Zhu-jun Shen

China Academy of Chinese Medical Sciences, Peping, Beijing, China

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Publications (21)3.55 Total impact

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    ABSTRACT: This study assessed the combined utility of estimated glomerular filtration rate (eGFR) and serum high-sensitivity C-reactive protein (hsCRP) levels to predict long-term mortality and cardiovascular outcomes of patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Elevated CRP levels and renal dysfunction have both been shown to independently and jointly predict mortality and cardiovascular outcomes after PCI in the short term. However, long-term results in patients with acute STEMI undergoing PCI have not been reported. A total of 262 patients with acute STEMI undergoing primary PCI were classified at admission into quartiles according to eGFR (<60, 60-70, 70-80 and ≥80 mL·min·1.73 m) and hsCRP (<3 and ≥3 mg/L). Mortality, nonfatal myocardial infarction (MI) and major adverse cardiac events (MACEs) were compared among the groups. During a median follow-up of 48.3 months, the composite of all-cause mortality and nonfatal MI (mortality + MI) was significantly higher (35.09%) in the group with the lowest eGFR compared with that of the other 3 eGFR groups (14.29%, 3.77% and 9.43%, respectively, P < 0.0001) and the group with elevated hsCRP (34.29%) versus that with hsCRP <3 mg/L (4.41%, P < 0.0001). A combined analysis showed an exaggerated hazard in patients with the lowest eGFR and highest hsCRP (hazard ratio: 44.658; 95% confidence interval: 5.955-111.890). Renal dysfunction and elevated hsCRP predict a high long-term incidence of MACE in patients with acute STEMI undergoing primary PCI, with the combination being of prognostic significance for long-term mortality and MI in these patients.
    The American Journal of the Medical Sciences 03/2015; 349(5). DOI:10.1097/MAJ.0000000000000430 · 1.52 Impact Factor
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    ABSTRACT: The long-term safety and efficacy of drug-eluting stents (DES) versus bare metal stents (BMS) are unclear and controversial issues in patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). The purpose of this study was to compare the long-term outcome of STEMI patients undergoing primary PCI with DES versus BMS implantation. A total of 191 patients with acute STEMI undergoing PCI from Jan. 2005 to Dec. 2007 were enrolled. Patients received DES (n = 83) or BMS (n = 108) implantation in the infarction related artery according to physician's discretion. The primary outcome was the occurrence of major adverse cardiac events (MACE), which was defined as a composite of death, myocardial infarction (MI), target vessel revascularization (TVR) and stent thrombosis. The difference of MACE was observed between DES and BMS groups. The clinical follow-up duration was 3 years ((41.7 ± 16.1) months). MACE occurred in 20 patients during three years follow-up. Logistic regression analysis showed that the left ventricular ejection fraction (LVEF) was an independent predictor for MACE in the follow-up period (P = 0.0301). There was no significant difference in all-cause mortality (3.61% vs. 7.41%, P = 0.2647), the incidence of myocardial infarction (0 vs. 0.93%, P = 0.379) and stent thrombosis (1.20% vs. 1.85%, P = 0.727) between the DES group and BMS group. The incidence of MACE was significantly lower in the DES group compared to the BMS group (4.82% vs. 14.81%, P = 0.0253). The rate of TVR was also lower in the DES group (0 vs. 5.56%, P = 0.029). In the DES group, there was no significant difference in the incidence of MACE between sirolimus eluting stents (SES, n = 73) and paclitaxel-eluting stents (PES, n = 10) subgroups (2.74% vs. 20.00%, P > 0.05). This finding suggested that drug-eluting stents significantly reduced the need for revascularization in patients with acute STEMI, without increasing the incidence of death or myocardial infarction. Use of DES significantly decreased the incidence of MACE compared with BMS during the 3-year follow-up.
    Chinese medical journal 08/2012; 125(16):2803-6. · 1.02 Impact Factor
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    ABSTRACT: To observe the clinical and coronary features of patients with systemic lupus erythematosus (SLE) and coronary artery disease (CAD). Among 2877 SLE inpatients (age ≥ 18 years, male 363, female 2514) admitted in the Peking Union Medical College Hospital between January 1999 to October 2009, 33 patients [mean age (50.7 ± 12.8) years] were diagnosed with CAD and coronary angiogram was available in 20 out of these 33 patients. Clinical and coronary features of these patients were retrospectively reviewed. The incidence of CAD was significantly higher in male SLE patients than in female patients [2.48% (9/363) vs. 0.95% (24/2514), P = 0.022]. Patients with secondary antiphospholipid syndrome were more likely to suffer from CAD [5.76% (8/139) vs. 0.91% (25/2738), P < 0.001]. Myocardial infarction was the major form of CAD (24/33). Coronary artery angiographic changes included coronary stenosis and occlusions, coronary aneurysms and acute thrombosis and multi-vessel lesions was found in 75.0% (15/20) patients with SLE and CAD. Male SLE patients and patients with secondary antiphospholipid syndrome are at higher risk for CAD. Myocardial infarction and multi-vessel lesions are common in SLE patients with CAD.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 05/2012; 40(5):382-5.
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    ABSTRACT: To evaluate the effects of hemoglobin (Hb) levels on long-term prognosis in the patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. A total of 150 patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention between January 2005 to December 2007 were enrolled. They were divided into 2 groups: Hb < 120 g/L group (n = 21) and Hb ≥ 120 g/L group (n = 129). The mean clinical follow-up period was 3 years (range: 41.4 ± 16.1 months). The differences of major adverse cardiac events (MACE), including death, acute myocardial infarction, stent thrombosis & stent restenosis), were observed between two groups. The parameters of infarction site, infarction relative artery, 2-vessel disease, 3-vessel disease, Killip class ≥ II, drug-eluting stent, TIMI grade 3 flow, hypertension, hyperlipidemia, smoking, obesity, aspirin and clopidogrel use were not different between two groups (all P > 0.05). The rate of diabetes was significantly higher in Hb < 120 g/L group than that in Hb ≥ 120 g/L group (47.62% vs 18.60%, P = 0.0032). The mean age and symptom-onset-to balloon-time (SOTB) were significantly higher in Hb < 120 g/L group than that in Hb ≥ 120 g/L group (68.5 ± 9.2 vs 61.2 ± 12.2 years, P < 0.0001; 8.8 ± 10.5 vs 6.3 ± 5.0 h, P < 0.0001). The mean LVEF (left ventricular ejection fraction)(%) and rate of complete revascularization were significantly lower in Hb < 120 g/L group than that in Hb ≥ 120 g/L group (51.25 ± 11.34 vs 58.79 ± 10.38, P < 0.0001; 61.9% vs 86.8%, P = 0.0045). Logistic regression analysis showed that LVEF was an independent predictor of MACE during the follow-up period (P = 0.0140). During a 3-year follow-up, MACE occurred in 16 patients. The incidence of MACE was significantly higher in Hb < 120 g/L group than that in Hb ≥ 120 g/L group (33.33% vs 6.98%, P = 0.0003); Moreover the all-cause mortality and cardiac mortality were significantly higher in Hb < 120 g/L group than those in Hb ≥ 120 g/L group (28.57% vs 3.10%, P < 0.0001; 23.81% vs 2.33%, P < 0.0001). In the patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention, hemoglobin level < 120 g/L at baseline is markedly associated with adverse outcomes and an elevated incidence of MACE and mortality during the follow-up period.
    Zhonghua yi xue za zhi 11/2011; 91(42):3003-6.
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    ABSTRACT: To analyze the clinical characteristics and long-term outcomes of patients underwent percutaneous coronary intervention (PCI) with prior ischemic stroke. A total of 2053 patients underwent PCI in Peking union medical college hospital from January 2003 to December 2007 were included in this analysis and patients were followed up to December 2009. End-point included all-cause mortality, cardiac death, stent thrombosis, target-lesion revascularization, myocardial infarction, re-cerebral infarction. Major bleeding events were recorded during follow-up. There are 1945 coronary heart disease patients were followed up and 222 patients with prior ischemic stroke. Compared patients without prior ischemic stroke, patients with prior ischemic stroke were older (P = 0.000), had higher hypertension morbidity (P = 0.000), higher diabetes mellitus morbidity (P = 0.005), higher incidence of multi-vessels disease (P = 0.000). During the follow-up of (35.0 ± 19.6) months, cardiac death rate (8.5% vs. 3.9%, P = 0.002) and re-cerebral infarction rate (5.8% vs. 1.4%, P = 0.000) were higher in patients with prior ischemic stroke than patients without prior ischemic stroke. Dual antiplatelet therapy treatment time [(13.77 ± 11.33) months vs. (13.94 ± 11.33) months, P = 0.986] and major bleeding events (5.8% vs. 3.6%, P = 0.100) were similar between the two groups and cerebral hemorrhage rate (1.8% vs. 0.5%, P = 0.028) were higher in patients with prior ischemic stroke than patients without prior ischemic stroke. Patients with prior ischemic stroke were associated with increased rate of risk factors, multiple coronary artery disease, cardiac death and re-cerebral infarction and higher cerebral hemorrhage rate during follow-up despite similar dual-anti platelet therapy time.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 11/2011; 39(11):980-3.
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    ABSTRACT: To evaluate the clinical and coronary angiographic features of patients with systemic vasculitis and coronary artery disease. Fifteen patients (11 male) with systemic vasculitis and coronary artery diseases admitted to our hospital from January 1999 to October 2009 were reviewed. There were 6 patients with Behcet's disease, 3 patients with Churg-Strauss syndrome, 2 patients with Takayasu arteritis, 1 patient with polyarteritis nodosa, 1 patient with microscopic polyangiitis, 1 patient with Wegner's granulomatosis and 1 patient with Kawasaki disease. Mean age of this cohort was (39.3 ± 11.9) years. Adverse coronary events occurred in 4 patients during the inactive phase of systemic vasculitis and in 9 patients during the active phase of systemic vasculitis. Twelve patients were hospitalized with acute myocardial infarction, 2 with angina pectoris and 1 with cardiac tamponade. There were 3 patients with acute left ventricular dysfunction and 3 patients with severe arrhythmias. Compared to patients in the inactive phase, patients in the active phase were younger [(32.4 ± 8.1) years vs. (47.0 ± 10.2) years], had less risk factors for atherosclerosis (1.2 ± 1.5 to 2.8 ± 1.7) and the time intervals between coronary artery disease and systemic vasculitis was shorter [0 - 7 years (average 1.6 years) to 3 - 30 years (average 17.7 years)]. Coronary angiography evidenced coronary stenosis or occlusions in 11 patients, coronary aneurysm and acute thrombosis in 1 patient, coronary aneurysms and occlusions in 1 patient and coronary spasm in 2 patients. LVEF measured by echocardiography was less than 50% in 8 patients. Patients with various systemic vasculitis could develop severe coronary artery disease due to coronary stenosis/occlusion, aneurysma, thrombosis and coronary spasm.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 08/2011; 39(8):730-3.
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    ABSTRACT: To evaluate the effect of left ventricular ejection fraction (LVEF) on clinical outcomes in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. A total of 158 patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention between January 2005 to December 2007 were enrolled. They were divided into three groups: LVEF≤40% (n=14), LVEF 41%-55% (n=46) and LVEF>55% group (n=98). The clinical follow-up end-point was major adverse cardiac event (MACE) including death, acute myocardial infarction, stent thrombosis and stent restenosis. The clinical follow-up duration was 43.1±15.2 months. MACE occurred in 15 patients. The rates of infarction site, infarction relative artery, 1-vessel disease, 2-vessel disease, hypertension, diabetes, hyperlipidemia, smoking, obesity and aspirin use were not different in three groups (P>0.05). Average CTnI, CK, CK-MB and duration of clopidogrel use were not different in three groups (P>0.05). The rate of 3-vessel disease was significantly higher in the LVEF≤40% group than that in the LVEF 41%-55% and LVEF>55% groups (P=0.0036). The rates of TIMI flow grades (Grade III) and complete revascularization were significantly higher in the LVEF 41%-55% and LVEF>55% groups than that in the LVEF≤40% group (P=0.0099, P=0.0010). The rates of Killip classification (classes II, III, IV) and average symptom-onset-to balloon-time (SOTB) were significantly lower in the LVEF 41%-55% and LVEF>55% groups than that in the LVEF≤40% group (P=0.0100, P=0.0087). The rate of drug-eluting stents was significantly lower in the LVEF≤40% group and LVEF 41%-55% group than that in LVEF>55% group (P=0.0242). Logistic regression analysis showed that LVEF was independent predictor for MACE in the follow-up period (P=0.0029). With LVEF decrease, incidence of MACE in the follow-up period significantly increased in LVEF>55% group, LVEF 41%-55% group and LVEF≤40% group (6.12% vs 8.7% vs 35.71%, P=0.0019). Incidence of total death and cardiac death in the follow-up period significantly increased in LVEF>55% group, LVEF 41%-55% group and LVEF≤40% group (1.02% vs 4.35% vs 21.43%, P=0.0090; 1.02% vs 2.17 vs 14.29%, P=0.0060). In patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention, LVEF was independent predictor for MACE in the follow-up period. With LVEF decrease, incidence of MACE in the follow-up period significantly increased.
    Zhonghua yi xue za zhi 01/2011; 91(4):265-8.
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    ABSTRACT: To explore the clinical characteristics and angiographic features of acute myocardial infarction in patients aged 30 years or younger. Data of 360 consecutive patients referred to Peking Union Medical College Hospital for evaluation of chest pain or discomfort from January 2007 to December 2009, diagnosed as acute myocardial infarction and underwent emergent coronary angiography were analyzed. Seven patients (1.9%) with age ≤ 30 years [4 male, (25 ± 5) years] were included in this study, patients were followed up for (12 ± 9) months. There were 6 cases of ST-segment elevated myocardial infarction and 1 non-ST-segment elevated myocardial infarction. The culprit vessels were as follows: 5 left anterior descending artery, 1 left main and 1 right coronary artery. All 3 female patients were complicated with congenital coronary malformation or autoimmune disease, including 1 coronary artery aneurismal dilation of left anterior descending, 1 Takayasu's arteritis and 1 systemic lupus erythematosus. Three of the 4 male patients were smokers. Two patients underwent percutaneous coronary intervention. There was no death or cardiovascular re-admission during the follow-up. The majority of acute myocardial infarction in patients aged 30 years or younger were presented with ST-segment elevated myocardial infarction and single vessel non-obstructive lesion. The most common culprit vessel was left anterior descending artery. All female patients were complicated with congenital coronary malformation or autoimmune disease. The short-term prognosis in patients of this cohort was good.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 12/2010; 38(12):1081-4.
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    ABSTRACT: To evaluate effect of duration of clopidogrel use on clinical follow-up outcomes in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. A total of 214 patients with acute myocardial infarction undergoing primary percutaneous coronary intervention between January 2005 to December 2007 were enrolled. All patients were divided into two groups by duration of clopidogrel use: <1 year group (n=59) and > or =1 years group (n=155). Baseline characteristics [age, gender, angiographic characteristics, Killip classification, LVEF (left ventricular ejection fraction) , CK (creatine kinase), CK-MB, CTnI (cardiac troponin-I), hemoglobin levels and history of hypertension, diabetes, hyperlipidemia, obesity and smoking] of two groups were collected. Clinical follow-up end-point was major adverse cardiac event (MACE) including death, acute myocardial infarction, stent thrombosis and stent restenosis. Clinical follow-up duration was 41.6 +/- 16.3 months. MACE occurred in 28 patients. Rates of male, infarction site, infarction relative artery, multivessel disease, Killip classification (class I), aspirin use and history of smoking, obesity, hypertension and hyperlipidemia were not different (P > 0.05) in duration of clopidogrel use <1 year group and > or =1 years group. Average LVEF, hemoglobin levels and rate of drug-eluting stents were significantly lower in duration of clopidogrel use <1 year group than that in duration of clopidogrel use > or =1 years group (P < 0.0001, P < 0.0001, P = 0.0065). Average CK, CK-MB, CTnI were significantly higher in duration of clopidogrel use > or =1 years group than that in duration of clopidogrel use <1 year group (P < 0.0001). Rate of diabetes and average age were significantly higher in duration of clopidogrel use <1 year group than that in duration of clopidogrel use > or =1 years group (P = 0.0190, P < 0.0001). Incidence of MACE in follow-up period was significantly lower in duration of clopidogrel use > or =1 years group than that in duration of clopidogrel use < 1 year group (6.45% vs. 30.51%, P < 0.01). After stopping clopidogrel use, incidence of MACE in followup period was significantly lower in duration of clopidogrel use > or =1 years group than that in duration of clopidogrel use <1 year group (2.58% vs. 20. 34%, P < 0.01). Primary percutaneous coronary intervention is an effective therapeutic method. Incidence of MACE in follow-up period was significantly lower in duration of clopidogrel use > or =1 years group than that in duration of clopidogrel use <1 year group. Duration of clopidogrel use may influence clinical outcomes in follow-up period in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.
    Zhonghua yi xue za zhi 06/2010; 90(24):1682-5.
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    Chinese medical journal 12/2009; 122(24):3097-8. · 1.02 Impact Factor
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    ABSTRACT: To compare side branch occlusion rate at sites of overlapping sirolimus- or paclitaxel-eluting stents in treating long coronary lesions. We retrospectively reviewed the PCI CD and medical records of PCI 141 patients with at least one stent overlapping for long coronary lesion in our institute from January 2004 to October 2007. The side branches occlusion was documented and analyzed. The study population were consisted of 141 patients that there were 115 man, and 26 women, who got 297 stents. There were 154 side branch vessels been observed. Side branch occlusion rate was 24.6% in Cypher group and 31.6% in TAXUS (P > 0.05), side branch TIMI flow decrease rate on overlapping region was 26.3% in Cypher group and 68.4% in TAXUS group (P > 0.05). A logistic regression model analysis show that the significant risk factors for side branch occlusion is the diameter and ostial occlusion of side branch. Side branch occlusion rate and TIMI flow decrease rate were similar on overlapping region in patients treated with Cypher or TAXUS stents for long coronary lesions. The significant predictors for side branch TIMI flow decrease are the diameter and ostial occlusion of side branch.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 06/2008; 36(6):497-500.
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    ABSTRACT: To analyze factors associated with reduced renal function post primary percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) patients with normal baseline serum creatinine level. The clinical and angiographic data of 216 consecutive AMI patients undergoing primary PCI with normal baseline serum creatinine level (< 1.5 mg/dl) were obtained and compared between patients with (n = 32) and without (n = 184) renal function deterioration (increase in serum creatinine > or = 25% from baseline level within 72 hours of primary PCI) post PCI. The incidence of renal function deterioration was 14.8% (32/216). Patients with age > 75 years (28.1% vs. 14.1%, P = 0.047), congestive heart failure (25.0% vs. 9.2%, P = 0.017), less use of low-molecular weight heparins (84.4% vs. 95.1%, P = 0.039) and beta-blockers (75.0% vs. 95.6%, P = 0.001) as well as angiotensin converting enzyme inhibitors/angiotensin receptor blockers (81.3% vs. 93.5%, P = 0.025) and statins (84.4% vs. 97.3%, P = 0.008) were risk factors for developing renal dysfunction post PCI. Renal function deterioration post PCI was also associated with increased in-hospital mortality (25.0% vs. 2.2%, P < 0.001). Multivariate analysis showed that congestive heart failure was the single independent predictor of renal function deterioration (odds ratio = 3.275, 95% confidence interval 1.275 - 8.408, P = 0.014), while renal function deterioration was the strongest independent predictor of in-hospital death (odds ratio = 10.313, 95% confidence interval 2.569 - 41.402, P = 0.001). Renal function deterioration is a common complication post primary PCI and is associated with higher risk of in-hospital death in AMI patients with normal baseline serum creatinine level.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 05/2008; 36(5):408-11.
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    ABSTRACT: To analyze the characteristics of angina symptom complex of patients with coronary artery disease (CAD) complicated with renal stenosis, and to analyze their sensitivity and specificity of angina symptom complex for the diagnosis of CAD. The medical records of 2820 in-hospital patients who underwent coronary angiography and renal angiography simultaneously during the period from Jan 1998 to May 2005 and could be diagnosed as with CAD or renal stenosis with the stenotic degree more than 50% of the coronary or renal artery in angiography, were analyzed. The diagnosis of CAD was based on the 3 groups of symptoms recommended by American College of Cardiology/American Heart Association: (1) substernal chest discomfort with a characteristic quality and duration, (2) chest pain provoked by exertion or emotional stress, and (3) chest pain that can be relieved by rest or nitroglycerin. 243 of the 2820 patients had renal stenosis and 2577 of the 2820 patient did not have renal stenosis. The prevalence rates of CAD and hypertension were higher in the renal stenosis group and in the patients without renal stenosis. To diagnose CAD with any one of the 3 groups of above mentioned angina symptom complex, the sensitivity rates were 94.2%, 69.7%, and 75.5% respectively, the specificity rates were 14.3%, 40.0%, and 25.7% respectively, the positive predictive values were 86.7%, 87.3%, and 85.8% respectively, and the negative predictive values were 29.4%, 18.2%, and 15.0% respectively. To diagnose CAD by the symptoms of groups (2) plus (3), (1) plus (2), and (1) plus (3) the sensitivity rates were 68.8%, 56.7%, and 72.6% respectively, specificity rate were 40.0%, 62.9%, and 45.7% respectively, positive predictive values were 87.2%, 90.1%, and 88.8% respectively, and negative predictive values were 17.7%, 19.6, and 21.9% respectively. To diagnose CAD based on all three groups of angina symptom complex, the sensitivity was 56.3%, specificity was 62.9%, positive predictive value was 90.0%, and negative predictive value was 19.5%. For detecting CAD based on one, two or three groups of angina symptom complex, there are not significant differences in the diagnostic sensitivity and specificity, however, the positive predictive value is greater and the negative predictive value is smaller in the patients with renal stenosis compared with those without renal stenosis.
    Zhonghua yi xue za zhi 12/2007; 87(42):2986-90.
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    ABSTRACT: To evaluate the effect of risk factors for coronary artery disease (CAD) on urokinase receptor (uPAR) expression on monocytes. A total of 106 patients were enrolled and divided into five risk-factor groups: sixteen with hypertension, twenty-four with dyslipidemia, eighteen with hypertension + obesity, eighteen with dyslipidemia + obesity and thirty with hypertension + dyslipidemia + obesity. Seventeen healthy volunteers were recruited as control group. Monocyte expression of uPAR and mean fluorescence intensity index (MFI Index) of uPAR were measured by flow cytometer (FACSCalibur). No difference in monocyte uPAR expression was detected between hypertension and control group [(4.9 +/- 12.5)% vs. (7.7 +/- 10.3)%, P=0.74]. However, the uPAR expression was raised to (23.7 +/- 22.5)% in hyperlipidemia group, a 3.9- and a 2.1-fold increase compared with those in hypertension (P<0.01) and control group (P<0.05), respectively. When combined with obesity, uPAR expression was elevated further to (32.9 +/- 30.8)% in hypertension + obesity group, (37.4 +/- 31.4)% in dyslipidemia + obesity group and (23.8 +/- 20.5)% in hypertension + dyslipidemia + obesity group, all having statistical significance compared with control group or hypertension group (P<0.01). The results were the same when corrected by age, BMI and hs-CRP. uPAR MFI Index was increased from 0.78 +/- 0.86 in control group to 1.91 +/- 1.97 and 3.33 +/- 2.52 in dyslipidemia group and hypertension + obesity group, respectively, P<0.05. Linear regression analysis revealed a significant correlation between uPAR expression and FBG concentration in dyslipidemia group, r=0.72, P=0.04. uPAR expression was elevated on monocytes in patients with risk factors for CAD. Dyslipidemia and obesity may contribute to the increase of uPAR expression.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 02/2007; 35(2):159-63.
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    ABSTRACT: To evaluate the safety, as well as short term and long term effect of percutaneous angioplasty and stenting in atherosclerotic renal artery stenosis. A total of 150 consecutive patients with atherosclerotic renal artery stenosis (ARAS) undergoing percutaneous transluminal renal angioplasty (PTRA) and stenting in a period of 6 years were followed up. Blood pressure, renal function before and after the procedure were monitored through-out the follow up years. Renal artery restenosis was tested with ultrasound and Doppler 6-9 months after the procedure. Clinically drive repeat angiogram was done in some patients. 96% of the patients had coronary artery disease and 54% triple vessel disease. A total of 174 renal arteries were found to have severe ARAS in these 150 patients. Procedure success rate was 99.3% with only 1 failure. 3 total occluded renal artery were not attempted, with a total of 170 renal arteries receiving PTRA and stenting. There was no immediate complication such as death, renal artery rupture or acute closure. 145 patients were clinically followed up, with a follow-up rate of 98.6%, and a follow up time between 7 months and 5 years. During follow-up, another 2 patients died in addition to the 3 died in the hospital. All of them died of cardiovascular disease. As to blood pressure, 66 patients among 101 with refractory hypertension and 20 among 42 with well controlled hypertension got improved in 6-9 months of follow up, with an improvement rate of 60.1%. These effects were kept throughout the follow up years. Most of the patient's renal function kept stable and a small number of patient's serum creatine level ameliorating. Renal artery restenosis was found in 10 among the 166 renal vessels undergoing ultrasound examination, with a restenosis rate of 6.0%. PTRA and stenting in ARAS patients with coronary artery disease are safe and effective, most of the patient's blood pressure can be controlled and renal function can be kept stable. Restenosis rate is quite low and acceptable.
    Zhonghua nei ke za zhi [Chinese journal of internal medicine] 11/2006; 45(10):804-6.
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    ABSTRACT: To evaluate the sensitivity and specificity of (99)Tc(m)-N-NOET myocardial perfusion tomographic imaging (MPI) for the diagnosis of coronary artery disease (CAD). Coronary angiography and (99)Tc(m)-N-NOET myocardial perfusion tomographic imaging were performed in the patients hospitalized in the Department of Cardiology, Peking Union Medical College Hospital, from June to December 2005 with known or suspected diagnosis of CAD. Adenosine was infused intravenously at a rate of 140 microg x kg(-1)min(-1) for 6 minutes. At the third minute of adenosine infusion, 740 MBq (20 mCi) (99)Tc(m)-N-NOET was injected intravenously. MPI was obtained 15 minutes after the (99)Tc(m)-N-NOET infusion. If the result was abnormal, rest myocardial perfusion imaging would be performed 2 hours later. Coronary angiography was performed in all patients within one week after the myocardial perfusion imaging. Myocardial perfusion imaging was performed in 53 cases, 36 males and 17 females, aged 56 +/- 10, who underwent coronary angiography, among which 31 had > or = 50% stenosis of coronary artery and 23 had normal coronary artery. All of the patients with stenosis of coronary artery had positive (99)Tc(m)-N-NOET adenosine stress myocardial perfusion imaging. Nineteen out of the 29 cases without stenosis of coronary artery had negative adenosine myocardial perfusion imaging. The sensitivity and specificity of (99)Tc(m)-N-NOET adenosine myocardial perfusion imaging were 100% and 73% respectively in the detection of stenosis of coronary arteries. Seven cases got percutaneous coronary intervention and 2 got coronary artery bypass graft. Six of the 9 patients undergoing revascularization had stenosis of stents or grafts, 5 of which had positive myocardial perfusion imaging. 3 cases hadn't restenosis and their results of myocardial perfusion imaging were negative. (99)Tc(m)-N-NOET myocardial perfusion imaging is a useful non-interventional method for detecting coronary artery stenosis.
    Zhonghua yi xue za zhi 08/2006; 86(26):1845-9.
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    ABSTRACT: To analyze the relationship between the early ST resolution magnitude and TIMI flow, MACE and the cardiac function in ST elevated AMI (STEMI) patients after successful primary PCI. A total of 120 consecutive patients with STEMI underwent primary PCI within 12 hours after the onset of chest pain were enrolled in this study, the ST segment resolution was calculated and the patients were divided into group A (n = 81, Sigma STE resolved > or = 50%) and group B (n = 39, Sigma STE resolved < 50%). TIMI flow after PCI, clinical events up to 30 days post PCI and cardiac function 30 days post PCI were assessed. LVEF was higher in group A than that of group B (58.6% +/- 7.1% vs. 50.5% +/- 7.1%, P < 0.05). There are fewer patients with Killip III and IV in group A than in group B (1.2% vs. 12.8%, P < 0.05). The incidence of in-hospital MACE was also significantly less in group A than in group B (0 vs. 7.7%, P < 0.001). As expected, there were more patients with TIMI 3 flow (95.1% vs. 79.5%, P < 0.05) and fewer TIMI 2 (4.9% vs. 20.5%, P < 0.05) flow post PCI in group A than in group B and all 3 patients with MACE were group B patients with TIMI 2 flow. Early ST resolution post PCI represents improved myocardial perfusion and function and is related to a favorable clinical outcome in STEMI patients.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 03/2006; 34(2):134-7.
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    ABSTRACT: To analyze the sensitivity and specificity of adenosine stress myocardial perfusion tomographic imaging for the diagnosis of coronary artery disease (CAD). Adenosine was infused intravenously at a rate of 140 microg.kg(-1).min(-1) for 6 minutes. 3 minutes after adenosine infusion, 925 MBq of (99m)Tc-MIBI were injected intravenously. SPECT myocardial imaging acquisition was obtained 1.5 hours after adenosine infusion. If the result was abnormal, rest myocardial perfusion imaging would be performed next day. Coronary angiography was performed in all patients within one week of myocardial imaging. Total 79 cases [(62 +/- 10) years old, 35 men, 44 women] were included in this study. In the 50 cases of CAD patients confirmed by coronary angiography, 44 patients have positive adenosine (99m)Tc-MIBI myocardial perfusion SPECT. Nineteen out of 29 cases without CAD have negative adenosine myocardial perfusion tomographic imaging. The sensitivity and specificity of adenosine myocardial perfusion tomographic imaging for the diagnosis of CAD were 88.0% and 65.5%. The sensitivity of adenosine myocardial perfusion tomographic imaging for diagnosing coronary stenosis in left anterior descending, left circumflex and right coronary artery are 32/40, 21/27 and 31/32. There was no severe adverse side effect during adenosine stress test. Adenosine stress myocardial perfusion tomographic imaging is an useful non-interventional method for detecting coronary artery disease.
    Zhonghua nei ke za zhi [Chinese journal of internal medicine] 03/2006; 45(2):112-5.
  • Zhu-jun Shen
    Zhonghua nei ke za zhi [Chinese journal of internal medicine] 12/2005; 44(11):806-7.
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    ABSTRACT: To analyze the clinical significance of adenosine (99m)Tc-MIBI myocardial perfusion single photon emission computed tomography (SPECT) in patients with coronary artery disease (CAD) for percutaneous coronary intervention (PCI). Coronary angiography and adenosine (99m)Tc-MIBI myocardial perfusion SPECT were performed for all patients. Adenosine myocardial perfusion was performed after PCI. Adenosine was infused intravenously at a rate of 140 microg.kg(-1).min(-1) for 6 minutes, and 925MBq (99m)Tc-MIBI was injected intravenously at 3 minutes after adenosine infusion. SPECT myocardial imaging acquisition was obtained in 1.5 hours after adenosine infusion. If the result was abnormal, rest (99m)Tc-MIBI myocardial perfusion SPECT would be performed next day. There were 17 segments of left ventricle, and four degrees of myocardial perfusion. There were 63 cases (63 +/- 10 years old) with CAD, in which 40 patients got PCI. Twenty eight cases after PCI. Adenosine myocardial perfusion imaging will be useful in detecting regional myocardial perfusion abnormalities for patients with PCI.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 12/2005; 33(11):1023-6.