[Show abstract][Hide abstract] ABSTRACT: Objective
The relationship between admission serum calcium levels and in-hospital mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) has not been well definitively explored. The objective was to assess the predictive value of serum calcium levels on in-hospital mortality in STEMI patients.
From 2003 to 2010, 1431 consecutive STEMI patients admitted to the First Affiliated Hospital of Nanjing Medical University were enrolled in the present study. Patients were stratified according to quartiles of serum calcium from the blood samples collected in the emergency room after admission. Between the aforementioned groups,the baseline characteristics, in-hospital management, and in-hospital mortality were analyzed. The association of serum calcium level with in-hospital mortality was calculated by a multivariable Cox regression analysis.
Among 1431 included patients, 79% were male and the median age was 65 years (range, 55–74). Patients in the lower quartiles of serum calcium, as compared to the upper quartiles of serum calcium, were older, had more cardiovascular risk factors, lower rate of emergency revascularization,and higher in-hospital mortality. According to univariate Cox proportional analysis, patients with lower serum calcium level (hazard ratio 0.267, 95% confidence interval 0.164–0.433, p<0.001) was associated with higher in-hospital mortality. The result of multivariable Cox proportional hazard regression analyses showed that the Killip's class≥3 (HR = 2.192, p = 0.026), aspartate aminotransferase (HR = 1.001, p<0.001), neutrophil count (HR = 1.123, p<0.001), serum calcium level (HR = 0.255, p = 0.001), and emergency revascularization (HR = 0.122, p<0.001) were significantly and independently associated with in-hospital mortality in STEMI patients.
Serum calcium was an independent predictor for in-hospital mortality in patients with STEMI. This widely available serum biochemical index may be incorporated into the current established risk stratification model of STEMI patients. Further studies are required to determine the actual mechanism and whether patients with hypocalcaemia could benefit from calcium supplement.
PLoS ONE 06/2014; 9(6):e99895. DOI:10.1371/journal.pone.0099895 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Iodinated contrast media (CM) can induce apoptosis and necrosis of renal tubular cells. The injuries of endothelial cells induced by CM on the systemic condition have not been fully understood. To assess the toxic effects of non-ionic CM on the glomerular and aortic endothelial cells, iopromide and iodixanol, two kinds of representative non-ionic CM, were used for the in vivo study. Sixty aged rats were respectively received the agents or normal sodium intravascularly. No obvious apoptosis and morphological change was detected in the glomerular and aortic endothelial cells apart from renal tubules after CM administration. However, expressions of the nitric oxide synthase (eNOS) in glomerular endothelium were decreased at 12h after CM injection. Furthermore, plasma creatinine and endothelin-1 were increased and plasma nitric oxide (NO) was decreased significantly after CM administration. However, we failed to observe the significant increase of plasma von Willebrand Factor. These results suggest that non-ionic iodinated CM do not induce apoptosis and necrosis of glomerular and aortic endothelial cells in vivo. Decreased eNOS expression and increased plasma endothelin-1 may be involved in non-ionic iodinated CM-induced endothelial dysfunction and kidney injury.
[Show abstract][Hide abstract] ABSTRACT: Objective
To investigate the regulation of High sensitive C-reactive protein (Hs-CRP) and WBC count in patients with coronary heart disease (CHD) by percutaneous transluminal intervention (PCI) and to discuss the mechanism of inflammatory reaction after coronary stenting.
Journal of Nanjing Medical University 07/2008; 22(4):246-249. DOI:10.1016/S1007-4376(08)60073-8
[Show abstract][Hide abstract] ABSTRACT: To study the relationship between insulin resistance and cardiovascular risk factor clustering.
The height, body weight, waist circumference, and hip circumference were measured, and fasting venous blood was drawn among 1 196 rural residents, 533 males (44.57%) and 663 females (55.43%), aged 35 approximately 59 with the average age of 46.69, in Pizhou City, Jiangsu Province, selected by random sampling. Fasting serum true insulin (TI) was determined by ELISA. Blood lipids were measured by completely automatic biochemical analyzer. Homeostasis model assessment (HOMA) index was calculated and used as the indicator to evaluate insulin resistance. The statistic methods, such as Spearman correlation, partial correlation and multivariate Logistic regression were used to study the relationship between insulin resistance and hypertension, overweight, visceral obesity, dyslipidemia and cardiovascular risk factors clustering.
The median (Q(R)) of TI and HOMA index were 4.89 (3.02 approximately 7.09) mIU/L and 0.98 (0.57 approximately 1.44) respectively, and TI and HOMA index of the female subjects were significantly higher than those of the male subjects (P < 0.01). The correlation coefficient between HOMA index and cardiovascular risk factors number was 0.290 (P < 0.01) by Spearman correlation analysis and 0.177 6 (P < 0.01) by partial correlation analysis after adjustment by age, sex, body mass index and waist circumference respectively. The results of non-conditional multivariate stepwise Logistic regression indicated that insulin resistance associated with cardiovascular risk factors aggregation and was independent of age, sex, body mass index and waist circumference, and the odds ratio (95% CI) was 1.250 (1.089 approximately 1.434).
Insulin resistance may be a common pathogenetic mechanism of cardiovascular risk factor dustering.