病变经皮冠状动脉介入治疗(Pereutaneous Coronary Intervention,PCI)的临床疗效.方法:血管造影成功的老年钙化病变冠心病患者107例随机分组,对照组52例行常规支架球囊释放支架术,后扩张组55例于支架常规释放后以非顺应性球囊行高压后扩张,观察两组术...     

Frequency of infarct-related artery with myocardial bridging in patients with ST-elevation myocardial infarction and its impact upon percutaneous coronary intervention

Background Myocardial bridging （MB） as a congenital condition with a reported frequency of 5%-12% in diagnostic coronary angiography may be an important factor causing myocardial ischemia. However, its frequency in the infarct-related artery （IRA） of patients with ST-elevation myocardial infarction （STEMI） and the impact upon percutaneous coronary intervention （PCI） remain undetermined. In this study, we investigated MB frequency and its impact upon primary PCI in patients with STEMI. Methods The data of coronary angiography for 554 consecutive patients with STEMI who had undergone successful primary PCI were retrospectively analyzed to identify a frequency of MB in the IRA and its association with gender and age. According to the angiographic findings, the patients were divided into MB patients and non-MB patients. The endpoints of this study included immediate angiographic findings after primary PCI and 6-month major adverse cardiac events （MACE） （death, recurrent myocardial infarction, target lesion or vessel revascularization） between the MB patients and the non-MB patients. Results A frequency of MB in the IRA of 46 patients （8.3%） was identified in this series; it was more common in patients ≥65 years old （36/206） than in those 〈65 years old （10/348） （17.5% vs 2.9%, P〈0.001）. The trend of MB in the IRA was observed more frequently in women without significant difference than in men （10.2% vs 7.8%）. TIMI grade Ⅲ flow was achieved in 91.9% （509/554） of all patients following primary PCI, in 60.9% （28/46） of the MB patients and in 94.7% （481/508） of the non-MB patients respectively （P〈0.001）. The in-hospital mortality was 4.7% （26/554） in this series including 13.0% （6/46） of the MB patients and 3.9% （20/508） of the non-MB patients （P〈0.001）. A significant difference in 6 months MACE was seen between the MB patients （19%） and the non-MB patients （6.2%） （P〈0.001）. Conclusions MB in the IRA is relatively common in elderly patients with STEMI with a more evident trend in women, suggesting that arteriosclerosis and plaque rupture occurs more easily in the proximal artery to MB than in younger patients. Poor TIMI grade flow in patients with MB in the IRA after primary PCI may contribute to a high in-hospital mortality rate （13%） and 6-month MACE （19%） in the MB patients.     

Improved outcomes from transradial over transfemoral access in primary percutaneous coronary intervention for patients with acute ST-segment elevation myocardial infarction and upstream use of tirofiban

Background Transradial access has been increasingly used during primary percutaneous coronary intervention (PCI)for patients with acute ST-segment elevation myocardial infarction (STEMI) in last decade...