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Mastoi QUA, Alqahtani A, Almakdi S, Sulaiman A, Rajab A, Shaikh A, Alqhtani SM. Heart patient health monitoring system using invasive and non-invasive measurement. Sci Rep 2024; 14:9614. [PMID: 38671304 PMCID: PMC11053009 DOI: 10.1038/s41598-024-60500-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/23/2024] [Indexed: 04/28/2024] Open
Abstract
The abnormal heart conduction, known as arrhythmia, can contribute to cardiac diseases that carry the risk of fatal consequences. Healthcare professionals typically use electrocardiogram (ECG) signals and certain preliminary tests to identify abnormal patterns in a patient's cardiac activity. To assess the overall cardiac health condition, cardiac specialists monitor these activities separately. This procedure may be arduous and time-intensive, potentially impacting the patient's well-being. This study automates and introduces a novel solution for predicting the cardiac health conditions, specifically identifying cardiac morbidity and arrhythmia in patients by using invasive and non-invasive measurements. The experimental analyses conducted in medical studies entail extremely sensitive data and any partial or biased diagnoses in this field are deemed unacceptable. Therefore, this research aims to introduce a new concept of determining the uncertainty level of machine learning algorithms using information entropy. To assess the effectiveness of machine learning algorithms information entropy can be considered as a unique performance evaluator of the machine learning algorithm which is not selected previously any studies within the realm of bio-computational research. This experiment was conducted on arrhythmia and heart disease datasets collected from Massachusetts Institute of Technology-Berth Israel Hospital-arrhythmia (DB-1) and Cleveland Heart Disease (DB-2), respectively. Our framework consists of four significant steps: 1) Data acquisition, 2) Feature preprocessing approach, 3) Implementation of learning algorithms, and 4) Information Entropy. The results demonstrate the average performance in terms of accuracy achieved by the classification algorithms: Neural Network (NN) achieved 99.74%, K-Nearest Neighbor (KNN) 98.98%, Support Vector Machine (SVM) 99.37%, Random Forest (RF) 99.76 % and Naïve Bayes (NB) 98.66% respectively. We believe that this study paves the way for further research, offering a framework for identifying cardiac health conditions through machine learning techniques.
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Affiliation(s)
- Qurat-Ul-Ain Mastoi
- School of Computer Science and Creative Technologies, University of the West of England, Bristol, BS16QY, UK
| | - Ali Alqahtani
- Department of Networks and Communications Engineering, College of Computer Science and Information Systems, Najran University, 61441, Najran, Najran, Saudi Arabia
| | - Sultan Almakdi
- Department of Computer Science, College of Computer Science and Information Systems, Najran University, 61441, Najran, Saudi Arabia
| | - Adel Sulaiman
- Department of Computer Science, College of Computer Science and Information Systems, Najran University, 61441, Najran, Saudi Arabia.
| | - Adel Rajab
- Department of Computer Science, College of Computer Science and Information Systems, Najran University, 61441, Najran, Saudi Arabia
| | - Asadullah Shaikh
- Department of Information Systems, College of Computer Science and Information Systems, Najran University, 61441, Najran, Saudi Arabia
| | - Samar M Alqhtani
- Department of Information Systems, College of Computer Science and Information Systems, Najran University, 61441, Najran, Saudi Arabia
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Liang D, Yixuan D, Chang L, Jingjing S, Sihai Z, Jie D. Mechanism of Artemisia annua L. in the treatment of acute myocardial infarction: network pharmacology, molecular docking and in vivo validation. Mol Divers 2023:10.1007/s11030-023-10750-3. [PMID: 37898972 DOI: 10.1007/s11030-023-10750-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 10/14/2023] [Indexed: 10/31/2023]
Abstract
This study was to evaluate the potential mechanism of action of Artemisia annua L. (A. annua) in the treatment of acute myocardial infarction (AMI) using network pharmacology, molecular docking and in vivo experiments. 22 active chemical compounds and 193 drug targets of A. annua were screened using the Traditional Chinese Medicine System Pharmacological (TCMSP) database. 3876 disease targets were also collected. Then 158 intersection targets between AMI and A. annua were obtained using R 4.2.0 software. String database was used to construct the protein-protein interaction (PPI) network and 6 core targets (MAPK1, TP53, HSP90AA1, RELA, AKT1, and MYC) were screened. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed using the R package. GO enrichment results were mainly related to cell responses to chemical stress and cell membrane microregions. KEGG pathways were mainly involved in lipids, atherosclerosis and fluid shear stress. In addition, molecular docking between A. annua active compounds and core targets showed high binding activity. As for in vivo validation, A. annua extract showed significant effects on improving post-infarction ventricular function, delaying ventricular remodeling, and reducing myocardial fibrosis and apoptosis. This study has revealed the potential components and molecular mechanisms of A. annua in the treatment of AMI. Our work also showed that A. annua has great effect on reducing myocardial fibrosis and scar area after infarction.
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Affiliation(s)
- Deng Liang
- School of Medicine, Shanxi Datong University, Datong, 037009, Shanxi, China
| | - Duan Yixuan
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Liu Chang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Sun Jingjing
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Zhao Sihai
- Laboratory Animal Center, Xi'an Jiaotong University School of Medicine, Xi'an, 710061, Shaanxi, China
| | - Deng Jie
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
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Li J, Xin Y, Li J, Meng M, Zhou L, Qiu H, Chen H, Li H. The predictive effect of direct-indirect bilirubin ratio on clinical events in acute coronary syndrome: results from an observational cohort study in north China. BMC Cardiovasc Disord 2022; 22:478. [DOI: 10.1186/s12872-022-02894-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background:
Patients with extremely high-risk ASCVD usually suffered poor prognosis, bilirubin is considered closely related to cardiovascular outcomes. However, there is controversy over the relationship between bilirubin and coronary artery disease. This study aimed to evaluate the predictive value of the DIBIL ratio in patients with extremely high-risk ASCVD.
Methods:
10,260 consecutive patients with extremely high-risk ASCVD were enrolled in this study. All patients were divided into three groups according to their DIBIL ratio. The incidence of MACCEs was recorded, and in a competing risk regression, the incidence of MACCEs and their subgroups were recorded. The direct-indirect bilirubin ratio (DIBIL ratio) was calculated by the direct bilirubin (umol/L)/indirect bilirubin (umol/L) ratio, all laboratory values were obtained from the first fasting blood samples during hospitalization.
Results:
The area under the ROC curve of the DIBIL ratio to predict the occurrence of all-cause death was 0.668, the cut-off value of which is 0.275. Competing risk regression indicated that DIBIL ratio was positively correlated with all-cause death [1.829 (1.405–2.381), p < 0.001], CV death [1.600 (1.103, 2.321), p = 0.013]. The addition of DIBIL ratio to a baseline risk model had an incremental effect on the predictive value for all-cause death [IDI 0.004(0, 0.010), p < 0.001; C-index 0.805(0.783–0.827), p < 0.001].
Conclusion:
The DIBIL ratio was an excellent tool to predict poor prognosis, suggesting that this index may be developed as a biomarker for risk stratification and prognosis in extremely ASCVD patients.
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Hoxha I, Guda B, Hoti A, Zhubi E, Selmani E, Avdiu B, Cegllar J, Marušič D, Osmani A. Clinical Decision-Making for Heart Failure in Kosovo: A Conjoint Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14638. [PMID: 36429362 PMCID: PMC9690698 DOI: 10.3390/ijerph192214638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/29/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Heart failure represents a life-threatening progressive condition. Early diagnosis and adherence to clinical guidelines are associated with improved outcomes for patients with heart failure. However, adherence to clinical guidelines remains limited in Kosovo. OBJECTIVE To assess the clinical decision-making related to heart failure diagnosis by evaluating clinicians' preferences for clinical attributes. METHOD Conjoint analysis with 33 clinical scenarios with physicians employed in public hospitals in Kosovo. SETTING Two public hospitals in Kosovo that benefited from quality improvement intervention. PARTICIPANTS 14 physicians (internists and cardiologists) in two hospitals in Kosovo. OUTCOME MEASURES The primary outcome was the overall effect of clinical attributes on the decision for heart failure diagnosis. RESULTS When considering clinical signs, the likelihood of a heart failure diagnosis increased for ages between 60 to 69 years old (RRR, 1.88; CI 95%, 1.05-3.34) and a stable heart rate (RRR, 1.93; CI 95%, 1.05-3.55) and decreased for the presence of edema (RRR, 0.23; CI 95%, 0.15-0.36), orthopnea (RRR, 0.31; CI 95%, 0.20-0.48), and unusual fatigue (RRR, 0.61; CI 95%, 0.39-0.94). When considering clinical examination findings, the likelihood for heart failure diagnosis decreased for high jugular venous pressure (RRR, 0.49; CI 95%, 0.32-0.76), pleural effusion (RRR, 0.35; CI 95%, 0.23-0.54), hearing third heart sound, (RRR, 0.50; CI 95%, 0.33-0.77), heart murmur (RRR, 0.57; CI 95%, 0.37-0.88), troponin levels (RRR, 0.59; CI 95%, 0.38-0.91), and NTproBNP levels (RRR, 0.36; CI 95%, 0.24-0.56). CONCLUSIONS We often found odd and wide variations of clinical signs and examination results influencing the decision to diagnose a person with heart failure. It will be important to explore and understand these results better. The study findings are important for existing quality improvement support efforts and contribute to the standardization of clinical decision-making in the public hospitals in the country. This experience and this study can provide valuable impetus for further examination of these efforts and informing policy and development efforts in the standardization of care in the country.
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Affiliation(s)
- Ilir Hoxha
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH 03766, USA
- Evidence Synthesis Group, 10000 Prishtina, Kosovo
- Research Unit, Heimerer College, 10000 Prishtina, Kosovo
- Lux Development, 10000 Prishtina, Kosovo
| | - Besim Guda
- General Hospital of Gjilan, 60000 Gjilan, Kosovo
| | - Ali Hoti
- General Hospital of Prizren, 20000 Prizren, Kosovo
| | - Esra Zhubi
- Evidence Synthesis Group, 10000 Prishtina, Kosovo
| | - Erza Selmani
- Evidence Synthesis Group, 10000 Prishtina, Kosovo
- Research Unit, Heimerer College, 10000 Prishtina, Kosovo
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Du X, Wang H, Wang S, He Y, Zheng J, Zhang H, Hao Z, Chen Y, Xu Z, Lu Z. Machine Learning Model for Predicting Risk of In-Hospital Mortality after Surgery in Congenital Heart Disease Patients. Rev Cardiovasc Med 2022; 23:376. [PMID: 39076183 PMCID: PMC11269077 DOI: 10.31083/j.rcm2311376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/27/2022] [Accepted: 08/26/2022] [Indexed: 07/31/2024] Open
Abstract
Background A machine learning model was developed to estimate the in-hospital mortality risk after congenital heart disease (CHD) surgery in pediatric patient. Methods Patients with CHD who underwent surgery were included in the study. A Extreme Gradient Boosting (XGBoost) model was constructed based onsurgical risk stratification and preoperative variables to predict the risk of in-hospital mortality. We compared the predictive value of the XGBoost model with Risk Adjustment in Congenital Heart Surgery-1 (RACHS-1) and Society of Thoracic Surgery-European Association for Cardiothoracic Surgery (STS-EACTS) categories. Results A total of 24,685 patients underwent CHD surgery and 595 (2.4%) died in hospital. The area under curve (AUC) of the STS-EACTS and RACHS-1 risk stratification scores were 0.748 [95% Confidence Interval (CI): 0.707-0.789, p < 0.001] and 0.677 (95% CI: 0.627-0.728, p < 0.001), respectively. Our XGBoost model yielded the best AUC (0.887, 95% CI: 0.866-0.907, p < 0.001), and sensitivity and specificity were 0.785 and 0.824, respectively. The top 10 variables that contribute most to the predictive performance of the machine learning model were saturation of pulse oxygen categories, risk categories, age, preoperative mechanical ventilation, atrial shunt, pulmonary insufficiency, ventricular shunt, left atrial dimension, a history of cardiac surgery, numbers of defects. Conclusions The XGBoost model was more accurate than RACHS-1 and STS-EACTS in predicting in-hospital mortality after CHD surgery in China.
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Affiliation(s)
- Xinwei Du
- Department of Cardiothoracic Surgery, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, 200127 Shanghai, China
| | - Hao Wang
- Department of Cardiothoracic Surgery, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, 200127 Shanghai, China
| | - Shunmin Wang
- Department of Cardiothoracic Surgery, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, 200127 Shanghai, China
| | - Yi He
- Information Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, 200127 Shanghai, China
| | - Jinghao Zheng
- Department of Cardiothoracic Surgery, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, 200127 Shanghai, China
| | - Haibo Zhang
- Department of Cardiothoracic Surgery, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, 200127 Shanghai, China
| | - Zedong Hao
- Shanghai Synyi Medical Technology Co., Ltd. 201203 Shanghai, China
| | - Yiwei Chen
- Shanghai Synyi Medical Technology Co., Ltd. 201203 Shanghai, China
| | - Zhiwei Xu
- Department of Cardiothoracic Surgery, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, 200127 Shanghai, China
| | - Zhaohui Lu
- Department of Cardiothoracic Surgery, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, 200127 Shanghai, China
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Huang X, Hui H, Zhu W, Chen N, Wei Y, Wang Z, Shi J. Effect of the interaction between alcohol and meat consumption on the hyperlipidaemia risk among elderly individuals: Evidence from Shanghai, China. Front Nutr 2022; 9:982626. [PMID: 36324622 PMCID: PMC9618893 DOI: 10.3389/fnut.2022.982626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/22/2022] [Indexed: 11/14/2022] Open
Abstract
Background Diet and other lifestyle habits may have an increased effect on blood lipids in older people. This study aimed to examine the associations between diet (meat, fish, and egg), alcohol consumption and blood lipids. Methods Surveillance data on chronic diseases and their risk factors were collected from Shanghai during 2017–2018. A Kish table was used for sampling 438 older adults, of whom 71 consumed alcohol. Logistic regression was used to test the relationships between diet, alcohol consumption and blood lipid levels in elderly individuals, and the marginal effects (MEs) were estimated. Results Dyslipidaemia was more common among drinkers than among nondrinkers (P < 0.01). Alcohol consumption was associated with dyslipidaemia (OR = 2.667, P < 0.01 for TC; OR = 1.919, P < 0.05 for LDL; OR = 3.412, P < 0.01 for TG), and consumption of more than 50 g of meat per day showed similar associations (OR = 3.227, P < 0.01 for TC; OR = 3.263, P < 0.01, for LDL; OR = 2.329, P < 0.01 for TG). The MEs of alcohol drinking and excessive meat consumption on the rate of dyslipidaemia were 0.324 for TC (P < 0.01), 0.255 for LDL (P < 0.05), and 0.174 for TG (P < 0.01). Discussion The risk of hyperlipidaemia was increased among elderly individuals with excessive meat and alcohol consumption, which also had an interactive effect.
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Affiliation(s)
- Xiaojing Huang
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Hong Hui
- General Department, Shanghai Baoshan District Gucun Town Community Health Service Center, Shanghai, China
| | - Wenqing Zhu
- Executive Office, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ning Chen
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Wei
- Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China
- *Correspondence: Yan Wei
| | - Zhaoxin Wang
- Health Management Center, First Affiliated Hospital of Hainan Medical University, Hainan, China
- School of Management, Hainan Medical University, Hainan, China
- Zhaoxin Wang
| | - Jianwei Shi
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Social Medicine and Health Management, School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Jianwei Shi
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Zhang G, Liu X, Zhai S, Song G, Song H, Liang L, Kong Y, Ma R, He X. Rural-urban differences in associations between air pollution and cardiovascular hospital admissions in Guangxi, southwest China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:40711-40723. [PMID: 35083669 DOI: 10.1007/s11356-021-18196-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Epidemiological studies found that exposure to air pollution increases cardiovascular hospitalizations. However, studies on rural-urban differences in associations between hospitalizations for cardiovascular diseases and air pollution are limited. The generalized linear model (GLM) was applied to investigate the associations between cardiovascular hospitalizations and air pollution (SO2, NO2, PM2.5, PM10, CO, and O3) in Guangxi, southwest China, in 2015 (January 1-December 31). The relative risk of pollutants (SO2, NO2) on cardiovascular hospital admissions was significantly different between urban and rural areas. The effect of SO2 on cardiovascular hospitalizations was higher in urban areas than in rural areas at lag0 to lag3 and cumulative lag01 to lag03. In urban areas, there were positive associations between NO2 and cardiovascular hospitalizations at lag0, lag1 and cumulative lag01, lag02. In contrast, the effect of NO2 on cardiovascular hospitalizations was not significant in rural areas. Urban residents were more sensitive than rural residents to SO2 and NO2. Subgroup analyses showed statistically significant differences between rural and urban areas in the association between SO2 and NO2 and cardiovascular hospitalizations for males. For age groups, people aged ≥ 65 years appeared to be more vulnerable to SO2 and NO2 in urban areas. The effects of PM2.5 PM10, CO, and O3 on cardiovascular hospitalizations were consistently negative for all groups. Our findings indicated that there were rural-urban differences in associations between cardiovascular hospitalizations and air pollutants. In rural areas, the risk of cardiovascular hospitalizations was mainly influenced by SO2. Therefore, we expect to pay attention to protecting people from air pollution, particularly for those aged ≥ 65 years in urban areas.
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Affiliation(s)
- Guangli Zhang
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
| | - Xiaoxiao Liu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary AQ2, Calgary, Canada
| | - Shiyan Zhai
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China.
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Henan University, Kaifeng, 475004, Henan, China.
| | - Genxin Song
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
| | - Hongquan Song
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Henan University, Kaifeng, 475004, Henan, China
| | - Lizhong Liang
- The Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China
| | - Yunfeng Kong
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Henan University, Kaifeng, 475004, Henan, China
| | - Rui Ma
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
| | - Xinxin He
- College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China
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Zuo S, Meng H, Liang J, Zhen H, Zhu Y, Zhao Y, Zhang K, Dai J. Residues of Cardiovascular and Lipid-Lowering Drugs Pose a Risk to the Aquatic Ecosystem despite a High Wastewater Treatment Ratio in the Megacity Shanghai, China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:2312-2322. [PMID: 35129343 DOI: 10.1021/acs.est.1c05520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The residues of pharmaceuticals in surface waters of megacities and ecotoxicological implications are of particular concern. In this study, we combined field investigations and model simulations to explore the contamination of cardiovascular and lipid-lowering drugs, one group of the most prescribed medications globally, in surface waters of a typical megacity, Shanghai, with a high wastewater treatment ratio (≈96%). Among 26 target substances, 19 drugs were detected with aqueous concentrations ranging from 0.2 (ketanserin) to 715 ng/L (telmisartan). Of them, angiotensin II receptor antagonists, telmisartan and irbesartan, were dominant besides β-blockers. Spatial distribution analysis demonstrated their much higher levels in tributaries compared to the mainstream. The results of model simulations and field investigation revealed relatively low concentrations of cardiovascular and lipid-lowering drugs in surface waters of Shanghai compared to other cities in highly developed countries, which is associated with low per capita usage in China. Ecotoxicological studies in zebrafish embryos further revealed developmental effects, including altered hatching success and heart rate, by irbesartan, telmisartan, lidocaine, and their mixtures at ng/L concentrations, which are typical levels in surface waters. Overall, the present results suggest that the high wastewater treatment ratio was not sufficient to protect fish species in the aquatic ecosystem of Shanghai. Exposure to cardiovascular and lipid-lowering drugs and associated risks will further increase in the future due to healthcare improvements and population aging.
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Affiliation(s)
- Shaoqi Zuo
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Haoyu Meng
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Jiahui Liang
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Huajun Zhen
- State Environmental Protection Key Lab of Environmental Risk Assessment and Control on Chemical Processes, School of Resources & Environmental Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Ying Zhu
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Yanbin Zhao
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Kun Zhang
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Jiayin Dai
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
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Mahfouz RA, Gad MM, Arab M, Abulfotouh MED. Presence of Microvascular Dysfunction and CHA 2DS 2-VASc Score in Patients with ST-Segment Myocardial Infarction after Primary Percutaneous Coronary Intervention. Pulse (Basel) 2022; 9:125-132. [PMID: 35083179 DOI: 10.1159/000520074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/19/2021] [Indexed: 11/19/2022] Open
Abstract
Objective We aimed to investigate the relation between CHA2DS2-VASc score and microvascular dysfunction (MVD) assessed by the index of microvascular resistance (IMR) immediately after primary percutaneous intervention (PPCI) for patients with ST-segment elevation myocardial infarction (STEMI). Subjects and Methods The study included 115 consecutive patients with STEMI who underwent successful PPCI. Angiographic results of reperfusion were inspected to evaluate the association of high CHA2DS2-VASc score and IMR. Also, we assessed echocardiographic changes with respect to CHA2DS2-VASc score. Results Subjects were stratified into 2 groups based on IMR </≥ 40 U; 72 patients (62.6) with IMR <40 U and 43 patients (37.4) with IMR ≥40 U. Patients with IMR ≥40 U had higher CHA2DS2-VASc score (p < 0.001). CHA2DS2-VASc score was significantly correlated with increased left atrial volume index, diastolic dysfunction, wall motion score index, and inversely correlated left ventricular ejection. Moreover, CHA2DS2-VASc score was strongly correlated with IMR (p < 0.001). At multivariate analysis, low systolic blood pressure, stent diameter, and CHA2DS2-VASc score were associated with MVD. Besides, CHA2DS2-VASc score ≥4 was the optimal value in predicting MVD (IMR ≥40) in STEMI patients. Conclusions The data of the current study point out that increased CHA2DS2-VASc score, lower systolic blood pressure <90 mm Hg, and stent diameter are associated with increased incidence of MVD (increased IMR) after PPCI of STEMI. We suggest that the CHA2DS2-VASc score may be a simple, inexpensive useful risk score for the prediction of MVD risk after PPCI for STEMI patients.
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Affiliation(s)
- Ragab A Mahfouz
- Cardiology Department, Zagazig University Hospital, Zagazig, Egypt
| | - Marwa M Gad
- Cardiology Department, Zagazig University Hospital, Zagazig, Egypt
| | - Mohamed Arab
- Cardiology Department, Zagazig University Hospital, Zagazig, Egypt
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Cai X, Zhou J, Li W, Cheng L, Yuan Z, Xiao Y. Potential Influential Factors of In-Hospital Myocardial Reinfarction in ST-Segment Elevation Myocardial Infarction (STEMI) Patients: Finding from the Improving Care for Cardiovascular Disease in China- (CCC-) Acute Coronary Syndrome (ACS) Project. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:9977312. [PMID: 34659644 PMCID: PMC8514929 DOI: 10.1155/2021/9977312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 08/15/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
In this study, 39915 inpatients with a discharge diagnosis of STEMI from the CCC-ACS project phase I and II were included. The prevalence of the medical history, clinical complications on admission and treatment during hospitalization in the STEMI inpatients with and without in-hospital reinfarction was presented. The factors that were differentially distributed and of critical clinical significance (e.g., age, sex, heart rate, smoking, MI history, HF history, COPD history, stroke, hypertension, diabetes, PCI treatment, administration of DAPT, and statins) were entered into standard Cox regression model and competing risk model for potential influential factors of in-hospital reinfarction. Patients with a higher heart rate (OR 1.018; 95% CI 1.003 to 1.033) were more susceptible to in-hospital reinfarction. Myocardial infarction history (OR 2.840; 95% CI 1.160 to 6.955) was a risk factor of in-hospital reinfarction independent of hypertension, diabetes, and dyslipidaemia.
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Affiliation(s)
- Xiaojie Cai
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Juan Zhou
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wenyuan Li
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lele Cheng
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zuyi Yuan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yihui Xiao
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Amsalu E, Liu M, Li Q, Wang X, Tao L, Liu X, Luo Y, Yang X, Zhang Y, Li W, Li X, Wang W, Guo X. Spatial-temporal analysis of cause-specific cardiovascular hospital admission in Beijing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:595-606. [PMID: 31621392 DOI: 10.1080/09603123.2019.1677862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The main aim of this study was to explore the spatial-temporal patterns of cause-specific CVD admission in Beijing using retrospective SaTScan analysis. METHODS A spatial-temporal analysis was conducted at the district level based on the rates of total and cause-specific CVD admissions, including coronary heart disease (CHD), atrial fibrillation (AF), and heart failure (HF) from 2013 to 2017. We used joint point regression, Global Moran's I and Anselin's local Moran's I, together with Kulldorff's scan statistic. RESULTS Hospital admission trend decreased during the study period. Admission rates followed a spatially clustered pattern with differences occurring between cause-specific CVDs. Clusters were mainly identified in ecological preservation areas, with a more likely cluster found in Daxing, Fangshan, Xicheng district for total CVD, CHD, AF and HF, respectively. CONCLUSIONS Hospital admission of cause-specific CVD showed spatial clustered pattern, especially in ecological preservation areas.
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Affiliation(s)
- Endawoke Amsalu
- Department Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Mengyang Liu
- Department Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Qihuan Li
- Department Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiaonan Wang
- Department Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Lixin Tao
- Department Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiangtong Liu
- Department Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yanxia Luo
- Department Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xinghua Yang
- Department Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yingjie Zhang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Weimin Li
- Beijing Chest Hospital, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Tribe University, Melbourne, Australia
| | - Wei Wang
- Global Health and Genomics, School of Medical Sciences and Health, Edith Cowan University, Joondalup, Perth, Australia
| | - Xiuhua Guo
- Department Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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Zhang Z, Liu Y, Zhang Y, Qin P, Zhao P, Wang C, Wang L, Peng X, Xu S, Chen H, Zhao D, Hu D, Zhang M, Lou Y, Hu F. The association between low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio cholesterol ratio and thickened carotid intima-media thickness: A case-control study. Vascular 2021; 30:943-951. [PMID: 34311590 DOI: 10.1177/17085381211035282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND It is indicated that Low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C ratio) has greater predictive value for thickened carotid intima-media thickness (CIMT) comparing with classic lipid parameters. However, there have been few reports about their association in general Chinese population. METHOD We included a total of 1220 CIMT participants and 2440 matched controls, who had ultrasonography of carotid artery during 2009 and 2016. Univariate and multivariate logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for thickened CIMT risk associated with LDL-C/HDL-C ratio. RESULT In the univariate logistic regression model, there was significant association between LDL-C/HDL-C ratio and thickened CIMT (Q4 vs. Q1, OR = 1.94, 95% CI: 1.60-2.36; ptrend < 0.05). After adjusting for potential covariates, LDL-C/HDL-C ratio remained significantly associated with thickened CIMT (Q4 vs. Q1, OR = 1.81, 95% CI: 1.41-2.34, ptrend < 0.001; ≥3.05 v.s. <3.05, OR = 1.66, 95% CI: 1.37-2.02). In subgroup analyses, the association between LDL-C/HDL-C ratio and thickened CIMT remained significant in the subgroups stratified by sex, impaired fasting glucose (IFG), hypertension, and fatty liver disease but only remained significant in the subgroups of ≥45 years (OR = 2.01, 95% CI: 1.46-2.76; Ptrend<0.05), BMI ≥24 (kg/m2) (OR = 2.22; 95% CI = 1.63-3.03; Ptrend < 0.05) and BMI ≥25 (kg/m2) (OR = 2.50, 95% CI: 1.76-3.54; Ptrend < 0.05), dyslipidemia (OR = 3.28, 95% CI: 1.83-5,85; Ptrend < 0.001), and without periodontitis (OR = 2.08, 95% CI: 1.54-2.81 ; Ptrend < 0.05) comparing Q4 to Q1. Similar results were observed in the subgroup analyses for LDL-C/HDL-C ratio ≥3.05 v.s. <3.05 except for the age stratification. CONCLUSION High LDL-C/HDL-C ratio could significantly increase the risk of thickened CIMT independent of gender, IFG, hypertension, and fatty liver disease in general Chinese population.
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Affiliation(s)
- Zhucheng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yanyan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Pei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Ping Zhao
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People's Republic of China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People's Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People's Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People's Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People's Republic of China
| | - Dan Zhao
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yanmei Lou
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, China
| | - Fulan Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
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Li M, Li X, Zhao Y, Zhang L, Yang J, Zhou M, Wang Z. The burden of ischemic heart disease and type 2 diabetes mellitus attributable to diet high in sugar-sweetened beverages in China: An analysis for the Global Burden of Disease Study 2017. J Diabetes 2021; 13:482-493. [PMID: 33151626 DOI: 10.1111/1753-0407.13132] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 10/25/2020] [Accepted: 10/29/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The aim of this study was to estimate the burden of ischemic heart disease (IHD) and type 2 diabetes mellitus (T2DM) attributable to a diet high in sugar-sweetened beverages (SSBs) in China from 1990 to 2017. METHODS Data from the Global Burden of Disease Study 2017 were used to assess all-age and age-standardized, risk-attributable mortality, years of life lost (YLL), years of life with disability (YLD), and disability-adjusted life years (DALYs) by age, sex, year, province, and sociodemographic index (SDI). RESULTS For total noncommunicable diseases (NCDs), 12 523 (95% uncertainty interval 776-27 631) deaths, 305 288 (18 611-661 847) YLL, 142 051 (64 530-257 468) YLD, and 447 339 (132 677-858 838) DALYs were attributable to diet high in SSBs in 2017, particularly among males. Age-standardized, risk-attributable mortality, YLL, YLD, and DALY rates increased distinctly by 507.3%, 410.3%, 571.0%, and 453.3% from 1990 to 2017 respectively. Age-sex-specific, risk-attributable mortality and YLL rates for IHD in older adults (over 65 years) were higher than in young (between 25 and 39 years) and middle-aged adults (between 40 and 64 years) in 2017; however, the YLD and DALY rates for T2DM were higher in young and middle-aged males than in older males. The age-standardized, risk-attributable DALY rates for total NCDs increased substantially in high-SDI and high-middle-SDI provinces during the period. CONCLUSIONS China has a huge and growing burden of IHD and T2DM attributable to diet high in SSBs, particularly among young and middle-aged male adults in wealthier provinces. Evidence-based public health policies at the provincial levels to reduce the consumption of SSBs should be prioritized in China.
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Affiliation(s)
- Man Li
- Hebei Key Laboratory of Environment and Human Health, Department of Epidemiology and Statistic, Hebei Medical University, Shijiazhuang, China
| | - Xiaojie Li
- Non-communicable Disease Branch of the Chinese Preventive Medicine Association, Beijing, China
| | - Yanfang Zhao
- National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Lu Zhang
- Hebei Key Laboratory of Environment and Human Health, Department of Epidemiology and Statistic, Hebei Medical University, Shijiazhuang, China
| | - Jing Yang
- National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Zhuoqun Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
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Coronary Anomalies in 11,267 Southwest Chinese Patients Determined by Angiography. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6693784. [PMID: 33681376 PMCID: PMC7910051 DOI: 10.1155/2021/6693784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/29/2021] [Accepted: 02/08/2021] [Indexed: 11/17/2022]
Abstract
Background The prevalence of coronary artery anomalies (CAAs) is rare and varies among different countries or areas. More importantly, the symptoms exhibited by some CAAs make the diagnosis of coronary artery disease (CAD) difficult and hamper the physician from making the right intervention for CAD patients. Objective To investigate the prevalence of CAAs in 11,267 patients from three hospitals in Southwest China. Methods 11,267 patients who have undergone coronary angiography from three Southwest China hospitals were investigated retrospectively. Dominance patterns, prevalence, and the location of each CAA were recorded and analyzed. Results The presence of a dominant right coronary artery (RCA) was found in 60.58% of patients. CAAs were found in 11.12% (1258) patients, and 87.66% anomalies were located in the left anterior descending (LAD) artery and its branches. Most of CAAs were found to be myocardial bridges (MBs, 1060 cases, 9.41%). Other CAAs included anomalous coronary origin (43 cases, 0.38%), coronary artery fistulas (CAFs, 36 cases, 0.32%), and coronary artery aneurysm or ectasia (119 cases, 1.06%). It also noted that most anomalies were found with RCA originating from the left coronary sinus (79.07%), most CAFs were located in the LAD and its branches (58.33%), and most coronary artery ectasias were located in the RCA (43.25%). Conclusions CAAs in patients from Southwest China were unique compared to other studies. Recognition of these CAAs is important for accurate diagnosis and treatment choice of patients with chest pain.
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Abstract
OBJECTIVE Stroke and ischaemic heart disease have become the leading causes of death in China. We evaluated recognition of stroke and heart attack symptoms and stroke treatment-seeking behaviour in a large representative sample of the Chinese adult population and explored characteristics associated with recognition rates. DESIGN Cross-sectional survey. SETTING Household interviews. PARTICIPANT 3051 Chinese adults aged between 18 and 69 (50.7% female) were interviewed between January and March 2019. PRIMARY AND SECONDARY OUTCOME MEASURES Primary measures include recognitions of stroke and heart attack symptoms and stroke treatment-seeking behaviour. Secondary measures include numeracy level, sociodemographics and prior history of cardiovascular diseases and high blood pressure. RESULTS Participants on average recognised 5.2 out of 14 stroke symptoms and 2.6 out of 6 heart attack symptoms. In the presence of stroke symptoms, three quarters of participants would take immediate action and call an ambulance, yet the second most common action was to advise the person to see a doctor (59%) rather than to consult a doctor immediately (34%). Recognition of atypical heartattack symptoms, such as nausea and feeling of anxiety, was poor. Symptom recognition rates were higher in females, people with a personal or family/friend history of cardiovascular events, those with higher numeracy scores, and for stroke symptoms, participants with high (versus low) education level. Furthermore, symptom recognition rate was negatively correlated with burden of cardiovascular diseases across the four economic regions of China. CONCLUSION Recognition of stroke and heart-attack symptoms was moderate and there remains a gap between recognising symptoms and taking immediate action. Interventions focusing on simple symptom detection tools and on building numerical competencies may help reduce the burden of cardiovascular diseases in China.
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Affiliation(s)
- Shenghua Luan
- CAS Key Laboratory of Behavioral Science, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of the Chinese Academy of Sciences, Beijing, China
| | - Yujia Yang
- Department of Psychology, University of the Chinese Academy of Sciences, Beijing, China
| | - Yuqi Huang
- Department of Psychology, University of the Chinese Academy of Sciences, Beijing, China
| | - Michelle McDowell
- Harding Center for Risk Literacy, Max-Planck-Institute for Human Development, Berlin, Germany
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Volkov I, Radchenko G, Tchernykh A. Digital Twins, Internet of Things and Mobile Medicine: A Review of Current Platforms to Support Smart Healthcare. PROGRAMMING AND COMPUTER SOFTWARE 2021; 47:578-590. [PMCID: PMC8713145 DOI: 10.1134/s0361768821080284] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/29/2021] [Accepted: 08/10/2021] [Indexed: 06/17/2023]
Abstract
As the population grows, the need for higher-quality medical services increases, as well as the demand for information technology in medicine. The Smart Healthcare concept brings various approaches to address the acute problems encountered in modern healthcare. In this paper, we review the main problems of modern healthcare and analyze existing approaches and technologies in digital twins, the Internet of Things, and mobile medicine. We will also analyze the key features of modern platforms that support Mobile Health Applications. Finally, based on our analysis, we will propose the concept of Smart Healthcare Platform, focused on solving tasks related to supporting the development of Mobile Health Applications, including organizing access, management, and sharing of user data.
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Affiliation(s)
- I. Volkov
- South Ural State University, 454080 Chelyabinsk, Russia
| | - G. Radchenko
- South Ural State University, 454080 Chelyabinsk, Russia
| | - A. Tchernykh
- South Ural State University, 454080 Chelyabinsk, Russia
- CICESE Research Center, 22860 Ensenada, B.C. Mexico
- Ivannikov Institute for System Programming of RAS, 109004 Moscow, Russia
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B Ramadhani F, Liu Y, Jing X, Qing Y, Xiong H, Zhang F, Wei P. Comparing the association of cardiovascular nursing care with blood pressure and length of stay of in-patients with coronary artery disease in Wuhan, China. Afr Health Sci 2020; 20:1716-1724. [PMID: 34394231 PMCID: PMC8351856 DOI: 10.4314/ahs.v20i4.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Coronary artery disease is a leading cause of morbidity and mortality worldwide. Comorbidity-like hypertension has been among the major risks of coronary artery disease. Recent evidence identified multiple benefits of cardiovascular nursing care to coronary patients. However, little has been appraised on benefits regarding patients' blood pressure control and length of hospitalisation. Objective To compare the association of cardiovascular nursing care delivered to coronary artery patients with patients' blood pressure and length of stay. Methods Records based retrospective design was applied at a large teaching hospital in Wuhan, China. SPSS 21 version was used for data entry and analysis with univariate and multivariate logistic regression models for comparing study variables. Results Of 300 patients, 224 (74.7%) were known to be hypertensive and admitted with subnormal blood pressure. Cardiovascular nursing care like “assess to grade pain severity on 1–10 scale” and “counsel patient to cope with stress” were six and three times more likely to contribute improved patients' blood pressure (AOR=5.8; 95%CI: 2.8–12.2, p=0.001) and (AOR=3.1; 95%CI: 1.2–7.8, p=0.015) respectively. No significant difference with length of stay (p>0.05). Conclusion There is a possibility of coronary artery patients to recover with normal blood pressure following reception of evidence-based cardiovascular nursing care.
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Li H, Wei Y, Yang Z, Zhang S, Xu X, Shuai M, Vitse O, Wu Y, Baccara-Dinet MT, Zhang Y, Li J. Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Alirocumab in Healthy Chinese Subjects: A Randomized, Double-Blind, Placebo-Controlled, Ascending Single-Dose Study. Am J Cardiovasc Drugs 2020; 20:489-503. [PMID: 32080823 PMCID: PMC7548281 DOI: 10.1007/s40256-020-00394-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The addition of alirocumab (a fully human monoclonal antibody to proprotein convertase subtilisin/kexin type 9 [PCSK9]) to background statin therapy provides significant incremental low-density lipoprotein cholesterol (LDL-C) lowering and cardiovascular event risk reduction. OBJECTIVES Our objectives were to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of single ascending doses of alirocumab in healthy Chinese subjects. METHODS In this double-blind, placebo-controlled, phase I study, 35 Chinese subjects (aged 21-45 years) with baseline LDL-C > 100 mg/dL (2.59 mmol/L) were randomized to receive a single 1 mL subcutaneous injection of alirocumab 75, 150, or 300 mg, or placebo, and followed up for ~ 12 weeks. RESULTS Treatment-emergent adverse events, most frequently nasal congestion and dry throat, were reported in three of seven or eight subjects in each alirocumab dose group (two of seven in the placebo group). One patient receiving alirocumab 300 mg had a mild local injection-site reaction. No alirocumab recipients demonstrated antidrug antibodies. Maximum alirocumab serum concentrations (6-34 mg/dL) occurred at a median of 3-7 days across the dose groups. Maximum mean LDL-C reductions from baseline were observed on days 8, 15, and 22 with alirocumab 75 (55.3%), 150 (63.7%), and 300 mg (73.7%), respectively. Mean free PCSK9 levels were reduced to below the lower limit of quantification within 4 h of dosing. Total cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B were reduced with alirocumab. CONCLUSIONS In Chinese subjects, alirocumab 75, 150, and 300 mg was safe and well-tolerated. Pharmacokinetic/pharmacodynamic parameters, including clinically meaningful reductions in LDL-C and other lipids/lipoproteins, were consistent with data from Japanese and Western populations. Clinicaltrials.gov identifier: NCT02979015.
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Affiliation(s)
- Haiyan Li
- Department of Cardiology, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Peking University Third Hospital, 49 North Garden Road, Haidian Distrct, Beijing, 100191, China.
- Drug Clinical Trial Center, Peking University Third Hospital, 49 North Garden Road, Haidian Distrct, Beijing, 100191, China.
| | - Yudong Wei
- Drug Clinical Trial Center, Peking University Third Hospital, 49 North Garden Road, Haidian Distrct, Beijing, 100191, China
| | - Zhenhua Yang
- Drug Clinical Trial Center, Peking University Third Hospital, 49 North Garden Road, Haidian Distrct, Beijing, 100191, China
| | - Shuang Zhang
- Drug Clinical Trial Center, Peking University Third Hospital, 49 North Garden Road, Haidian Distrct, Beijing, 100191, China
| | - Xiuxiu Xu
- Drug Clinical Trial Center, Peking University Third Hospital, 49 North Garden Road, Haidian Distrct, Beijing, 100191, China
| | | | - Olivier Vitse
- Clinical Development R&D, Sanofi, Montpellier, France
| | | | | | - Yi Zhang
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
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Ding L, Liang Y, Tan ECK, Hu Y, Zhang C, Liu Y, Xue F, Wang R. Smoking, heavy drinking, physical inactivity, and obesity among middle-aged and older adults in China: cross-sectional findings from the baseline survey of CHARLS 2011-2012. BMC Public Health 2020; 20:1062. [PMID: 32631359 PMCID: PMC7336642 DOI: 10.1186/s12889-020-08625-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prevention and control of cardiometabolic conditions and cardiovascular disease (CVD) in China may contribute to sustainable CVD reduction globally, given the fact that one-fifth of the worldwide population is in China. Knowing the distribution of behavioral risk factors (e.g., smoking and physical inactivity), especially at a national level in China, would be extremely relevant to the field of public health and CVD prevention. The objectives of this study were to investigate the nationwide prevalence of obesity, smoking, heavy drinking, and physical inactivity in Chinese adults, and further explore whether cardiometabolic conditions would modify the distribution of behavioral risk factors. METHODS This population-based study is based on the China Health and Retirement Longitudinal Study (2011-2012), including 17,302 adults (≥45 years, mean age 59.67 years, female 51.66%) from 25 provinces in China. Data on demographics, lifestyle factors, health status and history of diseases were collected via structured interviews and laboratory tests. Smoking, heavy drinking, obesity, and physical inactivity were defined following standard guidelines. We performed descriptive analysis and logistic regressions in this study. RESULTS The overall prevalence of heavy drinking, obesity, current smoking, and physical inactivity among middle-aged and older adults was 7.23% (95% confidence interval 6.53-7.29%), 11.53% (10.43-12.62%), 27.46% (26.30-28.62%), and 44.06% (41.19-46.92%), respectively. The prevalence varied between rural and urban areas as well as among geographic areas, with higher prevalence in the Northern and Northeastern regions. Heavy drinking and obesity were significantly associated with incident hypertension, diabetes, and high cholesterol; while current smoking was significantly associated with incident hypertension. Compared with healthy individuals, participants who self-reported a diagnosis of hypertension, high cholesterol, or diabetes were less likely to smoke currently and drink alcohol heavily, but more likely to be physically inactive and obese. CONCLUSIONS Among Chinese middle-aged and older adults, the prevalence of behavioral risk factors varies by geographic region. Further effort is required to improve physical activity and fitness for Chinese adults, especially those with cardiometabolic conditions.
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Affiliation(s)
- Lijie Ding
- Division of health management, School of sport social science, Shandong Sport University, Room 1415, 10600 Shijidadao Road, Jinan, 250102, China.
| | - Yajun Liang
- Department of Public Health Sciences, Karolinska Institutet (KI), Stockholm, Sweden
| | - Edwin C K Tan
- The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, New South Wales, Australia.,Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Yin Hu
- Södertälje Hospital, Stockholm, Sweden
| | - Chi Zhang
- Energy Processes, Royal Institute of Technology, Stockholm, Sweden
| | - Yanxun Liu
- Department of Biostatistics, School of Public Health, Shandong University, Box 100, 44 Wenhua Xi Road, Jinan, 250012, PO, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Box 100, 44 Wenhua Xi Road, Jinan, 250012, PO, China.
| | - Rui Wang
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. .,The Swedish School of Sport and Health Sciences, GIH, Lidingövägen 1, Box 5626, SE-11486, Stockholm, Sweden. .,Department of Medicine and Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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Lin Z, Zhang L, Yang X, Liu L, Xuan J. Cost-effective analysis of clopidogrel versus aspirin for high risk patients with established peripheral arterial disease in China. J Med Econ 2020; 23:659-666. [PMID: 31999196 DOI: 10.1080/13696998.2020.1724119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To assess the cost-effectiveness of clopidogrel versus aspirin for high risk patients (pre-existing symptomatic atherosclerosis or multi-vascular territory involvement) with established peripheral arterial disease (PAD) for secondary prevention of atherothrombotic events in a Chinese setting.Methods: A Markov model with a lifetime horizon was developed from the perspective of the national healthcare system in China. The primary outputs are quality adjusted life years (QALYs), direct medical costs, and the incremental cost-effectiveness ratios (ICERs). Clinical efficacy data were obtained from the CAPRIE trial. Drug acquisition cost, other direct medical costs, and utilities were from pricing records and the literature. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were conducted to test the robustness of the model on all parameters.Results: In patients with pre-existing atherosclerosis, 2 years of treatment with clopidogrel and aspirin would yield total QALYs of 8.776 and 8.576 at associated costs of ¥18,777 ($2,838) and ¥12,302 ($1,859), respectively, resulting in an ICER of ¥32,382 ($4,893) per QALY gained. In patients with PVD, secondary prevention with the same drugs would expect to lead to total QALYs of 8.836 and 8.632 at associated costs of ¥18,518 ($2,798) and ¥12,041 ($1,820), respectively, resulting in a corresponding ICER of ¥31,743 ($4,797) per QALY gained. The results were most sensitive to the discount rate for future outcomes and costs. The PSA indicated that the probability of clopidogrel being cost-effective was 100% at the willingness-to-pay threshold of 3-times GDP.Conclusions: Secondary prevention with clopidogrel is an attractive cost-effective option compared with aspirin for high risk patients with established PAD from the perspective of the national healthcare system in Chinese settings.
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Affiliation(s)
- Ziyi Lin
- Health Economics Department, Shanghai Centennial Scientific, Shanghai, China
| | - Lei Zhang
- Health Economics Department, Shanghai Centennial Scientific, Shanghai, China
| | - Xiaoyan Yang
- Health Economics and Outcome Research, Sanofi, Shanghai, China
| | - Li Liu
- Health Economics and Outcome Research, Sanofi, Shanghai, China
| | - Jianwei Xuan
- Health Economics Research Institute, Sun Yat-sen University, Guangzhou, China
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21
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Zhang L, Yuan M, An Z, Zhao X, Wu H, Li H, Wang Y, Sun B, Li H, Ding S, Zeng X, Chao L, Li P, Wu W. Prediction of hypertension, hyperglycemia and dyslipidemia from retinal fundus photographs via deep learning: A cross-sectional study of chronic diseases in central China. PLoS One 2020; 15:e0233166. [PMID: 32407418 PMCID: PMC7224473 DOI: 10.1371/journal.pone.0233166] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 04/29/2020] [Indexed: 12/31/2022] Open
Abstract
Retinal fundus photography provides a non-invasive approach for identifying early microcirculatory alterations of chronic diseases prior to the onset of overt clinical complications. Here, we developed neural network models to predict hypertension, hyperglycemia, dyslipidemia, and a range of risk factors from retinal fundus images obtained from a cross-sectional study of chronic diseases in rural areas of Xinxiang County, Henan, in central China. 1222 high-quality retinal images and over 50 measurements of anthropometry and biochemical parameters were generated from 625 subjects. The models in this study achieved an area under the ROC curve (AUC) of 0.880 in predicting hyperglycemia, of 0.766 in predicting hypertension, and of 0.703 in predicting dyslipidemia. In addition, these models can predict with AUC>0.7 several blood test erythrocyte parameters, including hematocrit (HCT), mean corpuscular hemoglobin concentration (MCHC), and a cluster of cardiovascular disease (CVD) risk factors. Taken together, deep learning approaches are feasible for predicting hypertension, dyslipidemia, diabetes, and risks of other chronic diseases.
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Affiliation(s)
- Li Zhang
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Mengya Yuan
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Zhen An
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Xiangmei Zhao
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Hui Wu
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Haibin Li
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Ya Wang
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Beibei Sun
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Huijun Li
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Shibin Ding
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Xiang Zeng
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Ling Chao
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Pan Li
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
- * E-mail: (PL); (WW)
| | - Weidong Wu
- School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
- * E-mail: (PL); (WW)
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22
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Liu X, Wang M, Li Q, Liu W, Song Q, Jiang H. CircRNA ACAP2 induces myocardial apoptosis after myocardial infarction by sponging miR-29. Minerva Med 2020; 113:128-134. [PMID: 32406223 DOI: 10.23736/s0026-4806.20.06600-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To investigate the effect of circular RNA circ ACAP2 on apoptotic phenotype of rat cardiomyocytes and its molecular mechanism. METHODS Left anterior descending ligation was used to establish a rat myocardial infarction (MI) model, and real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of circ ACAP2 in apoptotic rat cardiomyocytes. The stability of circ ACAP2 was tested by actinomycin D and RNase R. H9C2 cells were infected by recombinant circ ACAP2 adenovirus (rAd-circ ACAP2), and the expression of apoptotic related genes Bax and BCL-2 in H9C2 was detected. Double luciferase reporter gene experiment, RNA antisense purification experiment and RNA Pull-Down experiments verified the binding effect of circ ACAP2 and miR-29. RESULTS RT-qPCR results showed that the expression of circ ACAP2 was increased in cardiomyocytes of MI rats. Actinomycin D and RNase R experiment confirmed that circ ACAP2 had better stability and resistance to RNase R degradation than its host gene ACAP2 mRNA. Overexpression of circ ACAP2 promotes apoptosis. The double luciferase reporter gene assay, RNA antisense purification assay and RNA Pulldown assay consistently confirmed the specific binding effect between circ ACAP2 and miR-29, and circ ACAP2 promoted the apoptotic phenotype in rats. CONCLUSIONS The expression of circ ACAP2 increased in cardiomyocytes after MI and promoted apoptosis by binding to miR-29.
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Affiliation(s)
- Xue Liu
- Department of Internal Medicine-Cardiovascular, Yantaishan Hospital, Yantai, China
| | - Meixiang Wang
- Department of Internal Medicine-Cardiovascular, Jiangsu Taizhou People's Hospital, Taizhou, China
| | - Qiang Li
- Department of Internal Medicine-Cardiovascular, Yantaishan Hospital, Yantai, China
| | - Wenbo Liu
- Department of Internal Medicine-Cardiovascular, Yantaishan Hospital, Yantai, China
| | - Qin Song
- Department of Emergency, Yantaishan Hospital, Yantai, China
| | - Haipeng Jiang
- Department of Minimally Invasive Operating Room, Yantaishan Hospital, Yantai, China -
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23
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Buljubasic N, Zhao W, Cheng J, Li H, Oemrawsingh R, Akkerhuis M, Yu H, Zhou L, Wu Y, Boersma E, Gao W. Comparison of temporal changes in established cardiovascular biomarkers after acute coronary syndrome between Caucasian and Chinese patients with diabetes mellitus. Biomarkers 2020; 25:341-348. [PMID: 32366129 DOI: 10.1080/1354750x.2020.1759692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Population means of conventional cardiovascular biomarkers are known to differ between ethnic groups. In this study we performed detailed comparisons in the temporal pattern of these biomarkers between Caucasian and Chinese diabetic patients with acute coronary syndrome (ACS).Methods: We studied differences in temporal changes of established cardiovascular biomarkers, including high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol, cardiac Troponin T (TnT), NT-proBNP and C-reactive protein (CRP), in 48 Chinese and 48 clinically matched Caucasian patients with type 2 diabetes mellitus who were admitted for ACS. Blood samples were collected at regular time intervals during 30 days to 1 year after the index ACS.Results: In the >30 day post ACS period, mean serum levels of LDL (2.16 vs. 1.47 mmol/L; p-value <0.001), total cholesterol (4.08 vs. 3.11 mmol/L; p-value <0.001), TnT (11.0 vs. 7.76 ng/L; p-value 0.010) and CRP (2.0 vs. 0.78 mg/L; p-value <0.001) were systematically higher in Caucasian than in Chinese patients. HDL and NT-proBNP levels were similar.Conclusions: Our study showed clinically relevant differences in levels of established cardiovascular biomarkers between Caucasian and Chinese post ACS patients. Further cross-ethnic studies are warranted to determine secondary prevention treatment biomarker targets in specific populations.
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Affiliation(s)
- Nermina Buljubasic
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Wei Zhao
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China.,Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Beijing, China.,Ministry of Education, Key Laboratory of Molecular Cardiovascular Science, Beijing, China.,Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, China
| | - Jin Cheng
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Huijuan Li
- Peking University Clinical Research Institute, Beijing, China
| | - Rohit Oemrawsingh
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Martijn Akkerhuis
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Haiyi Yu
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China.,Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Beijing, China.,Ministry of Education, Key Laboratory of Molecular Cardiovascular Science, Beijing, China.,Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, China
| | - Lequn Zhou
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China.,Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Beijing, China.,Ministry of Education, Key Laboratory of Molecular Cardiovascular Science, Beijing, China.,Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, China
| | - Yangfeng Wu
- Peking University Clinical Research Institute, Beijing, China
| | - Eric Boersma
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Wei Gao
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China.,Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Beijing, China.,Ministry of Education, Key Laboratory of Molecular Cardiovascular Science, Beijing, China.,Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, China
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24
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Zhang X, Liao H, Shi D, Li X, Chen X, He S. Cost-effectiveness analysis of different hypertension management strategies in a community setting. Intern Emerg Med 2020; 15:241-250. [PMID: 31321709 DOI: 10.1007/s11739-019-02146-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 07/02/2019] [Indexed: 02/05/2023]
Abstract
Self-management schemes and mobile apps can be used for the management of hypertension in the community, but the most appropriate patient population is unknown. To explore whether the Chinese Health Literacy Scale (CHLSH) can be used to screen for appropriate patients with hypertension for self-management and to evaluate the clinical effectiveness and health economic evaluation of three hypertension management schemes. This was a prospective study performed from March 2017 to July 2017 in consecutive patients with primary hypertension and of 50-80 years of age from the Jinyang community, Wuhou District, Chengdu. The CHLSH was completed and the patients were classified into the high (n = 283) and low (n = 315) health literacy groups. The patients were randomly divided into the self-management, traditional management, and mobile app management groups. The high-health literacy group was selected to construct the cost-effectiveness decision tree model. Blood pressure control rate and the quality-adjusted life years (QALYs) were determined. At the end of follow-up, the success rate of self-management was 83.4%. The costs for 6 months of treatment for each patient with hypertension in the self-management, traditional management, and mobile app groups were 1266, 1751, and 1856 yuan, respectively. The costs required for obtaining 1 QALY when managing for 6 months were: 30,869 yuan for self-management; 48,628 yuan for traditional management; and 43,199 yuan for the mobile app. The CHLSH can be used as a tool for screening patients with hypertension for self-management. The cost-effectiveness of self-management was optimal.
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Affiliation(s)
- Xin Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Hang Liao
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Di Shi
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xinran Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaoping Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Sen He
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
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25
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Mastoi QUA, Ying Wah T, Gopal Raj R, Lakhan A. A Novel Cost-Efficient Framework for Critical Heartbeat Task Scheduling Using the Internet of Medical Things in a Fog Cloud System. SENSORS (BASEL, SWITZERLAND) 2020; 20:E441. [PMID: 31941106 PMCID: PMC7014221 DOI: 10.3390/s20020441] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/03/2019] [Accepted: 11/05/2019] [Indexed: 11/16/2022]
Abstract
Recently, there has been a cloud-based Internet of Medical Things (IoMT) solution offering different healthcare services to wearable sensor devices for patients. These services are global, and can be invoked anywhere at any place. Especially, electrocardiogram (ECG) sensors, such as Lead I and Lead II, demands continuous cloud services for real-time execution. However, these services are paid and need a lower cost-efficient process for the users. In this paper, this study considered critical heartbeat cost-efficient task scheduling problems for healthcare applications in the fog cloud system. The objective was to offer omnipresent cloud services to the generated data with minimum cost. This study proposed a novel health care based fog cloud system (HCBFS) to collect, analyze, and determine the process of critical tasks of the heartbeat medical application for the purpose of minimizing the total cost. This study devised a health care awareness cost-efficient task scheduling (HCCETS) algorithm framework, which not only schedule all tasks with minimum cost, but also executes them on their deadlines. Performance evaluation shows that the proposed task scheduling algorithm framework outperformed the existing algorithm methods in terms of cost.
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Affiliation(s)
- Qurat-ul-ain Mastoi
- Faculty of Computer Science and Information Technology, University of Malaya, Kuala lumpur 50603, Malaysia
| | - Teh Ying Wah
- Faculty of Computer Science and Information Technology, University of Malaya, Kuala lumpur 50603, Malaysia
| | - Ram Gopal Raj
- Faculty of Computer Science and Information Technology, University of Malaya, Kuala lumpur 50603, Malaysia
| | - Abdullah Lakhan
- School of Computer Science and Engineering, Southeast University, Nanjing 211189, China;
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26
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Wang Y, Li M, Zhong L, Ren S, Li H, Tang Y, Li Z, Fei H. Left Atrial Strain as Evaluated by Two-Dimensional Speckle Tracking Predicts Left Atrial Appendage Dysfunction in Chinese Patients with Atrial Fibrillation. Cardiol Res Pract 2020; 2020:5867617. [PMID: 32274210 PMCID: PMC7115138 DOI: 10.1155/2020/5867617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/27/2020] [Accepted: 02/15/2020] [Indexed: 02/05/2023] Open
Abstract
Left atrial appendage (LAA) dysfunction identified by transesophageal echocardiography (TEE) is a powerful predictor of stroke in patients with atrial fibrillation (AF). The aim of our study is to assess if there is a correlation between the left atrial (LA) functional parameter and LAA dysfunction in the AF patients. This cross-sectional study included a total of 249 Chinese AF patients who did not have cardiac valvular diseases and were undergoing cardiac ablation. TEE was performed in all the patients who were categorized into two groups according to their left atrial appendage (LAA) function. A total of 120 of the 249 AF patients had LAA dysfunction. Univariate and multivariate logistic regression was conducted to assess the independent factors that correlated with the LAA dysfunction. Different predictive models for the LAA dysfunction were compared with the receiver operating characteristic (ROC) curve. The final ROC curve on the development and validation datasets was drawn based on the calculation of each area under the curves (AUC). Univariate and multivariate analysis showed that the peak left atrial strain (PLAS) was the most significant factor that correlated with the LAA dysfunction. PLAS did not show inferiority amongst all the models and revealed strong discrimination ability on both the development and validation datasets with AUC 0.818 and 0.817. Our study showed that a decrease in PLAS is independently associated with LAA dysfunction in the AF patients.
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Affiliation(s)
- Yu Wang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510100, China
- Shantou University Medical College, Shantou, Guangdong 515000, China
| | - Mingqi Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510100, China
- Shantou University Medical College, Shantou, Guangdong 515000, China
| | - Lishan Zhong
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510100, China
| | - Siqi Ren
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510100, China
| | - Hezhi Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510100, China
| | - Yongwen Tang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510100, China
| | - Zhilian Li
- Department of Medical Imaging, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong 515000, China
| | - Hongwen Fei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510100, China
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27
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Zou C, Zuo X, Huang J, Hua Y, Yang S, Yang X, Guo C, Tan H, Chen J, Chu Z, Pei Q, Yang G. Phase I Trial of Pyragrel, a Novel Thromboxane Synthetase Inhibitor, to Evaluate the Safety, Tolerability, and Pharmacokinetics in Healthy Volunteers. Front Pharmacol 2019; 10:1231. [PMID: 31708774 PMCID: PMC6821791 DOI: 10.3389/fphar.2019.01231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 09/27/2019] [Indexed: 11/16/2022] Open
Abstract
Background and Objective: Inhibition of thrombosis and platelet aggregation through a thromboxane synthetase inhibitor proved to be an effective and promising treatment for cardiovascular and/or cerebrovascular disease (CCVD) patients. This phase I study evaluated the safety, tolerability, and pharmacokinetics of sodium pyragrel, a novel thromboxane A2 synthetase inhibitor, in healthy volunteers. Methods: A total of 84 healthy Chinese volunteers were enrolled in the study and randomized into one of five dosing regimens of intravenous pyragrel, which were single ascending dose (30 to 300 mg), multiple doses (pyragrel 180 mg once daily on Day 1 and Day 6, twice daily from Day 2 to Day 5), 3×3 Latin square crossover (60, 120, 240 mg), and a continuous dose (360 mg in 24 h), respectively. Plasma concentrations were determined using HPLC-MS/MS. Pharmacokinetics parameters were calculated with non-compartment analysis. Results: The maximum plasma concentrations of pyragrel were essentially reached at the end of the 3 h infusion. The pharmacokinetic process of pyragrel and two main metabolites (BBS and BJS) is linear over the 30–300 mg dose range, with no significant accumulation on multiple doses. The urinary excretion of pyragrel accounted for more than 70% of the total drug amount. Preliminary pharmacodynamic results demonstrated that the production of urinary 11-D-HTXB2 was time- and dose-dependently inhibited by single i.v. dose of pyragrel. Conclusions: Pyragrel was well tolerated after single ascending doses up to 300 mg, multiple doses of 180 mg, and continuous administration of 360 mg within 24 h. No drug-related, serious adverse drug reactions occurred during the five-part study. The most common pyragrel-related adverse events (AEs) were total bilirubin (TB)/direct bilirubin (DB) elevations with a relatively low incidence rate and seemed to be dose independent. Given the acceptable safety and appropriate pharmacokinetic properties of sodium pyragrel proven in this study, continued clinical development is warranted. The study was registered at http://www.chictr.org.cn (ChiCTR-IID-16010159).
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Affiliation(s)
- Chan Zou
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiaocong Zuo
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jie Huang
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ye Hua
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Shuang Yang
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoyan Yang
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Can Guo
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hongyi Tan
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jun Chen
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhaoxing Chu
- Innovative Drug Design and Evaluation Center, Hefei Industrial Pharmaceutical Institute Co., Ltd, Anhui, China
| | - Qi Pei
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Guoping Yang
- Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
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28
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Chen Y, She Y, Kaur R, Guo N, Zhang X, Zhang R, Gou X. Is Plant Sterols a Good Strategy to Lower Cholesterol? J Oleo Sci 2019; 68:811-816. [PMID: 31413246 DOI: 10.5650/jos.ess19116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cardiovascular disease (CVD) has emerged as the leading cause of dealth worldwide today. Lowering circulating total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) is one of the most effective approaches of CVD prevention. Dietary guidelines and health organizations approved using plant sterols (PS) as the alternative to conventional method in attenuating circulating TC and LDL-C levels and risk of CVD. However, current findings apprear to be controversial on the efficacy of PS. Giving the rise of the field "Nutrigenetics", single nucleotide polymorphisms (SNPs) such as CYP7A1-rs3808607 have been identified that strongly associate with cholesterol metabolism in response to PS intake, towards causing inter-individual variations. This review article aims to discuss the efficacy of dietary PS in managing cholesterol levels based on findings from recent studies. The scope includes reviewing evidence on supporting the efficacy, the metabolic claims, inter-individual variations as well as sitosterolemia associated with PS intake.
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Affiliation(s)
- Yuwei Chen
- Shaanxi Key Laboratory of Brain Disorders, Department of Public Health, Xi'an Medical University
| | - Yongbo She
- Department of Food and Human Nutritional Sciences, The University of Manitoba
| | - Ramandeep Kaur
- Department of Food and Human Nutritional Sciences, The University of Manitoba
| | - Na Guo
- Shaanxi Key Laboratory of Brain Disorders & Institute of Basic Medical Sciences & Institute of Basic and Translational Medcine, Xi'an Medical University
| | - Xiaohua Zhang
- Shaanxi Key Laboratory of Brain Disorders & Institute of Basic Medical Sciences & Institute of Basic and Translational Medcine, Xi'an Medical University
| | - Ruisan Zhang
- Shaanxi Key Laboratory of Brain Disorders & Institute of Basic Medical Sciences & Institute of Basic and Translational Medcine, Xi'an Medical University
| | - Xingchun Gou
- Shaanxi Key Laboratory of Brain Disorders & Institute of Basic Medical Sciences & Institute of Basic and Translational Medcine, Xi'an Medical University
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29
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Mokoena KK, Ethan CJ, Yu Y, Shale K, Fan Y, Liu F, Rong J. The effect of ambient air pollution on circulatory mortality: a short-term exposure assessment in Xi'an, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:22512-22521. [PMID: 31161547 DOI: 10.1007/s11356-019-05463-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/14/2019] [Indexed: 05/27/2023]
Abstract
Various studies have illustrated that exposure to ambient air pollution has negative impacts on health. However, little evidence exists on the effects of ambient air pollution on circulatory mortality in Xi'an, China. This study aims to investigate and ascertain the association between short-term exposure to ambient air pollutants and circulatory mortality in Xi'an, China. Daily average concentrations of PM2.5, SO2, and O3, meteorological data (temperature and relative humidity) and daily counts of circulatory mortality were obtained between January 2014 and June 2016. Mortality was stratified by gender and age group (≤ 64 years and ≥ 65 years). A generalized additive model (GAM) with natural splines (NS) was constructed to analyze the relationship between ambient air pollutants and daily circulatory mortality. There were 57,570 cases of circulatory mortality, with cerebrovascular and ischemic heart diseases accounting for 48.5% and 43.5%, respectively. All ambient air pollutants displayed different seasonal patterns. In the single pollutant model, 10 μg/m3 increase in 2-day moving average concentrations of PM2.5, SO2, and O3 was associated with relative risk of 1.288(1.198, 1.388), 1.360(0.877, 2.331), and 1.324(1.059, 1.705) in circulatory mortality, respectively. After adjusting for collinearity in the multi-pollutant model, the effects remained statistically significant. The ≥ 65 years and female sub-groups were associated with a higher risk of circulatory mortality. Short-term exposure to ambient air pollutants plays a pivotal role in the genesis of circulatory mortality in Xi'an. Responses to ambient air pollutants exposure in relation to circulatory mortality are different when analyzed by sub-groups.
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Affiliation(s)
- Kingsley Katleho Mokoena
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
- Department of Life Sciences, Central University of Technology, Free State, Bloemfontein, Free State, South Africa
| | - Crystal Jane Ethan
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Yan Yu
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China.
| | - Karabo Shale
- Department of Environmental and Occupational Studies, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Yameng Fan
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Feng Liu
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China.
| | - Jie Rong
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
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Hoschar S, Pan J, Wang Z, Fang X, Tang X, Shi W, Tu R, Xi P, Che W, Wang H, Li Y, Fritzsche K, Liu X, Ladwig KH, Ma W. The MEDEA FAR-EAST Study: Conceptual framework, methods and first findings of a multicenter cross-sectional observational study. BMC Emerg Med 2019; 19:31. [PMID: 31046724 PMCID: PMC6498495 DOI: 10.1186/s12873-019-0240-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/14/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The substantial increase in cardiovascular diseases (CVD) in China over the last three decades warrants comprehensive preventive primary and secondary strategies. Prolonged prehospital delay (PHD) has been identified as a substantial barrier to timely therapeutic interventions for acute myocardial infarction (AMI). Despite worldwide efforts to decrease the patient's decision-making time, minimal change has been achieved so far. Here, we aim to describe the conceptual framework and methods and outline key data of the MEDEA FAR-EAST Study, which aimed to elucidate in-depth barriers contributing to delay in Chinese AMI-patients. METHODS Data sources of this multicenter cross-sectional observational study are a standardized bedside interview, a self-administered tailored questionnaire tool and the patient chart. PHD was defined as the main outcome and triangulated at bedside. Standard operation procedures ensured uniform data collection by trained study personnel. The study was ethically approved by Tongji-Hospital and applied to all participating hospitals. RESULTS Among 379 consecutively screened patients, 296 (78.1%) fulfilled eligibility criteria. A total of 241 (81.4%) AMI-patients were male and 55 (18.6%) female. Mean age was 62.9 years. Prehospital delay time was assessed for 294 (99.3%) patients. Overall median PHD was 151 min with no significant sex difference. Symptom mismatch was present in 200 (69.7%) patients and 106 (39.0%) patients did not attribute their symptoms to cardiac origin. A total of 33 (12.4%) patients suffered from depression, 31 (11.7%) from anxiety and 141 (53.2%) patients employed denial as their major coping style. CONCLUSION This is the first study on prehospital delay with emphasis on psychological variables in Chinese AMI-patients. A comprehensive assessment tool to measure clinical and psychological factors was successfully implemented. Socio-demographic key data proved a good fit into preexisting Chinese literature. Potential barriers including cardiac denial and symptom-mismatch were assessed for the first time in Chinese AMI-patients. The pretested selection of instruments allows future in depth investigations into barriers to delay of Chinese AMI-patients and enables inter-cultural comparisons.
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Affiliation(s)
- Sophia Hoschar
- Institute of Epidemiology II, Mental Health Research Unit, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr 1, 85764, Neuherberg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Medical Center- University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Jiangqi Pan
- Department of Cardiology, Tongji-Hospital, Tongji-University, Shanghai, People's Republic of China
| | - Zhen Wang
- Department of Cardiology, Tongji-Hospital, Tongji-University, Shanghai, People's Republic of China
| | - Xiaoyan Fang
- Institute of Epidemiology II, Mental Health Research Unit, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr 1, 85764, Neuherberg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Technical University Munich, Munich, Germany
| | - Xian'e Tang
- Department of Cardiology, Tongji-Hospital, Tongji-University, Shanghai, People's Republic of China
| | - Weiqi Shi
- Department of Cardiology, Tongji-Hospital, Tongji-University, Shanghai, People's Republic of China
| | - Rongxiang Tu
- Department of Cardiology, Tongji-Hospital, Tongji-University, Shanghai, People's Republic of China
| | - Peng Xi
- Department of Cardiology, Tongji-Hospital, Tongji-University, Shanghai, People's Republic of China
| | - Wenliang Che
- Department of Cardiology, Tenth-Hospital, Tongji-University, Shanghai, People's Republic of China
| | - Hongbao Wang
- Department of Cardiology, Yangpu-Hospital, Tongji-University, Shanghai, People's Republic of China
| | - Yawei Li
- Department of Cardiology, 455-Hospital, Tongji-University, Shanghai, People's Republic of China
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center- University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Xuebo Liu
- Department of Cardiology, Tongji-Hospital, Tongji-University, Shanghai, People's Republic of China
| | - Karl-Heinz Ladwig
- Institute of Epidemiology II, Mental Health Research Unit, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr 1, 85764, Neuherberg, Germany. .,Department of Psychosomatic Medicine and Psychotherapy, Technical University Munich, Munich, Germany.
| | - Wenlin Ma
- Department of Cardiology, Tongji-Hospital, Tongji-University, Shanghai, People's Republic of China
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Cui Y, Luo F, Yang B, Li B, Zhang Q, Das G, Yue G, Li J, Tang Y, Wang X. Construction and application of service quality evaluation system in the preclinical research on cardiovascular implant devices. BMC Med Inform Decis Mak 2019; 19:37. [PMID: 30819177 PMCID: PMC6396521 DOI: 10.1186/s12911-019-0773-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 02/15/2019] [Indexed: 12/21/2022] Open
Abstract
Background Services for the preclinical development and evaluation of cardiovascular implant devices (CVIDs) is a new industry. However, there is still no indicator system for quality evaluation. Our aim is to construct a service for quality evaluation system for the preclinical research and development of CVIDs based on Fuzzy Analytical Hierarchy Process (FAHP). Methods First, we reviewed the related literature to identify and select possible factors. Second, we developed an analytic hierarchy process framework. Third, we developed a questionnaire based on pairwise comparisons and invited 10 experienced specialists to rate these factors. We then used FAHP to compute the weights of these factors and prioritize them. Finally, to demonstrate the effectiveness of the proposed indicator system, a case study was performed as a practical example. Results Four main indicators (professionalism, functionality, stability and security) and 15 subindicators were selected to form the service evaluation system based on literature review and expert’s proposals. According to the weight calculation data, the order of primary indicators by importance, is professionalism (0.6457), security (0.1193), functionality (0.0958) and stability (0.0596) in sequence. Top five secondary indices are personnel’s technical ability, facility and equipment attractiveness, data auditability, confidentiality capability and professional service procedures. In the case study, FW’s final actual effectiveness value was 0.9076, which is the same as the actual situation. Conclusion The indicator system established in this study is comprehensive, reasonable, reliable and with strong practicality. It is worth popularizing and applying. The implementation of this evaluation system can provide measurable evidence for service demander and a way to improve service quality for suppliers. Electronic supplementary material The online version of this article (10.1186/s12911-019-0773-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yongchun Cui
- Animal Experimental Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease & Center for cardiovascular experimental study and evaluation, National Center for Cardiovascular Diseases, Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials, Beijing, 100037, China.
| | - Fuliang Luo
- Animal Experimental Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease & Center for cardiovascular experimental study and evaluation, National Center for Cardiovascular Diseases, Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials, Beijing, 100037, China
| | - Boqing Yang
- Animal Experimental Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease & Center for cardiovascular experimental study and evaluation, National Center for Cardiovascular Diseases, Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials, Beijing, 100037, China
| | - Bin Li
- Animal Experimental Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease & Center for cardiovascular experimental study and evaluation, National Center for Cardiovascular Diseases, Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials, Beijing, 100037, China
| | - Qi Zhang
- Animal Experimental Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease & Center for cardiovascular experimental study and evaluation, National Center for Cardiovascular Diseases, Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials, Beijing, 100037, China
| | - Gopika Das
- Department of Biology, Boston University, Boston, MA, 02215, USA
| | - Guangxin Yue
- Animal Experimental Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease & Center for cardiovascular experimental study and evaluation, National Center for Cardiovascular Diseases, Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials, Beijing, 100037, China
| | - Jiajie Li
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, 100872, China
| | - Yue Tang
- Animal Experimental Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease & Center for cardiovascular experimental study and evaluation, National Center for Cardiovascular Diseases, Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials, Beijing, 100037, China.
| | - Xin Wang
- Animal Experimental Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease & Center for cardiovascular experimental study and evaluation, National Center for Cardiovascular Diseases, Beijing Key Laboratory of Pre-clinical Research and Evaluation for Cardiovascular Implant Materials, Beijing, 100037, China.
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Reservoir Computing Based Echo State Networks for Ventricular Heart Beat Classification. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9040702] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The abnormal conduction of cardiac activity in the lower chamber of the heart (ventricular) can cause cardiac diseases and sometimes leads to sudden death. In this paper, the author proposed the Reservoir Computing (RC) based Echo State Networks (ESNs) for ventricular heartbeat classification based on a single Electrocardiogram (ECG) lead. The Association for the Advancement of Medical Instrumentation (AAMI) standards were used to preprocesses the standardized diagnostic tool (ECG signals) based on the interpatient scheme. Despite the extensive efforts and notable experiments that have been done on machine learning techniques for heartbeat classification, ESNs are yet to be considered for heartbeat classification as a is fast, scalable, and reliable approach for real-time scenarios. Our proposed method was especially designed for Medical Internet of Things (MIoT) devices, for instance wearable wireless devices for ECG monitoring or ventricular heart beat detection systems and so on. The experiments were conducted on two public datasets, namely AHA and MIT-BIH-SVDM. The performance of the proposed model was evaluated using the MIT-BIH-AR dataset and it achieved remarkable results. The positive predictive value and sensitivity are 98.98% and 98.98%, respectively for the modified lead II (MLII) and 98.96% and 97.95 for the V1 lead, respectively. However, the experimental results of the state-of-the-art approaches, namely the patient-adaptable method, improved generalization, and the multiview learning approach obtained 92.8%, 87.0%, and 98.0% positive predictive values, respectively. These obtained results of the existing studies exemplify that the performance of this method achieved higher accuracy. We believe that the improved classification accuracy opens up the possibility for implementation of this methodology in Medical Internet of Things (MIoT) devices in order to bring improvements in e-health systems.
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Zhong Z, Hou J, Zhang Q, Zhong W, Li B, Li C, Liu Z, Yang M, Zhao P. Assessment of the LDL-C/HDL-C ratio as a predictor of one year clinical outcomes in patients with acute coronary syndromes after percutaneous coronary intervention and drug-eluting stent implantation. Lipids Health Dis 2019; 18:40. [PMID: 30711009 PMCID: PMC6359834 DOI: 10.1186/s12944-019-0979-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/21/2019] [Indexed: 12/15/2022] Open
Abstract
Background Despite significant advances in the management of acute coronary syndromes (ACS), there are still plenty of patients undergoing percutaneous coronary intervention (PCI) and stent implantation suffered poor prognosis and high treatment expenditure. Evidence increasingly suggests that the ratio of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio might be a novel marker for the risk of atherosclerotic cardiovascular disease, but the impact of LDL-C/HDL-C ratio on 1-year prognosis of drug-eluting stent (DES) implantation patients after PCI is still not reported. Our aim of the study was to investigate the impact of LDL-C/HDL-C ratio on 1-year prognosis of DES implantation patients after PCI. Methods Between May 2014 and July 2016, 1937 patients who were underwent primary PCI and DES implantation and achieving LDL-C with statins were enrolled and divided into two groups based on the ratio of LDL-C/HDL-C. Results The entire occurrence of adverse cardiovascular events according to the ratio of LDL-C/HDL-C showed that there were no significant differences in 1-year cardiovascular death (hazard ratio [HR]: 1.97, 95% confidence interval [CI]: 0.49 to 7.84, P = 0.329), myocardial infarction (MI) (HR: 1.66, 95% CI: 0.84 to 3.28, P = 0.172) and bleeding events (HR: 1.08, 95% CI: 0.83 to 1.41, P = 0.598) The cumulative incidence of target lesion revascularization (TLR) (HR: 1.43, 95% CI: 1.10 to 1.86, P = 0.007), stent thrombosis (ST) (HR: 2.04, 95% CI: 1.06 to 3.93, P = 0.037) and major adverse cardiac events (MACE) (HR: 1.54, 95% CI: 1.24 to 1.91, P < 0.001) were significantly higher in high group than in low group. Multivariate Cox regression analysis revealed that age (HR: 1.556, 95%, CI: 1.198 to 2.021, P < 0.001), together with diabetes mellitus (HR: 1.490, 95% CI: 1.142 to 1.945, P = 0.003), and ratio of LDL-C/HDL-C (HR: 1.638, 95% CI: 1.260 to 2.218, P < 0.001) were independent predictors of 1-year MACE. The Kaplan-Meier cumulative MACE-free survival curves with a log-rank test showed that the presence of high ratio of LDL-C/HDL-C was associated with higher incidences of MACE after PCI with DES implantation. Conclusions The high LDL-C/HDL-C ratio was associated with cardiovascular events in patients with ACS after PCI and DES implantation.
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Affiliation(s)
- Zhixiong Zhong
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technology Research Center for Clinical Molecular Diagnostics and Antibody Therapeutics, No 63 Huangtang Road, Meijiang District, Meizhou, 514031, People's Republic of China
| | - Jingyuan Hou
- Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technology Research Center for Clinical Molecular Diagnostics and Antibody Therapeutics, No 63 Huangtang Road, Meijiang District, Meizhou, 514031, People's Republic of China
| | - Qifeng Zhang
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China
| | - Wei Zhong
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China
| | - Bin Li
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China
| | - Cunren Li
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China
| | - Zhidong Liu
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China
| | - Min Yang
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China
| | - Pingsen Zhao
- Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China. .,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China. .,Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China. .,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, 514031, People's Republic of China. .,Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders, Meizhou, 514031, People's Republic of China. .,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, 514031, People's Republic of China. .,Guangdong Provincial Engineering and Technology Research Center for Clinical Molecular Diagnostics and Antibody Therapeutics, No 63 Huangtang Road, Meijiang District, Meizhou, 514031, People's Republic of China.
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Ma S, Ma J, Guo L, Bai J, Mao S, Zhang M. Tongguan capsule-derived herb reduces susceptibility to atrial fibrillation by inhibiting left atrial fibrosis via modulating cardiac fibroblasts. J Cell Mol Med 2019; 23:1197-1210. [PMID: 30456908 PMCID: PMC6349173 DOI: 10.1111/jcmm.14022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/11/2018] [Accepted: 10/16/2018] [Indexed: 12/19/2022] Open
Abstract
Tongguan capsule is a compound Chinese medicine used to treat ischaemic heart diseases. This study aimed to investigate whether Tongguan capsule-derived herb (TGD) has a preventive effect on atrial fibrillation (AF) in post-myocardial infarction (MI) rats and to determine the underlying mechanisms. MI was induced by ligation of the left anterior descending coronary artery. TGD was administered to the post-MI rats over a 4-week period. The TGD-treated rats had lower rates of AF inducibility and shorter AF durations than the MI rats. TGD improved the left atrial (LA) conduction velocity and homogeneity. It reduced the fibrosis-positive areas and the protein levels of collagen types I and III in the left atrium. In vitro, it inhibited the expression of collagen types I and III by inhibiting the proliferation, migration, differentiation and cytokine secretion of cardiac fibroblasts (CFs). In conclusion, the current study demonstrated that TGD reduces susceptibility to AF and improves LA conduction function in rats with post-MI by inhibiting left atrial fibrosis and modulating CFs. Targeting the CF population may be a novel antiarrhythmic therapeutic approach.
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Affiliation(s)
- Shiyu Ma
- Department of Critical‐care MedicineGuangdong Provincial Hospital of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
- Guangzhou Key Laboratory of Myocardial Infarction in Chinese Medical Prevention and TreatmentGuangzhouChina
| | - Jin Ma
- Cardiac Electrophysiology Research TeamGuangdong Provincial Hospital of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Liheng Guo
- Department of Critical‐care MedicineGuangdong Provincial Hospital of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
- Guangzhou Key Laboratory of Myocardial Infarction in Chinese Medical Prevention and TreatmentGuangzhouChina
| | - Junqi Bai
- New Patent Chinese Medicine and Decoction Pieces Innovative Research and Development TeamThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangdong Provincial Hospital of Chinese MedicineGuangzhouChina
| | - Shuai Mao
- Department of Critical‐care MedicineGuangdong Provincial Hospital of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
- Guangzhou Key Laboratory of Myocardial Infarction in Chinese Medical Prevention and TreatmentGuangzhouChina
| | - Minzhou Zhang
- Department of Critical‐care MedicineGuangdong Provincial Hospital of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
- Guangzhou Key Laboratory of Myocardial Infarction in Chinese Medical Prevention and TreatmentGuangzhouChina
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Shu Q, Wu L, Zhang R, Zhang Q, Huang J, Meng Y. Age-dependent changes in cardiac performance, motor function, QoL, and mental status in metoprolol-treated chronic heart failure patients. Sci Rep 2019; 9:453. [PMID: 30679746 PMCID: PMC6345765 DOI: 10.1038/s41598-018-37520-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/06/2018] [Indexed: 01/11/2023] Open
Abstract
No previous study reports the effect of age on cardiac performance, motor function and quality of life (QoL) in Chinese chronic heart failure (CHF) patients. This single-center, prospective study enrolled CHF patients with resting heart rate (RHR) > 80 bpm, who were treated with metoprolol and were followed up at 1, 3, 6, and 12 months. Changes in cardiac, motor, and QoL parameters between patients aged ≥60 years and those aged <60 years were compared at all time points. P < 0.05 was considered significant. A total of 154 patients were enrolled (median age: 66.39 years; 116 aged ≥60 years, 38 aged <60 years; 95% New York Heart Association class III-IV). RHR decreased significantly in both patient groups (P < 0.0001 for both groups). Patients aged ≥60 years had a significant improvement in both ejection fraction (EF) at 6 and 12 months and in cardiac index (CI) at 3, 6, and 12 months. However, no major difference was observed in motor function in both groups. Significantly higher SF-8 scores showed greater improvement in QoL in the <60 age group at 12 months (P = 0.0008). Metoprolol demonstrated improvement in cardiac performance, motor function, QoL, and anxiety with increase in depression and burnout in both genders; however, the findings were independent of age.
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Affiliation(s)
- Qiuhong Shu
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Liyong Wu
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Ran Zhang
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Qian Zhang
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Jingjing Huang
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China
| | - Yong Meng
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan, 650101, China.
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Xu Y, Sun H, Wang Z, Wang Y. Plasma levels of pro-inflammatory molecules and their expressions are associated with severity of heart failure: An investigation in Chinese cohort. EUR J INFLAMM 2019. [DOI: 10.1177/2058739219836577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Heart failure (HF) is a syndrome with multiple clinical phenotypes affecting around 1%–2% of adult population worldwide, and about 230 million Chinese are affected by cardiovascular diseases. The important role of pro-inflammatory plasma cytokines with HF has been demonstrated in different populations. The aim of this study was to investigate importance of pro-inflammatory cytokines in Chinese HF patients. In all, 134 HF patients were enrolled in this study and further classified in to four clinical distinct groups according to New York Heart Association classification criteria (NYHA-I: n = 34, NYHA-II: n = 35, NYHA-III: n = 22 and NYHA-IV: n = 43). Sixty-eight healthy Chinese were enrolled as controls. Plasma levels of tumour necrosis factor-α (TNF-α), TNF-receptor 1 (TNFRI), TNF-receptor 2 (TNFRII), interleukin 6 (IL-6), soluble IL-6 receptor (sIL-6R), C-reactive protein (CRP), soluble cluster of differentiation 14 (sCD14) and interleukin 1 beta (IL-1β) were quantified by enzyme-linked immunosorbent assay (ELISA). Plasma levels of all parameters investigated in this study remained comparable among healthy controls and NYHA-I group. Plasma levels of TNF-α, TNFRI, TNFRII, IL-6, sIL-6R, CRP, sCD14 and IL-1β were significantly higher in NYHA-III and NYHA-IV clinical categories compared to other HF phenotype (NYHA-I and NYHA-II). Interestingly, TNFR-II levels were significantly higher in NYHA-II compared to NYHA-I. No significant difference of plasma sIL-6R was observed among various clinical categories. In conclusion, plasma levels of pro-inflammatory molecules are elevated in severe HF patients and may be used as possible biomarkers for accessing severity of HF.
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Affiliation(s)
- Yongxi Xu
- Department of Cardiology, Weihai Central Hospital, Weihai, China
| | - Hongyan Sun
- Department of Cardiology, Weihai Central Hospital, Weihai, China
| | - Zhihao Wang
- Department of Cardiology, Weihai Central Hospital, Weihai, China
| | - Yufeng Wang
- Department of Cardiology, Weihai Central Hospital, Weihai, China
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Zhong Z, Hou J, Zhang Q, Li B, Li C, Liu Z, Yang M, Zhong W, Zhao P. Differential expression of circulating long non-coding RNAs in patients with acute myocardial infarction. Medicine (Baltimore) 2018; 97:e13066. [PMID: 30572424 PMCID: PMC6320201 DOI: 10.1097/md.0000000000013066] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Long noncoding RNAs (lncRNAs) are non-protein coding transcripts regulating various critical physiological and pathological processes, yet limited information is available about lncRNAs expression in acute myocardial infarction (AMI). We aimed to identified differentially expressed lncRNAs in blood samples of patients with AMI to assess their diagnostic value. Differential expression of lncRNAs in peripheral blood mononuclear cells (PBMC) of patients with non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) was compared by RNA sequencing method and validated by real-time polymerase chain reaction (PCR). The area under the receiver operating characteristic curve (ROC) was used to evaluate diagnostic accuracy. Gene ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of lncRNA-coexpressed mRNAs were conducted to determine the related biological modules and pathological pathways. RNA sequencing data showed that 58 lncRNAs were differentially expressed between NSTEMI patients and STEMI patients, including 42 upregulated lncRNAs and 16 down-regulated lncRNAs. The ROC curves showed that ENST00000508020.2, LNC_001265, LNC_001526, and LNC_002674 could distinguish AMI patients with preferable sensitivity and specificity. GO enrichment analysis of lncRNA-coexpressed mRNAs indicated that the biological modules were correlated with cell adhesion, calcium ion homeostasis, complement receptor mediated signaling pathway, and immune system process. KEGG pathway analysis indicated that the lncRNAs-co-expressed mRNAs were involved in the regulation of peroxisome proliferators-activated receptors (PPAR) signaling pathway, mTOR signaling pathway, Insulin signaling pathway, HIF-1 signaling, and chemokin signaling pathway. Our results are in line with the previous findings, suggesting that differential expression of lncRNAs would be helpful to understand the molecular mechanism of AMI and might be useful biomarkers for noninvasive diagnostic application. Further studies are still needed to verify our findings and hypothesis.
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Affiliation(s)
- Zhixiong Zhong
- Center for Cardiovascular Diseases
- Guangdong Provincial Engineering
- Center for Precision Medicine
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
| | - Jingyuan Hou
- Guangdong Provincial Engineering
- Center for Precision Medicine
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
- Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, P.R. China
| | - Qifeng Zhang
- Center for Cardiovascular Diseases
- Guangdong Provincial Engineering
- Center for Precision Medicine
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
| | - Bin Li
- Center for Cardiovascular Diseases
- Guangdong Provincial Engineering
- Center for Precision Medicine
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
| | - Cunren Li
- Center for Cardiovascular Diseases
- Guangdong Provincial Engineering
- Center for Precision Medicine
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
| | - Zhidong Liu
- Center for Cardiovascular Diseases
- Guangdong Provincial Engineering
- Center for Precision Medicine
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
| | - Min Yang
- Center for Cardiovascular Diseases
- Guangdong Provincial Engineering
- Center for Precision Medicine
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
| | - Wei Zhong
- Center for Cardiovascular Diseases
- Guangdong Provincial Engineering
- Center for Precision Medicine
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
| | - Pingsen Zhao
- Guangdong Provincial Engineering
- Center for Precision Medicine
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases
- Meizhou Municipal Engineering and Technology Research Center for Molecular Diagnostics of Major Genetic Disorders
- Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, P.R. China
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King-Shier K, Quan H, Mather C, Chong E, LeBlanc P, Khan N. Understanding ethno-cultural differences in cardiac medication adherence behavior: a Canadian study. Patient Prefer Adherence 2018; 12:1737-1747. [PMID: 30233153 PMCID: PMC6135069 DOI: 10.2147/ppa.s169167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND There are ethno-cultural differences in cardiac patients' adherence to medications. It is unclear why this occurs. We thus aimed to generate an in-depth understanding about the decision-making process and potential ethno-cultural differences, of white, Chinese, and south Asian cardiac patients when making the decision to adhere to a medication regimen. METHODS A hierarchical descriptive decision-model was generated based on previous qualitative work, pilot tested, and revised to be more parsimonious. The final model was examined using a novel group of 286 cardiac patients, using their self-reported adherence as the reference. Thereafter, each node was examined to identify decision-making constructs that might be more applicable to white, Chinese or south Asian groups. RESULTS Non-adherent south Asians were most likely to identify a lack of receipt of detailed medication information, and less confidence and trust in the health care system and health care professionals. Both Chinese and south Asian participants were less likely to be adherent when they had doubts about western medicine (eg, the effects and safety of the medication). Being able to afford the cost of medications was associated with increased adherence. Being away from home reduced the likelihood of adherence in each group. The overall model had 67.1% concordance with the participants' initial self-reported adherence, largely due to participants' overreporting adherence. CONCLUSION These identified elements of the decision-making process are generally not considered in traditionally used medication adherence questionnaires. Importantly these elements are modifiable and ought to be the focus of both interventions and measurement of medication adherence.
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Affiliation(s)
- Kathryn King-Shier
- Faculty of Nursing, University of Calgary, Calgary, Canada,
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada,
| | - Hude Quan
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada,
| | - Charles Mather
- Department of Anthropology, Faculty of Arts, University of Calgary, Calgary, Canada
| | - Elaine Chong
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Pamela LeBlanc
- Faculty of Nursing, University of Calgary, Calgary, Canada,
| | - Nadia Khan
- Division of General Internal Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Hammad M, Maher A, Wang K, Jiang F, Amrani M. Detection of abnormal heart conditions based on characteristics of ECG signals. MEASUREMENT 2018; 125:634-644. [DOI: 10.1016/j.measurement.2018.05.033] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
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Wang Q, Shen JJ, Frakes K. Limited contribution of health behaviours to expanding income-related chronic disease disparities based on a nationwide cross-sectional study in China. Sci Rep 2018; 8:12485. [PMID: 30131504 PMCID: PMC6104030 DOI: 10.1038/s41598-018-30256-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 07/26/2018] [Indexed: 11/08/2022] Open
Abstract
This study estimated the association of income and prevalence of cardiovascular diseases (CVD) and hypertension, and then quantified the contribution of health behaviors to the association in China. Using the 2013 survey of the China Health and Retirement Longitudinal Study (CHARLS), a logit model was applied to examine income-related health disparities in relation to CVD and hypertension. A four-step regression method was then constructed to measure the role of health behaviors in income-related health disparities. Using indirect effects, mediation by health behaviors was examined. Income-related health disparities in chronic diseases were found to exist in China. Specifically, individuals in the high-income group had a 14% (OR = 0.86; 95% CI 0.73-1.02) and 14% (OR = 0.86; 95% CI 0.76-0.97) lower odds of suffering from CVD and hypertension than those in the low-income group. However, limited evidence shows this association was mediated by health behaviors. The Heaviness of Smoking Index (HSI), heavy drinking, irregular eating, and nap time did not significantly mediate the association of income and prevalence of CVD and hypertension. To curb the rising prevalence of CVD and hypertension in China, policies should focus on the low-income subpopulation. However, healthy behaviors interventions targeting smoking, heavy drinking, unhealthy napping and irregular eating habits among low-income people may be ineffective in reduction of income-related disparities in prevalence of CVD and hypertension.
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Affiliation(s)
- Qing Wang
- School of business, Dalian University of Technology, Panjin, 124221, Liaoning, China.
- School of public health, Shandong University, Jinan, 250100, shandong, China.
| | - Jay J Shen
- Department of Health Care Administration and Policy, School of Community Health Sciences, University of Nevada Las Vegas, 4505 Maryland Parkway, Las Vegas, NV, 89154-3023, USA
| | - Kaitlyn Frakes
- Department of Health Care Administration and Policy, School of Community Health Sciences, University of Nevada Las Vegas, 4505 Maryland Parkway, Las Vegas, NV, 89154-3023, USA
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The characteristics of coronary stenosis in 11,267 patients from Southwest China: a retrospective study. J Thromb Thrombolysis 2018; 45:142-150. [PMID: 29019045 DOI: 10.1007/s11239-017-1568-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The characteristics of coronary stenosis vary among the different countries or areas. 11,267 patients who have undergone coronary angiography (CAG) from three Southwest China hospitals were investigated. Patient characteristics, coronary stenosis and stent-implant information were recorded and analyzed according to two criteria: "visible stenosis" and "≥ 50% stenosis". The patients who have undergone CAG increased year by year, with patients from 60 to 69 years-old taking the highest ratio (34.69%). Based on the "≥ 50% stenosis" criteria, the stenotic frequency was 40.54% for Southwest China patients getting CAG. Only 8.14% patients suffered ≥ 3 stenotic vessels, while 11.58 and 20.82% patients had 2 or 1 stenotic vessel, respectively. However, when using the "visible stenosis" criteria, the stenotic frequency increased to 64.68%. The prevalence of stenosis increased with age based on the "visible stenosis" criteria. There were more male patients with stenosis than female except patients over 80 years old. The stenosis affected almost all main coronary arteries and their branches, with the most affected artery being the left anterior descending artery. There were 3246 cases (28.8%) implanted with 5423 stents with a concurrent age-dependent increasing tendency for stent-implant frequency and average implanted stent number. The numbers of patients who have undergone CAG and suffered from CVD increased rapidly. In these patients, positive rate of CAG was 64.67%, which increased to 72.2% in patients over 60-years old. The incidence of ≥ 75% stenosis and multiple stenosis increased with age, however it should be noticed there were 18.93% for ≥ 75% stenosis and 19.52% for multiple stenosis in patients under 40 years old.
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Jan S, Lee SWL, Sawhney JPS, Ong TK, Chin CT, Kim HS, Krittayaphong R, Nhan VT, Pocock SJ, Vega AM, Hayashi N, Huo Y. Predictors of high-cost hospitalization in the treatment of acute coronary syndrome in Asia: findings from EPICOR Asia. BMC Cardiovasc Disord 2018; 18:139. [PMID: 29973147 PMCID: PMC6033225 DOI: 10.1186/s12872-018-0859-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 06/10/2018] [Indexed: 11/10/2022] Open
Abstract
Background The EPICOR Asia (long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients in Asia) study (NCT01361386) was an observational study of patients hospitalized for acute coronary syndromes (ACS) enrolled in 218 hospitals in eight countries/regions in Asia. This study examined costs, length of stay and the predictors of high costs during an ACS hospitalization. Methods and results Data for patients hospitalized for an ACS (n = 12,922) were collected on demographics, medical history, event characteristics, socioeconomic and insurance status at discharge. Patients were followed up at 6 weeks’ post-hospitalization for an ACS event to assess associated treatment costs from a health sector perspective. Primary outcome was the incurring of costs in the highest quintile by country and index event diagnosis, and identification of associated predictors. Cost data were available for 10,819 patients. Mean length of stay was 10.1 days. The highest-cost countries were China, Singapore, and South Korea. Significant predictors of high-cost care were age, male sex, income, country, prior disease history, hospitalization in 3 months before index event, no dependency before index event, having an invasive procedure, hospital type and length of stay. Conclusions Substantial variability exists in healthcare costs for hospitalized ACS patients across Asia. Of concern is the observation that the highest costs were reported in China, given the rapidly increasing numbers of procedures in recent years. Trial registration NCT01361386. Electronic supplementary material The online version of this article (10.1186/s12872-018-0859-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stephen Jan
- The George Institute for Global Health, Sydney Medical School, University of Sydney, King George V Building, 83-117 Missenden Rd, Camperdown, NSW, 2050, Australia.
| | | | | | | | | | - Hyo-Soo Kim
- Seoul National University Hospital, Seoul, South Korea
| | | | - Vo T Nhan
- Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | | | - Ana M Vega
- Observational Research Centre, Global Medical Affairs, AstraZeneca, Madrid, Spain
| | | | - Yong Huo
- Peking University First Hospital, Beijing, China
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Affiliation(s)
- Marianthi Papagianni
- a First Propedeutic Department of Internal Medicine , Medical School, Aristotle University of Thessaloniki, AHEPA Hospital , Thessaloniki , Greece
| | - Konstantinos Tziomalos
- a First Propedeutic Department of Internal Medicine , Medical School, Aristotle University of Thessaloniki, AHEPA Hospital , Thessaloniki , Greece
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Sun C, Jiang H, Sun Z, Gui Y, Xia H. Identification of long non-coding RNAs biomarkers for early diagnosis of myocardial infarction from the dysregulated coding-non-coding co-expression network. Oncotarget 2018; 7:73541-73551. [PMID: 27634901 PMCID: PMC5341997 DOI: 10.18632/oncotarget.11999] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 08/24/2016] [Indexed: 02/01/2023] Open
Abstract
Long non-coding RNAs (lncRNAs) have recently been shown as novel promising diagnostic or prognostic biomarkers for various cancers. However, lncRNA expression patterns and their predictive value in early diagnosis of myocardial infarction (MI) have not been systematically investigated. In our study, we performed a comprehensive analysis of lncRNA expression profiles in MI and found altered lncRNA expression pattern in MI compared to healthy samples. We then constructed a lncRNA-mRNA dysregulation network (DLMCEN) by integrating aberrant lncRNAs, mRNAs and their co-dysregulation relationships, and found that some of mRNAs were previously reported to be involved in cardiovascular disease, suggesting the functional roles of dysregulated lncRNAs in the pathogenesis of MI. Therefore, using support vector machine (SVM) and leave one out cross-validation (LOOCV), we developed a 9-lncRNA signature (termed 9LncSigAMI) from the discovery cohort which could distinguish MI patients from healthy samples with accuracy of 95.96%, sensitivity of 93.88% and specificity of 98%, and validated its predictive power in early diagnosis of MI in another completely independent cohort. Functional analysis demonstrated that these nine lncRNA biomarkers in the 9LncSigAMI may be involved in myocardial innate immune and inflammatory response, and their deregulation may lead to the dysfunction of the inflammatory and immune system contributing to MI recurrence. With prospective validation, the 9LncSigAMI identified by our work will provide additional diagnostic information beyond other known clinical parameters, and increase the understanding of the molecular mechanism underlying the pathogenesis of MI.
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Affiliation(s)
- Chaoyu Sun
- Department of cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Hao Jiang
- Department of General Surgery, The Affiliated Hongqi Hospital of Mudanjiang Medical University, Mudanjiang 157011, China
| | - Zhiguo Sun
- Department of General Surgery, The Affiliated Hongqi Hospital of Mudanjiang Medical University, Mudanjiang 157011, China
| | - Yifang Gui
- The Clinical laboratory, The Affiliated Hongqi Hospital of Mudanjiang Medical University, Mudanjiang 157011, China
| | - Hongyuan Xia
- Department of cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
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Halatchev IG, Zheng J, Ou J. Wild-type transthyretin cardiac amyloidosis (ATTRwt-CA), previously known as senile cardiac amyloidosis: clinical presentation, diagnosis, management and emerging therapies. J Thorac Dis 2018; 10:2034-2045. [PMID: 29707360 DOI: 10.21037/jtd.2018.03.134] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cardiac amyloidosis is thought to be a rare group of diseases caused by extracellular deposition of misfolded proteins in the extracellular cardiac matrix resulting in heart failure with preserved ejection fraction (HFpEF). This review focuses on the similarities and differences between the pathophysiology, clinical presentation and diagnostic tests of wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) compared to immunoglobulin light chain amyloidosis and hereditary cardiac amyloidosis. We address some obstacles to timely diagnosis and opportunities for management of the clinical symptoms as well as possibility of future novel disease modifying therapies.
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Affiliation(s)
- Ilia G Halatchev
- Division of Cardiology, John Cochran Veterans Affairs Medical Center, St. Louis, USA.,Division of Cardiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jingsheng Zheng
- Department of Cardiology, AtlantiCare Regional Medical Center, Pomona, NJ, USA
| | - Jiafu Ou
- Division of Cardiology, John Cochran Veterans Affairs Medical Center, St. Louis, USA.,Division of Cardiology, Washington University School of Medicine, St. Louis, MO, USA
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Yu W, Shi R, Li J, Lan Y, Li Q, Hu S. Need for hyperlipidemia management policy reform in China: learning from the global experience. Curr Med Res Opin 2018; 34:197-207. [PMID: 28696793 DOI: 10.1080/03007995.2017.1354833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the hyperlipidemia prevention programs and policies in different countries and highlight the need of reforming the hyperlipidemia prevention policies in China to lower the growing cardiovascular disease (CVD) risk. RESEARCH DESIGN AND METHODS PubMed, Google Scholar and Cochrane were searched for global hyperlipidemia prevention policies. Government-funded policies pertaining to lipid management were considered for this review. Only those studies that evaluated the success of prevention policies on the basis of: (i) achievement of hyperlipidemia targets; (ii) improvement in Cardiovascular (CV) risk reduction; and (iii) outcomes with reduction in hyperlipidemia after implementation of the policy, were included. RESULTS Several global policies and programs aimed to improve CV health by highlighting lipid profile management. Implementation of the global and national policies led to improvement in cholesterol related outcomes such as availability of diagnostic measures, awareness of the risk factors, decrease in cholesterol levels, achieving healthy lifestyle to prevent CVD and improvement in availability of hypolipidemic medications, etc. Statins have been covered under reimbursement policies in many countries to improve usage and thereby preventing incidence of stroke and CVD. We observed a need for introducing new programs in China as the ongoing hyperlipidemia management policies are inadequate. The World Bank Report 2016 recommended that prevention policies in China be modeled on the US Million Hearts program. CONCLUSIONS New hyperlipidemia prevention policies must set a time-bound target, and need to be patient and clinician centric in terms of applications, and revised periodically for long-term benefits.
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Affiliation(s)
- Wei Yu
- a Department of Medical Affairs , Pfizer , Beijing , China
| | - Ruizhi Shi
- a Department of Medical Affairs , Pfizer , Beijing , China
| | - Jim Li
- b Department of Medical Affairs , Pfizer Inc. , San Diego , CA , USA
| | - Yong Lan
- a Department of Medical Affairs , Pfizer , Beijing , China
| | - Qian Li
- a Department of Medical Affairs , Pfizer , Beijing , China
| | - Shanlian Hu
- c Shanghai Health Development Research Center , Fudan University , Shanghai , China
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Zhao S, Peng D. Efficacy and safety of rosuvastatin versus atorvastatin in high-risk Chinese patients with hypercholesterolemia: a randomized, double-blind, active-controlled study. Curr Med Res Opin 2018; 34:227-235. [PMID: 28836458 DOI: 10.1080/03007995.2017.1371584] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate and compare the efficacy and safety of rosuvastatin versus atorvastatin in a high-risk Chinese population with hypercholesterolemia. RESEARCH DESIGN AND METHODS This 6 week, prospective, multicenter, double-blind, three-arm, parallel-group, active-controlled study randomized adult Chinese patients (low-density lipoprotein cholesterol [LDL-C] ≥ 130-<250 mg/dL statin-naive and ≥100-<160 mg/dL in statin treated) to receive rosuvastatin (5 mg or 10 mg) or atorvastatin 10 mg. Patients not achieving National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III LDL-C targets in the randomized phase were administered rosuvastatin 10 mg and 20 mg in the open-label phase. RESULTS In total 414 patients (mean age: 59.5 ± 9.51 years, 59.4% females, mean LDL-C: 4.242 ± 0.676 mmol/L (rosuvastatin 5 mg), 4.13 ± 0.682 mmol/L (rosuvastatin 10 mg) and 4.213 ± 0.662 mmol/L (atorvastatin 10 mg) were analyzed. Compared with atorvastatin 10 mg, rosuvastatin 5 mg (-41.70% vs. -38.67%, p = .132) and rosuvastatin 10 mg showed greater LDL-C reduction (-46.28% vs. -38.67%, p = .0002). LDL-C target achievement rates with rosuvastatin 5 mg, rosuvastatin 10 mg and atorvastatin 10 mg were 61.0%, 79.1% and 58.3% in the randomized phase. In the open-label phase, LDL-C target achievement occurred in >40% with both doses of rosuvastatin. The rate of ≥1 adverse event was similar with rosuvastatin 5 mg (12.4%), 10 mg (11.7%) and atorvastatin 10 mg (8.9%). CONCLUSION Rosuvastatin 5 mg demonstrated non-inferiority and rosuvastatin 10 mg demonstrated superiority to atorvastatin 10 mg for lowering LDL-C in high-risk Chinese patients with dyslipidemia, which was maintained through the open-label phase. CLINICAL TRIAL REGISTRATION NCT00683618.
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Affiliation(s)
- Shuiping Zhao
- a Department of Cardiology , Second Xiangya Hospital, Central South University , Changsha , Hunan , China
| | - Daoquan Peng
- a Department of Cardiology , Second Xiangya Hospital, Central South University , Changsha , Hunan , China
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Ji Y, Ge J, Li X. Association of IL-1β polymorphisms and plasma levels with chronic heart failure: A case-control study in Chinese patients. EUR J INFLAMM 2018. [DOI: 10.1177/2058739218818686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Heart failure (HF) has been major health concern affecting 1%–2% of world adult population. Role of various cytokines in chronic heart failure (CHF) have been demonstrated in different populations; however, association of an important cytokine, interleukin-1β (IL-β), is poorly documented. Furthermore, polymorphism in promoter region is shown to be linked with cytokines levels. In this study, we explored plasma levels of IL-1β in healthy controls (HCs) and different clinical categories of CHF and association of common IL-1β promoter variants with susceptibility to development of HF. In all, 354 CHF patients admitted to Department of Cardiology at the first affiliated hospital of Soochow University were enrolled in this study. These patients were further clinically sub-categorized into New York Heart Association (NYHA)-I to IV based on NYHA criteria. A total of 77 HCs were included in the current investigation. Plasma levels of IL-1β were quantified by enzyme-linked immunosorbent assay (ELISA) and common promoter gene polymorphisms in IL-1β gene were genotyped by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP). CHF patients displayed higher plasma IL-1β compared to HCs. Interestingly, plasma levels of IL-1β were associated with severity of HF patients: NYHA-IV had highest levels, and least quantity was noticed in NYHA-I cases. Prevalence of heterozygous and homozygous mutant for C-511T polymorphisms were significantly higher in CHF patients when compared to HCs. Importantly, these observations remained valid for NYHA-III and IV sub-groups in comparison to controls. Elevated plasma levels of IL-1β were observed in 511 mutants (CT and TT) than wild type (CC), indicating important function variants determining plasma levels of cytokine in both controls and patients. In conclusion, IL-1β (C-511T) variants are associated with elevated plasma IL-1β and predisposed to severe chronic HF in Chinese.
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Affiliation(s)
- Yuan Ji
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Cardiology, The Second People’s Hospital of Changzhou, Changzhou, China
| | - Jiyong Ge
- Department of Cardiology, The Second People’s Hospital of Changzhou, Changzhou, China
| | - Xun Li
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Efficacy of nutritional interventions supplementing nuts on cardiovascular risk factors among adults individuals: A systematic review and meta-analysis of intervention studies. Proc Nutr Soc 2018. [DOI: 10.1017/s0029665118002100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Zhao W, Zheng XL, Jiang ZN, Liao XB, Zhao SP. Risk factors associated with atherogenic dyslipidemia in the presence of optimal statin therapy. Int J Cardiol 2017; 248:355-360. [DOI: 10.1016/j.ijcard.2017.06.105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 06/08/2017] [Accepted: 06/26/2017] [Indexed: 11/26/2022]
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