简介：ObjectivesTostudythestatusoffibrinolyticinhibitioninpatientsofacutecoronarysyndrome(ACS)complicatedwithtypeⅡdiabetesmellitus(NIDDM)andtoevaluatetheeffectoffibrinolyticinhibitiontotheclinicalprognosis.MethodsTypeⅡdiabetesmellituswasdefinedbyADA1997/WH01998criteria.Thesubjectsweredividedintotreatmentgroupsthatincluded39patientsofACSwith20casesofacutemyocardiacinfarction(AMI),36patientsofACS+NIDOMwith20casesofAMI.Twentycasesofhealthypeoplewererandomizedtocontrolgroup.Theplasmaleveloftissuetypeplasminogenactivator(t-PA),plasminogenactivatorin-hibitortype-1(PAI-1)andplasmaD-dimerweredetectedbyusingelisatechnique.TheindexofstatueinfibrinolysiswasdetectedwiththeplasmalevelofD-dimerandtherateofPAI-1/D-dimerinpercentage.ThisindexwasusedtoevaluatethefibrinolyticinhibitionandtheclinicaloutcomeinallthepatientswithAMIintreatmentgroups.TheclinicaloutcomeinpatientswithAMIconsistedoftherateofreperfusion,theincidencesofreinfarction,severi-ousarrhythmia,pumpfailureanddeathintheearlyperiodofAMI.ResultsTheplasmalevelofPAI-1andD-dimerwashigherinthetwotreatmentgroupsthanthatinthecontrolgroup(P<0.01).TheplasmalevelofPAI-1significantlyhigherinACS+NIDDMpatientsthanthatinACS(P<0.05),buttheplasmalevelofD-dimerraisedfrombasiclevelwassignificanflylowerinACS+NIDDMthanthatinACS(P<0.05).TherateofPAI-1/D-dimerinpercentagewassignificantlyhigherinACS+NIDDMthanthatinACSorincontrolgroup(P<0.01).ForAMIpatientsintwotreatmentgroups,therateofreperfusionafterthethrorabolytictherapywassignifi-candylowerinACS+NIDDMthanthatinACS(P<0.01).TherateofincidencesinpumpfailurewassignificantlyhigherinACS+NIDDMthanthatinACStoo(P<0.05).Themorbidityofseveriousarrhythmia,re-infarctionandthemortalitywerealsohigherinACS+NI

简介：Aim:Toinvestigatetheeffectofhome-basedcardiacrehabilitationonfunctionalcapacity,healthbehavior,andriskfactorsinpatientswithacutecoronarysyndromeinChina.Methods:Eightypatientswithacutecoronarysyndromewereenrolledinthisprospectiverandomizedcontrolledstudy.Patientsinthecardiacrehabilitationgroup(n=52)receivedhome-basedcardiacrehabilitationwithaheartmanualandahomeexercisevideofor3monthsandpatientsinthecontrolgroup(n=28)receivedonlyroutinesecondaryprevention.The6-minwalkdistance,laboratorytestresults,healthybehavior(questionnaire),qualityoflife(12-itemShortFormHealthSurvey),anxiety(7-itemGeneralizedAnxietyDisorderQuestionnaire),anddepression(9-itemPatientHealthQuestionnaire)wereevaluatedatthebeginningandaftertreatmentfor3months.Results:Comparedwithbaselinedata,52patientswhoparticipatedincardiacrehabilitationhadlonger6-minwalkdistance(515.26±113.74mvs0.445.30±97.92m,P<0.0002),higherproportionsof“alwaysexercise”(78.26%vs.28%,P<0.05),“alwayslimitfoodwithsugar”(65.22%vs12%,P<0.05),“alwayseatfruits200–400geveryday”(82.61%vs.4%,P<0.05).and“alwayseatvegetables300–500geveryday”(21.74%vs.12%,P<0.06)aftertreatmentfor3months.Thelow-densitylipoproteincholesterolcontrolrate(52.17%vs.28%,P<0.05)andthesystolicbloodpressurecontrolrate(100%vs.68%,P<0.05)werealsosignificantlyincreasedaftertreatmentfor3monthsinthecardiacrehabilitationgroup.Nosignificantincreasewasfoundinthecontrolgroupaftertreatmentfor3months.Nocardiac-eventrelatedtohomeexercisewasreportedinbothgroups.Conclusion:Home-basedcardiacrehabilitationisafeasibleandavailablecardiacrehabilitationmodeinChina.

简介：BackgroundInpatientswithacutecoronarysyndrome(ACS),loweradmissionsystolicbloodpressure(SBP)levelsinferaworseprognosis.However,thepredictivepotentialofadmissionSBPon1-yearmortalityhasnotfullyelucidatedinpatientswithnon-ST-segmentelevationACS(NSTEACS).MethodsWeenrolled1325patientstoinvestigatetheassociationbetweenadmissionSBPinpatientshospitalizedforNSTEACS.WeanalyzedtheassociationbetweenadmissionSBPand1-yearmortality.AdmissionSBPwascategorizedaslow(<110mmHg),normal(110-140mmHg),high(141-160mmHg),andveryhigh(>160mmHg).ResultsComparedwithpatientswithnormaladmissionSBP,thosewithlowSBPhadasignificantlyincreasedhazardratios(HRs)for1-yearmortalityof3.03(P<0.05),whilepatientswithhighandveryhighadmissionSBPhadnosignificantlyincreasedHRsfor1-yearmortality.ConclusionLowadmissionSBP,butnotelevatedadmissionSBP,isastrongindependentpredictorof1-yearmortalityinpatientswithNSTEACS.

简介：BackgroundNon-ST-segmentelevationacutecoronarysyndrome(NSTE-ACS)isanacuteheartdiseasecausedbyincompleteocclusionofrelatedcoronaryarterieswithunstableatheroscleroticplaques.LeadaVRSTsegmentelevationandcTnIpositivearecloselycorrelatedtotheprognosisofNSTE-ACSpatients.However,therearefewstudiesapplyingthetwopredictorstoearlyriskstratificationinNSTE-ACSpatients.MethodTwohundredandfivecasesofNSTE-ACSpatientsfollowedupfor6monthsafterdischargewerereviewed.Allpatientsweredividedintofourgroups:GroupA-cTnInegativecombinedwithaVR-non-ST-segmentelevationgroup(100cases);GroupB-cTnInegativecombinedwithaVR-ST-segmentelevationgroup(31cases);GroupC-cTnIpositivecombinedwithaVR-non-ST-segmentelevationgroup(43cases);GroupD-cTnIpositivecombinedwithaVR-ST-segmentelevationgroup(31cases).Therewasnosignificantdifferenceingender,age,oldmyocardialinfarction,previousPCIhistory,hypertension,anddiabetesbetweenaVR-STelevationgroupandnoaVR-STelevationgroup.Themorbidityofleftmainorthree-vesselcoronaryarterydiseaseaswellasadversecardiovasculareventsinthefourgroupswereobservedandanalyzed.Results(i)Themorbidityofleftmainorthree-vesselcoronaryarterydiseasewashighestinGroupD(87.1%),andwasmarkedlyhigherinGroupB(41.9%)thanthatinGroupA(7%)orGroupC(9.3%);(ii)TheincidenceofadversecardiovasculareventswashighestinGroupD(77.4%),andwasmuchhigherinB(35.5%)ascomparedwiththattinGroupA(1%)orgroupC(7%).ConclusionElectrocardiographicleadaVRST-segmentelevationcombinedwithcTnIpositivehasanimportantclinicalvalueinpredictingtheprognosisofthepatientswithNSTE-ACS.