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   2018| April-June  | Volume 3 | Issue 2  
    Online since July 16, 2018

 
 
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RESEARCH ARTICLES
Effect of atorvastatin and trimetazidine combination treatment in patients with NSTE-ACS undergoing PCI
Jiang-You Wang, Han Chen, Hua Yan, Xi Su
April-June 2018, 3(2):41-46
DOI:10.4103/cp.cp_11_18  
Background: Our study sought to assess the effect of atorvastatin (ATV) and trimetazidine (TMZ) combination treatment in patients with non-ST elevation acute coronary syndromes (NSTE-ACS) undergoing percutaneous coronary intervention (PCI). Materials and Methods: Two hundred and fifty patients with NSTE-ACS who were undergoing PCI were enrolled in this study. Standard secondary prevention of coronary heart disease drug treatment was administered to both the groups (the ATV + TMZ group and the ATV group). In the ATV + TMZ group, patients were given 80mg of the combination medical orally 12h before PCI, 60mg 30min before PCI, and a further 20mg every day for 30t days after PCI, and. In the ATV group, patients were given only 80mg orally 12h before PCI, with a further 20mg every day for 30t days after PCI. Echocardiography was executed and plasma N-terminal pro brain natriuretic peptide (NT-pro-BNP) levels were measured just prior to the PCI and at 30 days after PCI. The major cardiovascular events (MACE) were also evaluated in both groups 30 days after PCI. Results: MACE occurred in 14.17% of patients in the ATV group and 6.50% of those in the ATV + TMZ group (P = 0.047). NT-pro-BNP levels were decreased 30 days after PCI for both groups; however, NT-pro-BNP levels in the ATV + TMZ group were significantly lower than those in the ATV group (P < .05). Cardiac function in NSTE-ACS patients, as reflected by the increased left ventricular ejection fraction, fractional shortening as well as decreased left ventricular end-diastolic dimension (P < .05) increased in all groups at 30 days after intervention, but cardiac function parameters were more significantly improved in the group administered with ATV + TMZ (P < .05). Conclusions: Our study suggests that short-term pretreatment with the combination of ATV and TMZ administration before PCI could reduce the incidence of MACE, further decrease NT-pro-BNP levels and improve cardiac function compared to a single administration of the ATV.
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GUIDELINE AND CONSENSUS
ST-Segment elevation acute myocardial infarction prehospital thrombolytic therapy: Chinese expert consensus
Hongbin Yan, Dingcheng Xiang, Hongmei Liu, Hui Chen, Jiyan Chen, Yuguo Chen, Yundai Chen, Yingjie Chu, Weiyi Fang, Xianghua Fu, Chunji Lie, Wei Mao, Shuming Pang, Ruofei Shi, Xi Su, Yan Wang, Guirong Wang, Weimin Wang, Mei Xu, Lixia Yang, Hailing Yu, Zuyi Yuan, Zhijie Zheng, Yong Huo
April-June 2018, 3(2):71-80
DOI:10.4103/cp.cp_12_18  
Acute myocardial infarction (AMI) still seriously threatens the health of the people in our country. The situation is even more severe in the vast urban and rural areas in China. Timely treatment of AMI patients to reduce mortality and protect heart function is very important. Prehospital thrombolysis treatment has great significance in urban and rural areas outside the big cities. To this end, the Chinese Medical Doctor Association's chest pain professional committee and the Chinese Medical Rescue Association's Cardiovascular Emergency Sub-Commission organized relevant experts to formulate this consensus, aiming to help prehospital medical emergency personnel select the best treatment strategies for patients with AMI. However, the final decision on a specific patient should be made by the prehospital emergency personnel together with the patients and their family members.
  1,534 183 -
REVIEW ARTICLES
Soccer related emotion and stress-induced cardiovascular events
Chunsong Hu, Tengiz Tkebuchava
April-June 2018, 3(2):66-70
DOI:10.4103/cp.cp_14_18  
Some say soccer is a stimulant and others say that it is a jinx due to the strong excitement and anxiety that players and fans experience during and following soccer matches. Unexpected adverse events related to these emotions have been documented and include major cardiac events and death. For this reason, soccer may be called a “killer” by emotion. This article reviewed the literature for evidence relating to soccer clashes, riots and emotional stress-induced acute cardiovascular events. Mechanisms were also explored, and included blood pressure abnormalities, coronary heart disease, acute coronary syndrome or acute myocardial infarction, arrhythmia, sudden cardiac arrest, sudden cardiac deaths, and stroke.
  1,407 188 -
RESEARCH ARTICLES
Acute effect of air pollutant sulfur dioxide on acute myocardial infarction mortality from 2011 to 2017 in Jinan City
Tiantian Zhang, Kunkun Yu, Lin Zhou, Liangliang Cui
April-June 2018, 3(2):47-52
DOI:10.4103/cp.cp_18_18  
Objectives: The objective of this study is to quantitatively analyze the acute effects of atmospheric pollutant sulfur dioxide (SO2) on acute myocardial infarction (AMI) death in residents of Jinan City. Methods: A descriptive analysis of data on daily weather, air pollutants, and residents' AMI death events was collected from 2011 to 2017 in Jinan city. A generalized additive model (GAM) based on the Quasi-Poisson regression was used to analyze the associations of AMI deaths and SO2. The lag effect of current day (lag0~lag3) and cumulative lagged effect (lag01~lag03) were explored. The excess risk (ER) and 95% confidence interval (CI) of AMI deaths were calculated for every 10 μg/m3 increase in SO2. Results: A total of 40,843 AMI deaths occurred between 2011 and 2017, with a daily average of 16 deaths. During the same period, the average annual value of SO2was 65 μg/m3. An increase in SO2concentration of 10 μg/m3 was associated with an increased risk of death related to AMI at lag 1 by 0.35% (95% CI: 0.06%–0.64%). Especially in cold months, a higher increased risk of 0.49% (95% CI: 0.19%–0.79 %) for AMI death was observed with SO2a 10 μg/m3 increase. While there was a significant cumulative hysteresis effect, the maximum cumulative hysteresis effect appeared in lag 02. Conclusions: The atmospheric pollutant SO2in Jinan City has a significant acute effect on the risk of death from AMI , especially a higher increased risk was observed in cold months.
  1,127 184 -
REVIEW ARTICLES
Clinical benefits of renal denervation besides blood pressure reduction
Han Chen, Li Shen, Junbo Ge
April-June 2018, 3(2):58-65
DOI:10.4103/cp.cp_10_18  
Hypertension (HTN) is currently one of the most common chronic diseases, among which some cases are poorly controlled and defined as resistant HTN (RH). Through years of exploration, it has been discovered that hyperactivity in the sympathetic nervous system and the renin–angiotensin system (RAS) initiates the development of RH, followed by other chain reactions in inflammation and oxidative injury. Attributed to their shared pathogenesis with communal cytokines and factors, other comorbidities of HTN, usually associated with cardiovascular and metabolic pathophysiology, often occur alongside primary symptoms, namely, atherosclerosis, heart failure, arrhythmia, and glucose metabolic disorder. Renal denervation (RDN) was first introduced as an alternative measure to help alleviate RH. Renal denervation's clinical relevance comes from directly cutting down afferent and efferent renal nerves, resulting in fewer nerve impulses transmitted to central nervous system and peripheral target organs, and less RAS activation, resulting in lower blood pressure. However, the practical effects of RDN have extended beyond lowering blood pressure and and and plays a role in anti-inflammation and antioxidation pathways. In this review, we briefly summarize the possible mechanism and beneficial clinical effect of RDN treatment in atherosclerosis improvement, cardioprotection, and diabetes remission.
  1,027 185 -
RESEARCH ARTICLES
Clinical characteristics and antithrombotic status in 621 very elderly hospitalized patients with atrial fibrillation
Wen Liu, Zhi-Feng Qiu, Li Wang, Yan-Fang Zhang, Jia-Nan Chen, Lei Wu, Jun-Zhou Xin
April-June 2018, 3(2):53-57
DOI:10.4103/cp.cp_13_18  
Background: The prevalence of atrial fibrillation (AF) increases with age and is associated with high morbidity and mortality. The main objective of this study is to describe the clinical characteristics and antithrombotic status and the factors that determine antithrombotic use in hospitalized elderly patients with AF. Methods: Data were collected involving patients hospitalized at the First Affiliated Hospital of Shihezi Medical University from June 2015 to September 2017. Results: A total of 621 patients with an average age of 82.4 ± 5.0 years (42.3% females; 91.8% Han) were included. The prevalence of risk factors and cardiovascular disease: hypertension (56.5%), heart failure (38.2%), coronary artery disease (76.8%), and carotid atherosclerosis (21.3%). Among the 621 patients, 35.7% were taking oral anticoagulant therapy (OAT) including warfarin (25.6%) or a novel oral anticoagulant (10.1%), 32.4% of patients were taking oral antiplatelet therapy, and 31.9% received 17 anticoagulant therapy. According to the European Guidelines for AF management, CHA2DS2-VASc score was used for stroke risk stratification. All patients in this study had a score of ≥2; However, the rate of OAT was 35.7%. Follow-up data were available for 97.3% of the patients (n = 604), of which 26.6% of patients (n = 159) were deceased and 16.75% of patients (n = 104) continued to receive anticoagulation treatment. Hospitalized patients older than 80 years with AF showed numerous comorbidities. The percentage of appropriately anticoagulated patients was suboptimal according to CHA2DS2-VASc score, with only 35.7% of those requiring treatment receiving it. Conclusion: The percentage of patients with AF appropriately anticoagulated at the First Affiliated Hospital of Shihezi Medical University is at a substandard level.
  1,023 165 -