Objective:To evaluate neointimal coverage after Drug Eluting Stent implantation without no restenosis during angiographic follow up by using optical coherence tomography(OCT).Methods:18 case enrolled into this project who received angiography follow up and OCT checkout.Results:1.Totally,4709 struts were analyzed and 88.6% were completely covered with neointimal,and 0.7% were partly covered and 8.1% were uncovered.The rate of late malapposition of struts was 2.6%.The average neointimal hyperplasia thickness was 0.099 mm.2.The rates of uncovered struts,late strut malapposition were different among different types of DES,and so did the average neointimal hyperplasia thickness.3.Compared with DES implantation less than 12 months,the average neointimal hyperplasia thickness increased in the group of DES implantation more than 12 months(0.1183 mm vs 0.0875 mm ;P=0.001),and uncovered struts rate were 1.7% and 6.8%respectively(P<0.05),and late struts malapposition rate were 2.1% and 0.5% respectively(P<0.001).Conclusion:Rate of neointimal coverage over DES at about 16-months follow-up was 90.1%,as the rate of uncoverage was 9.9%.Out study suggests that dual antiplatelet therapy might be continued>16 months after DES implantation.
目的:探讨慢性稳定性心绞痛(CSA)患者妊娠相关蛋白-A(PAPP-A)的水平,及其与心血管危险因素和冠状动脉(冠脉)病变复杂程度的相关性。方法:入选因慢性胸痛接受诊断性冠脉造影的146例患者,平均年龄(57.1±8.2)岁,男性105例(71.9%),女性41例(28.1%)。146例患者中,冠脉正常或狭窄<50%者38例,为非CSA组;冠脉狭窄≥50%者108例,为CSA组,其中单支病变46例,多支病变62例。分析患者PAPP-A水平及其与心血管危险因素、左心室射血分数和冠脉SYNTAX评分的相关性。结果:PAPP-A水平(mIU/L):CSA组高于非CSA组(6.3±3.6 vs 3.7±1.0,P<0.001),多支冠脉病变者高于单支病变者(6.9±4.5 vs 5.4±1.5,P=0.011),男性明显高于女性(5.9±3.5 vs 4.4±2.7,P=0.021),高血压患者明显高于血压正常者(6.5±3.8 vs 4.4±2.4,P<0.001),差异均有统计学意义。CSA患者PAPP-A水平与冠脉SYNTAX评分成正相关(r=0.374,P<0.001),高敏C反应蛋白水平与冠脉SYNTAX评分无关(r=0.141,P=0.144)。单因素及多因素回归分析显示,PAPP-A水平与年龄(r=0.225,P=0.006)、冠脉SYNTAX评分呈正相关(r=0.374,P<0.001)。年龄和PAPP-A水平是CSA的独立危险因素。结论:PAPP-A水平与男性、年龄、高血压、冠脉病变范围及程度有关,PAPP-A是CSA的独立危险因素。
