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Comparison of the incidence of late stent thrombosis after implantation of different drug-eluting stents in the real world coronary heart disease patients： three-year follow-up results

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Chinese Medical Journal 2010年第7期123卷 778-781页

作者： CHEN Ji-lin GAO Li-jian YANG Yue-jin LI jian-jun QIAO Shu-bin XU Bo HUANG Jing-han YAO Min QIN Xue-wen LIU Hai-bo wu yong-jian YUAN Jin-qing CHEN Jue YOU Shi-jie DAI Jun GAO Run-lin Center for Coronary Heart Disease Cardiovascular Institute & Fu Wai Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100037 China

Background Late stent thrombosis （LST） is still concerned by interventions cardiologists in daily clinical practice. This study aimed to compare the incidence of LST after implantation of different drug-eluting stents （DES） in coronary heart disease （CHD） patients in the real *** From December 2001 to February 2009, a total of 11 875 consecutive CHD patients undergone DES implantation were enrolled in this single-center registery study. Patients with acute ST-segment elevation myocardial infarction, mixed DES implantation, restenosis lesions, and patients who could not take dual antiplatlet medication and those who were contraindicated for coronary interventional treatment were excluded. All patients were treated with completed dual antiplatelet medications for at least 9 months after DES deployment. The follow-up was completed by outpatient visits, letter correspondence, phone calls and coronary angiography. Definite LST was diagnosed auording to the Academic Research Consortium （ARC） *** Cypher or Cypher Select stents were implanted in 4104 cases, Taxus or Taxus Liberty stents in 2271 cases and Firebird stents （Chinese rapamycin-eluting stents） in 5500 cases. One-year follow-up was completed in 9693 patients, including 3346 cases with Cypher or Cypher Select stents, 1529 cases with Taxus or Taxus Liberty stents and 4818 cases with Firebird stents. Two- and three-year follow-up results were obtained in 7133 and 4353 patients, respectively, including 2410 and 1760 cases with Cypher or Cypher Select stents, 1285 and 900 cases with Taxus or Taxus Liberty stents as well as 3438 and 1693 cases with Firebird stents. One-year follow-up results showed that the incidence of LST was 1.08% in patients with Cypher or Cypher Select stents, 1.24% in those with Taxus or Taxus Liberty stents and 0.71% in those with Firebird stents; there was no significant difference between those with Cypher or Cypher Select and Firebird stents, but there was significant

关键词： coronary heart disease drug-eluting stents late stent thrombosis

Incidence of thrombosis after implantation of drug-eluting stents in patients with coronary artery disease

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Chinese Medical Journal 2008年第21期121卷 2144-2147页

作者： CHEN Ji-lin YANG Yue-jin GAO Li-jian HUANG Jing-han QIN Xue-wen QIAO Shu-bin XU Bo YAO Min LIU Hai-bo wu yong-jian YUAN Jin-qing CHEN Jue YOU Shi-jie DAI Jun LI jian-jun GAO Run-lin Department of Cardiology Cardiovascular Institute & Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Background Randomized clinical trials have demonstrated equivalent safety to bare-metal stents after drug-eluting stents （DES） implantation. However, the DES thrombosis in randomized trials could not be comparable to those observed in clinical practice, frequently including off-label indications. This study sought to assess the incidence of DES thrombosis after implantation of DES in patients with real world coronary artery disease （CAD） in China. Methods From December 2001 to April 2007, 8190 consecutive patients received the treatment with DES, 5412 patients completed one year follow-up： 2210 with sirolimus-eluting stent Cypher, 1238 with paclitaxel-eluting stent Taxus and 1964 with Chinese sirolimus-eluting stent Firebird, After two years of follow-up, there were 2176 patients （1245 Cypher, 558 Taxus and 373 Firebird）. All patients were treated with aspirin and clopidogrel over at least 9 months. Results Among 8190 patients, 17 patients had acute stent thrombosis （0.24%）： 7 in the Cypher group, 4 Taxus and 6 Firebird; 23 patients had subacute stent thrombosis： 8 Cypher, 6 Taxus and 9 Firebird. The incidence of acute and subacute thrombosis was 0.49%： 0.50% Cypher, 0.63% Taxus and 0.41% Firebird. The incidence of late thrombosis at one year followup was 0.63%： 0.63% Cypher, 0.88% Taxus and 0.46% Firebird; at two year follow-up the incidence was 0.74%： 0.72% Cypher, 0.90% Taxus and 0.54% Firebird. There was no significant difference among three groups at 1 year and 2 years follow-up. Conclusion The first generation DES in the treatment of complex lesions are safe and effective if patients are aggressively treated with dual antiplatelet agents.

关键词： drug-eluting stents coronary disease thrombosis safety

A randomized comparative study of using enoxaparin instead of unfractionated heparin in the intervention treatment of coronary heart disease

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Chinese Medical Journal 2006年第5期119卷 355-359页

作者： CHEN Ji-lin CHEN Jue QIAO Shu-bin GUO Yuan-lin wu yong-jian DAI Jun YUAN Jin-qing QIN Xue-wen YANG Yue-jin GAO Run-lin Cardiovascular Institute and Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College Beijing 100037 China

Background Low molecular weight heparin （LMWH） was more effective than unfractionated heparin （UFH） in treating acute coronary syndrome （ACS）. However, it remains uncertain whether LMWH can be used in patients undergoing percutaneous coronary intervention （PCI） instead of UFH. This study aimed to evaluate the efficacy and safety of using enoxaparin instead of UFH in the intervention treatment of patients with coronary heart disease （CHD） .Methods From October 2003 to Febuary 2005, 966 patients with CHD were enrolled into this study. Among 966 patients, 455 patients received the PCI, including 283 patients with Non-ST segment elevation ACS （NSTEACS）, 511 patients did not received PCI due to mild, moderate lesions or were suitable for coronary artery bypass graft （CABG）. The 966 patients were randomized to enoxaparin group （484 patients） and UFH group （482 patients）. Patients in the enoxaparin group were given enoxaparin at least twice subcutaneously （1 ms/kg, q12 h） before catheterization. Plasma anti-Xa activity was determined 1-8 hours after the last dose of enoxaparin was determined. The catheterization was performed within 8 hours after the last dose of enoxaparin. The sheath was removed immediately after the procedure. Patients in the UFH group were given UFH 25 mg intravenously before coronary angiography. Additional 65 mg was given intravenously if PCI was to be performed. The sheath was removed 4 hours after the procedure. Results A total of 227 patients in the enoxaparin group and 228 patients in the UFH group received PCI. In the enoxaparin group, one patient developed acute thrombosis during PCI and resulted in acute myocardial infarction （AMI）, no acute or subacute thrombosis was found during hospitalization. In the UFH group, no acute or subacute thrombosis occurred during PCI procedure and hospitalization. Therefore, the incidence of major adverse cardiovascular events （MACEs） during the hospitalization was 0.44% in the enoxaparin group and 0 in the

关键词： enoxaparin unfractionated heparin percutaneous coronary intervention

A novel and promising engineering application of carbon dots:Enhancing the chloride binding performance of cement

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Chinese Chemical Letters 2024年第6期35卷 409-416页

作者： wu-jian Long Yang Yu Chuang He Guangdong Provincial Key Laboratory of Durability for Marine Civil Engineering Key Lab of Coastal Urban Resilient InfrastructureMOECollege of Civil and Transportation EngineeringShenzhen UniversityShenzhen 518060China

Corrosion of reinforcement induced by chloride invasion is extensively considered as the dominating deterioration mechanism of reinforced concrete(RC)structures,leading to serious safety hazards and tremendous economic ***,it still lacks well dispersive and cost-efficient nanomaterials to improve the anti-chloride-corrosion ability of RC ***,specific carbon dots(CDs)with high dispersity and low cost are deliberately designed,successfully prepared by hydrothermal processing,and then firstly applied to immensely enhance chloride binding performance of cement,thereby contributing to suppressing the corrosion of ***,the tailored CDs are composed of the carbon core with highly crystalline sp^(2)C structures and oxygen-containing groups connecting on the carbon core;The typical equilibrium test confirms that with respect to that of the blank cement paste,the chloride binding capacity of cement paste involving 0.2 wt%(by weight of cement)CDs is increased by 109% after 14-day exposure to 3 mol/L Na Cl solution;according to comprehensive analyses of phase compositions,the chloride binding mechanism of CDs-modified cement is rationally attributed to the fact that the incorporation of CDs advances the formation of calcium silicate hydrate(C-S-H)gels and Friedel's salt(Fs),thus enormously enhancing the physically adsorbed and chemically bound chloride ions of cement *** work not only firstly provides a novel high-dispersity and low-cost nanomaterial toward the durability enhancement of RC structures,but also broadens the application of CDs in the field of engineering,conducing to stimulating their industrialization development.

关键词： Carbon dots Chloride binding Cement Chloride binding mechanism Friedel’s salt

Simulation of RFI Cancellation Using Subspace Projection Algorithm for PAF Receiver

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Research in Astronomy and Astrophysics 2024年第1期24卷 237-244页

作者： Peng wu jian Li Mao-Zheng Chen Xinjiang Astronomical Observatory Chinese Academy of SciencesUrumqi 830011China University of Chinese Academy of Sciences Beijing 100049China Xinjiang Key Laboratory of Microwave Technology Urumqi 830011China

The simulation of radio frequency interference(RFI) cancellation by applying a spatial filtering technique for phased array feed(PAF) is presented. In order to better reflect the characteristics of PAF, a new signal model is to add the coupling coefficient among elements of PAF to the conventional array signal model. Then the subspace projection(SP) algorithm is used to cancel RFI from the correlation matrix of the signal, and finally, the 2D power image is drawn. The power variation of signal-of-interest direction and RFI direction before and after using the SP algorithm is analyzed. The new signal model and simulation strategy can be used to test and verify the beamformer.

关键词： methods:analytical techniques:radar astronomy telescopes

Comparison of in-hospital and long-term outcomes between a Cypher stent and a Taxus stent in Chinese diabetic patients with coronary artery disease

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Chinese Medical Journal 2007年第21期120卷 1868-1873页

作者： YANG Yue-jin XU Bo KANG Sheng PEI Wei-dong CHEN Ji-lin QIAO Shu-bin QIN Xue-wen YAO Min CHEN Jue wu yong-jian LIU Hai-bo YOU Shi-jie LI jian-jun DAI Jun GAO Run-lin Coronary Heart Disease Center Department of Cardiology Cardiovascular Institute and Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Background The sirolimus and paclitaxel distribution patterns and tissue residence time may be modified in atherosclerotic lesions for patients with diabetes, and the biological mechanisms of action for these agents differ significantly. Previous clinical trials have yielded discrepant results of major adverse cardiac events and restenosis between a sirolimus-eluting stent and a paclitaxel-eluting stent in coronary artery disease. Therefore, this study was conduced to compare in-hospital and long-term clinical outcomes between patients receiving sirolimus-eluting stent （Cypher or Cypher Select stent） and paclitaxel-eluting stent （Taxus Express stent） after percutaneous intervention （PCI） in Chinese patients with diabetes. Methods One hundred and sixty-four consecutive diabetic patients underwent PCI in Fuwai Hospital from April 2004 to December 2004. Of them, 101 patients received Cypher or Cypher Select stents （Cypher group, 145 stents） and 63 patients received Taxus Express stents （Taxus group, 129 stents）. Repeat coronary angiography was performed at 6-month and clinical outcomes were evaluated at 1- and 3-year follow-up. Stent thrombosis was classified according to Academic Research Consortium （ARC）. Results The two groups did not differ significantly with respect to cardiac death, recurrent myocardial infarction （re-MI）, target vessel revascularization （TVR） and occurrence of major adverse cardiac events （MACE）. And the MACE-free cumulative survival at 1- and 3-year follow-up and early, late and very late thrombosis rates were also similar in the two groups （all P〉0.05）. There was a trend favoring PES over SES with regard to reducing cardiac death （0 vs 2.0%, P=-0.524）, re-MI （0 vs 2.0%, P=-0.524）, the composite of the cardiac death and re-MI （0 vs 4.0%, P=-0.299） and very late thrombosis （0 vs 3.0%, P=-0.295） between 1-year and 3-year follow-up. Conclusion The study indicates that PCI with either Cypher or Taxus stents is associated with similar efficacy and s

关键词： diabetes percutaneous coronary intervention, stent outcomes

Comparison of immediate and followup results between transradial and transfemoral approach for percutaneous coronary intervention in true bifurcational lesions

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Chinese Medical Journal 2007年第7期120卷 539-544页

作者： YANG Yue-jin XU Bo CHEN Ji-lin KANG Sheng QIAO Shu-bin QIN Xue-wen YAO Min CHEN Jue wu yong-jian LIU Hai-bo YUAN Jin-qing YOU Shi-jie LI jian-jun DAI Jun GAO Run-lin Centre for Coronary Artery Disease Department of Cardiology Cardiovascular Institute and Fuwai Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100037 China

Background A comparison of efficacy and safety between transradial and transfemoral approach for percutaneous coronary intervention （PCI） in bifurcations has not been done. This study evaluated feasibility of transradial PCI （TRI） and compared the immediate and followup results with transfemoral PCI （TFI） in bifurcations. Methods One hundred and thirty-four consecutive patients with bifurcations were treated with PCI in our hospital from April 2004 to October 2005. Of these, there were 60 patients （88 lesions） in TRI group and 74 patients （101 lesions） in TFI group. Bifurcations type was classified according to the Institut Cardiovasculaire Paris Sud Classification. Results TRI group had smaller stent diameter （（3.06±0.37） mm vs （3.18±0.35） mm, P=0.023） and postprocedural in-stent minimum lumen diameter （（2.62±0.37） mm vs （2.74±0.41） mm, P=0.029） than TFI, but there were not significant differences in in-stent subacute thrombosis rate （0% vs 1.0%, P=0.349）, target lesion revascularization （TLR）（0% vs 1.0%, P=0.349） following procedure and thrombosis （2.3% vs 1.0%, P=0.482）, in-stent restenosis （12.5% vs 10.9%, P=0.731）, in-segment restenosis （17.0% vs 14.9%, P=0.681）, TLR （10.2% vs 13.9%, P=0.446） and TLR-free cumulative survival rate （89.8% vs 86.1%, P=0.787） at seven months followup. No death was reported in the two groups. Conclusion Transradial intervention is feasible and appears to be as effective and safe as transfemoral PCI in treatment of true bifurcational lesions.

关键词： transradial percutaneous coronary intervention transfemoral percutaneous coronary intervention bifurcational lesions treatment outcome

Current treatment status in patients with severe aortic valve stenosis and outcome of long term follow-up at advanced age： a Chinese single center study

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Chinese Medical Journal 2011年第18期124卷 2879-2882页

作者： PEI Han-jun wu yong-jian YANG Yue-jin XU Bo CHEN Ji-lin QIAO Shu-bin LI jian-jun QIN Xue-wen YAO Min YUAN Jin-qing CHEN Jue LIU Hai-bo YOU Shi-jie GAO Run-lin Department of Cardiology Cardiovascular Institute and Fu WaiHospital Chinese Academy of Medical Sciences and Peking UnionMedical College Beijing 100037 China

Background Surgical aortic valve replacement is the standard treatment for patients with severe aortic stenosis, but some registries have indicated that 30% to 60% of these patients are not treated surgically, usually due to advanced age and/or comorbidities. This single center study in China investigated the current treatment status in the patients with severe aortic stenosis and evaluated the long term clinical outcome in advanced age patients whether or not undergoing aortic valve replacement. Methods Clinical data of 867 consecutive patients with severe aortic stenosis between January 2000 and December 2006 were retrospectively analyzed. The patients 〉65 years old were followed up by telephone or information from medical records. The primary end-point was all-cause mortality. Results The patients＇ average age was （52±19） years （range, 1-91 years）, and 34% were women. The percentages of the patients aged 〈15 years, between 15 and 34 years, between 35 and 54 years, between 55 and 64 years, between 65 and 74 years, and 〉75 years who underwent surgical aortic valve replacement were 82.3%, 87.2%, 88.8%, 78.2%, 65.3% and 22.2% respectively. In the patients （n=256）〉65 years old, 43.4% had New York Heart Association class III and IV symptoms, 39.1% had hypertension, 33.2% had coronary heart disease, and 3.1% had stroke. In the patients not undergoing aortic valve replacement, 1.6% had renal insufficiency, 4.7% had chronic obstructive pulmonary disease, 2.0% had critical hematopathy, and 0.4% had mammary cancer. A total of 186 （72.7%） patients finished the follow-up, and the average duration of the follow-up was （60±2.6） months. In the patients between 65 and 74 years old, the total deaths and cardiac deaths in the patients undergoing aortic valve replacement decreased significantly compared with those with conservative treatment （10.3% vs. 53.7%, P 〈0.001 and 6.3% vs. 50.7%, P〈0.001）. Similarly, in the patients ≥75 years old, there was a significant difference between

关键词： aortic stenosis aortic valve replacement advanced age comorbidity

ST-elevated acute myocardial infarction happening 1 month post stent implantation： late thrombosis in-stents or new lesions？

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Chinese Medical Journal 2009年第14期122卷 1610-1614页

作者： SONG Guang-yuan YANG Yue-jin XU Bo LI jian-jun GAO Run-lin QIAO Shu-bin YUAN Jin-qing TANG Yi-da YOU Shi-jie PEI Han-jun ZHAO Zhen-yan WANG Xi-mei wu yong-jian Center of Coronary Heart Disease Center of Interventional Therapy Cardiovascular Institute & Fuwai Hospital Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100037 China

Background ST-elevated acute myocardial infarction （STEAMI） happening in the first month post percutaneous coronary intervention （PCI） is almost related to acute thrombosis or subacute thrombosis in-stents. This study aimed to investigate the possible causes of myocardial infarction one month later. Methods Patients who had a history of successful PCI, and received coronary angiography or re-PCI due to STEAMI were included in this study. The AMI-related lesions and previous angiographic findings such as the number of lesions, the degree of the stenosis, the type of stents and acute results of last PCI were recorded. If the AMI-related lesion was localized in-stents or at the edge of stents （distance apart from the edge 〈5 mm）, it was defined to be late thrombosis; otherwise as a new-lesion induced AMI. Results One hundred and ninety-two patients aged 40-79 years were included in this study. New lesions, as the cause of STEAMI, were found in 144 patients （Group A, 75%）, and late thrombosis in 48 patients （Group B, 25%）. Almost all newly built thromboses were found at the sites of previous insignificant lesions （diameter stenosis 〈50%）. There was a significant difference in the average time from previous PCI to AMI （（30.1±12.4） vs （20.3±11.9） months） between the two groups. Diabetes mellitus （DM） and drug-eluting stent （DES） utilization were associated with markedly higher morbidity of late thrombosis in adjusted Logistic regression （hazard ratio （HR） 3.4, 95% confidence interval （C/） 1.1-10.9 and 5.3, 95% Cl 1.1-26.5）. Conclusions STEAMIs happening 1 month after PCI are more likely to develop from previous insignificant lesion rupture than from late thrombosis in-stents. Moreover, DM and DES are associated with the high incidence of late thrombosis, which may indicate that intensive antiplatelet therapy should be considered in patients with diabetes.

关键词： percutaneous coronary intervention acute myocardial infarction late thrombosis diabetes mellitus