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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2012年第8期13卷 624-630页

作者： Kai XU Ya-ling HAN Quan-min JING Shou-li wang Ying-yan MA Xiao-zeng wang Geng wang zu-lu wang Department of Cardiology Shenyang Northern HospitalShenyang 110016China

Objective:There is no simple or feasible post-procedural intravascular ultrasound (IVUS) score to predict major adverse cardiac events (MACE) in patients undergoing drug-eluting stents (DES) implantation. The aim of this study is to validate a new IVUS score for predicting MACE. Methods:A total of 295 patients (with 322 lesions) were enrolled. IVUS score was calculated in each lesion based on five IVUS morphological characteristics:inflow/outflow disease, malapposition, underexpansion, tissue protrusion, and edge dissection (iMUTE score). We assigned two points to an underexpansion and one point for each presence of other factors. Patients were divided into low score (iMUTE scorelusions:Post-procedural IVUS iMUTE scoring was simple and feasible in clinical practice, and can provide independent prognostic value for TVR in patients undergoing DES implantation.

关键词： Intravascular ultrasound Drug eluting stents Scoring schemes percutaneous coronary intervention

Efficacy and safety of individually tailored antiplatelet therapy in patients with acute coronary syndrome after coronary stenting： a single center, randomized, feasibility study

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Journal of Geriatric Cardiology 2015年第1期12卷 23-29页

作者： Hong-Chang ZHU Yi LI Shao-Yi GUAN Jing LI Xiao-Zeng wang Quan-Min JING zu-lu wang Ya-Ling HAN Second Affiliated Hospital of Dalian Medical University Dalianl 16023 Shandong Province China Cardiovascular Institute General Hospital of Shenyang Military Region Shenyang 110016 Liaoning Province China

Background Low responsiveness to clopidogrel （LRC） is associated with increased risk of ischemic events. This study was aimed to explore the feasibility of tailored antiplatelet therapy according to the responsiveness to clopidogrel. Methods A total of 305 clopidogrel naive patients with acute coronary syndromes （ACS） undergoing coronary stenting were randomly assigned to receive standard （n = 151） or tailored （n = 154） antiplatelet therapy. The ADP-induced platelet aggregation tests by light transmission aggregometry were performed to identify LRC patients assigned to the tailored group. The standard antiplatelet regimen was dual antiplatelet therapy with aspirin and clopidogrel. The tailored antiplatelet therapy was standard regimen for non-LRC patients and an additional 6-month cilostazol treatment for LRC patients. The primary efficacy outcome was the composite of cardiovascular death, myocardial infarction or stroke at one year. Results LCR was present in 26.6% （41/154） of patients in the tailored group. The percentage platelet aggregation for LCR patients was significantly decreased at three days after adjunctive cilostazol treatment （77.5% ± 12.1% vs. 64.5% ± 12.1%, P 〈 0.001）. At one year follow-up, a non-significant 37% relative risk reduction of primary events were observed in the tailored group as compared to the standard group （5.8% vs. 9.3%, P = 0.257）. There were no differences in the rates of stent thrombosis and hemorrhagic events between the two groups. Conclusions Tailored antiplatelet therapy for ACS patients after coronary stenting according to responsiveness to clopidogrel is feasible. However, its efficacy and safety need further confirmation by clinical trials with larger sample sizes.

关键词： Acute coronary syndrome Antiplatelet therapy Clopidogrel Coronary stenting

PR-segment depression during cryoballoon ablation of atrial fibrillation: a case report

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Journal of Geriatric Cardiology 2019年第10期16卷 789-792页

作者： Ming LIANG Yang LV zu-lu wang Gui-Tang YANG Ming-Yu SUN Zhi-Qing JIN Jian DING Ya-Ling HAN Department of Cardiology General Hospital of Northern Theater Command

Cryoballoon ablation has been widely used in the treatment of atrial fibrillation (AF).[1] The main complications of the procedure include pericardial tamponade, pulmonary vein stenosis, and atrial esophageal leakage,... 详细信息

关键词： Atrial fibrillation Chest pain Cryoballoon ablation

A high maintenance dose of clopidogrel improves short-term clinical outcomes in patients with acute coronary syndrome undergoing drug-eluting stent implantation

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Chinese Medical Journal 2009年第7期122卷 793-797页

作者： HAN Ya-ling wang Bin LI Yi XU Kai wang Shou-li JING Quan-min wang zu-lu wang Dong-mei MA Ying-yan wang Geng Department of Cardiology Shenyang Northern HospitalShenyang Liaoning 110016 China

Background Recurrent ischemic events occurred even during routine use of 75 mg clopidogrel in addition to aspirin, that indicated a potentially insufficient maintenance dosage of clopidogrel. The aim of the present study was to evaluate the short-term efficacy and safety of a 150 mg maintenance dose of clopidogrel following a 600 mg loading dose in patients with an acute coronary syndrome （ACS） undergoing drug eluting stent （DES） implantation. Methods Between November 2005 and November 2006, a total of 813 consecutive ACS patients undergoing DES implantation were enrolled. A 600 mg loading dose was administered before percutaneous coronary intervention （PCI） and patients were randomized to receive clopidogrel 75 mg or 150 mg for 30 days in addition to 300 mg aspirin daily. Primary end points were the composite of cardiac death, non-fatal myocardial infarction （MI） and urgent target vessel revascularization （UTVR）. Secondary end points included stent thrombosis （ST）, major and minor bleeding events at 30 days. Results At a follow-up period of 30 days, 4 （1.0%） patients in the 150 mg group and 9 （2.2%） patients in the 75 mg group （P 〉0.05） reached the primary end points. There was no significant difference in the incidences of MI （0.5% vs 1.2%, P〉0.05）, UTVR （0.7% vs 2.0%, P 〉0.05）, and cardiac death （0.2% vs 0.2%, P 〉0.05） between the two groups. The incidence of ST （0 vs 1.5%, P 〈0.05） was significantly lower in the 150 mg group than that in the 75 mg group. There were no significant differences between both groups regarding the risk of major （0.2% vs 0, P 〉0.05） or minor （0.5% vs 0.2%, P 〉0.05） bleedings. Conclusion A high clopidogrel maintenance dose of 150 mg daily following a 600 mg loading dose for the first month after PCI procedure reduces the risk of ST and appears to be safe in patients with ACS undergoing DES implantation.

关键词： angioplasty, transluminal, percutaneous coronary clopidogrel maintenance dose

Elective percutaneous intervention for unprotected left main coronary artery stenosis complicated with left anterior descending artery chronic total occlusive lesions

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Chinese Medical Journal 2010年第7期123卷 816-821页

作者： YANG Gui-tang HAN Ya-ling JING Quan-min wang Shou-li LI Yi MA Ying-yan wang Geng luAN Bo wang Xiao-zeng wang Bin wang zu-lu wang Dong-mei Department of Cardiology Shenyang Northern HospitalShenyang Liaoning 110840 China

Background The patients with unprotected left main coronary artery （ULMCA） stenosis and chronic total occlusion （CTO） lesions at the left anterior descending （LAD） artery are often recommended for bypass surgery. However, some of these patients are deemed inoperable or are at high risk for surgery. In this study, we explored strategies and evaluated the efficacy of percutaneous coronary intervention for the treatment of ULMCA stenosis complicated by LAD CTO. Methods From November 2001 to July 2009, 78 patients with ULMCA stenosis and LAD CTO lesions were selectively treated with stenting. Six patients （7.7%） refused surgery due to their young age （S40 years）, and the other 72 patients （92.3%） were unsuitable for surgery. Reasons for poor surgical candidacy included advanced age （〉80 years）, chronic obstructive pulmonary, unsuitable distal target vessels for bypass, EuroSCORE ≥6, and so on. Four different strategies were applied based on the degree of left main stenosis and the ostial diameter and involvement of the left circumflex. Results Total procedural success was achieved in 94.9%, there were no deaths or thromboses. Five patients （6.4%） experienced non-Q-wave myocardial infarction in hospital. At long-term follow-up （（52±28） months）, there were 3 cardiac deaths （3.8%） and 4 （5.1%） nonfatal myocardial infarctions. Angiographic follow-up was performed in 50 patients （64.1%）, and target vessel revascularizations were required in 10 patients （12.8%）, among which 4 nonfatal myocardial infarction patients included. The rate of major adverse cardiac events was 16.7% （13/78）.Conclusions This study indicates that percutaneous intervention can be performed safely in high risk surgical patients with ULMCA and LAD CTO lesions based on individual therapeutic strategies. It may be feasible to apply this technique in selected patients mentioned above.

关键词： percutaneous coronary intervention chronic total occlusion left main coronary artery disease strategy