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Dual versus single antiplatelet therapy for patients with long-term oral anticoagulation undergoing coronary intervention： a systematic review and meta-analysis

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Journal of Geriatric Cardiology 2017年第12期14卷 725-736页

作者： Jing-Jing WU Chan ZOU Wen-Yu LIU Guo-Ping YANG Center of Clinical Pharmacology the Third Xiangya Hospital Central South University Changsha Hunan China College of Pharmacy Central South University Changsha Hunan China

Objective The main aim of this meta-analysis is to compare the efficacy and safety of dual versus single antiplatelet therapy for pa- tients taking oral anticoagulation （OAC） after coronary intervention. Background The optimal regimen remains controversial for patients taking OAC after coronary intervention. Methods PubMed, Embase and Cochrane Central Register of Controlled Trials were searched for eligible studies including data of triple therapy （TT） versus OAC plus single antiplatelet therapy for patients requiring OAC after coronary intervention. The primary outcome was major adverse cardiac and cerebrovascular event （MACCE）. The safety outcome was major bleeding. Results Fourteen studies with 32,825 patients were included. Among prospective studies, patients with TT had a trend toward a higher risk of major bleeding [odds ratios （OR）： 1.56, 95% confidence interval （CI）： 0.98-2.49, P = 0.06] and a markedly higher risk of all-cause death （OR; 2.11, 95% CI： 1.10-4.06 P = 0.02） compared with OAC plus clopidogrel. Meanwhile, TT was associated with decreased risks of MACCE （OR： 0.63, 95% CI： 051-0.77 P 〈 0.0001）, all-cause death （OR： 0.45, 95% CI： 0.20-0.97, P = 0.04）, and stroke/transient ischemic attack （TIA）/peripheral embolism （PE）（OR= 0.29, 95% CI： 0.09~3.96, P = 0.04） compared with OAC plus aspirin. Conclusions For pa- tients requiring OAC after coronary intervention, OAC plus clopidogrel may bring more clinical net benefit than TT, whereas OAC plus aspirin should be the last choice. More large-size randomized control trials are needed to confirm these findings.

关键词： coronary intervention Dual therapy Efficacy Oral anticoagulation Safety Triple therapy

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Current status and perspective of percutaneous coronary intervention in China

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Chinese Medical Journal 2006年第7期119卷 531-532页

作者： GAO Run-lin Cardiovascular Institute and Fuwai Hospital Chinese Academy ofMedical Sciences Peking Union Medical College Beijing 100037China

The first percutaneous transluminal coronary angioplasty （PTCA） in China was performed in 1984. Since then the progresses in this field have been achieved gradually. The development process can be divided into 3 phases roughly. According to a national survey organized by Chinese Society of Cardiology, from 1984 to 1996, as the first phase, percutaneous coronary intervention （PCI） can only be performed in a few centers by a few cardiologists. By the end of 1996, only 6213 cases of PCI in total were undergone in 51 hospitals nationwide with success rate of 91.9%. The most common procedure was balloon angioplasty. A few cases of directional coronary atherectomy （DCA）, rotational atherectomy and excimer laser angioplasty were performed in very few centers. coronary stenting has been performed since 1992. By 1996, coronary stents were implanted in 51.3% of the patients undergone PCI. From 1997 to 2001,

关键词： coronary intervention coronary angioplasty development process

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The influence of diabetes mellitus on the procedural and in-hospital outcomes after elective percutaneous coronary intervention

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Chinese Medical Journal 2005年第14期118卷 1220-1224页

作者： LIChong-jian GAORun-lin YANGYue-jin CHENJi-lin QINXue-wen XUBo QIAOShu-bin YUANJin-qing WUYong-jian LIUHai-bo YAOMin CHENJue DAIJun CHENZai-jia CardiovascularInstitute＆FuWaiHospital ChineseAcademyofMedicalSciencesPekingUnionMedicalCollegeBeijing100037China

Approximately 15% - 20% of the patients undergoing percutaneous coronaryintervention (PCI) procedure complicate with diabetes and this patient population continues to be aparticular challenge for both the interventional cardiologist and the cardiac surgeon. It is welldocumented that diabetes is associated with more diffuse and severe coronary ***-term outcome after PCI is clearly worse in diabetics compared with non-diabetics. However,there is little information on the procedural and in-hospital outcomes of elective PCI in diabeticpatients. In this study we analyzed the practice and in-hospital outcomes in a large series ofconsecutively treated patients with and without diabetes who underwent elective PCI.

关键词： diabetes mellitus coronary intervention outcomes

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Clinical effect of postconditioning in ST-elevation myocardial infarction patients treated with primary percutaneous coronary intervention: a meta-analysis of randomized controlled trials

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2015年第3期16卷 198-207页

作者： Xian-qing HU Jian CHENG Biao TANG Zhong-heng ZHANG Ke HUANG Yi-ping YANG Yan-yan MAO Ming ZHONG Shen-wen FU Department of Cardiovascular Medicine Jinhua Municipal Central Hospital Department of Critical Care Medicine Jinhua Municipal Central Hospital

Objective： To evaluate the clinical effect of postconditioning on patients with ST-elevation myocardial infarction （STEMI） treated with primary percutaneous coronary intervention （PCI）. Methods： Randomized controlled trials were identified by searching relevant databases published up to April 2nd, 2014. A meta-analysis of eligible studies was performed by Stata 12.0 and Review Manager 5.2 with a fixed-effect model. Results： Ten studies providing adverse cardiac events in a total of 1346 STEMI patients treated with primary PCI were identified. The occurrence of heart failure was significantly reduced in patients treated with postconditioning compared with usual care （risk ratio （RR） 0.533; 95% confidence intervals （CI） 0.368-0.770）, whereas non-fatal reinfarction slightly increased in the postconditioning group （RR 2.746; 95% CI 1.007-7.488）. No significant difference in total major adverse cardiac events （MACEs） was observed between the two groups （RR 0.876; 95% CI 0.671-1.144）. Conclusions： Postcondi- tioning in STEMI patients undergoing primary PCI significantly reduces the risk of heart failure, but fails to decrease the incidence of total MACEs and the risk of non-fatal reinfarction.

关键词： Myocardial infarction Postconditioning coronary intervention

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Application of Medical Failure Mode and Effect Analysis in Preoperative Preparation for coronary intervention

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Medicinal Plant 2023年第3期14卷 70-73页

作者： Li ZHANG Yan ZHAN Jinlan ZHANG Jinghua TENG Rong CUI Hubei University of Medicine Shiyan 442000China Shiyan Taihe Hospital(Affiliated Hospital of Hubei University of Medicine) Shiyan 442000China

[Objectives]To explore application effect of healthcare failure mode and effect analysis(HFMEA)in preoperative management of coronary intervention.[Methods]The preoperative management process of 455 patients who underwent coronary intervention surgery from January to March in 2022 was sorted out,and the failure modes and causes in the preoperative management were *** priority risk value was calculated,and the top 6 failure modes were found *** measures were formulated according to the causes of failure *** months after the implementation of the procedure,470 patients who underwent coronary intervention surgery from May to July in 2022 were selected as the intervention group,and the optimized preoperative preparation procedure by HFMEA was *** decrease of risk priority number(RPN)and RPN value of two high-risk failure modes,as well as changes in the rate of the time of taking dual-antiplatelet drugs reaching the standard,the rate of passing the dress code,the rate of timely signing of informed consent,and the rate of filling in the handover form of preoperative preparation were analyzed.[Results]The rate of the time of taking dual-antiplatelet drugs reaching the standard,the rate of passing the dress code,the rate of timely signing of informed consent,and the rate of filling in the handover form of preoperative preparation in experimental groups were higher than those of the control group,and the difference was statistically significant(Pcoronary intervention can effectively improve the timeliness and qualification rate of preoperative preparation for coronary intervention,and provide guarantee for the safe and smooth implementation of coronary intervention.

关键词： HFMEA coronary heart disease coronary intervention Preoperative preparation Effect evaluation

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Role of fractional flow reserve in guiding intervention for borderline coronary lesions

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Family Medicine and Community Health 2014年第3期2卷 18-25页

作者： Xuekun Shi Lu Cheng Affiliated Hospital of Traditional Chinese Medicine XinJiang Medical UniversityXinJiang 830000China

Objective:This study investigated the clinical efficacy and value of fractional flow reserve(FFR)in guiding the treatment of borderline coronary ***:Forty-three patients with borderline coronary lesions,as demonstrated by coronary angiography,and who had FFR measurements were *** patients were grouped accord-ing to FFR *** patients were evaluated 6 months after surgery to record major adverse cardiac events(MACE[sudden cardiac death,non-fatal myocardial infarction,or revasculariza-tion])and recurrence of angina ***:After the 6-month follow-up,no sudden cardiac deaths or myocardial infarctions occurred in either group,and there were no statistically significant differences(P>0.05).Inter-group comparisons showed that in the groups with a FFR0.05).The recurrence rate of angina pectoris in the simple drug therapy group among the groups with a FFRcoronary intervention is used to treat borderline lesions,guiding inter-ventional therapy with measurement of FFR does not increase the incidence of adverse cardiovas-cular events in the short term and can better guide PCI therapy.

关键词： coronary intervention Borderline lesion Fractional flow reserve

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ST-Segment Elevation Myocardial Infarction Patients Complicated by Out-of-Hospital Cardiac Arrest May Not Benefit from Emergency Percutaneous intervention

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Chinese Medical Journal 2018年第6期131卷 746-747页

作者： Kun Wang Yu Shen Pei-Wen Li Rong Go Jing-Mei Zhang Lian Wang Jian Bai Biao Xu Department of Cardiology Drum Tower Hospital of Nanjing Medical University Nanjing Jiangsu 210008 China

To the Editor： Out-of-hospital cardiac arrest （OHCA） of cardiac origin is one of the leading causes of death in the industrialized world. The American Heart Association recommended patients who have been successfully resuscitated from OHCA and whose initial electrocardiogram （ECG） showing ST-segment elevation myocardial infarction （STEMI） should undergo emergent cardiac catheterization with the intent to identify and revascularize the culprit lesion by percutmleous intervention （PCI） when clinically applicable. However, few recent retrospective studies and prospective registries observed a beneficial effect of emergency coronary angiography and PCI on the outcome of resuscitated patients with OHCA.

关键词： coronary intervention IMPACT

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Optical coherence tomography guided treatment avoids stenting in an antiphospholipid syndrome patient:A case report

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World Journal of Clinical Cases 2020年第11期8卷 2399-2405页

作者： Bei-Bei Du Xing-Tong Wang Ya-Liang Tong Kun Liu Pei-Pei Li Xiang-Dong Li Ping Yang Ying Wang Department of Cardiology The Third Hospital of Jilin UniversityJilin Provincial Cardiovascular Research InstituteJilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular DiseaseChangchun 130031Jilin ProvinceChina Department of Hematology The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

BACKGROUND Increasing attention has been paid to acute myocardial infarction(AMI)in young female patients for whom secondary factors should be considered during the diagnostic ***-phospholipid syndrome(APS),a rare autoimmune disease that is most common in young female patients,is reportedly related to *** date,coronary interventions,particularly stenting,remains controversial in this special clinical *** SUMMARY A 26-year-old female patient was admitted to hospital for acute chest pain,palpitations,and *** had a past medical history of APS and pulmonary *** angiography showed acute occlusion of the proximal left anterior descending *** repeated thrombus aspirations,residual thrombus and mild stenosis were found in the proximal left anterior descending *** coherence tomography(OCT)was done,which confirmed the non-atherosclerosis coronary thrombosis and an intact intima in this *** or avoiding stenting based on follow-up intracoronary findings with intensified antithrombotic treatment was *** week later,coronary angiography and OCT confirmed an intact intima with no injury and no residual *** 3-mo telephone follow-up reported a good *** APS can cause acute non-atherosclerosis coronary thrombosis which presents as an AMI in young female *** OCT findings can guide interventional strategies in this special clinical scenario.

关键词： Anti-phospholipid syndrome Myocardial infarction Optical coherence tomography coronary intervention coronary thrombosis Case report

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An intriguing association between congestive heart failure and diabetes mellitus

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Chinese Medical Journal 2010年第6期123卷 643-645页

作者： SHEN Wei-feng Department of Cardiology Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China

The prevalence of type 2 diabetes is rising at an alarming rate in China due to aging of the population,increased frequency of obesity, and suboptimal nutritional habits.1 Although many diabetic Patients now survive severe coronary lesions or myocardial infarction as a result of dramatic advances in the management of ischemic heart disease in general and acute myocardial infarction specifically,2,3 they are subsequently succumbing to the consequences of myocardial damage, with an increased incidence of congestive heart failure （CHF）.

关键词： VENTRICULAR SYSTOLIC DYSFUNCTION GLYCATION END-PRODUCTS coronary intervention CLINICAL-OUTCOMES PROGNOSTIC VALUE ELDERLY-PATIENTS RISK HEMOGLOBIN PREVALENCE MANAGEMENT

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Acute ST-elevation Myocardial Infarction after Upper Gastrointestinal Bleeding： A Clinical Dilemma of Antiplatelet Therapy

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Chinese Medical Journal 2018年第3期131卷 370-371页

作者： Wen-Qiang Xue Yong-Xu Cai Jun Liu Bo Zhang Department of Cardiology First Affiliated Hospital Dalian Medical University Dalian Liaoning 116011 China

To the Editor：It is a challenge for a physician to manage acute ST-elevation myocardial infarction （STEMI） in a patient with upper gastrointestinal *** present a case of gastrointestinal bleeding due to antiplatelet therapy after percutaneous coronary intervention （PCI） and secondary in-stent thrombosis due to discontinuation of antiplatelet *** experience of treatment of this case may shed some light on antiplatelet therapy in this clinical dilemma for patients with both high bleeding and high ischemia risk.

关键词： coronary intervention

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