目的 探讨冠心病患者PCI后发生牙龈出血的影响因素.方法 选取2021年10月至2022年1月中南大学湘雅二医院收治的接受PCI的冠心病患者240例.根据患者术后72 h内牙龈出血(包括进食硬食物时出血、刷牙出血、自行出血)发生情况将其分为出血组与未出血组.观察患者术后72 h内牙龈出血发生率.通过单因素、多因素Logistic回归分析探讨冠心病患者PCI后发生牙龈出血的影响因素.结果 240例患者中37例发生牙龈出血,发生率为15.4％.多因素Logistic回归分析结果显示,肾功能不全〔OR=9.255,95％CI(1.487,57.613)〕与手术时长〔OR=1.010,95％CI(1.001,1.020)〕是冠心病患者PCI后发生牙龈出血的影响因素(P<0.05).结论 慢性肾功能不全和手术时长是冠心病患者PCI后发生牙龈出血的影响因素.

We read the article "Association of low serum albumin concentration and adverse cardiovascular events in stable coronary heart disease" by Chien et al. [ [1] Chien S.C. Chen C.Y. Leu H.B. Su C.H. Yin W.H. Tseng W.K. et al. Association of low serum albumin concentration and adverse cardiovascular events in stable coronary heart disease. Int. J. Cardiol. 2017; 241: 1-5 Abstract Full Text Full Text PDF PubMed Scopus (46) Google Scholar ] interestingly, which provided more evidences of the potential link between serum albumin concentration and cardiovascular (CV) outcomes in stable coronary heart disease (CHD) patients and showed low serum albumin concentration (<3.5 g/dL) worsened prognosis of patients with stable CHD.

We read the article “How safe are NOACs compared with phenprocoumon after pulmonary vein isolation with the cryoballoon technique using purse-string suture closure?” by Akkaya et al. [ [1] Akkaya E. Berkowitsch A. Zaltsberg S. Deubner N. Greiss H. Hain A. et al. How safe are NOACs compared with phenprocoumon after pulmonary vein isolation with the cryoballoon technique using purse-string suture closure?. Int. J. Cardiol. 2017; 248: 201-207 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar ] interestingly, which found that novel oral anticoagulants (NOACs) had a lower complication rate and appeared to be safer than phenprocoumon after pulmonary vein isolation (PVI) with the cryoballoon technique using purse-string suture closure, and the hospital costs and hospital stay length after PVI were significantly reduced in NOACs treated patients. Some recent studies [ 2 Lakkireddy D. Reddy Y.M. Di Biase L. Vallakati A. Mansour M.C. Santangeli P. et al. Feasibility and safety of uninterrupted rivaroxaban for periprocedural anticoagulation in patients undergoing radiofrequency ablation for atrial fibrillation: results from a multicenter prospective registry. J. Am. Coll. Cardiol. 2014; 63: 982-988 Crossref PubMed Scopus (173) Google Scholar , 3 di Biase L. Lakkireddy D. Trivedi C. Deneke T. Martinek M. Mohanty S. et al. Feasibility and safety of uninterrupted periprocedural apixaban administration in patients undergoing radiofrequency catheter ablation for atrial fibrillation: results from a multicenter study. Heart Rhythm. 2015; 12: 1162-1168 Abstract Full Text Full Text PDF PubMed Scopus (129) Google Scholar , 4 Eitel C. Koch J. Sommer P. John S. Kircher S. Bollmann A. et al. Novel oral anticoagulants in a real-world cohort of patients undergoing catheter ablation of atrial fibrillation. Europace. 2013; 15: 1587-1593 Crossref PubMed Scopus (52) Google Scholar , 5 Hohnloser S.H. Camm A.J. Safety and efficacy of dabigatran etexilate during catheter ablation of atrial fibrillation: a meta-analysis of the literature. Europace. 2013; 15: 1407-1411 Crossref PubMed Scopus (87) Google Scholar ] also showed that NOACs were non-inferior to phenprocoumon in preventing cardiac thromboembolism in AF patients.

We read the article “Excessive atrial ectopic activity as an independent risk factor for ischemic stroke” by Marinheiro et al. [ [1] Marinheiro R. Parreira L. Amador P. Sa C. Duarte T. Caria R. Excessive atrial ectopic activity as an independent risk factor for ischemic stroke. Int. J. Cardiol. 2017; 249: 226-230 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar ] interestingly, which has great significance in shedding light on the relationship between excessive atrial ectopic activity (EAEA) and ischemic stroke, atrial fibrillation (AF) and overall death. EAEA has been shown to be associated with an increased risk of AF and stroke [ 2 Murakoshi N. Xu D. Sairenchi T. Igarashi M. Irie F. Tomizawa T. et al. Prognostic impact of supraventricular premature complexes in community-based health checkups: the Ibaraki Prefectural Health Study. Eur. Heart J. 2015; 36: 170-178 Crossref PubMed Scopus (44) Google Scholar , 3 Larsen B.S. Kumarathurai P. Falkenberg J. Nielsen O.W. Sajadieh A. Excessive atrial ectopy and short atrial runs increase the risk of stroke beyond incident atrial fibrillation. J. Am. Coll. Cardiol. 2015; 66: 232-241 Crossref PubMed Scopus (129) Google Scholar ], however, the precise definition for “excessive” atrial ectopy and the cut-off value of premature atrial contractions (PACs) were ambiguous [ 3 Larsen B.S. Kumarathurai P. Falkenberg J. Nielsen O.W. Sajadieh A. Excessive atrial ectopy and short atrial runs increase the risk of stroke beyond incident atrial fibrillation. J. Am. Coll. Cardiol. 2015; 66: 232-241 Crossref PubMed Scopus (129) Google Scholar , 4 Chong B.H. Pong V. Lam K.F. Liu S. Zuo M.L. Lau Y.F. et al. Frequent premature atrial complexes predict new occurrence of atrial fibrillation and adverse cardiovascular events. Europace. 2012; 14: 942-947 Crossref PubMed Scopus (115) Google Scholar ]. Excessive atrial ectopic activity as an independent risk factor for ischemic strokeInternational Journal of CardiologyVol. 249PreviewExcessive atrial ectopic activity (EAEA) has been related with an increased risk of atrial fibrillation (AF) and stroke but different cutoff values have been used. We aimed to determine the association between EAEA and stroke, AF and overall death. Full-Text PDF “Excessive” atrial ectopy is worse than “frequent” atrial ectopyInternational Journal of CardiologyVol. 251PreviewThank you for your comments. We are entirely in agreement with you, there is not a precise definition for “excessive” atrial ectopy, as we referred in our article [1]. However, we intended to study a higher cut-off value than other previous studies, which in fact used the top 10th percentile [2,3]. Following their idea and with the aim of understanding if “excessive” atrial ectopy is worse than “frequent” atrial ectopy, we used the top 5th percentile in our population. A cut-off value determined by the receiver operating characteristic curve using stroke occurrence would probably give similar results but would not be able to distinguish if excessive is worse than frequent atrial ectopy. Full-Text PDF

BACKGROUND:To distinguish left ventricular outflow tract (LVOT) from right ventricular outflow tract (RVOT) origin in idiopathic outflow tract premature ventricular contractions (IOT-PVCs) patients with precordial R/S transition at lead V3 is still a challenge. We sought to develop a new electrocardiography (ECG) method for distinguishing LVOT from RVOT origin in IOT-PVCs patients with precordial R/S transition at lead V3.METHODS:We analyzed the surface 12-lead ECG characteristics and the difference of coupling interval variability (CIV) of PVCs between distinct origin sites in a retrospective cohort of IOT-PVCs patients with precordial R/S transition at lead V3 who underwent successful radiofrequency catheter ablation (RFCA) to develop a new diagnostic method, then validated it in a prospective cohort.RESULTS:A total of 196 consecutive patients (41 ± 15 years, 36.7% male) underwent RFCA of IOT-PVCs between January 2014 and August 2016. Among them, 68 patients (34.7%, 23 male) with precordial R/S transition at lead V3 constituted the retrospective cohort. Based on the areas under the receiver operating characteristic curves (AUCs), a CIV > 100 ms with the largest value of AUC was selected to develop a new diagnostic method with a specificity of 93.9% and an accuracy of 92.6%. It correctly identified the origin site of 38 from 41 patients in the prospective cohort, demonstrating a 96.8% specificity and 92.7% accuracy.CONCLUSIONS:We presented a new simple method, a CIV > 100 ms which could reliably distinguish LVOT from RVOT origin in IOT-PVCs patients with precordial R/S transition at lead V3.