简介：Tileterm‘percutaneouscoronaryintervention'(PCI)isusedtodescribevariousproceduresthatcanbeusedtomechanicallyimprovemyocardialperfusionwithoutresortingtosurgery.Themostcommonprocedureispercutaneoustransluminalcoronaryangioplasty(PTCA),usuallywithimplantationofanintracoronarystent.Othermethodsmaybeappropriateinsmallsubsetsofpatients.Morethan1millionPCIprocedureswereperformedworldwidein2000.

简介：Coronaryarterybypassgrafting(CABG)isenteringaneweraasminimallyinvasivetechniques,off-pumpsurgeryandtotal'arterialrevascularizationhavefotmdrolesinthesurgicaltreatmentofpatientswithcoronaryarterydisease.Thecontinueddevelopmentofthetechniquesofpercutaneouscoronaryintervention(PCI)isalsohavinganimpactonthetypeofpatientreferredforCABG.

简介：ObjectivesTounderstandtheeffectofcarvedilolonthecoronaryvascularendothelialfunctionofthepatientswithcoronaryheartdiseaseafterpercutaneoustransluminalcoronaryangioplasty(PTCA).Methods51cases,havingoneormorethantwobranchesnarrow(≥70%),werediagnosedbycoronaryangiography.Thesepatientsweredividedrandomlyintocarvedilolgroup(n=28)andcontrolgroup(n=23)whodidnottakecarvedilol.Endothelin(ET)andnitrodioxide(NO)levelsofperipheralbloodweremeasuredbeforeandafterPTCA,beforeandaftertwoweeksbytakingcarvedilol.ResuitsComparedwiththeETandNOlevelsbeforePTCA,ETweremarkedlyincreasedandNOweredecreasedafterPTCA(p<0.05);comparedwiththeETandNOlevelsbeforetakingcarvedilol,ETweredecreasedandNOwereincreasedaftertwoweek(p<0.05),buttheETandNOlevelsofthecontrolgroupdidnotchangeintheperiodoftwoweeksobservation(p>0.05).ConclusionsCarvedilolmayimprovethecoronaryvascularendothelialfunctionafterPTCA.

简介：Myocardialperfusioniswellcontrolledbyadjustmentofvasomotortoneofre-sistancevessels.Thestaticandsamedynamicaspectsofcoronaryflowcontrolcanwellbedescribedbyassumingfeedbackfromtissueoxygenpressuretothecoronaryvessel.Theseresistancevesselsaresmallarteriesfrom400/mandlessinarteriolesdownto10/m.Itisnotclearyethowvesselsofdifferentsizecanbeunderthecon-troloftissuefactorsandhowadaptationoftoneinlargervesselsistunedtothatofsmallerones.

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简介：ObjectivesTostudyclinicalandcoronaryangiographicfindingsinpatientswithbothcoronaryheartdiseases(CHD)andtype2diabetesmellitus(T2DM).Methods215patientswithCHDconfirmedbycoronaryangiographywereinvolvedinthisstudy.Thepatientsweredividedintotwogroups:74CHDpatientswithT2DM(meanage64.7±8.2years,male/female47/27),and141CHDpatientswithoutT2DM(meanage66.2±9.2years,male/female100/41).Theclinicalfeaturesandthedatafromselectivecoronaryangiographieswerecomparedbetweentype2diabeticandnon-diabeticCHDpatients.ResultsComparedtonon-diabeticCHDpatients,thepatientswithbothCHDandT2DMsufferedmorefromacutemyocardialinfarction,silentischemiaandseverearrhythmias(P＜0.01,P＜0.05),andhadhigherserumtriglyceridesandapo-lipoproteinB,alongwithincreasedserumuricacid(P＜0.01,P＜0.05),increasedleftventricularenddiastolicdiameter(P＜0.01),anddecreasedleftventricularejectionfraction(P＜0.001).Comparedtonon-diabeticCHDpatients,thepatientswithbothCHDandT2DMsufferedmorefromtriplevesseldisease(P＜0.01),severecoronaryarterystenosis,completeocclusionsanddiffuselesions(P＜0.001).ConclusionsSevereclinicalmanifestation,leftventriculardysfunction,diffuseorcomplicatedlesionsofcoronaryarteriesweremorecommoninpatientswithbothCHDandT2DM,itsuggeststhatthetype2diabeticCHDpatientshavepoorprognosis.

简介：ObjectivesTocomparethedifferentpatternsofcoronaryarterycalcification(CAC)inacuteandchroniccoronarysyndromesutilizingelectronbeamcomputedtomography.BackgroundPathologic,angiographic,andintracoronaryultrasoundstudiesrevealedsharpdifferencesintheplaquemorphologybetweenpatientswithacuteversuschroniccoronarysyndromes.Whethertherearedifferentpatternsofcoronaryarterycalcificationinpatientswithstableanginapectoris(SAP)andinthosewithunstableanginapectoris(UAP)oracutemyocardialinfarction(AMI),however,remainsunclear.MethodsTwohundredandsixty-fourpatients,including67withSAP,94withUAPand103withAMIwerestudiedwithelectronbeamcomputedtomographyforanalysisofcoronaryarterycalcificationandwithselectivecoronaryangiographyfordeterminationofatheroscleroticlesions.CACprevalenceandcalciumscorewerecomparedamongthreegroups,andrelationofCACtotheseverityofatheroscleroticdiseaseintheSAPandUAP

简介：ObjectivesToevaluatethesafetyandefficacyoftransradialcoronaryprocedures(TRCP).MethodsThedataof83caseswhoacceptedtransradialcoronaryangiography(CAG)andtransradialpercutaneouscoronaryintervention(PCI)inourdepartmentweresummarized.Thesuccessrates,proximalcoronarycomplications,peripheralvascularcomplications,severevagalreflex,meanoperationtime(MOT),meanrecumbenttime(MRT),meanhospital-stayingtime(MHT)wereanalyzed.Thedatawerecomparedwiththatof420casesoftransfemoralcoronaryprocedures(TFCP)inthesameperiod.ResultsSuccessratesandproximalcoronarycomplicationsweresimilarinbothgroups.SeverevagalreflexeswerelessinTRCPgroupthaninTFCPgroup.MOTwaslongerinTRCPgroup.MRTandMHTwereshorterinTRCPgroup.12(14.5%)radialarteryspasm,3(3.6%)radialarteryobstruction,1suddenrespiratoryarrestcausedbyjugularhematomawereobservedinTRCPgroup.ConclusionsTheefficacyandsafetyofTRCParedefinite.TRCPismoreeconomical.ForthepurposeofproperlyevaluatetheperipheralvascularcomplicationsofTRCP,itisnecessarytopayspecialattentiontoradialarteryocclusion,radialarterystenosis,andjugularhematoma.

简介：31aiscontributiondiscussestheuseofstatins(HMG-CoAreductaseinhibitors),aspirinandantihypertensivedrugsinsecondaryandprimarypreventionofcoronaryheartdisease(CHD),focusingontherationaleforandpracticalaspectsofCI-IDriskassessmentintargetingthesetreatments.

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简介：OjbectiveTofindtheindependentpredictorsforrestenosisaftercoronarystenting.MethodsQuantitativeangiographywasperformedon60cases(67successfullydilatedlesions)afterangio-plastyover6-monthsfollow-up,andbothunivariateandmultivariatelogisticregressionanalysisweredonetoi-dentifythecorrelationsofrestenosiswithclinicalfactors.ResultsThetotalrestenosisratewas31.3%(21of67lesions),andaccordingtounivariateanalysisthepatientswhounderwentcoronarystenting≥3.5mmhadalowerrateofrestenosis(P<0.01).Collateralcirculationtotheobstructionsite,highmaximalinflationpressure,smokingandthelessminimallumendiameterafterPTCAmadetherateofrestenosishigherower(P<0.05).Multivariatelogisticregressionanalysisshowedthatcoronarystenting≥3.5mmhadalowrateofrestenosis,buthighmaximalinflationpressureandsmokingmadetherestenosisratehigher.ConclusionCoronarystentsize,maximalinflationpressureand.smokin

简介：PatientswithAcuteCoronarySyndrome(ACS)areaclinicalcontinuum-withpatientspresentingwithunstableanginaononeend,withpatientswithSTelevationmyocardialinfarction(STEMI)attheotherendofthespectrum.Inbetweenarethosewithnon-ST

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简介：ToexploretherelationbetweenserumbilinabinandeoronaryheartdiseaseMethodsComparethelevelofserumbilinabinamongpatientswitheoronaryheartdisease,patientswithotherdiseaseandnormalpersons.ResultsThelevelofserumbilinabinofpatientswithcoronaryheartdiseaseishigherthanthatofnormalpersons.ConclusionThereductionofdensityofserumbihrubinisoneoftheindependentriskfactorsofcoronaryheartdisease.

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简介：ObjectivesTocomparetheshortandmid-termoutcomesincasesofpercutaneoustransluminalcoronaryangioplasty(PTCA)inpatientswithunstablevstableangina.MethodsPatientsselectedforPTCA/stentingweredividedintotwogroups,onewithstableanginapectoris(SAgroup,n=92)andonewithunstableanginapectoris(UAgroup,n=112).Theoutcomesofcoronaryangiographies(CAG),initial(30-d)successoftheprocedure,andfollow-upstatusinthetwogroupswerecompared.ResultsBaselinecharacteristicsweresimilar,althoughthepatientswithunstablesymptomsmorefemales(P<0.05),andhadahigheraverageCCSclass(P<0.05)andahigherincidenceofpostinfarctionangina(P<0.01).Thefrequencyof’complexstenosisinpatientswithunstableanginawashigherthanthatofpatientswithstableangina,33%v20%(P<0.01).Atotalof309vesselsacceptedtheprocedure;including210stentsweresuecessfullydeliveredto156patients.143and67stentswereimplantedinthe

简介：ObjectiveThecoronaryanatomicfeatureanddevelopmentafterthrombolysisinacutemyocardialinfarction(AMI)werestudied.Mehtods100patientswithAMIreceivedurokinaseandstrepokinase.Coronaryangiography(CAG)wasperformedat90minutsandagainat3to4weeks.ResultsSuccessfulthrombolysisoccurredin60cases,butfailedin40.Theratioofreperfusionwas60%.CAGshowedtherewereresidualthrombiin84patients(84%)andcompletecoronaryocclusionin40(40%).Angiographyat3to4weeksafterthrombolysisshowedthestenosisworsenedin8patientsandimprovedin10.ConclusionAMIiscausedbysuddencoronarythromboticocclusionandcanbereperfusedbyusingthrombolyticagentormechanicalmethods.Throm-bolyticagentsusuallycannotresolvethrombicompletely.Sopercutaneoustransluminalcoronaryangiography(PTCA)isrecommendedasanimportantmethodtoimproveseriousresidualstenosis.

简介：ObjectivesTotestthefeasibilityoftheuseofhighthoracicepiduralanesthesiaasasoleanestheticinpatientsundergoingoffpumpcoronaryarterybypasssurgery,avoidinggeneralanesthesia.MethodsBetweenOctober2002toApril2003,twentyfivecasesunderwentbeatingheartcoronaryarteryrevascularizationwithoutendotrachealgeneralanesthesia,usinghighthoracicepiduralanesthesiaandanalgesia.Allthepatientsunderwentepiduralcatheterizationontheeveningbeforethesurgery.ResuitsThepatientsinallreceived71grafts(singlen=11,doublen=5,triplen=6,quadruplen=3).Sixpatientsunderwentrepeatcoronaryarterybypass.Exceptonewasconvertedtogeneralanesthesiaandcardiopulmonarybypass,theotherpatientsunderwentoff-pumpcoronaryarterybypassgraftsurgery,2patientsunderwentgraftingvialeftthoracotomy(MIDCAB)andtherestthroughmidsternotomy.Therewasnomortality.Meanlengthofstayintheintensivecareunitwas16.2(4.2hoursandhospitalwas3.0(1.2days.ConclusionsOurexperienceconfirmsthefeasibilityofperformingmuhiplecoronaryarterybypassesinconsciouspatientswithoutendotrachealgeneralanesthesia.