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Angiographic characteristics and in-hospital mortality among patients with ST-segment elevation myocardial infarction presenting without typical chest pain: an analysis of China Acute Myocardial Infarction registry

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Chinese Medical Journal 2019年第19期132卷 2286-2291页

作者： Chen-Xi Song Rui Fu jin-Gang yang Hai-Yan Xu Xiao-jin Gao Chun-yue Wang yang Zheng Shao-Bin Jia Ke-Fei Dou yue-jin yang on behalf of the CAMI Registry study group Coronary Heart Disease Center Fuwai HospitalChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100037China Department of Cardiology The First Hospital of Jilin UniversityChangchunJilin 130031China Heart Center General Hospital of Ningxia Medical UniversityYinchuanNingxia 750004China 不详

Background:Patients with ST-segment elevation myocardial infarction(STEMI)who present without typical chest pain are associated with a poor ***,whether angiographic characteristics are related to a higher risk of mortality in this population is *** study aimed to investigate whether the higher mortality risk in patients with STEMI without chest pain could be explained by their"high-risk"angiographic ***:We used data of 12,145 patients with STEMI who was registered in China Acute Myocardial Infarction registry from January 2013 to September *** compared the infarct-related artery(IRA),thrombolysis in myocardial infarction(TIMI)flow grade in the IRA,and other angiographic characteristics between patients without and those with chest *** logistic regression model was used to identify independent risk factor of in-hospital ***:The 2922(24.1%)patients with STEMI presented without typical chest *** patients had a higher TIMI flow grade(mean TIMI flow grade:1.00 vs.0.94,P=0.02)and a lower rate of IRA disease of the left anterior descending artery(44.6%vs.51.2%,χ^2=35.63,P<0.01)than did those with typical chest *** without chest pain were older,more likely to have diabetes,longer time to hospital and higher Killip classification,and less likely to receive optimal medication treatment and primary percutaneous coronary intervention and higher In-hospital mortality(3.3%vs.2.2%,χ^2=10.57,P<0.01).After adjusting for multi-variables,presentation without chest pain was still an independent predictor of in-hospital death among patients with STEMI(adjusted odds ratio:1.36,95%confidence interval:1.02–1.83).Conclusions:Presentation without chest pain is common and associated with a higher in-hospital mortality risk in patients with acute myocardial *** results indicate that their poor prognosis is associated with baseline patient characteristics and delayed treatment,but not angiograp

关键词： Myocardial infarction Symptom assessment Coronary angiography Patient outcome assessment

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Local aneurysmal dilatation mimicking stent malapposition and concurrent vulnerable plaque within neointima of normal lumen after drug-eluting stent implantation： primary new findings from optical coherence tomography

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Chinese Medical Journal 2012年第6期125卷 1186-1188页

作者： GUO Yuan-lin yang yue-jin GAO Zhan QIAN Jie Clinical and Research Center for Coronary Disease Fu Wai HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100037China

Very late stent thrombosis is a life-threatening complication of implantation of drug-eluting stent （DES）. The mechanisms are still unidentified. Stent malapposition is supposed to be one debated reason. Here we report a case of 33 months after DES implanted. Observed by optical coherence tomography, we detected a lipid-rich plaque with defective fibrous cap within the neointima and many local aneurysmal dilatations between stent struts, which mimic ＂malapposition＂ on the angiogram. These indicated that vulnerable plaque hidden in the neointima at the stent segment might be a potential mechanism of very late stent thrombosis after DES implantation.

关键词： drug-eluting stent stent malapposition vulnerable plaque optical coherence tomography

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Traumatic left ventricular pseudoaneurysm

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Chinese Medical Journal 2009年第6期122卷 758-760页

作者： KANG Lian-ming ZHANG Jian FAN Chao-mei WANG Hong-yue LU Min-jie LU jin-guo yang yue-jin Department of Cardiology Cardiovascular Institute and Fu Wai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing 100037 China

Left ventricular pseudoaneurysm is a rare complication of chest trauma. Accurate diagnosis and early surgical intervention is essential for patients with large or expanding left ventricular pseudoaneurysms due to the ... 详细信息

关键词： traumatic left ventricular pseudoaneurysm

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In-hospital delay to primary angioplasty for patients with ST-elevated myocardial infarction between cardiac specialized hospitals and non-specialized hospitals in Beijing, China

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Chinese Medical Journal 2010年第7期123卷 800-805页

作者： XUN Yi-wen yang jin-gang SONG Li SUN Yi-hong LU Chang-lin yang yue-jin HU Da-yi Department of Emergency Tongren Hospital Capital Medical Univery. Department of Cardiology Cardiovascular Institute & Fu Wai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China Department of Emergency Anzhen Hospital Capital Medical University Beijing 100029 China Department of Cardiology Tongren Hospital Capital Medical University Beijng 100730 China Heart Center People's Hospital of Peking University Beijing 100044 China

Background Evidence indicates that early reperfusion therapy in patients with ST-elevation myocardial infarction （STEMI） reduces complications. This study was undertaken to compare the in-hospital delay to primary percutaneous coronary intervention （PPCI） for patients with STEMI between specialized hospitals and non-specialized hospitals in Beijing, China. Methods Two specialized hospitals and fifteen non-specialized hospitals capable of performing PPCI were selected to participate in this study. A total of 308 patients, within 12 hours of the onset of symptoms and undergoing PPCI between November 1, 2005 and December 31, 2006 were enrolled. Data were collected by structured interview and review of medical *** The median in-hospital delay was 98 （interquartile range 105 to 180） minutes, and 16.9% of the patients were treated within 90 minutes. Total in-hospital delay and ECG-to-treatment decision-making time were longer in the non-specialized hospitals than in the cardiac specialized hospitals （147 minutes vs. 120 minutes, P〈0.001; 55 minutes vs. 45 minutes, P=0.035）. After controlling the confounding factors, the non-specialized hospitals were independently associated with an increased risk of being in the upper median of in-hospital *** There were substantial in-hospital delays between arrival at the hospital and the administration of PPCI for patients with STEMI in Beijing. Patients admitted to the cardiac specialized hospitals had a shorter in-hospital delay than those to the non-specialized hospitals because of a shorter time of ECG-to-treatment decision-making.

关键词： cardiac specialized hospitals ST-elevated myocardial infarction primary percutaneous coronary intervention treatment delay

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Differences in symptoms and pre-hospital delay among acute myocardial infarction patients according to ST-segment elevation on electrocardiogram: an analysis of China Acute Myocardial Infarction (CAMI) registry

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Chinese Medical Journal 2019年第5期132卷 519-524页

作者： Rui Fu Chen-Xi Song Ke-Fei Dou jin-Gang yang Hai-Yan Xu Xiao-jin Gao Qian-Qian Liu Han Xu yue-jin yang Department of Cardiology Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Background: Approximately 70% patients with acute myocardial infarction (AMI) presented without ST-segment elevation on electrocardiogram. Patients with non-ST segment elevation myocardial infarction (NSTEMI) often presented with atypical symptoms, which may be related to pre-hospital delay and increased risk of mortality. However, up to date few studies reported detailed symptomatology of NSTEMI, particularly among Asian patients. The objective of this study was to describe and compare symptoms and presenting characteristics of NSTEMI vs. STEMI patients. Methods: We enrolled 21,994 patients diagnosed with AMI from China Acute Myocardial Infarction (CAMI) Registry between January 2013 and September 2014. Patients were divided into 2 groups according to ST-segment elevation: ST-segment elevation (STEMI) group and NSTEMI group. We extracted data on patients' characteristics and detailed symptomatology and compared these variables between two groups. Results: Compared with patients with STEMI (N=16,315), those with NSTEMI (N=5679) were older, more often females and more often have comorbidities. Patients with NSTEMI were less likely to present with persistent chest pain (54.3% vs.71.4%), diaphoresis (48.6% vs.70.0%), radiation pain (26.4% vs.33.8%), and more likely to have chest distress (42.4% vs.38.3%) than STEMI patients (all P<0.0001). Patients with NSTEMI were also had longer time to hospital. In multivariable analysis, NSTEMI was independent predictor of presentation without chest pain (odds ratio: 1.974, 95% confidence interval:1.849-2.107). Conclusions: Patients with NSTEMI were more likely to present with chest distress and pre-hospital patient delay compared with patients with STEMI. It is necessary for both clinicians and patients to learn more about atypical symptoms of NSTEMI in order to rapidly recognize myocardial infarction.

关键词： Non-ST segment elevation myocardial infarction Symptom assessment Time to treatment

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Off-hours admission does not impact outcomes in patients undergoing primary percutaneous coronary intervention and with a first medical contact-to-device time within 90 min

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Chinese Medical Journal 2021年第15期134卷 1795-1802页

作者： Wen-Jian Ma Si-De Gao Si-Zhuang Huang Xu-Ze Lin yue-jin yang Meng-yue Yu Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

Background:It remains unclear whether the outcomes of ST-elevation myocardial infarction(STEMI)patients treated with primary percutaneous coronary intervention(PPCI)during off-hours are as favorable as those treated during on-hours,especially those with a first medical contact-to-device(FMC-to-device)time within 90 *** aimed to determine whether off-hours admission impacted late outcomes in patients undergoing PPCI and with an FMC-to-device timejing from January 2018 to December *** were divided into on-hours group and off-hours group based on their arrival *** characteristics,clinical data,and key time intervals during treatment were collected from the Quality Control&Improvement Center of Cardiovascular Intervention of Beijing by the 4tHeart and Brain Green Channel”***:Overall,the median age of the patients was 58.8 years and 19.9%(133/670)were *** these,296(44.2%)patients underwent PPCI during on-hours and 374(55.8%)patients underwent PPCI during *** with the on-hours group,the off-hours group had a longer FMC-to-device time and fewer patients with FMC-to-device time0.05).According to the Cox regression analyses,off-hours admission was not a predictor of 2-year MACEs(P=0.788).Similarly,the Kaplan-Meier curves showed that the risks of a MACE,all-cause death,reinfarction,and target vessel revascularization were not significantly different between the two groups(P>0.05).Conclusions:This real-world,multicenter retrospective study demonstrated that for STEMI patients who underwent PPCI within 90 min,off-hours admission was

关键词： First medical contact-to-device time ST-segment elevation myocardial infarction Primary percutaneous coronary intervention Major adverse cardiovascular events Off-hours

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Mid-ventricular obstructive hypertrophic cardiomyopathy with apical aneurysm and sustained ventricular tachycardia： a case report and literature review

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Chinese Medical Journal 2011年第11期124卷 1754-1757页

作者： GAO Xiao-jin KANG Lian-ming ZHANG Jian DOU Ke-fei YUAN Jian-song yang yue-jin Department of Cardiology Cardiovascular Institute and FuwaiHospital Chinese Academy of Medical Sciences & Peking UnionMedical College Beijing 100037 China

The case is a 54-year-old man with hypertrophic cardiomyopathy, mid-ventricular obstruction, apical aneurysm, and recurrence sustained monomorphic ventricular tachycardia （VT）. A coronary angiogram revealed myocardial bridging located in the middle of the left anterior descending coronary artery （LAD）, and the left ventriculogram showed an hour-glass appearance of the left ventricular cavity. There was a significant pressure gradient of 60 mmHg across the mid-ventricular obliteration at rest. A successful myectomy of the inappropriate hypertrophy myocardium and excision of the apical aneurysm were performed. Pathologic analysis demonstrated fibrosis in the apical aneurysm and thickened and narrowed vessels in the adjacent area. During the follow-up of eighteen months, the patient remained clinically stable and free from arrhythmic recurrence.

关键词： hypertrophic cardiomyopathy aneurysm ventricular tachycardia

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Acute and reversible cardiomyopathy provoked by stress in a Chinese woman

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Chinese Medical Journal 2008年第23期121卷 2454-2457页

作者： KANG Lian-ming ZHANG Jian DOU Ke-fei XU Zhi-min GAO Xiao-jin yang yue-jin Department of Cardiology Cardiovascular Institute and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing 100037 China

Areversible cardiomyopathy triggered by psychologically stressful events occurs in older women and may mimic evolving acute myocardial infarction or coronary syndrome. This condition is characterized by a distinctive form of systolic dysfunction that predominantly affects the distal left ventricle chamber and a favourable outcome with appropriate medical therapy.

关键词： stress induced acute cardiomyopathy reversible cardiomyopathy

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Long-Term Prognosis of Different Reperfusion Strategies for ST-Segment Elevation Myocardial Infarction in Chinese County-Level Hospitals:Insight from China Acute Myocardial Infarction Registry

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生物医学与环境科学:英文版 2023年第9期36卷 826-836页

作者： WU Chao ZHANG Qiong Yu LI Ling ZHANG Xu Xia CAI Yong Chen yang jin Gang XU Hai Yan ZHAO Yan Yan WANG yang LI Wei jin Chen GAO Xiao jin yang yue jin QIAO Shu Bin Coronary Heart Disease Center Department of CardiologyState Key Laboratory of Cardiovascular DiseaseNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeFuwai HospitalBeijing 100037China Hypertension Center Department of CardiologyState Key Laboratory of Cardiovascular DiseaseNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeFuwai HospitalBeijing 100037China Medical Research&Biometrics Center State Key Laboratory of Cardiovascular DiseaseNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeFuwai HospitalBeijing 100037China Department of Cardiology Tonghua Central HospitalTonghua 134000JilinChina Department of Cardiology The First Hospital of SuihuaSuihua 152054HeilongjiangChina

Objective To evaluate the long-term prognosis of patients with ST-segment elevation myocardial infarction(STEMI)treated with different reperfusion strategies in Chinese county-level hospitals Methods A total of 2,514 patients with STEMI from 32 hospitals participated in the China Acute Myocardial Infarction registry between January 2013 and September *** success of fibrinolysis was assessed according to indirect measures of vascular *** primary outcome was 2-year *** Reperfusion therapy was used in 1,080 patients(42.9%):fibrinolysis(n=664,61.5%)and primary percutaneous coronary intervention(PCI)(n=416,38.5%).The most common reason for missing reperfusion therapy was a prehospital delay>12 h(43%).Fibrinolysis[14.5%,hazard ratio(HR):0.59,95%confidence interval(CI)0.44–0.80]and primary PCI(6.8%,HR=0.32,95%CI:0.22–0.48)were associated with lower 2-year mortality than those with no reperfusion(28.5%).Among fibrinolysistreated patients,510(76.8%)achieved successful clinical reperfusion;only 17.0%of those with failed fibrinolysis underwent rescue *** was no difference in 2-year mortality between successful fibrinolysis and primary PCI(8.8%vs.6.8%,HR=1.53,95%CI:0.85–2.73).Failed fibrinolysis predicted a similar mortality(33.1%)to no reperfusion(33.1%vs.28.5%,HR=1.30,95%CI:0.93–1.81).Conclusion In Chinese county-level hospitals,only approximately 2/5 of patients with STEMI underwent reperfusion therapy,largely due to prehospital *** 30%of patients with failed fibrinolysis and no reperfusion therapy did not survive at 2 *** improvement initiatives are warranted,especially in public health education and fast referral for mechanical revascularization in cases of failed fibrinolysis.

关键词： Acute myocardial infarction Reperfusion therapy Rural Outcome

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Free triiodothyronine level indicates the degree of myocardial injury in patients with acute ST-elevation myocardial infarction

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Chinese Medical Journal 2013年第20期126卷 3926-3930页

作者： Wang Wen-yao Tang Yi-da yang Min Cui Cheng Mu Mu Qian Jie yang yue-jin Chinese Acad Med Sci Natl Ctr Cardiovasc Dis State Key Lab Cardiovasc Dis Fuwai Hosp Beijing 100037 Peoples R China Peking Union Med Coll Beijing 100037 Peoples R China

Background Previous studies have suggested that hypothyroidism correlated with coronary heart diseases （CHD） mortality in long-term cohort, but whether the thyroid function status is associated with myocardial injur... 详细信息

关键词： myocardial injury thyroid hormone free triiodothyronine acute myocardial infarction

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