简介：BackgroundPatientswithunstableanginapectorisanddiabetesmellitusareverycommon.Whentheyreceiveinterventionaltherapy,contrastagentscancauserenalinjuryandplateletactivation.Alprostadilhasbeenshowntodecreaseinflammationandmicrovascularresistance.Thereisnoanyreportontheprotectioneffectsofalprostadilonrenalinjuryandtheplateletactivationduringcardiacinterventionaltherapy.MethodsAtotalof57patientsweredividedintotwogroups,alprostadilgroup(n=35)andnormalgroupn=22).BUN(bloodureanitrogen)andSCr(serumcreatine)weremeasuredastherenalfunctionparameters.GFR(glomerularfiltrationrate)wascalculatedbytheMDRDformula.Plateletparameters:PLT(plateletcount,109),PDW(plateletdistributionwidth,fL),MPV(meanplateletvolume,fL),PLCR(largeplateletscaleratio,%)weremeasuredastheplateletactivationindex.TtestandChi-squaretestwereusedasstatisticalmethods,andP<0.05wasconsideredstatisticallysignificant.ResultsInthealprostadilgroup,SCrwas71.1±13.8μmol/Land65.9±12.6μmol/L,beforeandafterinterventionaltherapy(P<0.05).BUNwas5.68±1.79mmol/Land3.86±1.19mmol/L(P<0.001),beforeandafterinterventionaltherapy.Intheplatelettests,MPVwasseemedtobetheonlyusefulplateletparameter,beforeandafterinterventionaltherapy(11.8±1.8fLand11.1±1.2fL,P<0.05),whilethePLT(109/L),PDW(fl),PLCR(%)didn'tshowanysignificantdifference.Inthenormalgroup,allthesetests'resultsdidn'tsignificantlychangeafterinterventionaltherapy.ConclusionsThepatientswiththeunstableanginapectorisanddiabetesmellitushaveontheriskofrenalfunctiondamageandplateletactivationwhenundertakingcardiacinterventionaltherapy.Alprostadilprotectsrenalfunctionandalleviatesplateletactivation.

简介：BackgroundDuringprimarypercutaneouscoronaryintervention(PCI),manualthrombectomymayreducedistalembolizationandthusimprovemicrovascularperfusion.Smalltrialshavesuggestedthatthrombectomyimprovessurrogateandclinicaloutcomes,butalargertrialhasreportedconflictingresults.MethodsWerandomlyassigned10,732patientswithST-segmentelevationmyocardialinfarction(STEMI)undergoingprimaryPCItoastrategyofroutineupfrontmanualthrombectomyversusPCIalone.Theprimaryoutcomewasacompositeofdeathfromcardiovascularcauses,recurrentmyocardialinfarction,cardiogenicshock,orNewYorkHeartAssociation(NYHA)classIVheartfailurewithin180days.Thekeysafetyoutcomewasstrokewithin30days.ResultsTheprimaryoutcomeoccurredin347of5033patients(6.9%)inthethrombectomygroupversus351of5030patients(7.0%)inthePCI-alonegroup(hazardratiointhethrombectomygroup,0.99;95%confidenceinterval[CI],0.85to1.15;P=0.86).Theratesofcardiovasculardeath(3.1%withthrombectomyvs.3.5%withPCIalone;hazardratio,0.90;95%CI,0.73to1.12;P=0.34)andtheprimaryoutcomeplusstentthrombosisortarget-vesselrevascularization(9.9%vs.9.8%;hazardratio,1.00;95%CI,0.89to1.14;P=0.95)werealsosimilar.Strokewithin30daysoccurredin33patients(0.7%)inthethrombectomygroupversus16patients(0.3%)inthePCI-alonegroup(hazardratio,2.06;95%CI,1.13to3.75;P=0.02).ConclusionsInpatientswithSTEMIwhowereundergoingprimaryPCI,routinemanualthrombectomy,ascomparedwithPCIalone,didnotreducetheriskofcardiovasculardeath,recurrentmyocardialinfarction,cardiogenicshock,orNYHAclassIVheartfailurewithin180daysbutwasassociatedwithanincreasedrateofstrokewithin30days.

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简介：ObjectivesToassesswhetherstatinsreduceall-causemortalityandCVeventsinelderlypeoplewithoutestablishedCVdisease.BackgroundSinceageingofthepopulationissteadilyraising,preventionofcardiovascular(CV)diseaseintheelderlyisrelevant.InelderlypatientswithpreviousCVevents,useofstatinsisrecommendedbyguidelines,whereasbenefitsofthesedrugsinelderlysubjectswithoutpreviousCVeventsarestilldebated.MethodsRandomizedtrialscomparingstatinsversusplaceboandreportingall-causeandCVmortality,myocardialinfarction(MI),stroke,andnewcanceronsetinelderly(>65yearsold)subjectswithoutestablishedCVdiseasewereincluded.ResultsEighttrialsenrolling24,674subjects(42.7%females;meanage73.0+2.9;meanfollow-up3.5+1.5years)wereincludedinanalyses.Statins,comparedtoplacebo,significantlyreducedtheriskofMIby39.4%(relativerisk[RR]:0.606[95%confidenceinterval(CI):0.434to0.847];P=0.003),aswellastheriskofstrokeby23.8%(RR:0.762[CI:0.626to0.926];P=0.006).Incontrast,theriskofall-causedeath(RR:0.941[CI:0.856to1.035];P=0.210)andofCVdeath(RR:0.907[CI:0.686to1.199];P=0.493)werenotsignificantlyreduced.Newcanceronsetdidnotdifferbetweenstatin-comparedtoplacebotreatedsubjects(RR:0.989[CI:0.851to1.151];P=0.890).ConclusionsPInelderlysubjectsathighCVriskwithoutestablishedCVdisease,statinssignificantlyreducetheincidenceofMIandstroke,butdonotsignificantlyprolongsurvivalintheshort-term.

简介：ObjectivesToevalu-atetheoutcomeofdiagnosisandsurgicaltreatmentforcortriatrium(CTA)in6patientsseenbetween1994and2002.Methods6patientsranginginagefrom5monthsto25yearswereobserved.Allofthemhadothercardiovasculardefects,andpresentedwithdyspnea,palpitations(andlowweightgrowingonlyintheinfants).Preopreativetwodimensionalechocardiogra-phyhaddemonstratedanabnormalseptumintheleftatriumandothercoexistentanomalies.In3ofthemthemembranewasobstructedbetweentheleftatrialaccessorychamberandtheleftatrium.Thecommunicationwereatrialseptaldefect(ASD)indirectly;Theclinicalfindingswereduetothepulmonaryhypervas-cularity.Onlyonecasehadafenestrationintheseptumwithasmallpatentforamenovale(FO)directly,andtheclinicalfindingswereduetotheobstructiontoflowthroughthemembraneintheleftatrium,producingvenocapilarpulmonaryhypertension.TwoofthemhadASDandfenestrationontheseptum.Theot

简介：Despitethehugedevelopmentofradiofrequencycatheterablation,surgicaloperation,pacemakerimplantation,anddrugtherapyremainsthefirstlinetreatmentofatrialfibrillation.Severalnewanti-arrhythmicdrugsandanticoagulationdrugshavecomeoutrecently,andhavemadethedrugtherapyofatrialfibrillationamorepromisingchoice.Thisarticleprovidesacontemporaryhighlightonthenewanti-arrhythmicagentsofatrialfibrillation.

简介：StandardTherapyforHeartFailureUntilnowtheprincipalfocusofheartfailuretherapyhasbeenonthesympatheticnervoussystemandtherenin-angiotensinsystem.Betablockadecounterstheunwantedeffectsofcatecholaminesonthemyocardiumaswellasmoderatelyreducingafterload.Sinceangiotensinisavasoconstrictorandhassometoxiceffectonthemyocardium,bothcontributingtoheartfailure,inhibitionoftherenin–angiotensinsystemhasbeenlogicaltherapyforheartfailure.However,useofangiotensinconvertingenzyme(ACE)inhibitorsmayincreasebradykininlevels,whichareresponsibleforthecoughthatmaybeassociatedwiththeiruseaswellasangioedemathatmayresultfromthesamemedications.

简介：PatientswithAcuteCoronarySyndrome(ACS)areaclinicalcontinuum-withpatientspresentingwithunstableanginaononeend,withpatientswithSTelevationmyocardialinfarction(STEMI)attheotherendofthespectrum.Inbetweenarethosewithnon-ST

简介：Leftbundlebranchblock(LBBB),traditionallyviewedasanelectrophysiologicabnormality,isincreasinglyrecognizedforitseffectsonhemodynamicsandpatient’sprognosis[1].Exercisenuclearstudiesfrequentlyshowreversibleperfusiondefectsintheabsenceofobstructivecoronaryarterydisease[2]andsomepatientswithintermittentLBBBdevelopanginacoincidentwiththeonsetofLBBB[3].WereportacaseofintermittentLBBBwithabnormalstresstechnetium99mTcsingle-photonemissioncomputedtomography(SPECT)studyandnormalcoronaryarteryangiography.

简介：ObjectivesToassesstheefficiencyandsafetyofdual-wireballoonangioplastysidebranchcombinedstentingthemainbranchinthetreatmentofcoronarybifurcationlesions.MethodsThisstudyincludedthirty-sixpatientswith41coronarybifurcationlesions.Selectivedual-wireballoonangioplastywasperformedinsidebranchand/orinmainbranch,andimplantationofstentswasperformedinmainbranchonly.Clinicaloutcomeandmajoradversecardiaceventswereobservedin-hospitalandfollow-up.ResultsSuccessrateofsidebranchdilatationbeforemainbranchstentingwas100%;mainbranchdirectstentingperformedin4cases;successmainbranchdilatationperformedintheother37cases;kissingtechniquewasperformedsuccessfullyin5cases,whichsidebranchwasjailedaftermainbranchstentingwithTIMIgrade0-2flow.NoQ-wavemyocardialinfarction,acuterevascularizationanddeathoccurredduringin-hospital.Clinicalfollow-upwasavailableinallpatients.NoQ-wavemyocardialinfarction,revascularizationanddeathoccurred,anginapectorisrecurredinthreepatients,releasedbystrengthendrugtreatment.ConclusionsDual-wireballoonangioplastysidebranchcombinedstentingthemainbranchissimple,safeandeffectiveforthetreatmentofcoronarybifurcationlesions.

简介：BackgroundTheconventionalextra-anatomicbypassisoriginatedfromtheaxillary'sarteryandthegraftsizeisoftenlimitedduetothesmalldiameterofaxillary'sartery.Extra-anatomicbypassgraftoriginatingfromascendingaortacanimprovethegraftsizeanddistalperfusion,butneedsternotomywhichmighthavehigheroperativeriskscomparedwithaxillo-femeralbypass.Wesummarizeourexperiencesofextra-anatomicbypassfromascendingaortaforatypicalaorticcoarctation.MethodsBetweenJanuary2005andFebruary2008,5womenagedfrom18to64yearsunderwentextra-anatomicbypassfromascendingaortatoabdominalaortaoriliacarterybypassfortreatmentofatypicalaorticcoarctation.Preoperatively,allpatientshadhypertensionandneededanti-hypertensivemedications.Systolicbloodpressurewas151±9mmHg.Anklepressureindex(API)were0.60±0.23inleftand0.56±0.23inright.Averagesystolicpressuregradientofaorticstenosiswas76±18mmHg.Threepatientsunderwentconcomitantcardiacoperation,includingcoronaryarterybypassgrafting,Bentallprocedureandatrialseptaldefectrepair.ResultsTherewasnohospitalandlatemortalityduring58±15monthsfollow-up(rangefrom44to81months).Postoperativesystolicbloodpressurewasreducedto126±11mmHgatthetimeofdischarge.Allpatientsmaintainednormalbloodpressurewithoutmedicationduringfollow-up.APIwasimprovedto1.12±0.24inleftand1.17±0.25inright(comparedwithpreoperativedata,P<0.05).Follow-upcomputertomographyshowedpatencyinallgrafts.ConclusionsSurgicaltreatmentofatypicalaorticcoarctationwithextra-anatomicbypassoriginatingfromascendingaortaalleviateshypertensionandlowlimbischemia.

简介：BackgroundDeepsternawoundinfection(DSWI)aftermediansternotomyforcardiacsurgeryisoneofthemostcomplexandpotentiallylife-threateningcomplications.ItsverydifficulttotreatDSWI,andthereislackofagreementregardingthebesttherapystrategy.Thus,weaimedtosummarizeourexperiencesofsurgicaltreatmentforDSWI,inwhichsatisfactoryclinicalresultswereobtained.MethodsWeretrospectivelyanalyzed17caseswhosufferedfromDSWIaftercardiacsurgeryinourdepartmentfromJanuary2010toJune2015.Therewere8maleand9femalepatientswiththeiraverageageof62.7±9.5years(range42~75years).Allpatientsreceivedreservationofpartofsternumcombinedwithvacuum-assistedsuctiondrainageandbilateralpectoralismajormyocutaneousadvancementflaps.ResultsTheaverageintervalbetweencardiacsurgeryanddiagnosedDSWIwas10.9±6.5days(range5~21days).Timeofvacuum-assistedsuctiondrainagewas11.6±4.8days(range5~15days)andwoundhealingtimewas27.3±7.2days(range23~35days).Allpatientshadanuneventfulpostoperativerecoveryandgoodwoundhealing.Follow-uptimewas33.7±13.3months(range8~74months).Norecurrentinfectionwasobserved.ConclusionsReservationofpartofsternumcombinedwithvacuum-assistedsuctiondrainageandbilateralpectoralismajormyocutaneousadvancementflapsisasimpleandeffectivesurgicalstrategyforthetreatmentofDSWIaftercardiacsurgery.

简介：ObjectivesWedidaretrospectivestudytosummarizethesurgicalexperienceofanomalouspulmonaryvenousdrainage(APVD)correctionanddiscusseffectivewayofimprovingthesurgicaloutcome.MethodsFromJanuary1985toMay2008,127patients[56menand71women,aged14-55yearswithanaverageof(26.79±10.62)years]withAPVDunderwentsurgicaltreatments.Amongthem,13patientshadsimplepartialAPVDwithintactatrialseptum,104patientshadpartialAPVDwithatrialseptaldefectand10patientshadtotalAPVD.Seventy-onepatientsofthemaccompaniedwithothercardiacanomalieswhichwerealsocorrectedintheiroperations.ResultsOneearlyoperativedeathduetoseverelowcardiacoutputsyndrome(LCOS)developedpostoperatively,whichresultedinamortalityrateof0.78%.Amongotherpatients,10patientscomplicatedwithLCOS,11patientswitharrhythmia,7patientswithacuterenalfailureand4patientswithpoorwoundhealing,alldischargedfromhospitalaftertreatment.Postoperativeechocardiographyreexaminationrevealed1caseofmildresidualshuntinatrialseptumbutwithoutpulmonaryveinstenosis.ConclusionForrightatrialandventricleenlargedpatientswithorwithoutpulmonaryhypertension,surgeonsshouldbevigilanceofaccompaniedAPVDwhetheratrialseptaldefectsexistornot.Aslongasnocontraindicationsarefound,surgicaltreatmentshouldbeperformedonceaccuratediagnosisisobtained.

简介：Therecognitionthatpsychosocialriskfactorscontributetothepathogenesisofcardiovasculardiseasehasledtothedevelopmentofanewfieldofbehavioralcardiology.Theinitialimpetusforthisfieldwasstudiesperformedinthe1980sand1990sthatprovidedepidemiologicalevidenceandapathophysiologicalbasisforastronglinkbetweenanumberofpsychosocialriskfactorsandcardiovasculardisease,includingdepression,anxiety,hostility,jobstress,andpoorsocialsupport.Inrecentyears,additionalpsychosocialriskfactorshavebeenidentified,includingpessimism;otherformsofchronicstress,suchaschildhoodabuseandtrauma,andthepsychologicalstressthatmaybeassociatedwithchronicmedicalillness;lackoflifepurpose;andthesyndromeof“vitalexhaustion,”whichconsistsofatriadofexhaustion,demoralization,andirritability.Newresearchinthelastdecadehasalsoestablishedthatpositivepsychosocialfactors,suchasoptimism,positiveemotions,avibrantsociallife,andastrongsenseoflifepurpose,canhaveanimportanthealth-bufferingeffectthroughtheirfavorableinfluenceonhealthbehaviorsandpromotionofpositivephysiologicalfunctioning.Patientscanbescreenedforpsychosocialriskfactorsinclinicalpracticethrougheithertheuseofopen-endedquestions,whichcanbeintegratedintoaphysician’sstandardreviewofsystems,ortheuseofshortquestionnaires.Physicianscanassistinthetreatmentofpsychosocialriskfactorsinvariousways,suchasscreeningpatientsforpsychologicaldistressandmakingappropriatereferralswhenindicated,providingpatientswithpracticallifestylesuggestions,andemployingofficepersonneltoteachpatientsbehavioralorpsychosocialinterventionsthatcanpromoteasenseofwell-beingand/orreducestress.

简介：Acutecoronarysyndrome(ACS)isthemaincauseofdeathworldwideandtheleadingcauseofdiseaseburdeninhigh-incomecountries.ACSreferstoaconstellationofclinicalsymptomsthatarecompatiblewithacutemyocardialischemia.Itdescribesaspectrumofclinicalmanifestationsthatresultfromacommonpathophysiologicalprocess.ThemostcommoncauseofACSareruptureofanatheroscleroticlesioncontainingalargenecroticcoreandathinfibrouscapfollowedbyacuteluminalthrombosis.Itwasthoughtthatahigh-resolutionimagingmodalitywouldbeidealtodetecthigh-riskplaquesbeforetheirdisruptionandtheformationofanocclusivethrombus.Opticalcoherencetomographyhasproventobeaninvaluabletoolinearlydetectionofhigh-riskplaquesandparticularlyintheunderstandingofACS.ThisreviewfocusesonthecurrentevidencefortheroleofopticalcoherencetomographyinthediagnosisandtreatmentofpatientswithACS.

简介：ObjectivesTocomparethedifferenteffectsoflatesuccessfulreperfusionwithPCIonleftventricularfunctionanditsrelationshipwithviablemyocardiumafteracuteanteriorwallmyocardialinfarctioninpatientswithorwithoutdiabetes.MethodsAtotalof125consecutivesubjectswithacuteanteriorwallmyocardialinfarctionwereselected,anddividedintodiabetesmellitus(DM)group(n=43)andNon-DMgroup(n=82)accordingtoWHOdiabetesdiagnosiscriteria.AllpatientsreceivedsuccessfulPCIat12±8daysfromonset.Ischemicviablemyocardiumwasdetectedwithlow-dosedobutamineechocardiography,andleftventricularfunctionandwallmotionabnormalitywerealsoassessedwithechocardiographybeforePCI.ThedataofclinicalmanifestationsandangiogramsbeforeandafterPCIwereanalyzed.Levelsofcreatininekinase-MB(CK-MB),andtroponinT(TnT)beforePCI,6hoursand24hoursafterPCIwereassessed.Allpatientsreceivedclinicandechocardiographyfollow-upfor6months.ResultsHigherrateofTIMI2flow,andlowerrateofTIMI3flowinDMgroupweredemonstratedimmediatelyafterPCI,andtherateofserumCK-MBand/orTnTlevelswerehigherinDMgroup,comparedwithNon-DMgroup(P<0.05).63%ofDMpatientsand56%ofnon-DMpatientshadviablemyocardiumbeforePCI(P>0.05).Therewerenosignificantdifferencesofleftventricularejectionfraction(LVEF),leftventricularenddiastolicvolumeindex(LVEDVI),leftventricularendsystolicvolumeindex(LVESVI),andwallmotionscore(WMS)betweentwogroupsatbaselinebeforePCI(P>0.05).Aftersixmonths,WMSwasdecreasedandLVEFwasincreasedinNon-DMgroup,buttheWMSandtheLVEFdidnotchanged,andtheLVEDVIwasincreasedinDMgroupcomparedwithbaseline;theLVEDVI,LVESVI,LVEF,andWMSweresignificantlydifferentbetweentwogroups(P<0.05orP<0.01).ConclusionsComparedwithnon-diabetics,delayedsuccessfulrevascularizationwithPCIindiabeticspatientwithacutemyocardialinfarctionhaslessbenefitialeffectontheimprovementoflatephasel

简介：ObjectiveTocomparetheacutehemodynamiceffectsoffivedifferentpacingmodesinpatientswithcardiacfunctionNYHAclassⅠtoⅡwithoutbundlebranchblock(BBB).MethodsThisstudyincluded12patients(SSS7,Ⅲ°AVB5)undergoingpacemakerimplantation.Rightventricularapex(RVA),rightventricularoutflowtract(RVOT),rightventricularbifocal(RV-Bi),leftventricularbase(LVB)andbi-ventricular(Bi-V)pacingat60-80ppmweredoneinVVImodepriortoimplantationofDDDpacemaker.Thecardiacindex(CI),meanpulmonaryarterypressure(mPAP)andpulmonarycapillarywedgepressure(PCWP)weremeasuredwithSwan-Ganzthermodilutioncatheterafter5minutesofeachpacingmode.Results(1)ComparingtopacingatRVA(CI:2.41±0.38L/minperm2,PCWP:16.7±3.3mmHg),theCIincreasedandthePCWPdecreasedsignificantlyinpacingatRVOT(CI:2.63±0.46,PCWP:13.8±2.3),LVB(CI:2.78±0.52,PCWP:14.4±3.1),RV-Bi(CI:2.83±0.57,PCWP:12.8±2.5)andBi-Vpacing(CI:2.

简介：BackgroundHospital-acquiredpneumonia(HAP)isthemostcommonandmostseriousnosocomialinfectionforcardiacsurgerypatients,withhighincidenceandfatalityrate1.ItisimportantforcardiacsurgeonstocorrectlyidentifyHAP,assesstheseverity,andthenadjustanti-infectionmethod,whichcanreducethemortalityrate,shortenhospitalizationtime,andreducethewasteofmedicalresources.ThepurposeofthisresearchistoevaluatetheapplicationvalueoflungCTindiagnosisandtreatmentofHAPaftercardiacsurgery.MethodsAretrospectiveanalysiswasconductedforclinicaldataabout76cardiacsurgerypatientswhowerediagnosedwithHAPduringJanuarytoDecember2013.Theclinicaldatamainlyincludedsymptoms,physicalsigns,laboratoryexaminations(suchasroutinebloodtestsandserumprocalcitonin),andlungCTandX-raydata.OurfocusisonthecomparisonbetweenlungCTandX-raydata.ResultsThepositivediagnosticrate,falsenegativerate,andfalsepositiverateoflungCTwere71/76(93.4%),5/76(6.6%),and1/76(1.3%)respectively.ThecoincidencerateofX-rayandCTwas45/76(59.2%),andthefalsenegativerateofX-raywas23/76(30.3%).ConclusionLungCTisbetterthanX-rayindiagnosisofHAPaftercardiacsurgeryandassessmentofseverity,andhasgreatersignificanceforguidingtherationaluseofantibiotics.Therefore,lungCTisworthyofapplicationandpopularization.

简介：BackgroundIntheHORIZONS-AMI(HarmonizingOutcomeswithRevasculariZatiONandStentsinAcuteMyocardialInfarction)trial,3,602patientsundergoingprimarypercutaneouscoronaryintervention(PCI)forST-segmentelevationmyocardialinfarction(STEMI)treatedwithbivalirudinhadlowerbleedingandmortalityrates,buthigheracutestentthrombosisratescomparedwithheparin+aglycoproteinⅡb/Ⅲainhibitor(GPI).SubsequentchangesinprimaryPCI,includingtheuseofpotentP2Y12inhibitors,frequentradialintervention,andpre-hospitalmedicationadministration,wereincorporatedintotheEUROMAX(EuropeanAmbulanceAcuteCoronarySyndromeAngiography)trial,whichassigned2,218patientstobivalirudinversusheparin±GPIbeforeprimaryPCI.ObjectivesThegoalofthisstudywastoexaminetheoutcomesofproceduralanticoagulationwithbivalirudinversusheparin±GPIforprimaryPCI,giventheevolutioninprimaryPCI.MethodsDatabasesfromHORIZONS-AMIandEUROMAXwerepooledforpatient-levelanalysis.TheBreslow-Daytestevaluatedheterogeneitybetweentrials.ResultsAtotalof5,800patientswererandomizedtobivalirudin(n=2,889)orheparin±GPI(n=2,911).Theradialapproachwasusedin21.3%ofpatients,prasugrel/ticagrelorwasusedin18.1%ofpatients,andGPIwasusedin84.8%ofthecontrolgroup.Bivalirudincomparedwithheparin±GPIresultedinreduced30-dayratesofmajorbleeding(4.2%vs.7.8%;relativerisk[RR]:0.53;95%confidenceinterval[CI]:0.43to0.66;P<0.0001),thrombocytopenia(1.4%vs.2.9%,RR:0.48;95%CI:0.33to0.71;P=0.0002),andcardiacmortality(2.0%vs.2.9%;RR:0.70;95%CI:0.50to0.97;P=0.03),withnonsignificantlydifferentratesofreinfarction,ischemia-drivenrevascularization,stroke,andall-causemortality.Bivalirudinresultedinincreasedacute(<24h)stentthrombosisrates(1.2%vs.0.2%;RR:6.04;95%CI:2.55to14.31;P<0.0001),withnonsignificantlydifferentratesofsubacutestentthrombosis.Compositenetadversec

简介：ObjectivesToevaluatetheeffectivenessoffirebirdstentforthetreatmentofcoronarydenovolesioncomparedwithcypherstent.MethodsNinety-oneconsecutivepatientswith156lesionswhounderwentcoronarycypher(n=68lesions)andfirebird(n=88lesions)implantation,quantitativecoronaryangiography(QCA)wasperformedatthetimeofstentimplantationandsubsequentlyat8monthspost-stenting.Smallvesseldiseasewasdefinedas≤2.5mmofreferencevesseldiametermeasuredbyQCA.Majoradversecardiacevents(MACE)includingdeath,thrombosis,nonfatalmyocardialinfarctionandtargetlesionrevascularization(TLR)werecomparedbetweenthetwogroups.ResultsBaselineclinicalcharacteristicsandangiographicparametersweresimilarbetweenthetwogroups.Seven-monthangiographicfollow-up,thelatelosswasnotdifferentbetweenthetwogroups(0.14±0.38mmvs0.13±0.17mm,P>0.05).Similarly,overallthrombosisrateweresimilarinbothgroups(1.5%vs1.1%,P>0.05).However,in-stentrestenosisaswellasin-segmentrestenosisrateweresignificantlyhigherincyphergroupthanthatinfirebirdgroup(4.4%vs0%and19.1%vs3.4%,P=0.047andP=0.001respectively).TLRwasalsohigherinthecyphergroup(10.3%vs2.3%,P=0.033)comparedwithfirebirdgroup.ConclusionsInthissmallsamplesize,non-randomizedstudy,thedataindicatedthatimplantationoffirebirdstentforthetreatmentofsmallcoronarylesionshowedmorefavorableresultsinrespectiveofrestenosiscomparedwithcypherstentimplantation.Amulti-center,large-samplesize,randomizedstudy,therefore,maybewarranted.