BACKGROUND Safety and efficacy of intravascular ultrasound(IVUS)guidance in percutaneous coronary intervention(PCI)has been consistently shown in recent trials.However,prospective data on the clinical effects of IVUS ...BACKGROUND Safety and efficacy of intravascular ultrasound(IVUS)guidance in percutaneous coronary intervention(PCI)has been consistently shown in recent trials.However,prospective data on the clinical effects of IVUS usage in primary PCI are still warranted.The ULTRA-STEMI trial is a prospective investigator-initiated observational single-center cohort trial aiming to enroll 80 patients with STEMI.AIM To investigate the outcomes of patients with STEMI undergoing IVUS-guided PCI and correlate derived IVUS measurements with clinical,procedural,imaging and follow-up outcomes of interest.METHODS Study participants will undergo primary PCI as per standardized procedures.IVUS pullbacks will be performed pre-intervention,post-lesion preparation,postintervention and post-optimization using a 20 MHz digital IVUS(Eagle Eye Platinum,Philips).Manual thrombus aspiration will be performed in cases of high thrombus burden.The aspirated thrombi will be scanned with micro-computed tomography to extract volumetric measurements of the aspirated thrombotic burden.Moreover,angiographic,peri-procedural and 3-year follow-up data will be gathered.Co-primary endpoints will be cardiovascular mortality and target vessel failure,defined as the composite of:Cardiovascular mortality,target vessel myocardial infarction and/or clinically driven target vessel revascularization.RESULTS The results of the study are expected by the third quarter of 2029.CONCLUSION The ULTRA-STEMI trial will add to the existing literature the clinical,angiographic,micro-computed tomography and follow-up outcomes of IVUS-guided PCI in 80 patients presenting with STEMI.展开更多
In the realm of medical rarity,the convergence of infective endocarditis with the development of an aortic root abscess stands as a formidable challenge,often bearing a grim prognosis.Recognizing this perilous conditi...In the realm of medical rarity,the convergence of infective endocarditis with the development of an aortic root abscess stands as a formidable challenge,often bearing a grim prognosis.Recognizing this perilous condition requires a vigilant eye.Embolic events stemming from infective endocarditis can precipitate acute coronary syndrome,adding another layer of complexity to diagnosis and treatment.展开更多
目的观察尼可地尔联合缺血后适应(MIP)对急性ST段抬高心肌梗死(STEMI)患者急诊直接经皮冠脉介入术(PPCI)心肌血流灌注及预后的影响。方法选取急诊行PPCI的STEMI患者200例,随机均分为对照组(PPCI)、尼可地尔组(PPCI+尼可地尔)、MIP组(PPC...目的观察尼可地尔联合缺血后适应(MIP)对急性ST段抬高心肌梗死(STEMI)患者急诊直接经皮冠脉介入术(PPCI)心肌血流灌注及预后的影响。方法选取急诊行PPCI的STEMI患者200例,随机均分为对照组(PPCI)、尼可地尔组(PPCI+尼可地尔)、MIP组(PPCI+MIP)、联合组(PPCI+尼可地尔+MIP)。比较4组患者心肌血流灌注恢复、心肌损伤、心功能和预后的差异。结果与对照组比较,尼可地尔组、MIP组及联合组术后即刻TIMI血流帧数、术后24 h肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)、术后72 h cTnI降低,尼可地尔组及联合组术后无复流发生率降低,联合组术后12个月N末端B型脑钠肽前体、术后7天心律失常严重程度评分、12个月内心衰和心绞痛再住院率降低,尼可地尔组及联合组术后2 h ST段回落率升高(P<0.05)。联合组术后24 h CK-MB显著低于尼可地尔组(P<0.05)。结论尼可地尔联合MIP在心肌血流灌注恢复、降低心肌损伤及改善患者预后方面的效果值得肯定。展开更多
目的探明急性STEMI患者血液中血清分泌型卷曲相关蛋白2(secreted frizzled-related protein 2,sFRP2)表达水平,及其与左心室重构及心功能的相关性,探究sFRP2对STEMI后左室重构的预测价值。方法招募急性STEMI患者137例为STEMI组,健康者10...目的探明急性STEMI患者血液中血清分泌型卷曲相关蛋白2(secreted frizzled-related protein 2,sFRP2)表达水平,及其与左心室重构及心功能的相关性,探究sFRP2对STEMI后左室重构的预测价值。方法招募急性STEMI患者137例为STEMI组,健康者103例为健康组。收集两组一般资料及生化指标,测定sFRP2浓度,心脏超声测定STEMI组入院7天及6个月时心功能。依据左室LVEDV增加率是否≥20%将STEMI组分为左室重构组和非左室重构组。对比STEMI组与健康组及两个亚组间的一般资料及血清sFPR2浓度;比较两个亚组入院7天及6个月时心功能。分析sFRP2与STEMI心功能的相关性;Logistic回归分析sFRP2与STEMI后左室重构的相关性,ROC曲线分析sFRP2对STEMI左室重构的预测价值。结果左室重构组sFRP2浓度>非左室重构组>健康组(P<0.05)。sFRP2与STEMI 6个月后LVEDV、LVPWT、IVST、ΔLVEDV以及ΔLVEF存在正相关,与LVEF存在负相关(P<0.05)。结论STEMI患者血清sFRP2浓度升高,且sFRP2水平与STEMI后左室重构呈正相关,与SETMI后心功能呈负相关,随着sFRP2浓度升高左室重构发生风险增加。sFRP2可预测STEMI后心室重构发生风险,联合梗死部位和NT-pro-BNP效果更佳。展开更多
文摘BACKGROUND Safety and efficacy of intravascular ultrasound(IVUS)guidance in percutaneous coronary intervention(PCI)has been consistently shown in recent trials.However,prospective data on the clinical effects of IVUS usage in primary PCI are still warranted.The ULTRA-STEMI trial is a prospective investigator-initiated observational single-center cohort trial aiming to enroll 80 patients with STEMI.AIM To investigate the outcomes of patients with STEMI undergoing IVUS-guided PCI and correlate derived IVUS measurements with clinical,procedural,imaging and follow-up outcomes of interest.METHODS Study participants will undergo primary PCI as per standardized procedures.IVUS pullbacks will be performed pre-intervention,post-lesion preparation,postintervention and post-optimization using a 20 MHz digital IVUS(Eagle Eye Platinum,Philips).Manual thrombus aspiration will be performed in cases of high thrombus burden.The aspirated thrombi will be scanned with micro-computed tomography to extract volumetric measurements of the aspirated thrombotic burden.Moreover,angiographic,peri-procedural and 3-year follow-up data will be gathered.Co-primary endpoints will be cardiovascular mortality and target vessel failure,defined as the composite of:Cardiovascular mortality,target vessel myocardial infarction and/or clinically driven target vessel revascularization.RESULTS The results of the study are expected by the third quarter of 2029.CONCLUSION The ULTRA-STEMI trial will add to the existing literature the clinical,angiographic,micro-computed tomography and follow-up outcomes of IVUS-guided PCI in 80 patients presenting with STEMI.
文摘In the realm of medical rarity,the convergence of infective endocarditis with the development of an aortic root abscess stands as a formidable challenge,often bearing a grim prognosis.Recognizing this perilous condition requires a vigilant eye.Embolic events stemming from infective endocarditis can precipitate acute coronary syndrome,adding another layer of complexity to diagnosis and treatment.
文摘目的观察尼可地尔联合缺血后适应(MIP)对急性ST段抬高心肌梗死(STEMI)患者急诊直接经皮冠脉介入术(PPCI)心肌血流灌注及预后的影响。方法选取急诊行PPCI的STEMI患者200例,随机均分为对照组(PPCI)、尼可地尔组(PPCI+尼可地尔)、MIP组(PPCI+MIP)、联合组(PPCI+尼可地尔+MIP)。比较4组患者心肌血流灌注恢复、心肌损伤、心功能和预后的差异。结果与对照组比较,尼可地尔组、MIP组及联合组术后即刻TIMI血流帧数、术后24 h肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)、术后72 h cTnI降低,尼可地尔组及联合组术后无复流发生率降低,联合组术后12个月N末端B型脑钠肽前体、术后7天心律失常严重程度评分、12个月内心衰和心绞痛再住院率降低,尼可地尔组及联合组术后2 h ST段回落率升高(P<0.05)。联合组术后24 h CK-MB显著低于尼可地尔组(P<0.05)。结论尼可地尔联合MIP在心肌血流灌注恢复、降低心肌损伤及改善患者预后方面的效果值得肯定。
文摘目的探明急性STEMI患者血液中血清分泌型卷曲相关蛋白2(secreted frizzled-related protein 2,sFRP2)表达水平,及其与左心室重构及心功能的相关性,探究sFRP2对STEMI后左室重构的预测价值。方法招募急性STEMI患者137例为STEMI组,健康者103例为健康组。收集两组一般资料及生化指标,测定sFRP2浓度,心脏超声测定STEMI组入院7天及6个月时心功能。依据左室LVEDV增加率是否≥20%将STEMI组分为左室重构组和非左室重构组。对比STEMI组与健康组及两个亚组间的一般资料及血清sFPR2浓度;比较两个亚组入院7天及6个月时心功能。分析sFRP2与STEMI心功能的相关性;Logistic回归分析sFRP2与STEMI后左室重构的相关性,ROC曲线分析sFRP2对STEMI左室重构的预测价值。结果左室重构组sFRP2浓度>非左室重构组>健康组(P<0.05)。sFRP2与STEMI 6个月后LVEDV、LVPWT、IVST、ΔLVEDV以及ΔLVEF存在正相关,与LVEF存在负相关(P<0.05)。结论STEMI患者血清sFRP2浓度升高,且sFRP2水平与STEMI后左室重构呈正相关,与SETMI后心功能呈负相关,随着sFRP2浓度升高左室重构发生风险增加。sFRP2可预测STEMI后心室重构发生风险,联合梗死部位和NT-pro-BNP效果更佳。
