ObjectiveTo study the relationship between plasma cardiac troponin I (cTnI) and global registry of acute coronary events (GRACE) risk score in patients with acute non ST segment elevation myocardial infarction (NSTEMI),and to assess the value of low GRACE risk score combined with plasma cTnI concentration in predicting hospital cardiovascular events in NSTEMI patients. MethodA total of 168 patients with NSTEMI treated between January 2011 and December 2012 were included in this study. Their serum CTnI level was measured instantly and on the second day (within 24 hours) to get the peak value. GRACE risk score was calculated by computer rating software. According to the GRACE risk score,risk stratification was performed,and patients were divided into low-risk group (n=48),middle-risk group (n=75) and high-risk group (n=45). Routine treatment was carried out for the patients during hospitalization. ResultsThe serum cTnI peak value was higher in high-risk patients than that in low-risk patients and middle-risk patients (P<0.05). The cTnI peak value was significantly higher in the middle-risk patients than in the low-risk patients (P<0.05). The incidence of major adverse cardiovascular events (MACE) in low-risk patients with higher serum cTnI peak value was relatively higher. Age,hyperlipidemia,and serum cTnI were closely related to MACE (P<0.05). ConclusionsFor NSTEMI patients with a low GRACE score,the MACE rate increases with the increase of serum cTnI concentration. GRACE low score and cTnI concentration have a certain clinical value in assessing the risk of MACE in NSTEMI patients.
Objective To determine the efficacy and safety of Amplatzer transcatheter closure and surgical closure for ostium secundum atrial septal defects. Methods MEDLINE (1966-July 2006), EMBASE (1966-July 2006), The Cochrane Library (Issue 2, 2006) and CBMdisc (1979-July 2006) were searched for randomized controlled trials or non-randomized controlled trials. Data were extracted by two reviewers using a specially designed extraction form. The quality of included trials was critically assessed. The Cochrane Collaboration’s RevMan 4.2 software was used for data analysis. Results Sixteen non-RCTs involving 2 043 patients were included. No deaths were reported in 14 trials. The other two trials reported one death respectively in the surgical group. Meta-analysis of 12 trials involving 1 722 patients showed that the procedure success rate for the Amplatzer group was lower than that for the surgical group [WMD:0.95, 95%CI (0.92,0.98)]. Similar results were also found in the complete closure rate in 24-hour follow-up [6 trials involving 1 106 patients, WMD:0.96, 95%CI (0.92 to 1.00)], the complication rate [16 trials involving 1 971 patients, WMD:0.27, 95%CI(0.21 to 0.35)] and the transfusion rate [14 trials involving 1 807 patients, WMD:0.03, 95%CI(0.02 to 0.06)]. Conclusions The success rate for Amplatzer device closure of ASD is lower than that of surgical repair. However, the complication rate, length of hospital stay and transfusion rate are lower or shorter for Amplatzer device closure than for surgical repair. Based on appropriate patient selection, Amplatzer closure of ASD is a safe and effective alternative to surgical repair.