Huo Yong

A systematic literature review of risk factors for stroke in China.

Other countries have seen a decline in stroke incidence after improved treatment and prevention of known risk factors for stroke. China is still experiencing significant increases in the incidence rate of total stroke. We systematically reviewed the evidence on the impact of 5 modifiable risk factors (hypertension, dyslipidemia, obesity, diabetes, and smoking) for the risk of stroke in the Chinese population, with the aim to develop more effective prevention and disease management programs. A literature search was conducted in MEDLINE and EMBASE for all observational studies that reported on the association between risk of stroke and any of the 5 risk factors and the composite risk factor. Selected articles were published in either English or Chinese from January 2004 to December 2010. Evidence of the association between hypertension and stroke was the strongest of the 5 factors reported in studies, with adjusted odds ratios ranging between 2.75 and 5.47. The association among obesity, diabetes, smoking, and the risk for stroke was evident, but not as strong as for hypertension. The risk ratios of hypertension to stroke were higher in the Chinese population than those in other countries.

TWO-YEAR OUTCOMES POST-DISCHARGE IN ASIAN PATIENTS WITH ACUTE CORONARY SYNDROME (ACS): FINDINGS FROM THE EPICOR ASIA STUDY

Real-world data on long-term outcomes after acute coronary syndrome (ACS) in China is scarce. We aimed to investigate the 2-year outcomes for Chinese patients with ACS. EPICOR Asia study ([NCT01361386][1]) was a prospective, multinational study in Asia. A total of 8,214 patients were enrolled from

CHARACTERISTICS AND OUTCOMES OF MEDICALLY MANAGED PATIENTS WITH NON-ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROMES: INSIGHTS FROM THE MULTINATIONAL EPICOR ASIA STUDY

Many NSTEACS patients are medically managed without coronary revascularization. The reasons vary and may impact prognosis. EPICOR Asia ([NCT01361386][1]) is a prospective study of hospital survivors post ACS enrolled in 219 hospitals from 8 countries/regions in Asia (06/2011-05/2012). All medically

e0664 Clinical research on influence factors of pulmonary artery systolic pressure derived from tricuspid regurgitation by echocardigraph

Objective To explore which factors influence PASP calculated by echocardigraph through tricuspid regurgitation pressure gradient. Methods The retrospective study recruited 869 consecutive inpatients of Department of Cardiology in Peking University First Hospital, excluding patients who had acute myocardial infarction, pericardial effusion, congenital heart diseases, acute pulmonary embolism and organic tricuspid diseases. Their admission NYHA classification, N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiographic and other clinic data were collected. Pulmonary artery systolic pressure (PASP) was derived from trans-tricuspid regurgitation pressure gradient (TRPG) by echocardigraph. We analysed the correlations between PASP and age, sex, renal function, cardiopulmonary diseases and echocardigraph parameters, using single factor analysis and multivariate linear regression analysis. Results Among these patients, 658 were found to have TR, with a proportion of 75.7%. PASP was independently correlated to chronic obstructive pulmonary disease (COPD) (B (SE): 2.489 (1.121), p=0.027), chronic pulmonary embolism (B (SE): 9.282 (2.175), p<0.001), aortic stenosis (B (SE): 13.846 (3.545), p<0.001), aortic regurgitation (B (SE): 2.386 (1.091), p=0.029), mitral regurgitation (B (SE): 2.093 (0.934), p=0.025) and hypertension (B (SE): 1.560 (0.677), p=0.022), but not to other cardiovascular diseases such as cardiomyopathy, atrial fibrillation, coronary heart diseases and renal function (p>0.05). PASP had independent correlation with both NYHA classification (B (SE): 3.701 (0.468), p=0.002) and NT-proBNP (B (SE): 2.235 (0.569), p<0.001). PASP was correlated to TR severity positively (B (SE): 5.801 (0.798), p<0.001), but not parallel to it. Age was an important predictor of PASP (B (SE): 0.081 (0.027), 95% CI (0.028 to 0.134), p<0.001), with an average increase in PASP of 0.81 mm Hg per decade. Conclusions Tricuspid regurgitation is common in cardiac patients. PASP was independently correlated to COPD, chronic pulmonary embolism, left ventricular valve diseases and hypertension, but not to cardiomyopathy, atrial fibrillation, coronary heart diseases and renal function. PASP elevated with the increase of NYHA classification and NT-proBNP. It may play an important role in the evaluation of heart function. PASP should not be substituted by TR severity on the valuation of pulmonary circulation pressure. Age was an important predictor of PASP.

e0484 The safety study of tirofiban in patients with STEMI during emergency PCI

Objective To assess the safety of GP IIb/IIIa antagonists tirofiban in patients with ST elevation myocardial infarction (STEMI) during emergency Percutaneous Coronary Intervention (PCI). Method 120 patients with STEMI during emergency PCI, divided into two groups, tirofiban+PCI group (n=60) and primary PCI group (n=60). The two groups are compared on their major adverse cardiovascular events (MACE) rates which consisted of death, new onset myocardial infarction, persistent myocardial ischeamic state, Cardiac function (1eft ventricular ejection fraction) after operation, compression haemostasia time and adverse drug effect while in hospital. Result Major adverse cardiovascular events (MACE) rates in tirofiban+PCI group was higher than that of primary PCI group (10% vs 6.7%); Postoperative heart function was better in tirofiban+PCI group than that in primary PCI group (56.97±8.41 vs 54.15±7.11): There was no difference in severe haemorrhage between the two groups.The bleeding event rates were of higher tendency in tirofiban+PCI group. (8.3% vs 3.3%). APTT and compression haemostasia time of tirofiban+PCI group were significant when prolonged (53.97±10.58 vs 32.51±6.31) p<0.05), but no more bleeding and heamatom events occurred during prolongation. Conclusion GPII b/III a antagonists tirofiban+PCI is a possible safe and effective reperfusion method with STEMI during emergency PCI.

e0485 Clinic study of domestic tirofiban on TIMI Flow during facilitated PCI

Objective To assess Thrombolysis In Myocardial Infarction (TIMI) flow of the nation-produced tirofiban in patients with ST-segment elevation myocardial infarction (STEMI) during primary Percutaneous Coronary Intervention (PCI). Methods 120 patients with STEMI during primary PCI from Nov 2006 to June 2009 were divided into two groups, tirofiban+PCI group of 60 cases (51 males and 9 females) with mean age (60.11±10.96) years old, and the other primary PCI group of 60 cases (42 males and 18 females) with mean age (64.33±11.91) years. The TIMI flow before and after operation were observed in all cases angiographically. Results By using tirofiban before operation improved TIMI flow, a greater percentage of TIMI 1 grade flow was achieved in the tirofiban+PCI group compared with the primary PCI group before operation (13.3.8% vs 3.3%, p>0.05). There was no difference of TIMI 3 grade flow between the two groups after operation, TIMI 2 grade flow was lesser in tirofiban+PCI group (6.7% vs 3.4%, p>0.05).Reperfusion arrhythmia was lesser in tirofiban+PCI group (3.4% vs 6.7%). Conclusion Tirofiban may improve TIMI flow of the IRA in patients with STEMI during emergency PCI.