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Objective: To study Curative efficacy of different doses of rosuvastatin in treatment of primary percutaneous coronary intervention(PCI) and its effects on lipoprotein associated phospholipase A2(Lp-PLA2), interleukin(IL)-6 and tumor necrosis factor(TNF) -αlevels levels. Methods: 120 patients of acute coronary syndromes(ACS) who received therapy from February 2014 to February 2016 in our hospital were selected, all emergency departments were PCI. According to randomnumber table, those patients were divided into the A group(n=40), B group(n=48) and C group(n=40). The three groups received routine treatment after PCI, on this basis, A group rosuvastatin dose of 10 mg, A group rosuvastatin dose of 20 mg, C group rosuvastatin dose of 40 mg, 1 times /d, take before going to bed, continuous medication 7 d. The changes of heart rate (HR), heart function and Lp-PLA2, IL-6 and TNF-αthe three groups were compared before and after treatment, the incidence of adverse cardiovascular events was recorded for a year following up. Results: After treatment, the HR, cardiac function index, Lp-PLA2, IL-6, TNF-αin three groups were significantly improved compared with before treatment(P＜ 0.05); in the HR, C group < B group < A group, there were significant differences between groups(P＜0.05); in the left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF) results, the improvement degree ofC group was better than that ofB group and A group, there were significant differences between groups(P＜0.05); in the Lp-PLA2, IL-6 and TNF-α, C group < B group

Objective To investigate the expression of monocyte subsets and their chemokine, i.e., monocyte chemoattractant protein (MCP-1) and fractalkine (FKN), in patients with acute coronary syndrome (ACS), and to analyze their correlation. Methods Patients with the syndrome of pectoralgia and to be inspected with coronary angiography (CAG) in our hospital from Sep. to Dec., 2016 were included. Patients’ venous blood was collected on the operation day before operation, the level and proportion of monocyte (Mon) subsets, which was namely CD14+CD16-Mon (Mon1), CD14+CD16+Mon (Mon2) and CD14-CD16+Mon (Mon3) according to the expression of cluster differentiation-14 (CD14) and CD16, were detected by flow cytometry (FCM). Patients’ venous blood was collected on the operation day before operation and one day after operation, the concentrations of MCP-1 and FKN in plasma were measured by ELISA. We compared the expression levels of MCP-1-Mon1 and FKN-Mon3, and analyzed their relationship between each other respectively in different groups. Results Diagnosed according to the clinical symptoms, myocardial markers, electrocardiogram and CAG results, 70 individuals were analyzed, including 30 patients with acute myocardial infarction (AMI group), 25 patients with unstable angina pectoris (UAP group) and 15 patients with the chest pain symptoms and normal CAG results (control group). The percentage of Mon1 in the AMI group was higher than that in the other groups (P<0.05); no difference was observed for Mon3 among the groups (P>0.05). The Mon3/Mon1 ratio in the AMI group was lower than that in the control group (P<0.05). Moreover, the levels of FKN and MCP-1 in the ACS group were greater than those in the control group. The level of red blood cell distribution width (RDW) was significantly increased in the AMI and UAP group than that in the control group (P<0.05). There was a significant correlation between FKN and Mon3 (P<0.05, R=0.650 2). Conclusions The monocyte subset of Mon1 and Mon3 increased in the early stage of ACS, with their chemokine (FKN and MCP-1) increasing at the same time. There is a significant correlation between FKN and Mon3, which indicates MCP-1-Mon1 and FKN-Mon3 may participate in the pathophysiological process of early ACS in patients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the application of CRUSADE scoring system in combination with thromboelastography(TEG)in prediction of hemorrhage in patient with ACS during antithrombotic therapy. Methods: CRUSADE scoring system was calculated and TEG was recorded in randomly collected 328 patients with ACS who were hospitalized in Xin Hua hospital Affiated to Shanghai Jiao Tong University of medicine from January 2013 to December 2013. All the patients were followed up 30 days to observe whether hemorrhage took place or not.79 of 328 patients were lost in follow-up. Results: There were 49 patients with hemorrhage in the 249 study population, and the bleeding rate was 18.5%. The 249 study patients were divided into five groups according to CRUSADE scoring system.Hemorrhage incidence rate from extremely-low-risk group to extremely-high-risk group were 15% 7.5% 21.2% 32.5% 26.7%. The comparisons of bleeding rate between each group The hemorrhage incidence rate of moderate-risk group, high-risk group and extremely-high-risk group was significant higher than extremely-low-risk group statistically. But only the high-risk group,s hemorrhage incidence rate of was higher than extremely-low-risk group, the other groups between extremely-low-risk group had no difference in statistically.Overall, the patients over low-risk group had higher bleeding rate. The bleeding rate of each group between moderate-risk group,high-risk group and extremely-high-risk group was considered without statistical significance.Patients were grouped by the median of platelet aggregation inhibition, those platelet aggregation inhibition greater than the median had greater bleeding rete. By multiple Logistic regression model, PAg T%(ADP)was identified the independent factor of hemorrhage. Using of ROC curve to evaluate CRUSADE scoring system, TEG and in combination of the two in prediction of hemorrhage inpatients with ACS. The area of ROC curve of the two in combination was bigger than CRUSADE scoring system. Conclusions: The incidence rate of hemorrhage raises with the increase of CRUSADE score. Patients above low-risk have higher risk of bleeding. TEG can be the supplement of CRUSADE scoring systems.In combination with TEG, the CRUSADE scoring system can be more productive in prediction of hemorrhage risk in patients with ACS. [ABSTRACT FROM AUTHOR]

Objective: To explore the influence of abdominal obesity on the severity of coronary artery lesion in patients with acute coronary syndromes (ACS). Methods: A total of 120 patients with ACS, who were treated in First People’s Affiliated Hospital of Shanghai Jiaotong University from April 2012 to April 2013, according to the ratio of waist to height (RWH), were divided into 60 cases of non-abdominal obesity (as control group, RWH<0.5), and 60 cases of abdominal obesity (as observation group, RWH<0.5). The basic data of the two groups were measured, and the RWH was calculated. The severity and the numbers of coronary artery lesion were judged by using coronary angiography. The coronary angiography results were evaluated by Gensini score. The correlation between the range of coronary artery lesion, Gensini score and RWH were analyzed. Results: The levels of SBP, FBG, TC, TG, LDL-C and Gensini score in the observation group were significantly higher than those in the control group, the differences were statistically significant (P<0.05), but the HDL-C in the observation group was significantly lower than that in the control group, the difference was statistically significant (P<0.05). Gensini score and RWH in the patients with two arteries lesions were significantly higher than those in the patients with single artery lesion, and Gensini score and RWH in the patients with three arteries lesions were higher than those in the patients with single artery and two arteries lesions, the differences were statistically significant (P<0.05). Spearman correlation analysis showed that the range of coronary artery lesion and Gensini score were positively correlated with RWH (r=0.635, 0.739;P=0.000, 0.000). Conclusion: The high level of RWH in the patients with ACS is closely correlated with the severity of coronary artery lesion, therefore, so effectively controlling the abdominal obesity has an important significance in reducing the morbidity of cardiovascular disease and alleviating the severity of coronary artery lesion. [ABSTRACT FROM AUTHOR]