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Gong Y, Li X, Ma X, Yu H, Li Y, Chen J, Zhang G, Wang B, Qi X, Meng H, Wang X, Mu J, Hu X, Wang J, Liu S, Liu G, Yang Z, Zhou Y, Kong X, Yan Y, Wang C, Wang JA, Wang L, Fu G, Wei L, Peng D, Zhang S, Li R, Mao A, Bian R, Tang W, Ran Y, Jiang J, Huo Y. Lipid goal attainment in post-acute coronary syndrome patients in China: Results from the 6-month real-world dyslipidemia international study II. Clin Cardiol 2021; 44:1575-1585. [PMID: 34651329 PMCID: PMC8571548 DOI: 10.1002/clc.23725] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/20/2021] [Accepted: 09/03/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dyslipidemia International Study II (DYSIS II)-China was conducted to determine the low-density lipoprotein cholesterol (LDL-C) goal (<1.8 mmol/L) attainment rate in patients with post-acute coronary syndrome (ACS). HYPOTHESIS Compliance with treatment guideline recommendations improves the LDL-C goal attainment rate in post-ACS patients. METHODS This multicenter prospective observational study conducted at 28 tertiary hospitals determined the LDL-C goal attainment rates at admission and 6-month follow-up in patients on lipid-lowering treatment (LLT) for ≥3 months and those not on LLT (LLT-naive or off LLT for ≥3 months) at admission. Predictors of goal attainment at 6 months were identified using multivariate logistic regression. RESULTS The LDL-C goal attainment rate at admission in 1102/1103 enrolled patients was 17.1%; it was 41.2% among 752 patients with available lipid results at 6 months. The distance to goal was 0.7 mmol/L at 6 months. Statin monotherapy was the most prescribed LLT. Only 7.7% of patients were receiving statin + ezetimibe and 8.4% of patients were receiving an atorvastatin-equivalent dose of ≥40 mg/day at 6 months. Being male (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.1-2.6) and undergoing percutaneous coronary intervention during index hospitalization (OR 1.5, 95% CI 1.1 to 2.1) were the independent predictors for LDL-C goal attainment. CONCLUSIONS This real-world DYSIS II study in China reports a low LDL-C goal attainment rate in post-ACS patients even after 6 months of LLT. Lack of intensification of statin therapy and underutilization of combinations suggest gaps between real-world treatment practices and guideline recommendations.
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Yu J, Li Y, Leng D, Cao C, Yu Y, Wang Y. microRNA-3646 serves as a diagnostic marker and mediates the inflammatory response induced by acute coronary syndrome. Bioengineered 2021; 12:5632-5640. [PMID: 34519257 PMCID: PMC8806520 DOI: 10.1080/21655979.2021.1967066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Acute coronary syndrome (ACS) is one of the main syndromes of coronary artery disease with high mortality. The identification of biomarkers associated with disease occurrence and progression could improve early detection and risk prediction. This study was aimed to reveal the clinical significance and function of miR-3646 in ACS. The expression of miR-3646 was evaluated in ACS patients, healthy volunteers, and non-ACS patients and estimated the clinical significance of miR-3646. The ACS modeling rats were also established in this study to explore the potential mechanism underlying the function of miR-3646. miR-3646 was upregulated in ACS patients compared with healthy volunteers and non-ACS patients. The expression of miR-3646 was positively correlated with the severity and progression of ACS patients and could discriminate ACS patients from healthy volunteers and non-ACS patients. The knockdown of miR-3646 could reverse the inflammatory response induced by ACS.miR-3646 serves as a diagnostic biomarker for ACS. The knockdown of miR-3646 could alleviate ACS by reversing inflammatory response. These results provide a potential therapeutic target of ACS.
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Affiliation(s)
- Jinming Yu
- Department of Clinical Laboratory, Zibo Municipal Hospital, Zibo, Shandong, China
| | - Yongmei Li
- Department of Clinical Laboratory, Zibo Municipal Hospital, Zibo, Shandong, China
| | - Deguo Leng
- Department of Clinical Laboratory, Zibo Municipal Hospital, Zibo, Shandong, China
| | - Cheng Cao
- Department of Clinical Laboratory, Zibo Municipal Hospital, Zibo, Shandong, China
| | - Yongzhi Yu
- Department of Cardiology, Zibo Municipal Hospital, Zibo, Shandong, China
| | - Yijuan Wang
- Department of Clinical Laboratory, Zibo Municipal Hospital, Zibo, Shandong, China
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Bayram F, Sonmez A, Haymana C, Sabuncu T, Dizdar OS, Gurkan E, Carlioglu AK, Agbaht K, Ozdemir D, Demirci I, Barcin C, Salman S, Tetiker T, Balci MK, Kebapci N, Ersoy C, Yumuk V, Toth PP, Satman I. Utilization of statins and LDL-cholesterol target attainment in Turkish patients with type 2 diabetes - a nationwide cross-sectional study (TEMD dyslipidemia study). Lipids Health Dis 2020; 19:237. [PMID: 33176832 PMCID: PMC7659134 DOI: 10.1186/s12944-020-01408-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/19/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Attaining acceptable levels of LDL Cholesterol (LDL-C) significantly improves cardiovascular (CV) outcomes in patients with type 2 diabetes mellitus (T2DM). The LDL-C target attainment and the characteristics of patients attaining these targets were investigated in this study. Furthermore, the reasons for not choosing statins and the physicians' attitudes on the treatment of diabetic dyslipidemia were also examined. METHODS A nationwide, cross-sectional survey was conducted in tertiary centers for diabetes management. Adult patients with T2DM, who were under follow-up for at least a year in outpatient clinics, were consecutively enrolled for the study. LDL-C goals were defined as below 70 mg/dL for patients with macrovascular complications or diabetic nephropathy, and below 100 mg/dL for other patients. Data about lipid-lowering medications were self-reported. RESULTS A total of 4504 patients (female: 58.6%) were enrolled for the study. The mean HbA1c and diabetes duration was 7.73 ± 1.74% and 10.9 ± 7.5 years, respectively. The need for statin treatment was 94.9% (n = 4262); however, only 42.4% (n = 1807) of these patients were under treatment, and only 24.8% (n = 448) of these patients achieved LDL-C targets. The main reason for statin discontinuation was negative media coverage (87.5%), while only a minority of patients (12.5%) mentioned side effects. Physicians initiated lipid-lowering therapy in only 20.3% of patients with high LDL-C levels. It was observed that the female gender was a significant independent predictor of not attaining LDL-C goals (OR: 0.70, 95% CI: 0.59-0.83). CONCLUSIONS Less than 50 % of patients with T2DM who need statins were under treatment, and only a quarter of them attained their LDL-C targets. There exists a significant gap between the guideline recommendations and the real-world evidence in the treatment of dyslipidemia in T2DM.
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Affiliation(s)
- Fahri Bayram
- Department of Endocrinology and Metabolism, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey.
| | - Tevfik Sabuncu
- Department of Endocrinology and Metabolism, Harran University, School of Medicine, Sanliurfa, Turkey
| | - Oguzhan Sitki Dizdar
- Department of Endocrinology and Metabolism, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Eren Gurkan
- Department of Endocrinology and Metabolism, Mustafa Kemal University, School of Medicine, Hatay, Turkey
| | - Ayse Kargili Carlioglu
- Department of Endocrinology and Metabolism, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Kemal Agbaht
- Department of Endocrinology and Metabolism, Private Defne Hospital, Hatay, Turkey
| | - Didem Ozdemir
- Department of Endocrinology and Metabolism, Yildirim Beyazit University, School of Medicine, Ankara, Turkey
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Cem Barcin
- Department of Cardiology, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Private Liv Hospital, Istanbul, Turkey
| | - Tamer Tetiker
- Department of Endocrinology and Metabolism, Cukurova University, School of Medicine, Adana, Turkey
| | - Mustafa Kemal Balci
- Department of Endocrinology and Metabolism, Akdeniz University, School of Medicine, Antalya, Turkey
| | - Nur Kebapci
- Department of Endocrinology and Metabolism, Osmangazi University, School of Medicine, Eskisehir, Turkey
| | - Canan Ersoy
- Department of Endocrinology and Metabolism, Uludag University, School of Medicine, Bursa, Turkey
| | - Volkan Yumuk
- Department of Endocrinology and Metabolism, Istanbul University, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Peter P Toth
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Preventive Cardiology, CGH Medical Center, Sterling, IL, USA
| | - Ilhan Satman
- Department of Endocrinology and Metabolism, Istanbul University, School of Medicine, Istanbul, Turkey
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Chen P, Ma X, Chen H, Wang K, Zhou L. Delays in Insulin Initiation among Patients with Type 2 Diabetes Mellitus in Southeast China: A Retrospective, Real-World Study. Diabetes Metab Syndr Obes 2020; 13:3059-3068. [PMID: 32922056 PMCID: PMC7457728 DOI: 10.2147/dmso.s256381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/10/2020] [Indexed: 04/20/2023] Open
Abstract
PURPOSE To describe the extent of delays in insulin initiation, analyze its impact on glycemic control, and explore factors influencing delayed insulin initiation among Chinese type 2 diabetes mellitus (T2DM) patients. METHODS A real-world, retrospective cohort study with regional electronic health records from Fuzhou, southeast China was conducted among T2DM patients. Adult patients uncontrolled with oral antidiabetic drugs (OADs; HbA1c ≥7%) and initiated on insulin treatment were included. Time to insulin initiation was described. After propensity-score matching, Wilcoxon rank-sum test and chi-square test were used to compare follow-up HbA1c (first HbA1c 3 months after insulin initiation) between timely (initiated insulin within 6 months after OAD failure) and delayed (initiated after 6 months) insulin-initiation groups. Sensitivity analysis was also performed by linear and logistic regression. Factors associated with delayed insulin initiation were explored using logistic regression. RESULTS A total of 940 patients were included, with mean±SD age 66.3±11.9 years. In sum, 328 had HbA1c recorded 3 months after insulin initiation. After propensity-score matching (1:1 matching), 184 patients were included for further analysis. Median follow-up HbA1c was lower in the timely-initiation group than the delayed-initiation group (7.25% vs 8.25%, P=0.009). Patients in the timely initiation group also had higher odds of achieving HbA1c <7% (OR=3.15, P=0.001). Results were confirmed by logistic regression. Hypertension, coronary artery disease, baseline HbA1c, and hospital level at insulin initiation were associated with delays in insulin initiation. CONCLUSION Timely insulin initiation after OAD failure is associated with better glycemic control.
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Affiliation(s)
- Pin Chen
- Department of Endocrinology, 900 Hospital of the Joint Logistics Team, Fuzhou Clinical Medical College of Fujian Medical University, Fuzhou, People’s Republic of China
| | - Xiao Ma
- Lilly Suzhou Pharmaceutical, Shanghai, People’s Republic of China
| | - Hong Chen
- Lilly Suzhou Pharmaceutical, Shanghai, People’s Republic of China
| | - Ke Wang
- Lilly Suzhou Pharmaceutical, Shanghai, People’s Republic of China
| | - Li Zhou
- Lilly Suzhou Pharmaceutical, Shanghai, People’s Republic of China
- Correspondence: Li Zhou Lilly Suzhou Pharmaceutical, Shanghai, People’s Republic of China Email
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