Aim:Epidemiological and genetic studies have shown that elevated basal remnant cholesterol (RC) levels increase cardiovascular disease (CVD) risk. However, the relationship between RC dynamics and CVD remains unclear. We aimed to investigate the relationship between the dynamic changes in RC and CVD occurrence in middle-aged and elderly populations in China. Methods and results:This cohort study investigated data from the study population of the 2011 and 2015 China Health and Retirement Longitudinal Study (CHARLS) and included 4,431 participants aged ≥45 years who provided complete information on RC and the occurrence or absence of CVD. Based on the change in RC in the population from 2011 to 2015, this study categorized the population into clusters 1, 2, and 3 using k-means cluster analysis. The relationship between baseline RC and CVD risk was examined using receiver operating characteristic (ROC) curves and restricted cubic spline (RCS) analysis. Logistic regression was used to explore the association between dynamic changes in RC levels and CVD risk, and subgroup analyses and sensitivity analyses were performed. There were 132 new cases of CVD among the 4,431 participants [2,386 women [53.85%] and 2,045 men [46.15%]; follow-up time, 4 years]. The area under the ROC curve for baseline RC in CVD was 0.534. RCS regression showed a linear association between RC at baseline and CVD. Logistic regression results showed a significantly increased CVD risk in Cluster 3 compared with Cluster 1 after correction for confounders (OR = 1.69, 95%CI: 1.13-2.55, P = 0.012); similarly, the risk of heart disease was significantly increased in Cluster 3 (OR = 1.76, 95%CI: 1.13-2.76, P = 0.012). Subgroup analyses showed a higher CVD risk in participants with baseline renal disease (OR = 15.34, 95%CI: 1.2-195.35, P = 0.035) and an interaction between RC change and body mass index (P for interaction = 0.038). Age-stratified analysis revealed a small difference in baseline RC between age groups (difference = -1.01 mg/dl, 95% CI: 0.08 to 1.94, P = 0.0328). RC showed the strongest correlation observed with TG (r = 0.80, p < 0.001). Conclusions:In middle-aged and older Chinese participants, increased dynamic RC predicts increased CVD risk. Therefore, continuous monitoring of changes in RC levels is needed to reduce the risk of CVD. Lay summary:This cohort study, including 4,431 middle-aged and elderly Chinese individuals, found that dynamically elevated remnant cholesterol was significantly associated with a 1.69-fold higher cardiovascular disease incidence, suggesting that dynamically elevated remnant cholesterol predicts a higher risk of cardiovascular disease in China's middle-aged and elderly population.

Objective::This study aimed to evaluate the major adverse cardiovascular and cerebrovascular events (MACCEs) and overall safety profile associated with iodixanol in Chinese patients undergoing percutaneous coronary intervention (PCI).Methods::Patients at 30 centers in China registered in the OpenClinic v3.6 database from October 30, 2013, to October 7, 2015, were included in the study. The primary endpoint was in-hospital MACCEs including target lesion revascularization (TLR), stroke, stent thrombosis, cardiac death, and PCI-related myocardial infarction (MI) within 72 h post-PCI. Secondary endpoints were MACCEs from 72 h to 30 d post-PCI and other safety events within 30 d post-PCI.Results::A total of 3,042 patients were enrolled. The incidence of MACCEs within 72 h post-PCI was 2.33% ( n = 71), including cardiac death (0.03%, n = 1) and PCI-related MI (2.30%, n = 70). The incidence of MACCEs from 72 h to 30 d post-PCI was 0.16% ( n = 5), including cardiac death (0.10%, n = 3), PCI-related MI (0.03%, n = 1), and TLR for stent thrombosis (0.03%, n = 1). The incidence of composite angiographic or procedural complications was 2.86% ( n = 87); 233 (7.86%) patients had results suggesting contrast-induced acute kidney injury. Conclusions::These findings indicate that the use of iodixanol in Chinese patients undergoing PCI is associated with a low incidence of MACCEs, confirming its safety in this population.

目的:在急性冠脉综合征行经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗并发急性非静脉曲张性上消化道出血患者中,观察直肠给抗血小板药物治疗策略的效果与安全性.方法:收集2016年12月—2020年3月在太原市中心医院因急性冠脉综合征入院,并行PCI治疗,并发急性非静脉曲张性上消化道出血患者248例,其中直肠给双联抗血小板药(替格瑞洛和阿司匹林)组86例(观察组),常规口服双联抗血小板药物组162例(对照组).收集患者的一般临床资料,住院期间血小板功能、直肠出血情况,记录心血管事件:死亡、心肌梗死、急性支架内血栓、再住院、靶血管血运重建,随访1年.结果:观察组与对照组比较有更少的女性(27.9％vs 14.7％),更高的入院时心率[(102.1±20.5)次/min vs(73.2±14.4)次/min],更低的入院收缩压[(99.1±21.2)mmHg vs(126.1±24.7)mmHg]、入院舒张压[(59.2±13.2)mmHg vs(79.2±11.8)mmHg]、血红蛋白[(107.9±21.6)g/L vs(119.4±19.7)g/L]、左室射血分数[(38.7±12.3)％vs(53.1±15.2)％],更高的多巴胺使用率(24.4％vs 6.8％).在急性非静脉曲张性上消化道出血疾病分类中,观察组较对照组有更多应激性溃疡(39.5％vs 20.4％)、急性胃黏膜病变(45.4％vs 32.1％),更少的消化性溃疡(15.1％vs 47.5％).观察组与对照组住院期间和随访1年总体心血管事件发生率差异无统计学意义(3.5％vs 2.5％,P=0.696;24.4％vs 17.3％,P=0.198).两组替格瑞洛有效率、血小板聚集率、血小板抑制率比较差异均无统计学意义(均P>0.05).结论:替格瑞洛和阿司匹林直肠给药方案治疗急性冠脉综合征患者PCI术后并发急性非静脉曲张性上消化道出血时具有一定的可行性.

钠-葡萄糖共转运蛋白 2抑制剂(SGLT2i)是一类用于治疗2型糖尿病的新型口服降糖药,可降低心血管事件风险.酮症酸中毒是 SGLT2i 少见的并发症,目前上市的药物中恩格列净的酮症酸中毒发生率最低.在2型糖尿病病人使用恩格列净并发酮症酸中毒导致急性ST段抬高型心肌梗死的发生最增加诊治的复杂性.现报道1例2型糖尿病病人应用恩格列净诱发酮症酸中毒致急性下壁心肌梗死的诊治经过,为此类病人的诊治提供参考.

目的 观察依替巴肽联合硝普钠在高血栓负荷急性ST段抬高型心肌梗死(ST-segment elevation myocardialinfarction,STEMI)患者急诊经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗中的疗效.方法 将太原市中心医院2019年1月至2020年6月高血栓负荷的90例STEMI患者作为研究对象,回顾性分析这些患者的病历资料,46例患者梗死相关动脉注射依替巴肽+硝普钠作为观察组,44例患者注射硝普钠作为对照组.两组患者均行急诊PCI治疗,并给予冠状动脉粥样硬化性心脏病(冠心病)二级预防药物.术中均给予血栓抽吸,分析靶血管再通情况[心肌梗死溶栓试验(myocardial infarction thrombolysis test,TIMI)血流分级、TIMI心肌灌注(TIMI myocardial perfusion classification,TMPG)分级,术后2 h ST段回落率(ST-segment fall rate,STR)].观察治疗前后血小板聚集率及术后出血事件发生率;PCI治疗后1周及6个月心功能情况,包括N末端B型脑钠肽前体(N-terminal B-type pro-brain natriuretic peptide,NT-proBNP)、生长刺激表达基因2蛋白(growth-stimulating expression gene 2 protein,ST2)、左心室射血分数(left ventricular ejection fraction,LVEF);随访6个月主要不良心血管事件(major adverse cardiovascular events,MACE).结果 两组患者靶血管治疗前TIMI及TMPG血流分级比较,差异无统计学意义(P>0.05);治疗后两组患者TIMI血流、TMPG血流分级及STR比较,差异有统计学意义(P<0.05).两组患者治疗前血小板聚集率及治疗后出血发生率比较,差异无统计学意义(P>0.05);治疗后两组患者血小板聚集率比较,差异有统计学意义(P<0.05).术后1周及6个月两组患者心功能指标比较,差异有统计学意义(P<0.05);随访期间两组患者MACE发生率比较,差异有统计学意义(8.7％vs.27.3％,P<0.05).结论 经抽吸导管向梗死相关动脉注射依替巴肽和硝普钠,可改善STEMI患者急诊PCI治疗后TIMI及TMPG血流,减少无复流,改善患者近期心功能,减少MACE发生率,未增加出血并发症,是一种切实有效的方法.

急性冠状动脉综合征(ACS)是全球致死的重要原因之一[1],进展快、对患者威胁大.在ACS中出现低血压甚至心源性休克的并发率较高[2],且疾病进展迅速,治疗不及时死亡率高[3].经皮冠状动脉介入治疗(PCI)术是目前ACS的主要治疗手段,可解除冠状动脉痉挛、进行早期血运重建,如术中出现心源性休克,可使冠状动脉灌注不足,易出现无复流的情况,此时应及时应用血管活性药物[4].本研究旨在观察急诊PCI术中合并心源性休克患者应用去甲肾上腺素与多巴胺治疗以维持血压,改善低灌注症状的临床效果以及其不良反应及护理,现报告如下.

One hundred and nine consecutive coronary heart disease (CHD) patients with obstructive sleep apnea (OSA) undergoing percutaneous coronary intervention (PCI) during February 2016 to August 2018 were enrolled in the study. After treatment the quality of sleep was improved in 35 cases (observation group) and was not improved in 74 patients (control group). The basic characteristics, coronary lesions of patients were compared between two groups. Compared with the control group, patients in observation group had significant higher proportion of males [80.0%(28/35) vs. 59.5%(44/74), χ 2=4.471, P=0.035], smoking history [85.7% (30/35) vs. 63.5% (47/74), χ 2=5.647, P=0.018], lower body mass index [(25.8±3.1) kg/m 2vs. (27.4±3.2) kg/m 2, t=2.461, P=0.033]. Compared with control group, the observation group had lower coronary Gensini score[(35.4±5.7) vs. (38.7±6.5), t=2.571, P=0.011], less number of stent[ (1.4±0.4) vs. (1.6±0.4), t=2.427, P=0.016]. And the lesions were mostly distributed in the right coronary artery in observation group (61.9%, 26/35) (χ 2=11.759, P=0.003). Conclusion:The improvement of sleep quality by PCI depends on the clinical features and coronary artery lesions of CHD patients with OSA.

OBJECTIVES:We aimed to evaluate the safety and efficacy of Nano+™ (Lepu Medical, Beijing, China) stent implantation in all-comer patients at the 1-year follow-up. BACKGROUND:The Nano+™ stent is a novel polymer-free sirolimus-eluting stent polymer that employs nanoporous stent surface technology to control drug-delivery. The Nano+™ stent is one of the most widely used drug-eluting stent (DES) in China. METHODS:A total of 2,481 consecutive patients were included in the multicenter and prospective NANO registry. In this study, the primary endpoint was target lesion failure (TLF) at 1-year follow-up, defined as a composite of cardiac death, target vessel nonfatal myocardial infarction (TV-MI), and clinically driven target lesion revascularization (TLR). The safety endpoint was the occurrence of definite or probable stent thrombosis (ST). RESULTS:Up to 40.2% of patients presented with acute myocardial infarction (AMI). A total of 63.9% of the 2,904 lesions were American College of Cardiology/American Heart Association (ACC/AHA) type B2 or C lesions. One-year follow-up data were available for 98.4% of patients. The 1-year rate of TLF was 3.1% with rates of 1.3, 1.8, and 0.4% for clinically driven TLR, cardiac death, and TV-MI, respectively. ST occurred in 0.4% of patients. Diabetes mellitus, AMI, left ventricular ejection fraction <40% and long lesions (>40 mm) were independent predictors of 1-year TLF. CONCLUSIONS:The 1-year clinical outcomes were excellent for Nano+™ polymer-free SES implantation in an all-comer patient population. Follow-up will be extended up to 5 years, to further elucidate the potential long-term clinical benefits. CLINICAL TRIAL REGISTRATION:URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02929030.

Objective To observe the clinical effect of ticagrelor on acute ST-segment elevation myocardial infarction (STEMI) and bradyarrhythmia during primary percutaneous coronary intervention (PCI).Methods Totally 103 patients with acute STEMI and bradyarrhythmia were randomly divided into ticagrelor group (n=51) and clopidogrel group (n=52).Both group received primary PCI in 12 h after attack.Ticagrelor group received oral administration of 180 mg of ticagrelor and 300 mg of aspirin before primary PCI,followed by 90 mg of ticagrelor and 100 mg of aspirin twice a day after PCI.Clopidogrel group received oral administration of 300 to 600 mg of clopidogrel and 300 mg of aspirin before primary PCI,followed by 75 mg of clopidogrel and 100 mg of aspirin once a day.The in-hospital cardiovascular events were compared between two groups.The hospitalization stay,as well as the proportions of using temporary pacemaker,permanent pacemaker,atropine and dopamine due to hradyarrhythmia were recorded.The peak value of cardiac troponin Ⅰ (cTnⅠ) and creatine kinase isoenzyme MB (CK-MB) during hospitalization,B-type natriuretic peptide (BNP) and left ventricular ejection fraction (LVEF) at discharge,and the occurrence of bradyarrhythmia at discharge were observed.Results There were no significant differences in the proportion of culprit vessels,the incidence of cardiovascular events (9.80％ vs 13.4％),hospitalization stay ((7.06±2.07) d vs (6.93±2.29) d),the proportions of using temporary pacemaker (29.41％ vs 30.77％),permanent pacemaker (0 vs 1.92％),atropine (19.61％ vs 19.23％) and dopamine (27.45％ vs 26.92％) during hospitalization,peak values of cTnⅠ ((18.86±12.77) μg/L vs (18.25±12.09) μg/L) and CK-MB ((190.87±71.69) u/L vs (182.54±66.81) u/L) during hospitalization,the levels of BNP ((879.60±117.33)ng/Lvs (894.13± 105.98) ng/L) and LVEF ((52.79±12.01)％ vs (52.11±12.82)％) at discharge,and the incidences of tachycardia (3.92 ％ vs 3.85 ％),the second degree atrioventricular block (1.96 ％ vs 0) and the third degree atrioventricular block (0 vs 1.92 ％) at discharge between ticagrelor group and clopidogrel group (P＞0.05).Conclusion Both ticagrelor and clopidogrel before and after primary PCI can achieve good curative effects on patients with acute STEMI complicated with bradyarrhythmia.

Objective To evaluate the efficacy and safety of combined use of ticagrelor and cilostazol for patients with acute coronary syndrome (ACS) complicated with upper digestive tract diseases following percutaneous coronary intervention ( PCI).Methods A total of 262 consecutive ACS patients complicated with upper digestive tract diseases followed-up for one-year after PCI were included in this study.The patients were allocated into control group (combined use of ticagrelor and aspirin , n＝184) and cilostazol group ( combined use of ticagrelor and cilostazol , n ＝78) for antiplatelet treatment.The basic characteristics of the patients , change of the treatment regimens , cardiovascular events and hemorrhagic events were compared between two groups .Results After one year of follow-up, 16.8%(31/184)patients in control group and 3.8%(3/78)in cilostazol group changed antiplatelet regimens (χ2＝8.200,P＝0.004).There was no statistical difference in use of statins and ACEI/ARB between two groups(P＞0.05).The rate of proton pump inhibitor use in control group was significantly higher than that in cilostazol group [82.1%(151/184) vs.52.6%(41/78), χ2＝24.35, P＝0.000].However, the dosage of β-blockers in cilostazol group was significantly higher than that in control group [(39.1 ±12.4) mg vs.(28.6 ±10.1) mg, t ＝7.174,P＝0.000].No statistical difference was found in total cardiovascular events between two groups [21.7%(40/184) vs.12.8%(10/78),χ2＝2.822,P＝0.121].The incidence of gastrointestinal hemorrhage in control group was significantly increased compared with cilostazol group [12.0%(22/184) vs.2.6%(2/78),χ2＝5.807,P ＝0.018], however, there was no significant difference in hemorrhagic events concerning the thrombolysis for myocardial infarction between two groups [17.4%(32/184) vs.9.0%(7/78), χ2＝3.063,P＝0.089].Conclusion Combined use of cilostazol and ticagrelor is effective and safe for ACS patients with gastrointestinal hemorrhage or a higher risk of hemorrhage .

目的 探讨健康的生活方式对高血压病人血压水平及主要并发症的影响.方法 选取某社区高血压病人500例作为干预组,由社区医师上门指导病人进行健康教育,包括合理膳食、适当运动、戒烟、分别在研究开始和结束时进行一次膳食调查.研究结束时从相邻社区以配对方式抽取高血压病人500例作为对照组进行比较.结果 干预组病人研究结束后钠的摄入量、动物脂肪摄入量和动物胆固醇摄入量均下降,差异有统计学意义(P＜0.01);钾的摄入量升高,差异有统计学意义(P＜0.05或p＜0.01).干预组新发脑卒中、新发糖尿病、新发冠心病的发生率与对照组比较,差异有统计学意义(p＜0.05或p＜0.01).干预组病人戒烟25例,对照组病人仅戒烟8例,差异有统计学意义(P＜0.01).结论 高血压病人实行健康的生活方式,有利于控制病人血压,减少并发症的发生.

Objective To observe the effect of ticagrelor on bradyarrhythmia in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI).Methods The Clinical data of 514 cases were retrospective analysed.The patients were divided into ticagrelor (T) group and clopidogrel (C) group.Basic characteristics,develop ment,and treatment of the bradyarrhythmia,hospital stay,ejection fraction,and peak troponin value were compared between groups.The patients were further divided into subgroups according to whether complicated by bradyarrhythmia.Thus,T group was divided as TB (bradyarrhythmia) group and TN (non-bradyarrhythmia) group and C group was divided as CB group and CN group.Basic characteristics of the patients were compared between TB and TN group,and CB and CN group.Results 514 STEMI cases were included,including 236 cases in T group,278 cases in C group.Patients in TB group had significantly lower heart rate,systolic pressure and diastolic pressure (all P =0.000),lower level of blood potassium (P =0.000),higher level of blood glucose (P =0.021) and BNP (P =0.000),and higher incidence of heart failure history (P =0.003) compared with those in TN group.Patients in CB group had significantly lower heart rate,systolic pressure and diastolic pressure (all P =0.000),lower level of blood potassium (P =0.000),higher level of blood glucose (P =0.013) and BNP (P =0.000),and lower EF value (P =0.024) compared with those in CN group.Conclusion There was no significant difference of the therapeutic effect on the bradyarrhythmia in the acute STEMI patients undergoing emergency PCI between ticagrelor and clopidogrel.

目的:探讨分析影响冠心病出院患者自我效能因素.方法:选取2013年3月—2015年5月在我院进行治疗出院的100例冠心病患者,收集病患的各项资料进行自我效能量表进行自我效能调查,以调查询问的方式分析影响冠心病出院患者自我效能因素.结果:100例病患的自我效能调查得为(79.97±7.42),得分指数为(0.58±0.12),本组病患的疾病认知和自我效能水平较为低下;经研究发现影响冠心病出院患者自我效能的因素主要为:运动锻炼、教育水平、年龄、居住地及经济水平等.结论:冠心病疾病患者的自我效能相对低下,收集病患的各项资料对病患进行深入的研究分析后发现,病患的自我效能主要受到运动锻炼、教育水平、年龄、居住地及经济水平等因素影响,需要根据病患的自身情况进行分析并采取相应对的措施进行有效改善,从而有效的提升病患的自我效能和生活质量.

在日常工作当中,心血管内科医生接触的最多的疾病就是冠心病,很多患者都因为各种原因需要做支架,患者经常会问的一个问题就是:放了支架以后,冠心病是不是就治愈了呢? 对于这样的问题,我的回答通常是这样的,治疗冠心病很像是修理汽车轮胎,当轮胎扎了钉子的时候,我们需要把钉子拔出来,然后补上补丁,充上气,这样绝大多数的轮胎还是能够继续用的,但是我们不能保证所有补过的轮胎下次不扎钉子,唯一能做的事情就是尽可能在平坦的路面上开车,平时多检查,多保养.而得了冠心病就像是轮胎被扎了钉子,支架仅仅相当于一块补丁,并不能保证后期不复发,后面的保养才是更重要的,保养靠的是长期的药物治疗以及心血管康复治疗.

Objective To evaluate the diagnostic value of cardiac magnetic resonance (CMR) in suspected coronary heart disease patients with electrocardiogram abnormalities but normal coronary angiography. Methods The data of 25 suspected coronary heart disease patients with electrocardiogram abnormalities but normal coronary angiography were collected from Taiyuan central hospital between October 2010 and April 2012. Comparison was done in terms of anterior interventricular septal thickness, left ventricular posterior wall thickness, left ventricular end diastolic dimension, left ventricular end systolic dimension, left atrial diameterand ejection fraction measured by CMR and by UCG. Correlation of the aboved paremeters between the 2 imaging exams. Results 40%of patients had their diagnosis changed after CMR exam, 32%of the patients with adjusted assessment. The differences in anterior interventricular septal thickness, left ventricular posterior wall thickness, left ventricular enddiastolic dimension, left ventricular end systolic dimension, left atrial diameter, ejection fraction by CMR and by UCG were similar (P>0.05) with positive correlation (P<0.01). Conclusions CMR can provide diagnosis and evaluation information to chest pain patients with ECG abnormalities but normal CAG, and it is a good supplement for routine examination.

近年来,随着冠心病诊治方法的进展,冠心病的近期死亡率明显下降,随之由冠心病引起的心力衰竭有增高趋势.冠心病并发心力衰竭常引起不良临床事件,心律失常作为心力衰竭患者的常见并发症,与患者的临床症状及预后有着密切的联系.芪苈强心胶囊具有多效性的改善心功能的作用,目前尚无关于芪苈强心胶囊对心力衰竭并发心律失常的影响,本研究通过回顾性分析160例患者的临床资料,进行分析,为临床治疗提供参考.

目的：从人皮肤组织中成功分离培养出皮肤间充质干细胞（SMSCs），并将其诱导分化为成骨细胞、软骨细胞、脂肪细胞及血管内皮细胞。体外长期传代培养SMSCs仍保持良好的干细胞特性,这为SMSCs的深入研究与心血管系统细胞移植提供了新的细胞来源。方法：分离、培养SMSCs，传至第5代用流式细胞仪进行表面标志鉴定；取第5代细胞分别向脂肪、成骨细胞、软骨细胞及血管内皮细胞诱导分化。结果：倒置相差显微镜下细胞呈成纤维细胞状形态，细胞表面标记物CD29、CD44、CD73、CD90、CD105呈高表达，而CD34、CD45和HLA-DR表达阴性。经诱导分化后，细胞均可分化为脂肪细胞、成骨细胞、软骨细胞和血管内皮细胞。结论：从人体皮肤组织中可成功分离、培养出SMSCs并能成功定向诱导分化为成骨细胞、软骨细胞、脂肪细胞和血管内皮细胞，为细胞移植治疗心血管疾病提供新的原料来源。

急性 ST段抬高型心肌梗死（ STEM I）是目前严重威胁人类健康的疾病，室性心律失常是其常见的并发症［1］。目前直接冠状动脉介入治疗（ PPC I）已经大大降低了心肌梗死的死亡率，但心肌梗死后室性心律失常的发生仍是发生临床事件的重要因素［1，2］。在临床上寻找 STEM I进行 PPC I治疗后室性心律失常发生的危险因素，进一步为优化 STEM I进行 PPC I的治疗方案，减少室性心律失常的发病率，进而降低 STEM I死亡率有非常重要的临床意义。

Catestatin (CST) displays potent vasodilatory effect and acts on lowering blood pressure in vivo. The clinical utility of CST in patients with acute myocardial infarction (AMI) has not been clearly delineated. The aim of this study was to investigate the predictive value of CST for the development of in-hospital malignant arrhythmia and other adverse cardiac events in patients with AMI. A total of 125 consecutive patients diagnosed with AMI were included. The clinical characteristics and previous history of the patients were collected. Malignant arrhythmia and other major adverse cardiac events (MACE) such as postinfarction angina pectoris or reinfarction and death were recorded during hospitalization. The levels of plasma CST, norepinephrine (NE) and amino-terminal pro-brain sodium peptides (NT-proBNP) were determined by sandwich ELISA. A multiple logistic regression model was used to predict the influence factors of malignant arrhythmia and other MACE during hospitalization of AMI patients. The results showed that the levels of plasma cystatin-C (CysC), high sensitivity C-reactive protein (hs-CRP), NE and NT-proBNP increased in a CST concentration dependent manner. The incidence of malignant arrhythmia significantly increased as the elevation of CST level (P<0.05). Age, CST and NT-proBNP were independent predictors for the MACE occurred during hospitalization. Increased blood glucose (≥6.1mmol/L) and CST were independent predictors for the complicated malignant arrhythmia of AMI patients. These data demonstrated that CST can be used as a new biological marker for prediction of malignant arrhythmia in patients with AMI.