Objective To study the clinical and angiographic features in ST Segment Elevation Myocardial Infarction (STEMI) patients with spontaneous reperfusion. Methods A total of 519 patients with STEMI underwent Primary percutaneous coronary intervention (PCI) from January 2006 to December 2009 in Anzhen Hospital were enrolled. All patients were divided into the spontaneous reperfusion group (TIMI flow gradeⅢ ) and the non-spontaneous reperfusion group (TIMI flow grade 0-Ⅱ ) according to the TIMI flow grade before primary PCI. The incidence rate of spontaneous reperfusion through coronary angiography before primary PCI was observed, and the clinical relevant factors and angiographic lesion features of spontaneous reperfusion were analyzed. Results There were significant differences in age, CTnI peak value, high thrombus burden, and lesion location in distant LAD (P=0.000, 0.000, 0.002, 0.000, and 0.003, respectively) between the two groups. But there were no significant differences in gender, hypertension, diabetes mellitus, smoking history, hyperlipemia, angina pectoris history, culprit vessel distribution, lesion distribution in LCX and RCA, and collateral circulation between the two groups (Pgt;0.05 for all). Conclusion Compared to the patients without spontaneous reperfusion, patients with spontaneous reperfusion are younger in age, lower in CTnI peak value, and heavier in thrombosis burden, with culprit lesions mostly located in the distant LAD.
Objective
To estimate the incidence of post-myocardial infarction depression among Chinese acute myocardial infarction (AMI) patients by meta-analysis and to provide references for the management of AMI patients.
Methods
We searched databases including PubMed, The Cochrane Library (Issue 6, 2016), CNKI, CBM, WanFang Data and VIP from January 2000 to July 2016, to collect literature regarding the incidence of post-myocardial infarction depression among patients with AMI. Two reviewers independently screened literature, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed by using Comprehensive Meta Analysis (CMA) 2.0 software.
Results
Totally, 22 cross-sectional studies were included, involving 2 986 AMI patients, of which1 239 were post-myocardial infarction depression patients. The overall incidence of post-myocardial infarction depression among the AMI patients was 42.7% (95%CI 36.3% to 49.4%). There was no statistical differences observed when the studies were stratified by sex, regions, scales and years (allP values>0.05).
Conclusion
In China, the incidence of post-myocardial infarction depression is high and rising year by year roughly among AMI patients. The status should be paid more attention.
Objective\ To analyze the experiences of emergent or urgent coronary artery bypass grafting(CABG) for patients with acute myocardial infarction(AMI). Methods\ From May, 1996 through December, 1999, 9 patients with AMI underwent emergent CABG including eight males and one female, with mean age 61 years, and year range 44 70. The localization of the AMI was anterior in 4 and inferior in 5. The interval between the onset of AMI and CABG was within 24 hours in 7 cases, 10 days in 1 case and 14 days in 1 case....
A 55-year-old male patient was admitted to the hospital due to "recurrent chest pain for 8 months, with worsening symptoms for 2 weeks". After admission, comprehensive relevant examinations led to the consideration of a giant chronic left ventricular pseudoaneurysm caused by myocardial infarction with non-obstructive coronary arteries. Surgical treatment was performed at our hospital. We discuss the diagnosis and treatment of this patient.
ObjectiveTo systematically review the efficacy and safety of early oxygen therapy for patients with acute myocardial infarction (AMI).
MethodsWe searched databases including PubMed, EMbase, The Cochrane Library (Issue 11, 2015) and CBM from inception to October 2015, to collect randomized controlled trials (RCTs) about early oxygen therapy for patients with AMI. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.
ResultsA total of 7 RCTs involving 1 388 patients were included. The results of meta-analysis showed that, there were no significant differences between the oxygen therapy group and the control group in mortality (OR=1.12, 95%CI 0.57 to 2.20, P=0.75), the incidence of major cardiovascular and cerebrovascular events (MACCE) (OR=1.00, 95%CI 0.46 to 2.18, P=1.00), the incidence of arrhythmia (OR=1.01, 95%CI 0.45 to 2.24, P=0.98) and the incidence of cardiac death (OR=0.53, 95%CI 0.17 to 1.67, P=0.28). But, the oxygen therapy group had higher risk of recurrent myocardial infarction (OR=5.50, 95%CI 1.44 to 20.99, P=0.01) and longer average hospital length of stay (MD=1.28, 95%CI 1.10 to 1.47, P<0.0001).
ConclusionThe efficacy of early oxygen therapy for patients with AMI is not clear, even may increase the risk of recurrent myocardial infarction and the average hospital length of stay. Due to the limited quantity and quality of include studies, more high quality studies are needed to verify the above conclusion.
Objective To search, evaluate and summarize the relevant evidence of the treatment and management of patients with acute myocardial infarction (AMI) under the chest pain center mode by using the evidence-based medicine method, so as to provide references for optimizing the clinical pathway, improving the medical quality and improving the prognosis of patients. Methods Relevant evidence on the treatment and management of AMI patients in relevant databases and websites at home and abroad was retrieved, and the retrieval time limit was from the establishment of databases to January 1, 2025. The quality of the included literature was evaluated, and the evidence was extracted and summarized. Results A total of 15 articles were included, including 2 clinical decisions, 2 systematic reviews, 8 guidelines, and 3 expert consensuses. Finally, 23 pieces of best evidence were extracted, including the basic conditions of chest pain center, the evaluation and treatment of patients with acute chest pain, the integration of pre-hospital emergency system and hospital green channel, and training and education. Conclusions The best evidence for the treatment and management of AMI under the chest pain center mode can provide evidence-based basis for clinical practice. It is necessary to combine the situation of the chest pain center, fully consider the validity and feasibility of the evidence, and help the chest pain center improve the medical quality and improve the prognosis of patients in a standardized and scientific way.
ObjectiveTo systematically review the effect of compound Danshen dripping pills combined with Western medicine on inflammatory factors and cardiac function after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction.MethodsDatabases including CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, EMbase and The Cochrane Library were searched for randomized controlled trials of compound Danshen dripping pills combined with Western medicine in the treatment of acute myocardial infarction after PCI. The retrieval time was from the establishment of the databases to June 11th, 2020. Two reviewers independently screened literature, extracted data and evaluated the risk bias of included studies. RevMan 5.3 software was used for meta-analysis.ResultsA total of 16 studies were included, involving 2 069 patients. The results of the meta-analysis showed that the combination of compound Danshen dripping pills could increase the left ventricular ejection fraction (MD =?4.74, 95%CI 4.07 to 5.42, P<0.01), decrease the B-type natriuretic peptide (SMD=?3.81, 95%CI ?5.06 to ?2.57, P<0.01), the level of interleukin-6 (SMD=?3.20, 95%CI ?4.54 to ?1.86, P<0.01) and level of tumor necrosis factor-a (SMD=?4.96, 95%CI ?7.03 to ?2.89, P<0.01).ConclusionsCurrent evidence suggests that the combination of compound Danshen dropping pills has potential benefits in inhibiting inflammation and improving cardiac function after PCI. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
In order to construct and express human cardiac troponin C-linker-troponin I(P) fusion protein, detect its activity and prepare lyophilized protein, we searched the CDs of human cTnC and cTnI from GenBank, synthesized cTnC and cTnI(30-110aa) into cloning vector by a short DNA sequence coding for 15 neutral amino acid residues. pColdⅠ-cTnC-linker-TnI(P) was constructed and transformed into E. coli BL21(DE3). Then, cTnC-linker-TnI(P) fusion protein was induced by isopropyl-β-D-thiogalactopyranoside (IPTG). Soluable expression of cTnC-linker-TnI(P) in prokaryotic system was successfully obtained. The fusion protein was purified by Ni2+ Sepharose 6 Fast Flow affinity chromatography with over 95% purity and prepared into lyophilized protein. The activity of purified cTnC-linker-TnI(P) and its lyophilized protein were detected by Wondfo FinecareTM cTnI Test. Lyophilized protein of cTnC-linker-TnI(P) was stable for 10 or more days at 37℃and 4 or more months at 25℃and 4℃. The expression system established in this research is feasible and efficient. Lyophilized protein is stable enough to be provided as biological raw materials for further research.
Early accurate detection of inferior myocardial infarction is an important way to reduce the mortality from inferior myocardial infarction. Regrading the existing problems in the detection of inferior myocardial infarction, complex model structures and redundant features, this paper proposed a novel inferior myocardial infarction detection algorithm. Firstly, based on the clinic pathological information, the peak and area features of QRS and ST-T wavebands as well as the slope feature of ST waveband were extracted from electrocardiogram (ECG) signals leads Ⅱ, Ⅲ and aVF. In addition, according to individual features and the dispersion between them, we applied genetic algorithm to make judgement and then input the feature with larger degree into support vector machine (SVM) to realize the accurate detection of inferior myocardial infarction. The proposed method in this paper was verified by Physikalisch-Technische Bundesanstalt (PTB) diagnostic electrocardio signal database and the accuracy rate was up to 98.33%. Conforming to the clinical diagnosis and the characteristics of specific changes in inferior myocardial infarction ECG signal, the proposed method can effectively make precise detection of inferior myocardial infarction by morphological features, and therefore is suitable to be applied in portable devices development for clinical promotion.
ObjectiveTo systematically evaluate the clinical value of miRNA-1 in the diagnosis of acute myocardial infarction (AMI) patients.MethodsWe searched PubMed, EMbase, Cochrane Library, CNKI, Wangfang, VIP, etc databases to identify literature about miRNA-1 in the diagnosis of AMI. Quality of the included literature was assessed by (quality assessment for diagnostic accuracy studies-2, QUADAS-2). The indices of pooled sensitivity (Sen), specificity (Spe), positivity likelihood ratio (PLR), negative likelihood ratio (NLR), diagnosis odds ratio (DOR), and the area under the summary receiver operating characteristic (SROC) curve were pooled using MetaDisc 1.4 software.ResultsA total of 12 articles were included. According to the different populations of miRNA-1 to be tested, subgroup analysis of healthy people (7 articles) and non-AMI disease groups (5 articles) was conducted. The results showed that AMI compared with healthy people, the pooled Sen was 0.78 with 95%CI 0.73 to 0.82, Spe was 0.88 with 95%CI 0.83 to 0.91 of miRNA-1 in the diagnosis of AMI. AUC of SROC curve was 0.911 2. Comparison of AMI and non-AMI patients, the pooled Sen was 0.59 with 95%CI 0.54 to 0.64, Spe was 0.74 with 95%CI 0.68 to 0.79 of miRNA-1 in the diagnosis of AMI. AUC of SROC curve was 0.743 2.ConclusionMiRNA-1 has a certain value in the diagnosis of AMI. It has an advantage in identifying AMI and patients with other systemic diseases, and can be combined with other biomarkers to diagnose AMI.
