International journal of cardiology
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Multicenter Study Clinical Trial
Early rule-out and rule-in of myocardial infarction using sensitive cardiac Troponin I.
It is currently unknown, whether and to what extent sensitive cardiac troponin (s-cTn) allows shortening of the time required for safe rule-out and rule-in of acute myocardial infarction (AMI). ⋯ When used in conjunction with other clinical information including the ECG, a simple algorithm incorporating s-cTnI values at presentation and after 1h (or 2h) will allow safe rule-out and accurate rule-in of AMI in the majority of patients.
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Randomized Controlled Trial Multicenter Study
Efficacy of electroacupuncture pretreatment for myocardial injury in patients undergoing percutaneous coronary intervention: A randomized clinical trial with a 2-year follow-up.
Electroacupuncture pretreatment (EAP) safely protects the heart from ischemic injury, however, the efficacy of EAP for periprocedural myocardial injury after percutaneous coronary intervention (PCI) remains unclear. Our aim was to investigate whether EAP prior to PCI reduces post-PCI myocardial injury in patients with coronary artery disease (CAD). 388 patients (≥ 18 years old) with CAD, undergoing elective PCI were enrolled and randomized, out of those 204 went through the whole trial. EAP was conducted by 30-minute electrical stimulation through 4 electrodes attached to the Antiguan (PC6) and Ximen (PC4) acupoints in the forearm bilaterally 1-2h prior to PCI. ⋯ The MACCE rate was significantly decreased in the EAP group at 24 month follow-up compared to the control group (P=0.0157). Moreover, multivariate logistic regression analysis showed that EAP was associated with decreased likelihood of MACCE (odds ratio 0.327, 95% CI 0.140-0.767, P=0.010). EAP prior to PCI significantly reduced cTnI release and protected patients with CAD from subsequent myocardial injury after PCI procedure.