Objective To evaluate the efficacy of normalization management on prognosis in elderly patients with coronary artery disease, in aspects of drug compliance, readmission rate and quality of life. Methods A total of 110 patients above 65 years old with coronary artery disease visiting West China Hospital from August 2010 to February 2011 were investigated. The patients were divided into two groups: the intensive management group (n=55) and the general management group (n=55). The measures such as regular follow-up, regular examination and medical education were conducted in the intensive management group, and the two groups were observed in aspects of drug compliance, readmission rate and quality of life. Results After 1-year follow-up, the percentages of patients taking aspirin/clopidogrel (98.18% vs. 67.27%, Plt;0.05), nitrate (85.45% vs. 40.00%, Plt;0.05), ACEI/ARB (56.36% vs. 18.18%, Plt;0.05), β receptor blocker (58.18% vs. 29.09%, Plt;0.05) and statin (94.55% vs. 32.73%, Plt;0.05) were higher in the intensive management group than those in the general management group. Also, the readmission rate was lower (12.73% vs. 41.42%, Plt;0.05) and the score of quality of life was higher in the intensive management group than that in the general management group. Conclusion The normalization management guided by evidence-based medicine for the elderly patients with coronary artery disease is helpful to improve the drug compliance, reduce the readmission rate, and improve the quality of life.
This study demonstrates that nerve growth factor (NGF) plays a protective role in myocardial infarction and early reperfusion by reducing the myocardial cell apoptosis and by improving ventricular remodeling and seeks to assess the effects and mechanisms of NGF on late reperfusion after myocardial infarction. The models of late reperfusion were established by ligating the left main coronary artery and then cutting the suture 2 hours after coronary artery ligation. The rats in NGF treatment group were injected 10μL Ad-NGF (by constructing the adenovirus vector Ad-NGF containing NGF gene) at four locations around infarction. The rats in adenoviral vector (Adv) group were injected 10μL adenoviral cector as the NGF group. The late reperfusion group and the sham group were given normal saline as above, and the sham group underwent thracotomy without coronary ligation. On the 3rd, 7th, 14th and 28th day after operation, we investigated the role of NGF on late reperfusion by recording cardiac structure and function with echocardiography, by examining the expression of NGF andⅧfactor with immunohistochemical method, and by evaluating the myocardial cell apoptosis with terminal dUTP nick end-labeling method (TUNEL). We found that the NGF group had higher expression of NGF protein (P < 0.01) and lower apoptosis index (AI) (P < 0.01 or P < 0.05) compared to the late reperfusion group and Adv group on all time points. The NGF group had remarkably higher level of neovascularization compared to the late reperfusion group on the 14th day (P < 0.01) and the 28th day (P < 0.05). The NGF group also had higher LVEF and FS levels compared to the late reperfusion group on the 14th day (P=0.006, P=0.006) and on the 28th day (P=0.000, P=0.000). Whereas the NGF group had lower LVEDD, LVESD (P=0.038, P=0.000) and lower LVEDV, LVESV (P=0.001, P=0.000) on the 28th day compared to late reperfusion group. In this experiment, the NGF gene carried by adenovirus vector had been trans-fected and obviously increased the expression of NGF protein in NGF group. NGF may help postpone the myocardial remodeling and improve the heart function by promoting the myocardial neovascularization and inhibiting myocardial apoptosis.