Wei Yidong

e0419 The applying of aspiration catheter in revascularisation in patients with ST-elevation myocardial infarction

Objectives To observe the immediate and recent treatment effects of applying the aspiration catheter in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods From March to June 2010, we enrolled the STEMI patients presenting with TIMI Flow Grade 0 or 1 in the infarct related artery (IRA) at baseline CAG undergoing primary PCI. The aspiration catheter (Medtronic Inc., Export?) was applied immediately to aspirate the intracoronary thrombus. Whether predilatating and/or stenting were decided by the blood flow and the condition of lesions. The patients from October 2009 to February 2010 who was diagnosed as STEMI and received non-aspiration were enrolled as control group. The immediate and recent clinical outcomes of applying the aspiration catheter were compared between the two groups. Results There were 25 cases in Group thrombus-aspiration (2 cases of subacute stent thrombosis). After having aspirated the intracoronary thrombus using the aspiration catheter, 14 cases of STEMI recovered immediately (9 cases received direct stenting; 3 cases implanted stents after balloon predilatation, and had satisfied results; 2 cases of subacute stent thrombosis received the antithrombotic therapy, included intravenous infusion of Xinweining for 36 h in CCU immediately after recovering TIMI grade-3 flow). 10 cases recovered TIMI 1-2, 1 cases also showed no-reflow. All of the 11 cases received the balloon predilatation and stenting, only one showed slow flow, the others recovered. There was no other severe complication during and after the operation. There was no in-stent thrombosis during 1 month follow-up, and the cardiac function improved largely. There were 22 cases in Group non-aspiration, 4 cases received direct stenting, 18 cases received balloon predilatation and stenting.5 cases showed slow flow, 3 cases recovered normal flow after intra-coronary infusion of nitroglycerin, verapamil and Xinweinin, but 2 cases also showed TIMI 1, and accompanied heart failure. Conclusions The applying of aspiration catheter in patients with STEMI prior to primary PCI could increase the opportunities of direct stenting, improve myocardial reperfusion, immediate and recent clinical outcomes as compared with PCI in the absence of thrombus aspiration, and also show ease and safe procedure.

e0365 Clinical study on relationship between serum gamma-glutamyltransferase and coronary heart disease in women

Objective To study the relationship between serum gamma-glutamyltransferase (GGT) and coronary heart disease (CHD) in women. Methods 636 patients (354 men, 282 women) undergoing coronary angiography were enrolled from March 2009 to November 2009 in the department of cardiology, Shanghai Tenth Peoples Hospital, Tongji University. The various indicators of blood testing and clinical data were collected among 636 patients. According to the results of coronary angiography, men and women respectively divided into CHD group and non-CHD group. According to the level of serum GGT, men and women respectively divided into five grade groups (normal low, normal high, moderately elevated, elevated, highly elevated). Results The serum GGT levels in CHD group were statistically different from those in non-CHD group in women (p=0.010) but not in men (p=0. 480). More women had elevated serum GGT levels in CHD group than those in non-CHD group (p=0.009, OR=1.877), but this significant difference was not found in men (p=0.427, OR=0.829). The prevalence of CHD in women was significantly increased as serum GGT levels elevated (p=0.012), but this trend was not found in men (p=0.369). The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), direct bilirubin (DBIL), post prandial blood glucose (PBG) and the values of Ln triglycerides (LnTG) in women were positively correlated with the values of Ln serum GGT levels (LnGGT) separately, but levels of high density lipoprotein cholesterol (HDL-C) were negatively correlated with LnGGT. The levels of ALT, uric acid (UA), fasting blood glucose (FBG), total cholesterol (TC) and LnTG in men were positively correlated with the values LnGGT separately. Logistic regression indicated that serum GGT was independent risk factor of CHD in women (OR=1.782, 95% CI 1.043 to 3.043, p=0.034). Conclusion (1) Serum GGT was correlated with morbidity of CHD in women. (2) The prevalence of CHD in women was significantly increased as serum GGT levels elevated. (3) The values of LnGGT were positively correlated with the levels of PBG and the values of LnTG in women, but negatively correlated with the levels of HDL-C. (4) Serum GGT was independent risk factor of CHD in women.

e0385 Anklebrachial index as a predictor for the severity of coronary artery stenosis

Objective To study the relationship between ankle-brachial index (ABI) and the severity of coronary artery stenosis. Method This study enrolled 180 patients, who underwent coronary angiography and ABI measurement in addition to date collection regarding cardiovascular risk factors. They were divided into two groups according to ABI. The correlation between cardiovascular risk factors, ABI and the CAD severity were analysed. Results Gensini score (69.0±20.1), three vessel (56, 56%) and B2/C type stenotic lesion (79, 79%) was significantly higher in ABI<0.9 group compared with control group (50.7±17.6), (19, 23.8%), (31, 38.8%). Result Gensini score (69.0±20.1), three vessel (56, 56%) and B2/C type stenotic lesion (79, 79%) was significantly higher in ABI<0.9 group, Compared with control group (50.7±17.6), (19, 23.8%), (31, 38.8%). Binary regression analysis showed that ABI, correlated with several risk factors, was a statistically significant independent predictor for three vessel or complex (B2/C) stenotic lesions and odds ratio were 3.620 and 4.011 respectively. The stepwise multivariable regression analysis shown, ABI<0.9 (R=−3.018, P<0.05) and age (R=1.206, P<0.05) enter the gensini score regression equation. Conclusion ABI is negatively correlated with the degree of coronary artery stenosis. ABI≤0.9 is a good predictor of severe coronary artery disease.

e0693 Comparison of myocardial bridges imaging with multi-slice spiral CT and coronary angiograph

Objective To assess the diagnostic and clinical value of 64-slice CT coronary angiography (64SCTCA) for evaluation of myocardial bridge (MB) and mural coronary artery (MCA). Methods A total of 527 patients underwent 64SCTCA. The CT data was reconstructed and post-processed in the work-station. All the cases with MB were submitted to coronary angiography (CAG) studies observing the existence, length and thickness of MB as well as the stenosis of MCA. The results of CT and CAG were compared and analysed in the end. Results The 118 of 527 cases with MB segments were found through 64SCTCA. The detection rate is 22.4%. The 45 of 118 cases which were detected by 64SCTCA were found MB positive by CAG. The detection rate is 9.1%. The dates represent significant difference from 64SCTCA and CAG. Statistical significance was established at the p<0.05 level. The MB cases were found by 64SCTCA with the mean length of (6.1±2.5) mm, the mean thickness of (2.5±1.6) mm and the mean stenosis rate of MC of (47.3±11.3)%. The length and the stenosis rate of MB measured by CAG represent significant differences from those dates by 64SCTCA (p<0.05). Conclusion The 64SCTCA can clearly characterise MB and MC, and has important clinical values.