Background： Spontaneous coronary artery dissection （SCAD） is a nonatherosclerotic but a rare and extremely dangerous clinical entity, it has a high prevalence in young female population with acute myocardial infarc...Background： Spontaneous coronary artery dissection （SCAD） is a nonatherosclerotic but a rare and extremely dangerous clinical entity, it has a high prevalence in young female population with acute myocardial infarction （AMI）. The previous reports were restricted to other countries＇ population, but rare in China. Hence, this study aimed to focus on the characteristics of SCAD as a cause of young female AMI population in Jiangsu, China. Methods： This study enrolled young female AMI patients aged ≤50 years who underwent coronary angiography （CAG） and intracoronary imaging in our center between January 2013 and December 2016. Their clinical presentations, risk factors, and CAG characteristics were analyzed. Results： A total of 60 young l＇emale AMI （〈7 days） patients were enrolled. From their CAG and intracoronary imaging results, the prevalence of SCAD in young female AMI population was 35% （21/60）, the prevalence of coronary atherosclerostic heart disease was 65% （39/60）. In the SCAD group, 43% （9/21） presented with non-ST-elevation myocardial infarction （NSTEM1） and the remainder presenting as STEMI. SCAD usually occurred in a single vessel （20/21, 95%）, especially in left anterior descending artery （14/21, 67%）. Eighteen patients （18/21, 86%） underwent conservative treatment, whereas the remaining three patients （3/21, 14%） underwent percutaneous coronary intervention. Regarding the angiographic results of SCAD lesions, intramural hematoma was discriminated in 95% （20/21）, and Type I imaging was observed in 5% （1/21）, Type l I was observed in 67% （14/21）, and Type Ⅲ was 29% （6/21）. The average stenosis in the group was 76.9% - 20.6%, and the mean lesion length was 36.6 ± 8.6 ±m. Conclusions： SCAD has a high prevalence in young female AMI population in Jiangsu, China. Discriminating the cause of AMI in young female population is very important.展开更多
Background： While depression and certain cardiac biomarkers are associated with acute myocardial infarction （AM1）, the relationship between them remains largely unexplored. We examined the association between depre...Background： While depression and certain cardiac biomarkers are associated with acute myocardial infarction （AM1）, the relationship between them remains largely unexplored. We examined the association between depressive symptoms and biomarkers in patients with AMI. Methods： We performed a cross-sectional study using data from 103 patients with AM1 between March 2013 and September 2014. The levels of depression, N-terminal proB-type natriuretic peptide （NT-proBNP）, and troponin 1 （Tnl） were measured at baseline. The patients were divided into two groups： those with depressive symptolns and those without depressive symptoms according to Zung Self-rating Depression Scale （SDS） score. Baseline comparisons between two groups were made using Student＇s t-test for continuous variables, Chi-square or Fisher＇s exact test for categorical variables, and Wilcoxon test for variables in skewed distribution. Binomial logistic regression and multivariate linear regression were performed to assess the association between depressive symptoms and biomarkers while adjusting for demographic and clinical variables. Results： Patients with depressive symptoms had significantly higher NT-proBNP levels as compared to patients without depressive symptoms （ 1135.0 [131.5, 2474.0] vs. 384.0 [ 133.0, 990.0], Z = -2.470, P 0.013）. Depressive symptoms were associated with higher NT-proBNP levels （odds ratio [OR] 2.348, 95% CI： 1.344 to 4.103, P= 0.003） and higher body mass index （OR = 1.169, 95% confidence interval [CI]： 1.016 to 1.345, P = 0.029）. The total SDS score was associated with the NT-proBNP level （[3 ： 0.327, 95% CI：1.674 to 6.119, P = 0.001） after multivariable adjustment. In particular, NT-proBNP was associated with three of the depressive dimensions, including core depression （β = 0.299, 95% CI：0.551 to 2.428, P=0.002）, cognitive depression （β= 0.320, 95% CI：0.476 to 1.811, P=0.001）, and somatic depression （β= 0.333, 95% CI： 0.240 to 0.847, P = 0.001）. Neither the overall depressive symptomatology nor the individual depressive dimensions were associated with TnI levels. Conclusions： Depressive symptoms, especially core depression, cognitive depression, and somatic depression, were related to high NT-proBNP levels in patients with AMI.展开更多
文摘Background： Spontaneous coronary artery dissection （SCAD） is a nonatherosclerotic but a rare and extremely dangerous clinical entity, it has a high prevalence in young female population with acute myocardial infarction （AMI）. The previous reports were restricted to other countries＇ population, but rare in China. Hence, this study aimed to focus on the characteristics of SCAD as a cause of young female AMI population in Jiangsu, China. Methods： This study enrolled young female AMI patients aged ≤50 years who underwent coronary angiography （CAG） and intracoronary imaging in our center between January 2013 and December 2016. Their clinical presentations, risk factors, and CAG characteristics were analyzed. Results： A total of 60 young l＇emale AMI （〈7 days） patients were enrolled. From their CAG and intracoronary imaging results, the prevalence of SCAD in young female AMI population was 35% （21/60）, the prevalence of coronary atherosclerostic heart disease was 65% （39/60）. In the SCAD group, 43% （9/21） presented with non-ST-elevation myocardial infarction （NSTEM1） and the remainder presenting as STEMI. SCAD usually occurred in a single vessel （20/21, 95%）, especially in left anterior descending artery （14/21, 67%）. Eighteen patients （18/21, 86%） underwent conservative treatment, whereas the remaining three patients （3/21, 14%） underwent percutaneous coronary intervention. Regarding the angiographic results of SCAD lesions, intramural hematoma was discriminated in 95% （20/21）, and Type I imaging was observed in 5% （1/21）, Type l I was observed in 67% （14/21）, and Type Ⅲ was 29% （6/21）. The average stenosis in the group was 76.9% - 20.6%, and the mean lesion length was 36.6 ± 8.6 ±m. Conclusions： SCAD has a high prevalence in young female AMI population in Jiangsu, China. Discriminating the cause of AMI in young female population is very important.
基金This study was supported by grants from the National Natural Science Foundation of China （No. 81172774, and No. 31371336）.
文摘Background： While depression and certain cardiac biomarkers are associated with acute myocardial infarction （AM1）, the relationship between them remains largely unexplored. We examined the association between depressive symptoms and biomarkers in patients with AMI. Methods： We performed a cross-sectional study using data from 103 patients with AM1 between March 2013 and September 2014. The levels of depression, N-terminal proB-type natriuretic peptide （NT-proBNP）, and troponin 1 （Tnl） were measured at baseline. The patients were divided into two groups： those with depressive symptolns and those without depressive symptoms according to Zung Self-rating Depression Scale （SDS） score. Baseline comparisons between two groups were made using Student＇s t-test for continuous variables, Chi-square or Fisher＇s exact test for categorical variables, and Wilcoxon test for variables in skewed distribution. Binomial logistic regression and multivariate linear regression were performed to assess the association between depressive symptoms and biomarkers while adjusting for demographic and clinical variables. Results： Patients with depressive symptoms had significantly higher NT-proBNP levels as compared to patients without depressive symptoms （ 1135.0 [131.5, 2474.0] vs. 384.0 [ 133.0, 990.0], Z = -2.470, P 0.013）. Depressive symptoms were associated with higher NT-proBNP levels （odds ratio [OR] 2.348, 95% CI： 1.344 to 4.103, P= 0.003） and higher body mass index （OR = 1.169, 95% confidence interval [CI]： 1.016 to 1.345, P = 0.029）. The total SDS score was associated with the NT-proBNP level （[3 ： 0.327, 95% CI：1.674 to 6.119, P = 0.001） after multivariable adjustment. In particular, NT-proBNP was associated with three of the depressive dimensions, including core depression （β = 0.299, 95% CI：0.551 to 2.428, P=0.002）, cognitive depression （β= 0.320, 95% CI：0.476 to 1.811, P=0.001）, and somatic depression （β= 0.333, 95% CI： 0.240 to 0.847, P = 0.001）. Neither the overall depressive symptomatology nor the individual depressive dimensions were associated with TnI levels. Conclusions： Depressive symptoms, especially core depression, cognitive depression, and somatic depression, were related to high NT-proBNP levels in patients with AMI.
