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MA CS, WU SL, LIU SW, HAN YL. Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation. J Geriatr Cardiol 2024; 21:251-314. [PMID: 38665287 PMCID: PMC11040055 DOI: 10.26599/1671-5411.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, significantly impacting patients' quality of life and increasing the risk of death, stroke, heart failure, and dementia. Over the past two decades, there have been significant breakthroughs in AF risk prediction and screening, stroke prevention, rhythm control, catheter ablation, and integrated management. During this period, the scale, quality, and experience of AF management in China have greatly improved, providing a solid foundation for the development of guidelines for the diagnosis and management of AF. To further promote standardized AF management, and apply new technologies and concepts to clinical practice in a timely and comprehensive manner, the Chinese Society of Cardiology of the Chinese Medical Association and the Heart Rhythm Committee of the Chinese Society of Biomedical Engineering have jointly developed the Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation. The guidelines have comprehensively elaborated on various aspects of AF management and proposed the CHA2DS2-VASc-60 stroke risk score based on the characteristics of AF in the Asian population. The guidelines have also reevaluated the clinical application of AF screening, emphasized the significance of early rhythm control, and highlighted the central role of catheter ablation in rhythm control.
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XU JJ, JIA SD, ZHU P, SONG Y, YUAN DS, ZHAO XY, YAO Y, JIANG L, LI JX, ZHANG Y, SONG L, GAO RL, HAN YL, YUAN JQ. Prolonging dual antiplatelet therapy improves the long-term prognosis in patients with diabetes mellitus undergoing complex percutaneous coronary intervention. J Geriatr Cardiol 2023; 20:586-595. [PMID: 37675261 PMCID: PMC10477584 DOI: 10.26599/1671-5411.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVE To investigate the optimal duration of dual antiplatelet therapy (DAPT) in patients with diabetes mellitus (DM) requiring complex percutaneous coronary intervention (PCI). METHODS A total of 2403 patients with DM who underwent complex PCI from January to December 2013 were consecutively enrolled in this observational cohort study and divided according to DAPT duration into a standard group (11-13 months, n = 689) and two prolonged groups (13-24 months, n = 1133; > 24 months, n = 581). RESULTS Baseline characteristics, angiographic findings, and complexity of PCI were comparable regardless of DAPT duration. The incidence of major adverse cardiac and cerebrovascular event was lower when DAPT was 13-24 months than when it was 11-13 months or > 24 months (4.6% vs. 8.1% vs. 6.0%, P = 0.008), as was the incidence of all-cause death (1.9% vs. 4.6% vs. 2.2%, P = 0.002) and cardiac death (1.0% vs. 3.0% vs. 1.2%, P = 0.002). After adjustment for confounders, DAPT for 13-24 months was associated with a lower risk of major adverse cardiac and cerebrovascular event [hazard ratio (HR) = 0.544, 95% CI: 0.373-0.795] and all-cause death (HR = 0.605, 95% CI: 0.387-0.944). DAPT for > 24 months was associated with a lower risk of all-cause death (HR = 0.681, 95% CI: 0.493-0.942) and cardiac death (HR = 0.620, 95% CI: 0.403-0.952). The risk of major bleeding was not increased by prolonging DAPT to 13-24 months (HR = 1.356, 95% CI: 0.766-2.401) or > 24 months (HR = 0.967, 95% CI: 0.682-1.371). CONCLUSIONS For patients with DM undergoing complex PCI, prolonging DAPT might improve the long-term prognosis by reducing the risk of adverse ischemic events without increasing the bleeding risk.
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Affiliation(s)
- Jing-Jing XU
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Si-Da JIA
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Pei ZHU
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying SONG
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - De-Shan YUAN
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xue-Yan ZHAO
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi YAO
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin JIANG
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian-Xin LI
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yin ZHANG
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei SONG
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Run-Lin GAO
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ya-Ling HAN
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Jin-Qing YUAN
- Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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LI YX, WANG BN, FAN FF, ZHANG Y, JIANG J, LI JP, HAN YL, Huo Y. Thirty-day outcomes of in-hospital multi-vessel versus culprit-only revascularization strategy for ST-segment elevation myocardial infarction with multivessel coronary disease. J Geriatr Cardiol 2023; 20:485-494. [PMID: 37576484 PMCID: PMC10412540 DOI: 10.26599/1671-5411.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease. However, only a few single-center retrospective studies were performed on small Chinese cohorts. Our study aims to demonstrate the advantage of multivessel percutaneous intervention (PCI) strategy on 30-day in-hospital outcomes to patients with STEMI and multivessel disease in larger Chinese population. METHODS From the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome (CCC-ACS) project, 5935 patients with STEMI and multivessel disease undergoing PCI and hospitalized for fewer than 30 days were analyzed. After 5: 1 propensity score matching, 3577 patients with culprit-only PCI and 877 with in-hospital multivessel PCI were included. The primary outcome was major adverse cardiovascular and cerebrovascular event (MACCE), defined as a composite of myocardial infarction, all-cause death, stent thrombosis, heart failure, and stroke. RESULTS Multivariable logistic regression analysis revealed that in-hospital multivessel PCI was associated with lower risk of 30-day MACCE (adjusted OR = 0.75, 95% CI: 0.57-0.98, P = 0.032) than culprit-only PCI and conferred no increased risk of all-cause death, myocardial infarction, stent thrombosis, stroke, or bleeding. Subgroup analysis showed that MACCE reduction was observed more often from patients with trans-femoral access (OR = 0.34, 95% CI: 0.15-0.74) than with trans-radial access (OR = 0.87, 95% CI: 0.66-1.16, P for interaction = 0.017). CONCLUSIONS The in-hospital multivessel PCI strategy was associated with a lower risk of 30-day MACCE than culprit-only PCI in patients with STEMI and multivessel coronary artery disease.
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Affiliation(s)
- Yu-Xi LI
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Bei-Ning WANG
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Fang-Fang FAN
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan ZHANG
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jie JIANG
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jian-Ping LI
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Ya-Ling HAN
- Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
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Chinese Society of Cardiology of Chinese Med, Yong H, Ya-Ling H, Run-Lin G, Da-Yi H, Yun Z, Jun-Bo G, Yong-Qiang Z, Xu-Bo S, Yi-Da T, Zhen-Yu L, Jing-Bo H, Feng B, Ji-Yan C, Shao-Liang C, Yun-Dai C, Hong-Liang C, Zhi-Min D, Wei-Yi F, Guo-Sheng F, Xiang-Hua F, Chuan-Yu G, Run-Lin G, Wei G, Jun-Bo G, Lei G, Li-Jun G, Ya-Ling H, Ben H, Jing-Bo H, Da-Yi H, Yong H, Fu-Sui J, Da-Lin J, Guo-Liang J, Shao-Bin J, Xue-Jun J, Quan-Min J, Bao L, Chun-Jian L, Guo-Qing L, Hong-Wei L, Jian-Ping L, Lang L, Xiao-Ying L, Xiao-Dong L, Yi L, Yong-Jun L, Chun L, Bin L, Jun-Ming L, Qi-Ming L, Zhen-Yu L, Shu-Zheng L, Gen-Shan M, Li-Kun M, Yi-Tong M, Shao-Ping N, Jian-Jun P, Shu-Bin Q, Chun-Guang Q, Wei-Feng S, Zhu-Jun S, Xu-Bo S, Fu-Cheng S, Yi-Hong S, Yi-Da T, Ye T, Chun-Xue W, Hai-Chang W, Jian-An W, Le-Feng W, Wei-Min W, Chang-Qian W, Meng W, Shang-Yu W, Yong-Jian W, Ya-Wei X, Hong-Bing Y, Li-Xia Y, Tian-He Y, Yue-Jin Y, Bo Y, Jin-Qing Y, Zu-Yi Y, Qi Z, Rui-Yan Z, Shu-Yang Z, Yun Z, Zheng Z, Xue-Zhong Z, Yong-Qiang Z, Xu-Chen Z, Yu-Jie Z, Jian-Hua Z, Jun Z. Chinese experts recommendation on the monitoring and management of variability in responsiveness to antiplatelet therapy. Eur Heart J Suppl 2015. [DOI: 10.1093/eurheartj/suv025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Jian Z, Xiao-Xiang T, Cheng-Hui Y, Xiao-Lin Z, Jian K, Ya-Ling H. ASSA14-03-28 Cellular repressor of E1A-stimulated genes improves heart function in a mouse model of MI. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Xin Z, Xiaoxu Y, Cheng-Hui Y, xiao-Lin Z, Ya-Ling H. ASSA14-11-03 Dietary Salt Intake and Coronary Atherosclerosis in Patients with Prehypertension. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Jian Z, Ya-Ling H, Quanmin J, Xiaozeng W, Ying-Yan M, Geng W, Bin W. ASSA14-03-30 Long-term Efficacy of PCI vs CABG for Patients with Multiple Coronary Chronic Total Occlusions. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Xin Z, Li W, Yu-Yang D, Ya-Ling H. ASSA14-12-15 Efficacy and safety of direct thrombin inhibitor of bivalirudin during percutaneous coronary intervention therapy in AMI patients with Heparin-Induced Thrombocytopenia. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Yang L, Ya-Ling H, Cheng-Hui Y, Xiao-Xiang T. ASSA14-03-19 The change of cellular repressor of E1A-stimulated genes during vascular remodelling in a mouse model of arterial injury. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Quan-Yu Z, Feng-Qi X, Jing-Jing R, Jie D, Xiaozeng W, Ya-Ling H. ASSA14-07-02 Comparision of metoprolol succinate sustained-release tablets and metoprolol tartrate tablets on cardiac function in patients with chronic congestive heart failure. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bin W, Ya-Ling H, Xiaozeng W, Quanmin J, Zhen-Yang L, Ying-Yan M, Geng W, Haiwei L, Xin Z, Kai X, Jie D, Shao-Yi G. ASSA14-12-16 Comparative analysis of left trans-radial approach and trans-femoral approach in coronary bypass graft vessel angiography. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Quan-Yu Z, Ya-Ling H. ASSA14-03-36 Guanxinkeli protects myocardial cells from ischemia-reperfusion injury in rats via JNK signal pathway. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Xiaozeng W, Ruo-Xi G, Jing L, Jie D, Xing-Xing L, Jiao W, Ya-Ling H. ASSA14-03-35 Effects of Omeprazole and Pantoprazole on platelet function in Acute Coronary Syndrome patients receiving clopidogrel: A Single-centre Prospective Randomised Controlled Clinical Trials. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Xiaozeng W, Zhan-Kui D, Jie D, Quanmin J, Ya-Ling H. ASSA14-12-13 Experience Analysis of Endovascular Repair 0f Thoracic Aortic Traumatic Transection. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jian Z, Ya-Ling H, Quanmin J, Xiaozeng W, Ying-Yan M, Geng W, Bin W. ASSA14-03-29 Angiographic features of patients with atherosclerosis in the segments proximal to the myocardial bridge. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Xiaozeng W, Xing-Xing L, Jie D, Ruo-Xi G, Ya-Ling H. ASSA14-04-01 Long-Term efficiency of percutaneous transluminal septal myocardial ablation for hypertrophic obstractive cardiomyopathy. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Li-Wen L, Zhan-Kui D, Ya W, Ya-Na S, Xiaozeng W, Ya-Ling H. ASSA14-04-03 The Clinical Characteristics and Coronary Angiography Features of Patients with Apical Hypertrophic Cardiomyopathy. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Xiaozeng W, Xing-Xing L, Jie D, Ruo-Xi G, Ya-Ling H. ASSA14-04-02 Long-Term efficiency of percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Haiwei L, Ya-Ling H, Ying-Yan M, Quanmin J, Xiaozeng W, Geng W, Bin W. ASSA14-01-05 Thrombus aspiration followed by direct stenting during primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Quanmin J, Bing T, Geng W, Shao-Yi G, Zhan-Chun C, Li-Li S, Hai D, Jing H, Ya-Ling H. ASSA14-12-12 The analyses of incidence of failure and relate factors in patients with retrograde wire for the treatment of chronic coronary artery occlusion. Heart 2015. [DOI: 10.1136/heartjnl-2014-307109.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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WU GZ, YAN CH, HAN YL, TAO J, DENG J, TIAN XX, ZHANG BH, WANG T, KANG J, ZHANG XL. Overexpression of The Cellular Repressor of E1A-stimulated Genes Inhibits The Apoptosis of Human Vascular Smooth Muscle Cells <I>via</I> Blocking p38/JNK MAP Kinase Activation*. PROG BIOCHEM BIOPHYS 2010. [DOI: 10.3724/sp.j.1206.2009.00448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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