OBJECTIVE To evaluate the feasibility and tolerability of metoprolol standard dosing pathway(MSDP)in Chinese patients with acute coronary syndrome(ACS).METHODS In this multicenter,prospective,open label,single-arm and...OBJECTIVE To evaluate the feasibility and tolerability of metoprolol standard dosing pathway(MSDP)in Chinese patients with acute coronary syndrome(ACS).METHODS In this multicenter,prospective,open label,single-arm and interventional study that was conducted from February 2018 to April 2019 in fifteen Chinese hospitals.A total of 998 hospitalized patients aged≥18 years and diagnosed with ACS were included.The MSDP was applied to all eligible ACS patients based on the standard treatment recommended by international guidelines.The primary endpoint was the percentage of patients achieving the target dose at discharge(V2).The secondary endpoints included the heart rate and blood pressure at V2 and four weeks after discharge(V4),and percentage of patients experiencing bradycardia(heart rate<50 beats/min),hypotension(blood pressure<90/60 mmHg)and transient cardiac dysfunction at V2 and V4.RESULTS Of the 998 patients,29.46%of patients achieved the target dose(≥95 mg/d)at V2.The total population was divided into two groups:target group(patients achieving the target dose at V2)and non-target group(patients not achieving the target dose at V2).There was significant difference in the reduction of heart rate from baseline to discharge in the two groups(-4.97±11.90beats/min vs.-2.70±9.47 beats/min,P=0.034).There was no significant difference in the proportion of bradycardia that occurred in the two groups at V2(0 vs.0,P=1.000)and V4(0.81%vs.0.33%,P=0.715).There was no significant difference in the proportion of hypotension between the two groups at V2(0.004%vs.0.004%,P=1.000)and V4(0 vs.0.005%,P=0.560).No transient cardiac dysfunction occurred in two groups during the study.A total of five adverse events(1.70%)and one serious adverse event(0.34%)were related to the pathway in target group.CONCLUSIONS In Chinese ACS patients,the feasibility and tolerability of the MSDP have been proved to be acceptable.展开更多
目的探讨老年女性急性心肌梗死后心力衰竭的临床特点、危险因素,为临床诊治提供参考。方法回顾性分析北京市顺义区医院心血管内科2021年1—12月收治的80例老年急性心肌梗死患者(>60岁)的临床资料,按照性别进行分组后,对比2组临床特点...目的探讨老年女性急性心肌梗死后心力衰竭的临床特点、危险因素,为临床诊治提供参考。方法回顾性分析北京市顺义区医院心血管内科2021年1—12月收治的80例老年急性心肌梗死患者(>60岁)的临床资料,按照性别进行分组后,对比2组临床特点:年龄、就诊时间、心功能分级、心肌酶、B型钠尿肽(N terminal pro B type natriuretic peptide,NT-proBNP)、多支病变比例等,并对心肌梗死患者心力衰竭的相关危险因素进行分析。结果老年女性发病年龄、病程、心梗后心衰发生率,就诊时间高于老年男性(t=5.235、4.644、8.876、14.755,P<0.05),老年女性心功能分级、TnⅠ、NT-proBNP高于老年男性(t=2.330、16.361,P<20.05),老年女性多支病变比例高于老年男性(χ=6.573,P<0.05)。老年女性急性心肌梗死患者发生心力衰竭的主要危险因素为冠心病家族史、高血压、糖尿病、高脂血症(P<0.05)。结论老年女性急性心肌梗死患者发生心力衰竭的危险性高于老年男性,合并冠心病家族史、高血压、糖尿病、高脂血症的患者发生心力衰竭的风险明显增加。展开更多
结合病例评价经皮D-shant心房分流器植入在重度肺动脉高压(PAH)右心衰竭患者的安全性及有效性。1例53岁女性患者,诊断重度特发性PAH合并右心衰竭,世界卫生组织心功能分级Ⅳ级,于2021年11月30日在局部麻醉下行右心导管+D-shant心房分流...结合病例评价经皮D-shant心房分流器植入在重度肺动脉高压(PAH)右心衰竭患者的安全性及有效性。1例53岁女性患者,诊断重度特发性PAH合并右心衰竭,世界卫生组织心功能分级Ⅳ级,于2021年11月30日在局部麻醉下行右心导管+D-shant心房分流器植入术。术中选择6 mm×4 cm外周动脉球囊扩张房间隔,植入开口直径4 mm D-shant心房分流器,术后患者症状好转,血流动力学改善。姑息性经皮心房分流器植入以建立右向左分流是治疗晚期PAH患者的另一种方法,具有良好的安全性和有效性。或许是目前耐药重度PAH患者改善症状和延长生存期的另一种替代治疗。展开更多
基金supported by the National Key Research and Development Program of China(2016YFC1300300)。
文摘OBJECTIVE To evaluate the feasibility and tolerability of metoprolol standard dosing pathway(MSDP)in Chinese patients with acute coronary syndrome(ACS).METHODS In this multicenter,prospective,open label,single-arm and interventional study that was conducted from February 2018 to April 2019 in fifteen Chinese hospitals.A total of 998 hospitalized patients aged≥18 years and diagnosed with ACS were included.The MSDP was applied to all eligible ACS patients based on the standard treatment recommended by international guidelines.The primary endpoint was the percentage of patients achieving the target dose at discharge(V2).The secondary endpoints included the heart rate and blood pressure at V2 and four weeks after discharge(V4),and percentage of patients experiencing bradycardia(heart rate<50 beats/min),hypotension(blood pressure<90/60 mmHg)and transient cardiac dysfunction at V2 and V4.RESULTS Of the 998 patients,29.46%of patients achieved the target dose(≥95 mg/d)at V2.The total population was divided into two groups:target group(patients achieving the target dose at V2)and non-target group(patients not achieving the target dose at V2).There was significant difference in the reduction of heart rate from baseline to discharge in the two groups(-4.97±11.90beats/min vs.-2.70±9.47 beats/min,P=0.034).There was no significant difference in the proportion of bradycardia that occurred in the two groups at V2(0 vs.0,P=1.000)and V4(0.81%vs.0.33%,P=0.715).There was no significant difference in the proportion of hypotension between the two groups at V2(0.004%vs.0.004%,P=1.000)and V4(0 vs.0.005%,P=0.560).No transient cardiac dysfunction occurred in two groups during the study.A total of five adverse events(1.70%)and one serious adverse event(0.34%)were related to the pathway in target group.CONCLUSIONS In Chinese ACS patients,the feasibility and tolerability of the MSDP have been proved to be acceptable.
文摘目的探讨老年女性急性心肌梗死后心力衰竭的临床特点、危险因素,为临床诊治提供参考。方法回顾性分析北京市顺义区医院心血管内科2021年1—12月收治的80例老年急性心肌梗死患者(>60岁)的临床资料,按照性别进行分组后,对比2组临床特点:年龄、就诊时间、心功能分级、心肌酶、B型钠尿肽(N terminal pro B type natriuretic peptide,NT-proBNP)、多支病变比例等,并对心肌梗死患者心力衰竭的相关危险因素进行分析。结果老年女性发病年龄、病程、心梗后心衰发生率,就诊时间高于老年男性(t=5.235、4.644、8.876、14.755,P<0.05),老年女性心功能分级、TnⅠ、NT-proBNP高于老年男性(t=2.330、16.361,P<20.05),老年女性多支病变比例高于老年男性(χ=6.573,P<0.05)。老年女性急性心肌梗死患者发生心力衰竭的主要危险因素为冠心病家族史、高血压、糖尿病、高脂血症(P<0.05)。结论老年女性急性心肌梗死患者发生心力衰竭的危险性高于老年男性,合并冠心病家族史、高血压、糖尿病、高脂血症的患者发生心力衰竭的风险明显增加。
文摘结合病例评价经皮D-shant心房分流器植入在重度肺动脉高压(PAH)右心衰竭患者的安全性及有效性。1例53岁女性患者,诊断重度特发性PAH合并右心衰竭,世界卫生组织心功能分级Ⅳ级,于2021年11月30日在局部麻醉下行右心导管+D-shant心房分流器植入术。术中选择6 mm×4 cm外周动脉球囊扩张房间隔,植入开口直径4 mm D-shant心房分流器,术后患者症状好转,血流动力学改善。姑息性经皮心房分流器植入以建立右向左分流是治疗晚期PAH患者的另一种方法,具有良好的安全性和有效性。或许是目前耐药重度PAH患者改善症状和延长生存期的另一种替代治疗。
