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预测非ST段抬高急性冠状动脉综合征患者1个月和1年发生主要事件风险的多指标方法

世界核心医学期刊文摘（心脏病学分册） 2005年第8期1卷 22-23页

作者： Bod V. Sanchis J. Llàcer .  郝广华 servei de cardiologa Hosp. Clnic I Universitari Avda Blasco Ibáez 17 46010 Valè ncia Spain

Background: The aim of this study was to define the utility of the combined measurement of troponin I, myoglobin, C- reactive protein, fibrinogen, and homocysteine to predict risk in non- ST elevation acute coronary syndromes. Methods: Troponin I, myoglobin, high- sensitivity C- reactive protein, fibrinogen, and homocysteine were measured in 557 consecutive patients admitted to our institution for non- ST elevation acute coronary syndrome. The risk for major events(death or nonfatal myocardial infarction) at first month and at first year follow- up was analyzed. Results: In a multivariate model adjusting for baseline characteristics and electrocardiographic changes, the only biomarkers related to major events at first month were C- reactive protein(P=.007) and myoglobin(P=.02), and at first year troponin I(P=.02), C- reactive protein(P=.03), and homocysteine(P=.04). The rate of major events depending on the number(0- 5) of elevated biomarkers were at first month: 4.1% , 3.7% , 5.7% , 6.1% , 6.5% , and 30.8% (Pde prognostic information. The number of elevated biomarkers is an independent risk predictor of major events.

关键词：事件风险指标方法致命性心肌梗死预后信息炎症标记物高半胱氨酸事件相关心电图改变多变量模型综合测量

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维普期刊数据库

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急性心源性肺水肿与心脏多支血管病变、传导异常以及无症状心肌缺血的关系

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世界核心医学期刊文摘（心脏病学分册） 2006年第1期2卷 56-57页

作者： Pena-Gil C. Figueras J. Soler-Soler J. 张宪伟 Unitat Coronria Servei de Cardiologa Universitat Autonoma de Barcelona P. Vall d’Hebron 119-129 08035 Barcelona Spain

The frequency distribution and severity of the cardiac disease underlying acute cardiogenic pulmonary edema(APE) to define appropriate subsequent diagnostic and management strategies were investigated in 216 consecutive patients. To this effect, the clinical, electrocardiographic, echocardiographic and angiographic characteristics were analyzed. Coronary artery disease was identified in 185 patients(86%)-146 with acute myocardial infarction-as the underlying cause, isolated valvular disease in 10(5%) and other causes in 21(11%). Most patients were elderly(≥70 years, 72%), hypertensive(71%)and diabetic(44%). Among coronary disease(CAD) patients, however, 105(57%) showed conduction disturbances in theECG(QRS >0.10 s) and 84(45%) had no anginal pain during pulmonary edema. A 2D echocardiogram showed a 30%incidence of moderate-severe mitral regurgitation in coronary disease and non-coronary disease patients, and a 67%incidence of reduced ejection fraction(dence of significant left main disease. Therefore, these findings demonstrate that coronary disease is the most common cause of acute pulmonary edema and it is associated with a distinctly high prevalence of multivessel and left main disease. This diagnosis, however, may often be overlooked if no serial enzymatic sampling is performed given the increased frequency of conduction abnormalities and lack of anginal pain.

关键词：急性心源性肺水肿无症状心肌缺血多支血管病变心脏病传导异常老年患者冠心病患者急性心肌梗死超声心动图心绞痛症状

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