1
|
Wang H, Li Y, Chai K, Long Z, Yang Z, Du M, Wang S, Zhan S, Liu Y, Wan Y, Wang F, Yin P, Li W, Liao Y, Dong Y, Li X, Zhou J, Yiu KH, Zhou M, Huo Y, Yang J. Mortality in patients admitted to hospital with heart failure in China: a nationwide Cardiovascular Association Database-Heart Failure Centre Registry cohort study. Lancet Glob Health 2024; 12:e611-e622. [PMID: 38485428 DOI: 10.1016/s2214-109x(23)00605-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/04/2023] [Accepted: 12/18/2023] [Indexed: 03/19/2024]
Abstract
BACKGROUND China has the largest burden of heart failure worldwide. However, large-scale studies on heart failure mortality are scarce. We aimed to investigate mortality and identify risk factors for mortality among patients with heart failure in China. METHODS This prospective cohort study used data from the China Cardiovascular Association (CCA) Database-Heart Failure Centre Registry, which were linked to the National Mortality Registration Information Management System by the Chinese Centre for Disease Control and Prevention. We included patients enrolled from Jan 1, 2017, to Dec 31, 2021, across 572 CCA Database-Heart Failure Centre certified hospitals in 31 provinces of mainland China. Eligible patients were aged 18 years or older (younger than 100 years) with a principal discharge diagnosis of heart failure based on Chinese heart failure guidelines. All-cause mortality at 30 days, 1 year, and 3 years for patients with heart failure were calculated and the causes of death were recorded. Multivariable analysis was used to analyse factors associated with all-cause mortality and cardiovascular mortality. This study was registered with the Chinese Clinical Trial Registry, ChiCTR2200066305. FINDINGS Of the 327 477 patients in the registry, 230 637 eligible adults with heart failure were included in our analyses. Participant mean age was 69·3 years (SD 13·2), 94 693 (41·1%) participants were female, and 135 944 (58·9%) were male. The median follow-up time was 531 days (IQR 251-883). Post-discharge all-cause mortality of patients with heart failure at 30 days was 2·4% (95% CI 2·3-2·5), at 1 year was 13·7% (13·5-13·9), and at 3 years was 28·2% (27·7-28·6). Cardiovascular death accounted for 32 906 (71·5%) of 46 006 all-cause deaths. Patients with heart failure with reduced ejection fraction had the highest all-cause mortality. A lower guideline adherence score was independently associated with the increase of all-cause and cardiovascular mortality. INTERPRETATION In China, mortality for patients with heart failure is still high, especially in patients with reduced ejection fraction. Our findings suggest that guideline-directed medical therapy needs to be improved. FUNDING National High Level Hospital Clinical Research Funding, the Capital's Funds for Health Improvement and Research, and the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
Collapse
Affiliation(s)
- Hua Wang
- Department of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yingying Li
- Department of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Ke Chai
- Department of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Long
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Zhikai Yang
- Department of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Minghui Du
- Department of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yujia Liu
- Department of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuhao Wan
- Department of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Fang Wang
- Department of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Peng Yin
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Weimin Li
- The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yuhua Liao
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yugang Dong
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xinli Li
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jingmin Zhou
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Kai-Hang Yiu
- Cardiology Division, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Maigeng Zhou
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China.
| | - Jiefu Yang
- Department of Cardiology, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
| |
Collapse
|
2
|
Zhou S, Zhang Y, Dong X, Ma J, Li N, Shi H, Smith SC, Jin Y, Xu M, Xiang D, Zheng ZJ, Huo Y. Regional variations in management and outcomes of patients with acute coronary syndrome in China: Evidence from the National Chest Pain Center Program. Sci Bull (Beijing) 2024:S2095-9273(24)00154-3. [PMID: 38519397 DOI: 10.1016/j.scib.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/25/2023] [Accepted: 12/19/2023] [Indexed: 03/24/2024]
Abstract
Regional variations in acute coronary syndrome (ACS) management and outcomes have been an enormous public health issue. However, studies have yet to explore how to reduce the variations. The National Chest Pain Center Program (NCPCP) is the first nationwide, hospital-based, comprehensive, continuous quality improvement program for improving the quality of care in patients with ACS in China. We evaluated the association of NCPCP and regional variations in ACS healthcare using generalized linear mixed models and interaction analysis. Patients in the Western region had longer onset-to-first medical contact (FMC) time and time stay in non-percutaneous coronary intervention (PCI) hospitals, lower rates of PCI for ST-elevation myocardial infarction (STEMI) patients, and higher rates of medication usage. Patients in Central regions had relatively lower in-hospital mortality and in-hospital heart failure rates. Differences in the door-to-balloon time (DtoB) and in-hospital mortality between Western and Eastern regions were less after accreditation (β = -8.82, 95% confidence interval (CI) -14.61 to -3.03; OR = 0.79, 95%CI 0.70 to 0.91). Similar results were found in differences in DtoB time, primary PCI rate for STEMI between Central and Eastern regions. The differences in PCI for higher-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients among different regions had been smaller. Additionally, the differences in medication use between Eastern and Western regions were higher after accreditation. Regional variations remained high in this large cohort of patients with ACS from hospitals participating in the NCPCP in China. More comprehensive interventions and hospital internal system optimizations are needed to further reduce regional variations in the management and outcomes of patients with ACS.
Collapse
Affiliation(s)
- Shuduo Zhou
- Department of Global Health, Peking University School of Public Health, Beijing 100191, China; Institute for Global Health and Development, Peking University, Beijing100871, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - Xuejie Dong
- Department of Global Health, Peking University School of Public Health, Beijing 100191, China; Institute for Global Health and Development, Peking University, Beijing100871, China
| | - Junxiong Ma
- Department of Global Health, Peking University School of Public Health, Beijing 100191, China; Institute for Global Health and Development, Peking University, Beijing100871, China
| | - Na Li
- Department of Global Health, Peking University School of Public Health, Beijing 100191, China; Institute for Global Health and Development, Peking University, Beijing100871, China
| | - Hong Shi
- Chinese Medical Association, Beijing 100052, China
| | - Sidney C Smith
- Division of Cardiovascular Medicine, School of Medicine, University of North Carolina at Chapel Hill, North Carolina 27599-3140, USA
| | - Yinzi Jin
- Department of Global Health, Peking University School of Public Health, Beijing 100191, China; Institute for Global Health and Development, Peking University, Beijing100871, China
| | - Ming Xu
- Department of Global Health, Peking University School of Public Health, Beijing 100191, China; Institute for Global Health and Development, Peking University, Beijing100871, China
| | - Dingcheng Xiang
- Department of Cardiology, General Hospital of Southern Theater Command of PLA, Guangzhou 510010, China.
| | - Zhi-Jie Zheng
- Department of Global Health, Peking University School of Public Health, Beijing 100191, China; Institute for Global Health and Development, Peking University, Beijing100871, China.
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China.
| |
Collapse
|
3
|
Zhang N, Wu Z, Bai X, Song Y, Li P, Lu X, Huo Y, Zhou Z. Dosage exploration of combined B-vitamin supplementation in stroke prevention: a meta-analysis and systematic review. Am J Clin Nutr 2024; 119:821-828. [PMID: 38432716 DOI: 10.1016/j.ajcnut.2023.12.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The optimal dosage range for B-vitamin supplementation for stroke prevention has not received sufficient attention. OBJECTIVE Our aim was to determine the optimal dosage range of a combination of folic acid, vitamin B12, and vitamin B6 supplementation in stroke prevention. METHODS We searched PubMed, the Cochrane Central Register of Controlled Trials, and Embase database for randomized controlled trials published between January 1966 and April 2023, whose participants received B-vitamin supplementation and that reported the number of stroke cases. Relative risk (RR) was used to measure the effect of combined supplementation on risk of stroke using a fixed-effects model. Risk of bias was assessed with the Cochrane risk-of-bias algorithm. RESULTS The search identified 14 randomized controlled trials of folic acid combined with vitamin B12 and vitamin B6 supplementation for stroke prevention that included 76,664 participants with 2720 stroke cases. In areas without and with partial folic acid fortification, combined B-vitamin supplementation significantly reduced the risk of stroke by 34% [RR: 0.66; 95% confidence interval (CI): 0.50, 0.86] and 11% (RR: 0.89; 95% CI: 0.79, 1.00), respectively. Further analysis showed that a dosage of folic acid ≤0.8 mg/d and vitamin B12 ≤0.4 mg/d was best for stroke prevention (RR: 0.65; 95% CI: 0.48, 0.86) in these areas. In contrast, no benefit of combined supplementation was found in fortified areas (RR: 1.04; 95% CI: 0.94, 1.16). CONCLUSIONS Our meta-analysis found that the folic acid combined with vitamin B12 and vitamin B6 supplementation strategy significantly reduced the risk of stroke in areas without and with partial folic acid fortification. Combined dosages not exceeding 0.8 mg/d for folic acid and 0.4 mg/d for vitamin B12 supplementation may be more effective for populations within these areas. This trial was registered at PROSPERO asCRD42022355077.
Collapse
Affiliation(s)
- Nan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - ZhongYun Wu
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Xinlei Bai
- Department of Medical Information and Biostatistics, College of Science, China Pharmaceutical University, Nanjing, China
| | - Yun Song
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Ping Li
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xinzheng Lu
- Department of Cardiology, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Ziyi Zhou
- Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
4
|
Huo Y, Wang W, Zhang J, Xu D, Bai F, Gui Y. Maternal androgen excess inhibits fetal cardiomyocytes proliferation through RB-mediated cell cycle arrest and induces cardiac hypertrophy in adulthood. J Endocrinol Invest 2024; 47:603-617. [PMID: 37642904 PMCID: PMC10904501 DOI: 10.1007/s40618-023-02178-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Maternal hyperandrogenism during pregnancy is associated with adverse gestational outcomes and chronic non-communicable diseases in offspring. However, few studies are reported to demonstrate the association between maternal androgen excess and cardiac health in offspring. This study aimed to explore the relation between androgen exposure in utero and cardiac health of offspring in fetal and adult period. Its underlying mechanism is also illustrated in this research. METHODS Pregnant mice were injected with dihydrotestosterone (DHT) from gestational day (GD) 16.5 to GD18.5. On GD18.5, fetal heart tissue was collected for metabolite and morphological analysis. The hearts from adult offspring were also collected for morphological and qPCR analysis. H9c2 cells were treated with 75 μM androsterone. Immunofluorescence, flow cytometry, qPCR, and western blot were performed to observe cell proliferation and explore the underlying mechanism. RESULTS Intrauterine exposure to excessive androgen led to thinner ventricular wall, decreased number of cardiomyocytes in fetal offspring and caused cardiac hypertrophy, compromised cardiac function in adult offspring. The analysis of steroid hormone metabolites in fetal heart tissue by ultra performance liquid chromatography and tandem mass spectrometry showed that the content of androgen metabolite androsterone was significantly increased. Mechanistically, H9c2 cells treated with androsterone led to a significant decrease in phosphorylated retinoblastoma protein (pRB) and cell cycle-related protein including cyclin-dependent kinase 2 (CDK2), cyclin-dependent kinase 4 (CDK4), and cyclin D1 (CCND1) in cardiomyocytes. This resulted in cell cycle arrest at G1-S phase, which in turn inhibited cardiomyocyte proliferation. CONCLUSION Taken together, our results indicate that in utero exposure to DHT, its metabolite androsterone could directly decrease cardiomyocytes proliferation through cell cycle arrest, which has a life-long-lasting effect on cardiac health. Our study highlights the importance of monitoring sex hormones in women during pregnancy and the follow-up of cardiac function in offspring with high risk of intrauterine androgen exposure.
Collapse
Affiliation(s)
- Y Huo
- National Children's Medical Center, Children's Hospital of Fudan University, Fudan University, Shanghai, 201102, China
- National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, 399 Wanyuan Road, Minhang, Shanghai, 201102, China
| | - W Wang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510080, China
| | - J Zhang
- National Children's Medical Center, Children's Hospital of Fudan University, Fudan University, Shanghai, 201102, China
- National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, 399 Wanyuan Road, Minhang, Shanghai, 201102, China
- Institute of Pediatrics, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - D Xu
- National Children's Medical Center, Children's Hospital of Fudan University, Fudan University, Shanghai, 201102, China
- National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, 399 Wanyuan Road, Minhang, Shanghai, 201102, China
| | - F Bai
- National Children's Medical Center, Children's Hospital of Fudan University, Fudan University, Shanghai, 201102, China
- National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, 399 Wanyuan Road, Minhang, Shanghai, 201102, China
| | - Y Gui
- National Children's Medical Center, Children's Hospital of Fudan University, Fudan University, Shanghai, 201102, China.
- National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Fudan University, 399 Wanyuan Road, Minhang, Shanghai, 201102, China.
- Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, 201102, China.
| |
Collapse
|
5
|
Ma W, Yuan Y, Wang S, Huo Y. [Neurocardiology: a pressing subject to be developed]. Zhonghua Nei Ke Za Zhi 2024; 63:225-229. [PMID: 38448187 DOI: 10.3760/cma.j.cn112138-20231103-00292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Affiliation(s)
- W Ma
- Department of Cardiology,Peking University First Hospital,Beijing 100034,China
| | - Y Yuan
- Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - S Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Y Huo
- Department of Cardiology,Peking University First Hospital,Beijing 100034,China
| |
Collapse
|
6
|
Pan W, Zhou D, Hijazi ZM, Qureshi SA, Promphan W, Feng Y, Zhang G, Liu X, Pan X, Chen L, Cao Q, Tiong KG, Leong MC, Roymanee S, Prachasilchai P, Choi JY, Tomita H, Le Tan J, Akhtar K, Lam S, So K, Tin DN, Nguyen LH, Huo Y, Wang J, Ge J. 2024 Statement from Asia expert operators on transcatheter pulmonary valve replacement. Catheter Cardiovasc Interv 2024; 103:660-669. [PMID: 38419402 DOI: 10.1002/ccd.30978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/13/2023] [Accepted: 02/06/2024] [Indexed: 03/02/2024]
Abstract
Transcatheter pulmonary valve replacement (TPVR), also known as percutaneous pulmonary valve implantation, refers to a minimally invasive technique that replaces the pulmonary valve by delivering an artificial pulmonary prosthesis through a catheter into the diseased pulmonary valve under the guidance of X-ray and/or echocardiogram while the heart is still beating not arrested. In recent years, TPVR has achieved remarkable progress in device development, evidence-based medicine proof and clinical experience. To update the knowledge of TPVR in a timely fashion, and according to the latest research and further facilitate the standardized and healthy development of TPVR in Asia, we have updated this consensus statement. After systematical review of the relevant literature with an in-depth analysis of eight main issues, we finally established eight core viewpoints, including indication recommendation, device selection, perioperative evaluation, procedure precautions, and prevention and treatment of complications.
Collapse
Affiliation(s)
- Wenzhi Pan
- Zhongshan Hopital, Fudan University, Shanghai, China
| | - Daxin Zhou
- Zhongshan Hopital, Fudan University, Shanghai, China
| | - Ziyad M Hijazi
- Pediatrics & Medicine, Weill Cornell Medicine, Doha, Qatar
| | | | - Worakan Promphan
- Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - Yuan Feng
- West China Hospital, Sichuan University, Chengdu, China
| | | | - Xianbao Liu
- Second Hospital of Zhejiang Medical University, Hangzhou, China
| | - Xin Pan
- Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | | | | | | | | | | | - Pimpak Prachasilchai
- Queen Sirikit National Institute of Child Health, Pediatric Cardiac Center, Thailand
| | | | | | - Ju Le Tan
- National Heart Center, Singapore, Singapore
| | - Khurram Akhtar
- Armed Forces Institute of Cardiology National Institute of Heart Diseases, Rawalpindi, Pakistan
| | - Simon Lam
- Queen Marry Hospital, Hong Kong, China
| | - Kent So
- The Chinese University of Hong Kong, Hong Kong, China
| | - Do N Tin
- Children's Hospital, Hanoi, Vietnam
| | | | - Yong Huo
- Peking University First Hospital, Beijing, China
| | - Jian'an Wang
- Second Hospital of Zhejiang Medical University, Hangzhou, China
| | - Junbo Ge
- Zhongshan Hopital, Fudan University, Shanghai, China
| |
Collapse
|
7
|
Chi X, Zhang N, Fan F, Jia J, Zheng J, Liu L, Song Y, Wang B, Tang G, Qin X, Huo Y, Li J. Systemic immune-inflammation index predicts first stroke and affects the efficacy of folic acid in stroke prevention. Heliyon 2024; 10:e24837. [PMID: 38314266 PMCID: PMC10837552 DOI: 10.1016/j.heliyon.2024.e24837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 02/06/2024] Open
Abstract
Background Systemic immune-inflammation index (SII) is a novel biomarker of growing interest in predicting stroke. The aim of this study was to investigate its predictive value and explore its effect modification on folic acid supplement for stroke primary prevention in a Chinese population with hypertension. Methods A total of 10,013 participants from the China Stroke Primary Prevention Trial with available neutrophil, platelet and lymphocyte count were included, including 5,019 subjects in the enalapril group and 4,994 in the enalapril-folic acid group. SII was calculated as (platelet × neutrophil)/lymphocyte. The primary endpoint was first stroke. Cox proportional hazards models were used to evaluate the association between SII and first stroke. Results A U-shape association between SII and first stroke risk was observed in enalapril group. Compared with the reference group (Quartile 2: 335.1 to <443.9 × 109 cell/L), the adjusted HRs were 1.68 (95 % CI: 1.06-2.66, P = 0.027) in Quartile 1 (<335.1 × 109 cell/L), 1.43 (95 % CI: 0.90-2.27, P = 0.126) in Quartile 3 (443.9 to <602.6 × 109 cell/L), and 1.61 (95 % CI: 1.03-2.51, P = 0.035) in Quartile 4 (≥602.6 × 109 cell/L). There was no significant association between SII and first stroke in the enalapril-folic acid group, with adjusted HR of 0.92 (95%CI: 0.54-1.56, P = 0.749) in Quartile 1(<334.7 × 109 cell/L), 1.36 (95%CI: 0.84-2.21, P = 0.208) in Quartile 3 (446.2 to <595.2 × 109 cell/L), and 1.41 (95%CI: 0.87-2.27, P = 0.163) in Quartile 4 (≥595.2 × 109 cell/L). A remarkable interaction between baseline SII and folic acid supplement for stroke prevention was observed, with particularly reduced risk by 44 % (HR: 0.56; 95 % CI: 0.34-0.90; P = 0.018) in the lowest SII group (P for interaction = 0.041). Conclusions Among Chinese adults with hypertension, both low and high SII at baseline predicted increased first stroke risk. And compensatory folic acid particularly reduced first stroke risk in the lowest SII subgroup.
Collapse
Affiliation(s)
- Xiying Chi
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
- Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Nan Zhang
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
- Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
- Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Jia Jia
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
- Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Jianhang Zheng
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing 211198, China
| | - Lishun Liu
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Yun Song
- Shenzhen Evergreen Medical Institute, Shenzhen, China
- Institute for Biomedicine, Anhui Medical University, Hefei, China
- AUSA Research Institute, Shenzhen AUSA Pharmed Co Ltd, Shenzhen, China
| | - Binyan Wang
- Institute for Biomedicine, Anhui Medical University, Hefei, China
| | - Genfu Tang
- School of Health Administration, Anhui Medical University, Hefei, 230000, China
| | - Xianhui Qin
- National Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
- Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
- Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| |
Collapse
|
8
|
Qu X, Guan S, Cai J, Gan Q, Han W, Lu L, Fang W, Yin P, Shi H, Wang A, G Y, Zhou M, Huo Y. Reperfusion strategies on the clinical outcomes of ST-elevation myocardial infarction patients over 80 years old in China. Eur Heart J Qual Care Clin Outcomes 2024:qcae013. [PMID: 38337188 DOI: 10.1093/ehjqcco/qcae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
BACKGROUNDS AND AIMS This study aims to explore the efficacy of reperfusion strategies on the clinical outcomes of ST-elevation myocardial infarction (STEMI) patients over 80 years old in China. METHODS A retrospective cohort study was performed on STEMI patients over 80 years old who underwent reperfusion strategies and no reperfusion between January 2014 and December 2021 based on the China Cardiovascular Association (CCA) Database-Chest Pain Center. RESULTS This study included a total of 42,699 patients (mean age 84.1 ± 3.6 years, 52.2% male) among which 19,280 (45.2%) underwent no reperfusion, 20,924 (49.0%) underwent primary percutaneous coronary intervention (PCI), and 2,495 (5.8%) underwent thrombolytic therapy. After adjusting for potential confounders, multivariable logistic regression analysis revealed that patients who underwent primary PCI strategy showed a significantly lower risk of in-hospital mortality (OR = 0.62, 95% CI: 0.57-0.67, P < 0.001) and the composite outcome (OR = 0.83, 95% CI: 0.79-0.87, P < 0.001) compared to those received no reperfusion. In contrast, patients with thrombolytic therapy exhibited a non-significantly higher risk of in-hospital mortality (OR = 0.99, 95% CI: 0.86-1.14, P = 0.890), and a significantly elevated risk of the composite outcome (OR = 1.15, 95% CI: 1.05-1.27, P = 0.004). During a median follow-up of 6.7 months post-hospital admission, there was a percentage 31.4% of patients died and patients in the primary PCI group consistently demonstrated a reduced incidence of all-cause mortality (HR = 0.58, 95% CI: 0.56-0.61, P < 0.001). CONCLUSION STEMI patients over 80 years old who underwent the primary PCI strategy are more likely to have favorable clinical outcomes compared to those who received no reperfusion, whereas, thrombolytic therapy warrants careful assessment and monitoring.
Collapse
Affiliation(s)
- Xinkai Qu
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, 221 Yanan West Road, Shanghai, 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, 221 Yanan West Road, Shanghai, 200040, China
| | - Shaofeng Guan
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, 221 Yanan West Road, Shanghai, 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, 221 Yanan West Road, Shanghai, 200040, China
| | - Jiasheng Cai
- Department of Cardiology, Qingpu Branch of Zhongshan Hospital affiliated to Fudan University, 1158 Park East Road, Shanghai, 201799, China
| | - Qian Gan
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, 221 Yanan West Road, Shanghai, 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, 221 Yanan West Road, Shanghai, 200040, China
| | - Wenzheng Han
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, 221 Yanan West Road, Shanghai, 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, 221 Yanan West Road, Shanghai, 200040, China
| | - Liming Lu
- Shanghai Key Laboratory of Clinical Geriatric Medicine, 221 Yanan West Road, Shanghai, 200040, China
- Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China
| | - Weiyi Fang
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, 221 Yanan West Road, Shanghai, 200040, China
- Shanghai Key Laboratory of Clinical Geriatric Medicine, 221 Yanan West Road, Shanghai, 200040, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Hong Shi
- Chinese Medical Association, Beijing, 100052, China
| | - Annai Wang
- Chinese Cardiovascular Association, China Heart House, No.36 Shuifang Rd, Su Zhou, 215024, China
| | - Yuanchao G
- Chinese Cardiovascular Association, China Heart House, No.36 Shuifang Rd, Su Zhou, 215024, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China; 8# St. Xishiku, Beijing, China
| |
Collapse
|
9
|
He P, Li H, Zhang Y, Song Y, Liu C, Liu L, Wang B, Guo H, Wang X, Huo Y, Zhang H, Xu X, Nie J, Qin X. Evaluation of plasma vitamin E and development of proteinuria in hypertensive patients. J Transl Int Med 2024; 12:78-85. [PMID: 38525444 PMCID: PMC10956724 DOI: 10.2478/jtim-2023-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Background The prospective relationship between plasma vitamin E levels and proteinuria remains uncertain. We aimed to evaluate the association between baseline plasma vitamin E levels and the development of proteinuria and examine any possible effect modifiers in patients with hypertension. Methods This was a post hoc analysis of the renal sub-study of the China Stroke Primary Prevention Trial (CSPPT). In total, 780 participants with vitamin E measurements and without proteinuria at baseline were included in the current study. The study outcome was the development of proteinuria, defined as a urine dipstick reading of a trace or ≥ 1+ at the exit visit. Results During a median follow-up duration of 4.4 years, the development of proteinuria occurred in 93 (11.9%) participants. Overall, there was an inverse relationship between plasma vitamin E and the development of proteinuria (per standard deviation [SD] increment; odds ratio [OR]: 0.73, 95% confidence interval [CI]: 0.55-0.96). Consistently, when plasma vitamin E was assessed as quartiles, lower risk of proteinuria development was found in participants in quartiles 2-4 (≥ 7.3 μg/mL; OR: 0.57, 95% CI: 0.34-0.96) compared to those in quartile 1. None of the variables, including sex, age, and body mass index, significantly modified the association between vitamin E and proteinuria development. Conclusion There was a significant inverse association between plasma vitamin E levels and the development of proteinuria in patients with hypertension. The results were consistent among participants with different baseline characteristics.
Collapse
Affiliation(s)
- Panpan He
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou510515, Guangdong Province, China
| | - Huan Li
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou510515, Guangdong Province, China
| | - Yuanyuan Zhang
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou510515, Guangdong Province, China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing100083, China
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei230032, Anhui Province, China
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing100083, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei230032, Anhui Province, China
- Shenzhen Evergreen Medical Institute, Shenzhen518057, Guangdong Province, China
| | - Huiyuan Guo
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing100083, China
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore21205, MD, USA
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing100034, China
| | - Hao Zhang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing100083, China
| | - Xiping Xu
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou510515, Guangdong Province, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing100083, China
- AUSA Research Institute, Shenzhen AUSA Pharmed Co Ltd, Shenzhen518057, Guangdong Province, China
| | - Jing Nie
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou510515, Guangdong Province, China
| | - Xianhui Qin
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou510515, Guangdong Province, China
| |
Collapse
|
10
|
Huo Y, Lesogor A, Lee CW, Chiang CE, Mena-Madrazo J, Poh KK, Jeong MH, Maheux P, Zhang M, Wei S, Han Y, Li Y. Efficacy and Safety of Inclisiran in Asian Patients: Results From ORION-18. JACC Asia 2024; 4:123-134. [PMID: 38371290 PMCID: PMC10866732 DOI: 10.1016/j.jacasi.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/22/2023] [Accepted: 09/11/2023] [Indexed: 02/20/2024]
Abstract
Background Management of low-density lipoprotein cholesterol (LDL-C) in Asia remains suboptimal, with ∼50% of patients who are treated with lipid-lowering therapies (LLTs) unable to achieve their guideline-recommended LDL-C goals. Asian-representative studies of the use of inclisiran are needed. Objectives The authors sought to evaluate the efficacy and safety of inclisiran in Asian patients with atherosclerotic cardiovascular disease (ASCVD) or high risk of ASCVD, as an adjunct to diet and maximally tolerated statin dose, with or without additional LLTs. Methods The ORION-18 was a phase 3 double-blind trial in which patients were randomized 1:1 to receive either 300 mg inclisiran sodium or matching placebo on days 1, 90, and 270. Percentage change in LDL-C from baseline to day 330 was the primary endpoint. Results A total of 345 patients (mean age 59.5 years, mean baseline LDL-C 109 mg/dL, 74.7% male) were randomized to inclisiran or placebo. Baseline characteristics were similar in both groups. The percentage decrease in LDL-C from baseline to day 330 was 57.2% (P < 0.001); proprotein convertase subtilisin/kexin type 9 was reduced by 78.3% (P < 0.001). Time-adjusted percentage reduction in LDL-C from baseline after day 90 and up to day 360 was 56.3%. At day 330, 71.7% of participants with inclisiran achieved ≥50% reduction in LDL-C compared with 1.5% with placebo. Over the study period, total cholesterol, apolipoprotein B, and non-high-density lipoprotein cholesterol (HDL-C) levels were decreased significantly, and HDL-C levels increased. The incidence of adverse events with inclisiran was similar to that with placebo. Conclusions In Asian patients with ASCVD or high risk of ASCVD, inclisiran was effective and safe. (Study of Efficacy and Safety of Inclisiran in Asian Participants With Atherosclerotic Cardiovascular Disease [ASCVD] or ASCVD High Risk and Elevated Low-Density Lipoprotein Cholesterol [LDL-C] [ORION-18]; NCT04765657).
Collapse
Affiliation(s)
- Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | | | | | - Chern-En Chiang
- General Clinical Research Center and Division of Cardiology, Taipei Veterans General Hospital and Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore and Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Myung Ho Jeong
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | | | - Mengli Zhang
- China Novartis Institutes for Biomedical Research Co., Shanghai, China
| | | | - Yajun Han
- Mongolia People’s Hospital, Hohhot, China
| | - Yong Li
- Fudan University Hua Shan Hospital, Shanghai, China
| |
Collapse
|
11
|
Maimaitiming M, Ma J, Dong X, Zhou S, Li N, Zhang Z, Lu S, Chen L, Ma L, Yu B, Ma Y, Zhao X, Zheng Z, Shi H, Zheng Z, Jin Y, Huo Y. Factors associated with the delay in informed consent procedures of patients with ST-segment elevation myocardial infarction and its influence on door-to-balloon time: a nationwide retrospective cohort study. J Transl Int Med 2024; 12:86-95. [PMID: 38525440 PMCID: PMC10956723 DOI: 10.2478/jtim-2023-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Background and Objectives ST-segment elevation myocardial infarction (STEMI) is the deadliest and most time-sensitive acute cardiac event. However, failure to achieve timely informed consent is an important contributor to in-hospital delay in STEMI care in China. We investigated the factors associated with informed consent delay in patients with STEMI undergoing percutaneous coronary intervention (PCI) and the association between the delay and door-to-balloon time. Methods We conducted a nationally representative retrospective cohort study using patient data reported by hospital-based chest pain centers from 1 January 2016 to 31 December 2020. We applied generalized linear mixed models and negative binomial regression to estimate factors independently predicting informed consent delay time. Logistic regressions were fitted to investigate the association of the informed consent delay time and door-to-balloon time, adjusting for patient characteristics. Results In total, 257, 510 patients were enrolled in the analysis. Mean informed consent delay time was 22.4 min (SD = 24.0), accounting for 39.3% in door-to-balloon time. Older age (≥65 years) was significantly correlated with informed consent delay time (RR: 1.034, P = 0.001). Compared with ethnic Han patients, the minority (RR: 1.146, P < 0.001) had more likelihood to extend consent giving; compared with patients who were single, longer informed consent time was found in married patients (RR: 1.054, P = 0.006). Patients with intermittent chest pain (RR: 1.034, P = 0.011), and chest pain relief (RR: 1.085, P = 0.005) were more likely to delay informed consent. As for transfer modes, EMS (RR: 1.063, P < 0.001), transfer-in (RR: 1.820, P < 0.001), and in-hospital onset (RR: 1.099, P = 0.002) all had positive correlations with informed consent delay time compared to walk-in. Informed consent delay was significantly associated with prolonged door-to-balloon time (OR: 1.002, P < 0.001). Conclusion Informed consent delay is significantly associated with the door-to-balloon time which plays a crucial role in achieving better outcomes for patients with STEMI. It is essential to shorten the delay time by identifying and intervening modifiable factors that are associated with shortening the informed consent procedure in China and other countries.
Collapse
Affiliation(s)
- Mailikezhati Maimaitiming
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Junxiong Ma
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Xuejie Dong
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Shuduo Zhou
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Na Li
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Zheng Zhang
- First People’s Hospital of Lanzhou University, Lanzhou, Gansu Province, China
| | - Shijuan Lu
- Haikou People’s Hospital, Haikou, Hainan Province, China
| | - Lianglong Chen
- Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
| | - Likun Ma
- Anhui Provincial Hospital, Hefei, Anhui Province, China
| | - Bo Yu
- Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yitong Ma
- First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Xingsheng Zhao
- Inner Mongolia People’s Hospital, Huhhot, Inner Mongolia Autonomous Region, China
| | - Zhaofen Zheng
- Hunan Provincial People’s Hospital, Changsha, Hunan Province, China
| | - Hong Shi
- Chinese Medical Association, Beijing, China
| | - Zhijie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| |
Collapse
|
12
|
Mas-Llado C, Rossello X, González-Del-Hoyo M, Pocock S, de Werf FV, Chin CT, Danchin N, Lee SWL, Medina J, Huo Y, Bueno H. Secondary Prevention Therapies in Real-World Patients with Myocardial Infarction: Eligibility Based on Randomized Trials Supporting European and American Guidelines. Am J Med 2024; 137:137-146.e10. [PMID: 37838236 DOI: 10.1016/j.amjmed.2023.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE We aimed to evaluate the applicability of the eligibility criteria of randomized controlled trials (RCTs) cited in guideline recommendations in a real-world cohort of patients receiving secondary prevention after acute myocardial infarction from the EPICOR registries. METHODS Recommendations provided by American and European guidelines for acute myocardial infarction were classified into general (applying to all patients) and specific (applying to patients with left ventricular dysfunction or heart failure). Randomized controlled trials cited in these recommendations were selected, and their entry criteria were applied to our international cohort of 18,117 patients. RESULTS There were 91.5% patients eligible for beta blockers (84.6% for general, and 5.9% for specific recommendations), 97.7% eligible for renin-angiotensin system inhibitor (angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers [ACEI/ARB]) recommendations (69.9% for general, 27.9% for specific) and 4.1% eligible for mineralocorticoid receptor antagonists (only specific recommendations). The percentages of patients with eligibility criteria who were discharged with a prescription of the recommended therapies were 80%-85% for beta blockers, 70%-75% for ACEI/ARB, and 29% for mineralocorticoid receptor antagonists. There were large regional variations in the percentage of eligible patients and in those receiving the medications (eg, 95% in Northern Europe and 57% in Southeast Asia for beta blockers). CONCLUSION Most real-world acute myocardial infarction patients are eligible for secondary prevention therapy in both general and specific guideline recommendations, and the percentage of those on beta blockers and ACEI/ARB at hospital discharge is high. There are large regional variations in the proportion of patients receiving recommended therapies. Local targeted interventions are needed for quality improvement.
Collapse
Affiliation(s)
- Caterina Mas-Llado
- Cardiology Department, Hospital de Manacor, Spain; Health Research Institute of the Balearic Islands, Palma, Spain; Facultad de Medicina, Universitat de les Illes Balears, Palma, Spain
| | - Xavier Rossello
- Health Research Institute of the Balearic Islands, Palma, Spain; Facultad de Medicina, Universitat de les Illes Balears, Palma, Spain; Cardiology Department, Health Research Institute of the Balearic Islands, Hospital Universitari Son Espases, Palma, Spain; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain.
| | | | | | - Frans Van de Werf
- Department of Cardiovascular Sciences, University of Leuven, Belgium
| | | | - Nicolas Danchin
- Hôpital Européen Georges Pompidou & René Descartes University, France
| | | | | | - Yong Huo
- Beijing University First Hospital, China
| | - Héctor Bueno
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; Cardiology Department, Hospital Universitario 12 de Octubre, and Instituto de Investigación i+12, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.
| |
Collapse
|
13
|
Ye Y, Hao Y, Zhao X, Liu J, Yang N, Smith SC, Huo Y, Fonarow GC, Ge J, Morgan L, Sun Z, Hu D, Yang Y, Ma CS, Zhao D, Han Y, Liu J, Zeng Y. Percutaneous Coronary Intervention in Acute Coronary Syndrome with Mild-to-Moderate Thrombocytopenia. Thromb Haemost 2024. [PMID: 38081311 DOI: 10.1055/a-2225-5263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND Baseline thrombocytopenia is commonly observed in patients with acute coronary syndrome (ACS) requiring percutaneous coronary intervention (PCI). AIM The purpose of this analysis was to investigate safety and effectiveness of PCI in ACS patients with baseline mild-to-moderate thrombocytopenia. METHODS The data were collected from the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome project. A total of 50,009 ACS patients were recruited between July 2017 and December 2019. Among them, there were 6,413 patients with mild-to-moderate thrombocytopenia, defined as a platelet count of ≥50 × 109/L and <150 × 109/L on admission. The primary outcome was in-hospital net adverse clinical events (NACE), consisting of major adverse cardiac events (MACE) and major bleeding events. The associations between PCI and in-hospital outcomes were analyzed by inverse probability treatment weighting (IPTW) method. RESULTS PCI was performed in 4,023 of 6,413 patients (62.7%). The IPTW analysis showed that PCI was significantly associated with a reduced risk of in-hospital MACE (odd ratio [OR]: 0.45; 95% confidence interval [CI]: 0.31-0.67; p < 0.01) and NACE (OR: 0.59; 95% CI: 0.42-0.83; p < 0.01). PCI was also associated with an increased risk of any bleeding (OR: 1.56; 95% CI: 1.09-2.22; p = 0.01) and minor bleeding (OR: 1.52; 95% CI: 1.00-2.30; p = 0.05), but not major bleeding (OR: 1.51; 95% CI: 0.76-2.98; p = 0.24). CONCLUSION Compared with medical therapy alone, PCI is associated with better in-hospital outcomes in ACS patients with mild-to-moderate thrombocytopenia. Further studies with long-term prognosis are needed.
Collapse
Affiliation(s)
- Yicong Ye
- Department of Cardiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Yongchen Hao
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Xiliang Zhao
- Department of Cardiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Jun Liu
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Na Yang
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Sidney C Smith
- Division of Cardiology, University of North Carolina, Chapel Hill, North Carolina, United States
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Gregg C Fonarow
- Division of Cardiology, Geffen School of Medicine at University of California, Los Angeles, California, United States
| | - Junbo Ge
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Fudan University, Zhongshan Hospital, Shanghai, China
| | - Louise Morgan
- International Quality Improvement Department, American Heart Association, Dallas, Texas, United States
| | - Zhaoqing Sun
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Danqing Hu
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Yiqian Yang
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Chang-Sheng Ma
- Department of Cardiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Dong Zhao
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Yaling Han
- Department of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Jing Liu
- Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Yong Zeng
- Department of Cardiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| |
Collapse
|
14
|
Liu J, Zhang Q, Liu Z, Wang X, Gong Y, Fan F, Zhang B, Jia J, Zhang Y, Liu Y, Zheng B, Li J, Huo Y. Microvascular reperfusion of fibrinolysis followed by percutaneous coronary intervention versus primary percutaneous coronary intervention for ST-segment-elevation acute myocardial infarction. Quant Imaging Med Surg 2024; 14:765-776. [PMID: 38223092 PMCID: PMC10784020 DOI: 10.21037/qims-23-666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 11/30/2023] [Indexed: 01/16/2024]
Abstract
Background Primary percutaneous coronary intervention (PPCI) has been widely recognized as the preferred treatment for ST-segment-elevation myocardial infarction (STEMI). However, substantial numbers of STEMI patients cannot receive timely PPCI. Early fibrinolysis followed by routine percutaneous coronary intervention (FPCI) has been proposed as an effective and safe alternative for eligible patients. To date, few studies have compared FPCI with PPCI in terms of microvascular reperfusion. This study aimed to evaluate the microvascular function of FPCI and PPCI. Methods STEMI patients at the Peking University First Hospital and Miyun Hospital were enrolled in this retrospective study between January 2015 to December 2020. Microvascular function documented by the coronary angiography-derived index of microvascular resistance (caIMR) was measured at the final angiogram after revascularization. The primary end point was the caIMR of the culprit vessels. The secondary end points were in-hospital and follow-up major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal recurrent myocardial infarction, target-vessel revascularization (TVR), and non-fatal stroke/transient ischemic attacks (TIA). Details of the adverse clinical events were obtained from telephone interviews and electronic medical record systems until January 2022. Results In total, 496 STEMI patients were enrolled in this cross-sectional retrospective study. Of these patients, 81 underwent FPCI, and 415 underwent PPCI. At the baseline, the PPCI patients had a higher-risk profile than the FPCI patients. The time from symptom onset to reperfusion therapy was significantly shorter in the FPCI group than the PPCI group (median 3.0 vs. 4.5 hours; P<0.001). The caIMR was significantly lower in the FPCI group than the PPCI group (median 20.34 vs. 40.33; P<0.001). The median follow-up duration was 4.1 years. During the follow-up period, the rate of MACE was lower in the FPCI group than the PPCI group [7 (10.1%) vs. 82 (20.8%), P=0.048]. After propensity score matching to adjust for the imbalances at the baseline, the caIMR remained significant and the clinical outcomes did not differ significantly between the two groups. Conclusions In eligible STEMI patients, clinically successful FPCI may be associated with better microvascular reperfusion and comparable clinical outcomes as compared with PPCI.
Collapse
Affiliation(s)
- Jiahui Liu
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
| | - Qihua Zhang
- Department of Cardiology, Miyun Hospital, Peking University First Hospital, Beijing, China
| | - Zhaoping Liu
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Xingang Wang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yanjun Gong
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Bin Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jia Jia
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yajuan Liu
- Department of Cardiology, Miyun Hospital, Peking University First Hospital, Beijing, China
| | - Bo Zheng
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| |
Collapse
|
15
|
Huo Y, Chen B, Lian Q, Wang S, Liu L, Lu D, Qu Y, Zheng G, Li L, Ji Y, Yin G, Huang W, Xie Y, Yang X, Gao X, An P, Xue F, Li H, Deng H, Li L, Pei L, Qian L. Tafolecimab in Chinese patients with non-familial hypercholesterolemia (CREDIT-1): a 48-week randomized, double-blind, placebo-controlled phase 3 trial. Lancet Reg Health West Pac 2023; 41:100907. [PMID: 37808342 PMCID: PMC10558773 DOI: 10.1016/j.lanwpc.2023.100907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023]
Abstract
Background Tafolecimab, a fully human proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibody developed for the treatment of hypercholesterolemia, demonstrated robust lipid-lowering efficacy and favorable safety in previous short-term studies. We aimed to assess the long-term efficacy and safety of tafolecimab in Chinese non-familial hypercholesterolemia (non-FH) patients. Methods Non-FH patients at high or very-high cardiovascular risk with screening low-density lipoprotein cholesterol (LDL-C) level ≥1.8 mmol/L or non-FH patients with screening LDL-C level ≥3.4 mmol/L and on stable lipid-lowering therapy for at least 4 weeks, were randomized in a 2:2:1:1 ratio to receive subcutaneous tafolecimab 450 mg Q4W, tafolecimab 600 mg Q6W, placebo 450 mg Q4W, or placebo 600 mg Q6W, respectively, in the 48-week double-blind treatment period. The primary endpoint was the percent change from baseline to week 48 in LDL-C levels. Findings A total of 618 patients were randomized and 614 patients received at least one dose of tafolecimab (n = 411) or placebo (n = 203). At week 48, tafolecimab induced significant reductions in LDL-C levels (treatment differences versus placebo [on-treatment estimand]: -65.0% [97.5% CI: -70.2%, -59.9%] for 450 mg Q4W; -57.3% [97.5% CI: -64.0%, -50.7%] for 600 mg Q6W; both P < 0.0001). Significantly more patients treated with tafolecimab achieved ≥50% LDL-C reductions, LDL-C < 1.8 mmol/L, and LDL-C < 1.4 mmol/L than placebo group at both dose regimens (all P < 0.0001). Furthermore, tafolecimab significantly reduced non-HDL-C, apolipoprotein B, and lipoprotein(a) levels. The most commonly-reported treatment emergent adverse events in the tafolecimab groups included upper respiratory infection, urinary tract infection and hyperuricemia. Interpretation Tafolecimab dosed at 450 mg Q4W and 600 mg Q6W was safe and showed superior lipid-lowering efficacy versus placebo, providing a novel treatment option for Chinese hypercholesterolemia patients. Funding This study was sponsored by Innovent Biologics, Inc.
Collapse
Affiliation(s)
- Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Beijian Chen
- Department of Cardiology, Heze Municipal Hospital, Heze, China
| | - Qiufang Lian
- Department of Cardiology, Yan'an University Xianyang Hospital, Xianyang, China
| | - Shuqing Wang
- Department of Cardiology, The First Hospital of Qiqihar City, Qiqihar, China
| | - Lu Liu
- Department of Cardiology, The First Hospital of Qiqihar City, Qiqihar, China
| | - Di Lu
- Department of Cardiology, China National Petroleum Corporation Central Hospital, Langfang, China
| | - Yanling Qu
- Department of Cardiology, Yuncheng Central Hospital of Shanxi Province, Yuncheng, China
| | - Guanzhong Zheng
- Department of Cardiology, Zibo Municipal Hospital, Zibo, China
| | - Lipeng Li
- Department of Cardiology, Luoyang Third People's Hospital, Luoyang, China
| | - Yuan Ji
- Department of Cardiology, Changzhou Second People's Hospital, Changzhou, China
| | - Guotian Yin
- Department of Cardiology, The Third Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - Wenjun Huang
- Department of Cardiology, Pingxiang People's Hospital, Pingxiang, China
| | - Ying Xie
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Xinchun Yang
- Department of Cardiology, Beijing Chaoyang Hospital, Beijing, China
| | - Xiufang Gao
- Department of Cardiology, Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Pei An
- Innovent Biologics, Inc., Suzhou, China
| | | | - Haoyu Li
- Innovent Biologics, Inc., Suzhou, China
| | - Huan Deng
- Innovent Biologics, Inc., Suzhou, China
| | - Li Li
- Innovent Biologics, Inc., Suzhou, China
| | | | - Lei Qian
- Innovent Biologics, Inc., Suzhou, China
| |
Collapse
|
16
|
Zhou S, Zhang Y, Dong X, Zhang X, Ma J, Li N, Shi H, Yin Z, Xue Y, Hu Y, He Y, Wang B, Tian X, Smith SC, Xu M, Jin Y, Huo Y, Zheng ZJ. Sex Disparities in Management and Outcomes Among Patients With Acute Coronary Syndrome. JAMA Netw Open 2023; 6:e2338707. [PMID: 37862014 PMCID: PMC10589815 DOI: 10.1001/jamanetworkopen.2023.38707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/28/2023] [Indexed: 10/21/2023] Open
Abstract
Importance Sex disparities in the management and outcomes of acute coronary syndrome (ACS) have received increasing attention. Objective To evaluate the association of a quality improvement program with sex disparities among patients with ACS. Design, Setting, and Participants The National Chest Pain Centers Program (NCPCP) is an ongoing nationwide program for the improvement of quality of care in patients with ACS in China, with CPC accreditation as a core intervention. In this longitudinal analysis of annual (January 1, 2016, to December 31, 2020) cross-sectional data of 1 095 899 patients with ACS, the association of the NCPCP with sex-related disparities in the care of these patients was evaluated using generalized linear mixed models and interaction analysis. The robustness of the results was assessed by sensitivity analyses with inverse probability of treatment weighting. Data were analyzed from September 1, 2021, to June 30, 2022. Exposure Hospital participation in the NCPCP. Main Outcomes and Measures Differences in treatment and outcomes between men and women with ACS. Prehospital indicators included time from onset to first medical contact (onset-FMC), time from onset to calling an emergency medical service (onset-EMS), and length of hospital stay without receiving a percutaneous coronary intervention (non-PCI). In-hospital quality indicators included non-PCI, use of statin at arrival, discharge with statin, discharge with dual antiplatelet therapy, direct PCI for ST-segment elevation myocardial infarction (STEMI), PCI for higher-risk non-ST-segment elevation ACS, time from door to catheterization activation, and time from door to balloon. Patient outcome indicators included in-hospital mortality and in-hospital new-onset heart failure. Results Data for 1 095 899 patients with ACS (346 638 women [31.6%] and 749 261 men [68.4%]; mean [SD] age, 63.9 [12.4] years) from 989 hospitals were collected. Women had longer times for onset-FMC and onset-EMS; lower rates of PCI, statin use at arrival, and discharge with medication; longer in-hospital delays; and higher rates of in-hospital heart failure and mortality. The NCPCP was associated with less onset-FMC time, more direct PCI rate for STEMI, lower rate of in-hospital heart failure, more drug use, and fewer in-hospital delays for both men and women with ACS. Sex-related differences in the onset-FMC time (β = -0.03 [95% CI, -0.04 to -0.01), rate of direct PCI for STEMI (odds ratio, 1.11 [95% CI, 1.06-1.17]), time from hospital door to balloon (β = -1.38 [95% CI, -2.74 to -0.001]), and rate of in-hospital heart failure (odds ratio, 0.90 [95% CI, 0.86-0.94]) were significantly less after accreditation. Conclusions and Relevance In this longitudinal cross-sectional study of patients with ACS from hospitals participating in the NCPCP in China, sex-related disparities in management and outcomes were smaller in some aspects by regionalization between prehospital emergency and in-hospital treatment systems and standardized treatment procedures. The NCPCP should emphasize sex disparities to cardiologists; highlight compliance with clinical guidelines, particularly for female patients; and include the reduction of sex disparities as a performance appraisal indicator.
Collapse
Affiliation(s)
- Shuduo Zhou
- Department of Global Health, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yan Zhang
- Division of Cardiology, Peking University First Hospital, Beijing, China
| | - Xuejie Dong
- Department of Global Health, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Xu Zhang
- Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Junxiong Ma
- Department of Global Health, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Na Li
- Department of Global Health, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Hong Shi
- Chinese Medical Association, Beijing, China
| | - Zuomin Yin
- Department of Emergency, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao, Shandong, China
| | - Yuzeng Xue
- Division of Cardiology, Liaocheng People’s Hospital, Liaocheng, China
| | - Yali Hu
- Division of Cardiology, Cangzhou People’s Hospital, Cangzhou, China
| | - Yi He
- Division of Cardiology, Zhuzhou Central Hospital, Zhuzhou, China
| | - Bin Wang
- Division of Cardiology, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Xiang Tian
- Division of Cardiology, Baoding No.1 Central Hospital, Baoding, China
| | - Sidney C. Smith
- Division of Cardiovascular Medicine, School of Medicine, The University of North Carolina at Chapel Hill
| | - Ming Xu
- Department of Global Health, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yinzi Jin
- Department of Global Health, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yong Huo
- Division of Cardiology, Peking University First Hospital, Beijing, China
| | - Zhi-Jie Zheng
- Department of Global Health, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| |
Collapse
|
17
|
Zhu YJ, Huo Y. Clinical gestalt in identifying pulmonary embolism: does one size fit all? J Thromb Haemost 2023; 21:2702-2704. [PMID: 37739587 DOI: 10.1016/j.jtha.2023.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 09/24/2023]
Affiliation(s)
- Yong-Jian Zhu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China.
| |
Collapse
|
18
|
González-Del-Hoyo M, Rossello X, Peral V, Pocock S, Van de Werf F, Chin CT, Danchin N, Lee SWL, Medina J, Huo Y, Bueno H. Impact of standard modifiable cardiovascular risk factors on 2-year all-cause mortality: Insights from an international cohort of 23,489 patients with acute coronary syndrome. Am Heart J 2023; 264:20-30. [PMID: 37279841 DOI: 10.1016/j.ahj.2023.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/20/2023] [Accepted: 05/28/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Controversial findings have been reported in the literature regarding the impact of the absence of standard modifiable cardiovascular risk factors (SMuRFs) on long-term mortality risk in patients with acute coronary syndrome (ACS). While the prognostic additive value of SMuRFs has been well described, the prognostic role of prior cardiovascular disease (CVD) by sex is less well-known in patients with and without SMuRFs. METHODS EPICOR and EPICOR Asia are prospective, observational registries conducted between 2010 and 2014, which enrolled ACS patients in 28 countries across Europe, Latin America, and Asia. Association between SMuRFs (diabetes, dyslipidaemia, hypertension, and smoking) and 2-year postdischarge mortality was evaluated using adjusted Cox models stratified by geographical region. RESULTS Among 23,489 patients, the mean age was 60.9 ± 11.9 years, 24.3% were women, 4,582 (20.1%) presented without SMuRFs, and 16,055 (69.5%) without prior CVD. Patients with SMuRFs had a higher crude 2-year postdischarge mortality (HR 1.86; 95% CI, 1.56-2.22; P < .001), compared to those without SMuRFs. After adjustment for potential confounding, the association between SMuRFs and 2-year mortality risk was substantially attenuated (HR 1.17, 95% CI 0.98-1.41; P = .087), regardless of the type of ACS. The risk conferred by prior CVD was added to the underlying risk of SMuRFs to provide risk-specific phenotypes (eg, women with SMuRFs and with prior CVD were at higher risk of dying than women without SMuRFs and without CVD; HR 1.67, 95% CI 1.34-2.06). CONCLUSIONS In this large-scale international ACS cohort the absence of SMuRFs was not associated with a lower adjusted 2-year postdischarge mortality risk. Patients with both SMuRFs and prior CVD had a higher mortality irrespective of their sex.
Collapse
Affiliation(s)
- Maribel González-Del-Hoyo
- Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma, Spain
| | - Xavier Rossello
- Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Facultad de Medicina, Universitat de les Illes Balears (UIB), Palma, Spain.
| | - Vicente Peral
- Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma, Spain; Facultad de Medicina, Universitat de les Illes Balears (UIB), Palma, Spain
| | - Stuart Pocock
- Facultad de Medicina, Universitat de les Illes Balears (UIB), Palma, Spain; London School of Hygiene and Tropical Medicine, London, UK
| | - Frans Van de Werf
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | | | - Nicolas Danchin
- Hôpital Européen Georges Pompidou & René Descartes University, Paris, France
| | | | - Jesús Medina
- BioPharmaceuticals Medical, AstraZeneca, Madrid, Spain
| | - Yong Huo
- Beijing University First Hospital, Beijing, China
| | - Héctor Bueno
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Cardiology Department, Hospital Universitario 12 de Octubre, and Instituto de investigación i+12, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
| |
Collapse
|
19
|
Fan F, David Spence J, Huo Y. Beyond hypertension: hypertension with hyperhomocysteinemia. Sci Bull (Beijing) 2023; 68:1975-1977. [PMID: 37612221 DOI: 10.1016/j.scib.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Affiliation(s)
- Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China; Institute of Cardiovascular Disease, Peking University First Hospital, Beijing 100034, China; Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing 100034, China
| | - J David Spence
- Divisions of Neurology and Clinical Pharmacology, Western University, London ON N6G 2V4, Canada
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China; Institute of Cardiovascular Disease, Peking University First Hospital, Beijing 100034, China; Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing 100034, China.
| |
Collapse
|
20
|
Liu J, Zhang K, Wang X, Liu Z, Chen M, Fan F, Jia J, Hong T, Li J, Huo Y, Gong Y, Zheng B. Complete revascularization based on angiography derived fractional flow reserve versus incomplete revascularization in patients with ST-segment elevation myocardial infarction. Cardiol J 2023:VM/OJS/J/92762. [PMID: 37772351 DOI: 10.5603/cj.92762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 07/29/2023] [Accepted: 08/09/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Nearly half of ST-segment elevation myocardial infarction (STEMI) patients present with significant multivessel coronary artery disease, they are at high risk of subsequent adverse events. Whether complete revascularization guided by coronary angiography-derived fractional flow reserve (caFFR) further reduces such events risk is not fully investigated. METHODS In this study, 367 consecutive STEMI patients who underwent successful primary percutaneous coronary intervention (PCI) were enrolled. caFFR of all three coronary vessels were measured, including 367 culprit vessels and 703 non-culprit vessels. Complete revascularization was defined as post-PCI caFFR > 0.8 of all three coronary vessels. The primary endpoint was major adverse cardiovascular events (MACE, a composite of cardiovascular death, non-fatal recurrent myocardial infarction, ischemia-driven revascularization and non-fatal stroke/transient ischemic attacks) during follow-up. RESULTS At a median follow-up of 3.8 years, MACE had occurred in 39 patients of the 220 (17.7%) in the complete revascularization group as compared with 49 patients of the 131 (37.4%) in the incomplete revascularization group (hazard ratio [HR] 1.9; 95% confidence interval [CI] 1.2-3.0; p = 0.005). The incomplete revascularization in culprit vessels evaluated by caFFR showed the highest risk for MACE occurrence. CONCLUSIONS In STEMI patients with multivessel coronary artery disease, incomplete revascularization based on caFFR might contribute to identifying patients at high-risk.
Collapse
Affiliation(s)
- Jiahui Liu
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Kaiping Zhang
- Department of Cardiology, Hospital 302 Attached to Guizhou Aviation Group, Guizhou, China
| | - Xingang Wang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Zhaoping Liu
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Ming Chen
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jia Jia
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Tao Hong
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Yanjun Gong
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Bo Zheng
- Department of Cardiology, Peking University First Hospital, Beijing, China.
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.
| |
Collapse
|
21
|
Huang D, Gong Y, Fan Y, Zheng B, Lu Z, Li J, Huo Y, Escaned J, Huo Y, Ge J. Coronary angiography-derived index for assessing microcirculatory resistance in patients with non-obstructed vessels: The FLASH IMR study. Am Heart J 2023; 263:56-63. [PMID: 37054908 DOI: 10.1016/j.ahj.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/21/2023] [Accepted: 03/31/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Assessing index of microcirculatory resistance (IMR) is customarily performed using intracoronary wires fitted with sensors by at least 3 intracoronary injections of 3 to 4 mL of room-temperature saline during sustained hyperemia, which is time- and cost-consuming. METHODS The FLASH IMR study is a prospective, multicenter, randomized study to assess the diagnostic performance of coronary angiography-derived IMR (caIMR) in patients with suspected myocardial ischemia with nonobstructive coronary arteries using wire-based IMR as a reference. The caIMR was calculated by an optimized computational fluid dynamics model simulating hemodynamics during diastole based on coronary angiograms. TIMI frame count and aortic pressure were included in computation. caIMR was determined onsite in real time and compared blind to wire-based IMR by an independent core laboratory, using wire-based IMR ≥25 units as indicative of abnormal coronary microcirculatory resistance. The primary endpoint was the diagnostic accuracy of caIMR, using wire-based IMR as a reference, with a pre-specified performance goal of 82%. RESULTS A total of 113 patients underwent paired caIMR and wire-based IMR measurements. Order of performance of tests was based on randomization. Diagnostic accuracy, sensitivity, specificity, positive and negative predictive values of caIMR were 93.8% (95% CI: 87.7%-97.5%), 95.1% (95% CI: 83.5%- 99.4%), 93.1% (95% CI: 84.5%-97.7%), 88.6% (95% CI: 75.4%-96.2%) and 97.1% (95% CI: 89.9%-99.7%). The receiver-operating curve for caIMR to diagnose abnormal coronary microcirculatory resistance had area under the curve of 0.963 (95% CI: 0.928-0.999). CONCLUSIONS Angiography-based caIMR has a good diagnostic yield with wire-based IMR. CLINICALTRIALS GOV IDENTIFIER NCT05009667.
Collapse
Affiliation(s)
- Dong Huang
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yanjun Gong
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yongzhen Fan
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bo Zheng
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Zhibing Lu
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yunlong Huo
- PKU-HKUST Shenzhen-Hongkong Institution, Shenzhen, Guangdong, China; Institute of Mechanobiology & Medical Engineering, School of Life Sciences & Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Javier Escaned
- Department of Cardiology, Hospital Clinico San Carlos IDISSC, Universidad Complutense de Madrid, Madrid, Spain
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Junbo Ge
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
| |
Collapse
|
22
|
Li C, Zhao W, Zhou H, Wu J, Huo Y, Jiang D, Ji X, Liu K, Xu Q, Li W. Functional Mutations in the microRNA-155 Promoter Modulate its Transcription Efficiency and Expression. Mol Biotechnol 2023:10.1007/s12033-023-00857-1. [PMID: 37624482 DOI: 10.1007/s12033-023-00857-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023]
Abstract
Limited research has been conducted on porcine miR-155 promoters, and previous study from our group have identified two haplotypes (TT and CC) in different pig breeds, each associated with five fully linked mutation sites within or near the miR-155 gene (Li et al. Dev Comp Immunol 39(1):110-116, 2013). In this study, the promoter region of porcine miR-155 was screened, and two important transcription factors, Foxp3 and RelA, were identified. The binding ability of Foxp3 protein was found to be affected by the first mutation site (A/C) using EMSA analysis. In vitro experiments revealed that the expression level of miR-155 was significantly higher in the C haplotype compared to the T haplotype. Additionally, northern blotting assays indicated that both the first mutation site (A/C) and the fourth mutation site (G/T) had a significant impact on miR-155 expression levels. These findings provide further insights into the transcriptional regulation of porcine miR-155 and identify crucial mutation sites that influence miR-155 expression. This knowledge can serve as a basis for identifying potential molecular markers associated with disease resistance in swine.
Collapse
Affiliation(s)
- Congcong Li
- College of Animal Science and Technology, Henan University of Animal Husbandry and Economy, No. 6 Longzi North Road, Zhengdong New District, Zhengzhou, 450046, Henan, China.
| | - Wanxia Zhao
- College of Animal Science and Technology, Henan University of Animal Husbandry and Economy, No. 6 Longzi North Road, Zhengdong New District, Zhengzhou, 450046, Henan, China
| | - Huijie Zhou
- College of Animal Science and Technology, Henan University of Animal Husbandry and Economy, No. 6 Longzi North Road, Zhengdong New District, Zhengzhou, 450046, Henan, China
| | - Jiao Wu
- College of Animal Science and Technology, Henan University of Animal Husbandry and Economy, No. 6 Longzi North Road, Zhengdong New District, Zhengzhou, 450046, Henan, China
| | - Yong Huo
- College of Animal Science and Technology, Henan University of Animal Husbandry and Economy, No. 6 Longzi North Road, Zhengdong New District, Zhengzhou, 450046, Henan, China
| | - Dongfeng Jiang
- College of Animal Science and Technology, Henan University of Animal Husbandry and Economy, No. 6 Longzi North Road, Zhengdong New District, Zhengzhou, 450046, Henan, China
| | - Xiangbo Ji
- Henan Key Laboratory of Unconventional Feed Resources Innovative Utilization, Henan University of Animal Husbandry and Economy, Zhengzhou, Henan, China
| | - Kun Liu
- Henan Key Laboratory of Unconventional Feed Resources Innovative Utilization, Henan University of Animal Husbandry and Economy, Zhengzhou, Henan, China
| | - Qiuliang Xu
- College of Animal Science and Technology, Henan University of Animal Husbandry and Economy, No. 6 Longzi North Road, Zhengdong New District, Zhengzhou, 450046, Henan, China
| | - Wantao Li
- College of Animal Science and Technology, Henan University of Animal Husbandry and Economy, No. 6 Longzi North Road, Zhengdong New District, Zhengzhou, 450046, Henan, China
| |
Collapse
|
23
|
Bao H, Huang X, Li P, Sheng C, Zhang J, Wang Z, Song D, Hu L, Ding C, Cheng Z, Yao C, Chen G, Cui Y, Qin X, Tang G, Wang X, Huo Y, Cheng X, Wang J. Combined use of amlodipine and folic acid are significantly more efficacious than amlodipine alone in lowering plasma homocysteine and blood pressure among hypertensive patients with hyperhomocysteinemia and intolerance to ACEI: A multicenter, randomized, double-blind, parallel-controlled clinical trial. J Clin Hypertens (Greenwich) 2023; 25:689-699. [PMID: 37433173 PMCID: PMC10423753 DOI: 10.1111/jch.14697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/13/2023]
Abstract
Hyperhomocysteinemia with hypertension can synergistically increase the risk of stroke. The China stroke primary prevention trial showed that combining 0.8 mg folic acid (FA) with angiotensin-converting enzyme inhibitor (ACEI) can effectively lower plasma total homocysteine (tHcy) and blood pressure (BP); and reduce first stroke risk by additional 21% compared to ACEI alone. However, intolerance to ACEI is common in Asians and amlodipine can be alternative. This is a multicenter, randomized, double-blind, parallel-controlled clinical trial (RCT) which evaluated whether amlodipine combined with FA is more efficacious than amlodipine alone in lowering tHcy and BP among Chinese hypertensive with hyperhomocysteinemia and intolerance to ACEI. 351 Eligible patients were randomly assigned by 1:1:1 ratio to receive amlodipine-FA tablet daily (amlodipine 5 mg/FA 0.4 mg, A group); amlodipine 5 mg/FA 0.8 mg tablet daily (B group); amlodipine 5 mg daily (C group, control group). Follow-up was conducted at 2, 4, 6, and 8 weeks. The primary outcome was efficacy of lowering both tHcy and BP at the end of 8-week treatment. Compared with C group, A group had a significantly higher rate of lowering both tHcy and BP (23.3% vs. 6.0%; Odds Ratio [OR], 8.68; 95% CI, 3.04-24.78, P < .001); B group also had a higher rate of lowering both tHcy and BP (20.3% vs. 6.0%; OR: 5.90; 95% CI, 2.11-16.47, P < .001). This RCT showed amlodipine combined with FA compared with amlodipine alone, each had significantly higher efficacy of lowering both tHcy and BP. No difference was found in BP-lowering and occurrence of adverse events between the three groups.
Collapse
Affiliation(s)
- Huihui Bao
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Xiao Huang
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Ping Li
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Changsheng Sheng
- The Shanghai Institute of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Jin Zhang
- The Shanghai Institute of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Zhirong Wang
- Affiliated Hospital of Xuzhou Medical CollegeXuzhouChina
| | | | - Lihua Hu
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Congcong Ding
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Zaihua Cheng
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Chen Yao
- Peking University Clinical Research InstitutePeking University Health Science CenterBeijingChina
| | - Guangliang Chen
- College of Integrated Chinese and Western MedicineAnhui University of Chinese MedicineHefeiChina
| | - Yimin Cui
- Department of PharmacyPeking University First HospitalBeijingChina
| | - Xianhui Qin
- National Clinical Research Study Center for Kidney Diseasethe State Key Laboratory for Organ Failure ResearchRenal DivisionNanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Genfu Tang
- School of Health AdministrationAnhui Medical UniversityHefeiChina
| | - Xiaobin Wang
- Department of PopulationFamily and Reproductive HealthJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Yong Huo
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Xiaoshu Cheng
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Jiguang Wang
- The Shanghai Institute of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| |
Collapse
|
24
|
Qi L, Liu D, Qu Y, Chen B, Meng H, Zhu L, Li L, Wang S, Liu C, Zheng G, Lian Q, Yin G, Lv L, Lu D, Chen X, Xue F, An P, Li H, Deng H, Li L, Qian L, Huo Y. Tafolecimab in Chinese Patients With Hypercholesterolemia (CREDIT-4): A Randomized, Double-Blind, Placebo-Controlled Phase 3 Trial. JACC Asia 2023; 3:636-645. [PMID: 37614541 PMCID: PMC10442872 DOI: 10.1016/j.jacasi.2023.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 08/25/2023]
Abstract
Background Tafolecimab is a novel fully human proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibody, developed for the treatment of hypercholesterolemia. Objectives The purpose of this study was to assess the efficacy and safety of tafolecimab in Chinese patients at high or very high cardiovascular risk with hypercholesterolemia. Methods Patients with diagnoses of heterozygous familial hypercholesterolemia (HeFH) by the Simon Broome criteria or at high or very high cardiovascular risk with nonfamilial hypercholesterolemia, with screening low-density lipoprotein cholesterol (LDL-C) level ≥1.8 mmol/L, were randomized 2:1 to receive tafolecimab or placebo 450 mg every 4 weeks (Q4W) in the 12-week double-blind treatment period. The primary endpoint was the percent change from baseline to week 12 in LDL-C levels. Results A total of 303 patients were enrolled and received at least 1 dose of tafolecimab (n = 205) or placebo (n = 98). The least squares mean percent change in LDL-C level from baseline to week 12 was -68.9% (SE 1.4%) in the tafolecimab group and -5.8% (1.8%) in the placebo group (difference: -63.0%; [95% CI: -66.5% to -59.6%]; P < 0.0001). More patients treated with tafolecimab achieved ≥50% LDL-C reductions, LDL-C <1.8 mmol/L, and LDL-C <1.4 mmol/L at week 12 than did those in the placebo group (all P < 0.0001). Furthermore, tafolecimab markedly reduced non-HDL-C, apolipoprotein B, and lipoprotein(a) levels. During the double-blind treatment period, the most commonly reported adverse events included urinary tract infection (5.9% with tafolecimab vs 4.1% with placebo) and hyperuricemia (3.4% vs 4.1%). Conclusions Tafolecimab was safe and showed robust lipid-lowering efficacy in Chinese patients at high or very high cardiovascular risk with hypercholesterolemia. (A Study of IBI306 in Participants With Hypercholesterolemia; NCT04709536).
Collapse
Affiliation(s)
- Litong Qi
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Dexue Liu
- Department of Endocrinology, The First Affiliated Hospital of Nanyang Medical College, Nanyang, China
| | - Yanling Qu
- Department of Cardiology, Yuncheng Central Hospital of Shanxi Province, Yuncheng, China
| | - Beijian Chen
- Department of Cardiology, Heze Municipal Hospital, Heze, China
| | - Haiyan Meng
- Department of Cardiology, Shandong Provincial Third Hospital, Jinan, China
| | - Lei Zhu
- Department of Cardiology, Shandong Provincial Third Hospital, Jinan, China
| | - Lipeng Li
- Department of Cardiology, Luoyang Third People's Hospital, Luoyang, China
| | - Shuqing Wang
- Department of Cardiology, The First Hospital of Qiqihar City, Qiqihar, China
| | - Changyi Liu
- Department of Cardiology, The First Hospital of Qiqihar City, Qiqihar, China
| | - Guanzhong Zheng
- Department of Cardiology, Zibo Municipal Hospital, Zibo, China
| | - Qiufang Lian
- Department of Cardiology, Yan'an University Xianyang Hospital, Xianyang, China
| | - Guotian Yin
- Department of Cardiology, The Third Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - Lingchun Lv
- Department of Cardiology, Lishui Central Hospital, Lishui, China
| | - Di Lu
- Department of Cardiology, China National Petroleum Corporation Central Hospital, Langfang, China
| | - Xiaoshu Chen
- Department of Cardiology, Wenzhou People's Hospital, Wenzhou, China
| | | | - Pei An
- Innovent Biologics, Inc, Suzhou, China
| | - Haoyu Li
- Innovent Biologics, Inc, Suzhou, China
| | - Huan Deng
- Innovent Biologics, Inc, Suzhou, China
| | - Li Li
- Innovent Biologics, Inc, Suzhou, China
| | - Lei Qian
- Innovent Biologics, Inc, Suzhou, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| |
Collapse
|
25
|
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.
Collapse
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
| |
Collapse
|
26
|
Guo T, Chu C, Wang Y, He M, Jia H, Sun Y, Wang D, Liu Y, Huo Y, Mu J. Lipid goal attainment in diabetes mellitus patients after acute coronary syndrome: a subanalysis of Dyslipidemia International Study II-China. BMC Cardiovasc Disord 2023; 23:337. [PMID: 37393236 PMCID: PMC10315034 DOI: 10.1186/s12872-023-03312-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/18/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Lipid management with a low-density lipoprotein cholesterol (LDL-C) goal of < 1.4 mmol/L is recommended for patients with acute coronary syndrome (ACS) and diabetes mellitus (DM) due to a high risk for adverse cardiovascular events. This study evaluated the lipid-lowering treatment (LLT) pattern and the LDL-C goal attainment rate in this special population. METHODS DM patients were screened from the observational Dyslipidemia International Study II-China study which assessed LDL-C goal attainment in Chinese ACS patients. The baseline characteristics between the LLT and no pre-LLT groups were compared. The proportions of patients obtaining LDL-C goal at admission and at 6-months, the difference from the goal, and the pattern of the LLT regimen were analyzed. RESULTS Totally 252 eligible patients were included, with 28.6% taking LLT at admission. Patients in the LLT group were older, had a lower percentage of myocardial infarction, and had decreased levels of LDL-C and total cholesterol compared to those in the no pre-LLT group at baseline. The overall LDL-C goal attainment rate was 7.5% at admission and increased to 30.2% at 6 months. The mean difference between the actual LDL-C value and LDL-C goal value dropped from 1.27 mmol/L at baseline to 0.80 mmol/L at 6 months. At 6 months, 91.4% of the patients received statin monotherapy, and only 6.9% received a combination of statin and ezetimibe. The atorvastatin-equivalent daily statin dosage was moderate during the study period. CONCLUSION The low rate of lipid goal attainment observed was in line with the outcomes of other DYSIS-China studies.
Collapse
Affiliation(s)
- Tongshuai Guo
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Mingjun He
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Hao Jia
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Yue Sun
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Dan Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Yan Liu
- Medical Affairs, Organon, China
| | - Yong Huo
- Department of Cardiovascular Medicine, Peking University First Hospital, Beijing, China.
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, 100034, Beijing, China.
| | - Jianjun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China.
| |
Collapse
|
27
|
Liu Y, Tan N, Huo Y, Chen SQ, Liu J, Wang Y, Li L, Tao JH, Su X, Zhang L, Li QX, Zhang JY, Guo YS, Du ZM, Zhou YP, Fang ZF, Xu GM, Liang Y, Tao L, Chen H, Ji Z, Han B, Chen PY, Ge JB, Han YL, Chen JY. Simplified Rapid Hydration Prevents Contrast-Associated Acute Kidney Injury Among CKD Patients Undergoing Coronary Angiography. JACC Cardiovasc Interv 2023; 16:1503-1513. [PMID: 37380233 DOI: 10.1016/j.jcin.2023.03.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Patients with chronic kidney disease (CKD) undergoing coronary angiography (CAG) are at high risk of contrast-associated acute kidney injury (CA-AKI) and mortality. Therefore, there is a clinical need to explore safe, convenient, and effective strategies for preventing CA-AKI. OBJECTIVES This study sought to assess whether simplified rapid hydration is noninferior to standard hydration for CA-AKI prevention in patients with CKD. METHODS This multicenter, open-label, randomized controlled study was conducted across 21 teaching hospitals and included 1,002 patients with CKD. Patients were randomized to either simplified hydration (SH) (SH group, with normal saline from 1 hour before to 4 hours after CAG at a rate of 3 mL/kg/h) or standard hydration (control group, with normal saline 12 hours before and 12 hours after CAG at a rate of 1 mL/kg/h). The primary endpoint of CA-AKI was a ≥25% or 0.5-mg/dL rise in serum creatinine from baseline within 48 to 72 hours. RESULTS CA-AKI occurred in 29 of 466 (6.2%) patients in the SH group and in 38 of 455 (8.4%) patients in the control group (relative risk: 0.8; 95% CI: 0.5-1.2; P = 0.216). In addition, the risk of acute heart failure and 1-year major adverse cardiovascular events did not differ significantly between the groups. However, the median hydration duration was significantly shorter in the SH group than in the control group (6 vs 25 hours; P < 0.001). CONCLUSIONS In CKD patients undergoing CAG, SH is noninferior to standard hydration in preventing CA-AKI with a shorter hydration duration.
Collapse
Affiliation(s)
- Yong Liu
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
| | - Ning Tan
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Shi-Qun Chen
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Jin Liu
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yan Wang
- Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China
| | - Lang Li
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Jian-Hong Tao
- Department of Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xi Su
- Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China
| | - Li Zhang
- Department of Cardiology, West China Hospital, Sichuan University, China
| | - Qing-Xian Li
- Department of Cardiology, Affiliated Hospital, Jining Medical College, Shandong, China
| | - Jin-Ying Zhang
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan-Song Guo
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
| | - Zhi-Min Du
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Heart Brain and Vessel Diseases, Dongguan Tungwah Hospital, Dongguan, China
| | - Yin-Pin Zhou
- Department of Cardiology, ChongQing FuLing Central Hospital, Chong Qing, China
| | - Zhen-Fei Fang
- Department of Cardiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Guang-Ma Xu
- Department of Cardiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Province, China
| | - Yan Liang
- Department of Cardiology, Maoming People's Hospital, Maoming, China
| | - Ling Tao
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University, Shaanxi, China
| | - Hui Chen
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zheng Ji
- Department of Cardiology, Tangshan Gongren Hospital, Hebei, China
| | - Bing Han
- Department of Cardiology, Xuzhou Central Hospital, Xuzhou, China
| | - Ping-Yan Chen
- Department of Biostatistics, Southern Medical University, Guangzhou, China
| | - Jun-Bo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai, China
| | - Ya-Ling Han
- Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Ji-Yan Chen
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
| |
Collapse
|
28
|
Liu X, Ren L, Yu S, Li G, He P, Yang Q, Wei X, Thai PN, Wu L, Huo Y. Late sodium current in synergism with Ca 2+/calmodulin-dependent protein kinase II contributes to β-adrenergic activation-induced atrial fibrillation. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220163. [PMID: 37122215 PMCID: PMC10150221 DOI: 10.1098/rstb.2022.0163] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Atrial fibrillation (AF) is frequently associated with β-adrenergic stimulation, especially in patients with structural heart diseases. The objective of this study was to determine the synergism of late sodium current (late INa) and Ca2+/calmodulin-dependent protein kinase (CaMKII)-mediated arrhythmogenic activities in β-adrenergic overactivation-associated AF. Monophasic action potential, conduction properties, protein phosphorylation, ion currents and cellular trigger activities were measured from rabbit-isolated hearts, atrial tissue and atrial myocytes, respectively. Isoproterenol (ISO, 1-15 nM) increased atrial conduction inhomogeneity index, phospho-Nav1.5 and phospho-CaMKII protein levels and late INa by 108%, 65%, 135% and 87%, respectively, and induced triggered activities and episodes of AF in all hearts studied (p < 0.05). Sea anemone toxin II (ATX-II, 2 nM) was insufficient to induce any atrial arrhythmias, whereas the propensities of AF were greater in hearts treated with a combination of ATX-II and ISO. Ranolazine, eleclazine and KN-93 abolished ISO-induced AF, attenuated the phosphorylation of Nav1.5 and CaMKII, and reversed the increase of late INa (p < 0.05) in a synergistic mode. Overall, late INa in association with the activation of CaMKII potentiates β-adrenergic stimulation-induced AF and the inhibition of both late INa and CaMKII exerted synergistic anti-arrhythmic effects to suppress atrial arrhythmic activities associated with catecholaminergic activation. This article is part of the theme issue 'The heartbeat: its molecular basis and physiological mechanisms'.
Collapse
Affiliation(s)
- Xiaoyan Liu
- Department of Cardiology, Peking University First Hospital, 8, Xishiku Street, West District, Beijing 100034, People's Republic of China
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Lu Ren
- Department of Cardiology, Peking University First Hospital, 8, Xishiku Street, West District, Beijing 100034, People's Republic of China
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of California, Davis, CA, 95616, USA
| | - Shandong Yu
- Department of Cardiology, Peking University First Hospital, 8, Xishiku Street, West District, Beijing 100034, People's Republic of China
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Gang Li
- Department of Cardiology, Peking University First Hospital, 8, Xishiku Street, West District, Beijing 100034, People's Republic of China
| | - Pengkang He
- Department of Cardiology, Peking University First Hospital, 8, Xishiku Street, West District, Beijing 100034, People's Republic of China
| | - Qiaomei Yang
- Department of Cardiology, Peking University First Hospital, 8, Xishiku Street, West District, Beijing 100034, People's Republic of China
| | - Xiaohong Wei
- Department of Cardiology, Peking University First Hospital, 8, Xishiku Street, West District, Beijing 100034, People's Republic of China
| | - Phung N Thai
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of California, Davis, CA, 95616, USA
| | - Lin Wu
- Department of Cardiology, Peking University First Hospital, 8, Xishiku Street, West District, Beijing 100034, People's Republic of China
- Key Laboratory of Medical Electrophysiology of Ministry of Education, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, 646000, People's Republic of China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, 8, Xishiku Street, West District, Beijing 100034, People's Republic of China
| |
Collapse
|
29
|
Wang L, Zhao Y, Zheng B, Huo Y, Fan Y, Ma D, Gu Y, Wang P. Ultrawide-bandwidth high-resolution all-optical intravascular ultrasound using miniaturized photoacoustic transducer. Sci Adv 2023; 9:eadg8600. [PMID: 37294755 PMCID: PMC10256152 DOI: 10.1126/sciadv.adg8600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/05/2023] [Indexed: 06/11/2023]
Abstract
Conventional intravascular ultrasound (IVUS) uses piezoelectric transducers to electrically generate and receive ultrasound. However, it remains a challenge to achieve large bandwidth for high resolution without compromising imaging depth. We report an all-optical IVUS (AO-IVUS) imaging system using picosecond laser pulse-pumped carbon composite for ultrasound excitation and π-phase-shifted fiber Bragg gratings for ultrasound detection. Using this all-optical technique, we achieved ultrawide-bandwidth (147%) and high-resolution (18.6 micrometers) IVUS imaging, which is unattainable by conventional technique. Imaging performance has been characterized in phantoms, presenting 18.6-micrometer axial resolution, 124-micrometer lateral resolution, and 7-millimeter imaging depth. Rotational pullback imaging scans are performed in rabbit iliac artery, porcine coronary artery, and rabbit arteries with drug-eluting metal stents, in parallel with commercial intravenous ultrasound scans as reference. Results demonstrated the advantages of high-resolution AO-IVUS in delineating details in vascular structures, showing great potential in clinical applications.
Collapse
Affiliation(s)
- Lei Wang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Institute of Medical Photonics, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Yongwen Zhao
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Institute of Medical Photonics, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Bo Zheng
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing 100034, China
| | - Yong Huo
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing 100034, China
| | - Yubo Fan
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Institute of Medical Photonics, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Dinglong Ma
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Institute of Medical Photonics, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Ying Gu
- Department of Laser Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing 100039, China
| | - Pu Wang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Institute of Medical Photonics, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| |
Collapse
|
30
|
Zheng ZW, Huo Y, Li M, Zhang JN. [Research advances in current state, diagnosis and treatment in subjective idiopathic tinnitus patients with anxiety]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:631-636. [PMID: 37339907 DOI: 10.3760/cma.j.cn115330-20221122-00702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Affiliation(s)
- Z W Zheng
- Department of Otolaryngology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Y Huo
- Department of Otolaryngology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - M Li
- Department of Otolaryngology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - J N Zhang
- Department of Otolaryngology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| |
Collapse
|
31
|
He P, Pan Y, Jiang J, Fan F, Zhou J, Xia Y, Liu J, Yang N, Hao Y, Li J, Liu J, Zhao D, Huo Y. In-hospital therapies and determinants of treatment strategy selection in patients with atrial fibrillation and left ventricular systolic dysfunction in China: a retrospective study based on the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation (CCC-AF) project, 2015-2019. BMJ Open 2023; 13:e070070. [PMID: 37277219 DOI: 10.1136/bmjopen-2022-070070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
OBJECTIVES The optimal treatment strategy remains debatable in patients with atrial fibrillation (AF) and heart failure. Our objectives were to summarise in-hospital therapies and determine factors associated with treatment strategy selections. DESIGN A retrospective study analysing the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation (CCC-AF) project from 2015 to 2019. SETTING The CCC-AF project included patients from 151 tertiary and 85 secondary hospitals across 30 provinces in China. PARTICIPANTS Patients with AF and left ventricular systolic dysfunction (LVSD, defined as left ventricular ejection fraction<50%) were included, with 5560 patients in the study sample. METHODS Patients were classified by treatment strategies. In-hospital treatments and trends of therapies were analysed. Multiple logistic regression models were used to find determinants of treatment strategies. RESULTS Rhythm control therapies were used in 16.9% of patients with no significant trends (p trend=0.175). Catheter ablation was used in 5.5% of patients, increasing from 3.3% in 2015 to 6.6% in 2019 (p trend<0.001). Factors negatively associated with rhythm control included increased age (OR 0.973, 95% CI 0.967 to 0.980), valvular AF (OR 0.618, 95% CI 0.419 to 0.911), AF types (persistent: OR 0.546, 95% CI 0.462 to 0.645; long-standing persistent: OR 0.298, 95% CI 0.240 to 0.368), larger left atrial diameters (OR 0.966, 95% CI 0.957 to 0.976) and higher Charlson Comorbidity Index scores (CCI 1-2: OR 0.630, 95% CI 0.529 to 0.750; CCI≥3: OR 0.551, 95% CI 0.390 to 0.778). Higher platelet counts (OR 1.025, 95% CI 1.013 to 1.037) and prior rhythm control attempts (electrical cardioversion: OR 4.483, 95% CI 2.369 to 8.483; catheter ablation: OR 4.957, 95% CI 3.072 to 7.997) were positively associated with rhythm control strategies. CONCLUSION In China, non-rhythm control strategy remained the dominant choice in patients with AF and LVSD. Age, AF types, prior treatments, left atrial diameters, platelet counts and comorbidities were major determinants of treatment strategies. Guideline-adherent therapies should be further promoted. STUDY REGISTRATION NUMBER NCT02309398.
Collapse
Affiliation(s)
- Pengkang He
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yannan Pan
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jie Jiang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jing Zhou
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yulong Xia
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jun Liu
- Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Na Yang
- Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Yongchen Hao
- Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jing Liu
- Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Dong Zhao
- Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| |
Collapse
|
32
|
Zhou J, Li C, Zhang H, Liu C, Yang J, Zhao J, Hou Y, Tan Y, Wang H, Li Y, Xie C, Wang M, Wang C, Zhang E, Wang S, Zhao P, Shan D, Liang S, Gao Y, Huo Y, Cong H, Guo Z, Chen Y. Association between Coronary Artery Disease Reporting and Data System-recommended Post-Coronary CT Angiography Management and Clinical Outcomes in Patients with Stable Chest Pain from a Chinese Registry. Radiology 2023; 307:e222965. [PMID: 37310243 DOI: 10.1148/radiol.222965] [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: 06/14/2023]
Abstract
Background Coronary Artery Disease Reporting and Data System (CAD-RADS) was developed to standardize and optimize disease management in patients after coronary CT angiography (CCTA), but the impact of CAD-RADS management recommendations on clinical outcomes remains unclear. Purpose To retrospectively assess the association between the appropriateness of post-CCTA management according to CAD-RADS version 2.0 and clinical outcomes. Materials and Methods From January 2016 to January 2018, consecutive participants with stable chest pain referred for CCTA were prospectively included in a Chinese registry and followed for 4 years. Retrospectively, CAD-RADS 2.0 classification and the appropriateness of post-CCTA management were determined. Propensity score matching (PSM) was used to adjust for confounding variables. Hazard ratios (HRs) for a major adverse cardiovascular event (MACE), relative risks for invasive coronary angiography (ICA), and the corresponding number needed to treat were estimated. Results Of the 14 232 included participants (mean age, 61 years ± 13 [SD]; 8852 male), 2330, 2756, and 2614 were retrospectively categorized in CAD-RADS 1, 2, and 3, respectively. Only 26% of participants with CAD-RADS 1-2 disease and 20% with CAD-RADS 3 received appropriate post-CCTA management. After PSM, appropriate post-CCTA management was associated with lower risk of MACEs (HR, 0.34; 95% CI: 0.22, 0.51; P < .001), corresponding to a number needed to treat of 21 in CAD-RADS 1-2 but not CAD-RADS 3 (HR, 0.86; 95% CI: 0.49, 1.85; P = .42). Appropriate post-CCTA management was associated with decreased use of ICA in CAD-RADS 1-2 (relative risk, 0.40; 95% CI: 0.29, 0.55; P < .001) and 3 (relative risk, 0.33; 95% CI: 0.28, 0.39; P < .001), resulting in a number needed to treat of 14 and 2, respectively. Conclusion In this retrospective secondary analysis, appropriate disease management after CCTA according to CAD-RADS 2.0 was associated with lower risk of MACEs and more prudent use of ICA. ClinicalTrials.gov registration no. NCT04691037 © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Leipsic and Tzimas in this issue.
Collapse
Affiliation(s)
- Jia Zhou
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Chunjie Li
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Hong Zhang
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Chang Liu
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Junjie Yang
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Jia Zhao
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Yonghong Hou
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Yahang Tan
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Hao Wang
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Yaoshuang Li
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Cun Xie
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Minghui Wang
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Chengjian Wang
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Enyuan Zhang
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Shuo Wang
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Pengyu Zhao
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Dongkai Shan
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Shuo Liang
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Yufan Gao
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Yong Huo
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Hongliang Cong
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Zhigang Guo
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| | - Yundai Chen
- From the Departments of Cardiology, Radiology (H.Z., S.L., Y.G.), and Cardiovascular Surgery (Z.G.), Tianjin University Chest Hospital, No. 261 Taierzhuang South Road, Tianjin 300350, China (J. Zhou, C. Li, C. Liu, J. Zhao, Y.L., C.X., M.W., C.W., S.W., E.Z., H.C.); Clinical School of Thoracic, Tianjin Medical University, Tianjin, China (C. Liu, S.W.); Senior Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (J.Y., D.S., Y.C.); School of Electrical and Information Engineering, Tianjin University, Tianjin, China (Y. Hou, P.Z.); Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Y.T.); Department of Clinical Epidemiology and Evidence-Based Medicine, Friendship Hospital, Capital Medical University, Beijing, China (H.W.); and Department of Cardiology, Peking University First Hospital, Beijing, China (Y. Huo)
| |
Collapse
|
33
|
Jiang Y, Ge W, Zhao Y, Wu Y, Huo Y, Pan L, Cao S. [LINC00926 promotes pyroptosis of hypoxia-induced human umbilical vein vascular endothelial cells by recruiting ELAVL1]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:807-814. [PMID: 37313823 DOI: 10.12122/j.issn.1673-4254.2023.05.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate the regulatory role of the long non-coding RNA LINC00926 in pyroptosis of hypoxia-induced human umbilical vein vascular endothelial cells (HUVECs) and explore the molecular mechanism. METHODS HUVECs were transfected with a LINC00926-overexpressing plasmid (OE-LINC00926), a siRNA targeting ELAVL1, or both, followed by exposure to hypoxia (5% O2) or normoxia. The expression of LINC00926 and ELAVL1 in hypoxia-treated HUVECs was detected using real-time quantitative PCR (RT-qPCR) and Western blotting. Cell proliferation was detected using Cell Counting Kit-8 (CCK-8), and the levels of IL-1β in the cell cultures was determined with ELISA. The protein expression levels of pyroptosis-related proteins (caspase-1, cleaved caspase-1 and NLRP3) in the treated cells were analyzed using Western blotting, and the binding between LINC00926 and ELAVL1 was verified with RNA immunoprecipitation (RIP) assay. RESULTS Exposure to hypoxia obviously up-regulated the mRNA expression of LINC00926 and the protein expression of ELAVL1 in HUVECs, but did not affect the mRNA expression of ELAVL1. LINC00926 overexpression in the cells significantly inhibited cell proliferation, increased IL-1β level and enhanced the expressions of pyroptosis-related proteins (all P < 0.05). LINC00926 overexpression further up-regulated the protein expression of ELAVL1 in hypoxia-exposed HUVECs. The results of RIP assay confirmed the binding between LINC00926 and ELAVL1. ELAVL1 knockdown significantly decreased IL-1β level and the expressions of pyroptosis-related proteins in hypoxia-exposed HUVECs (P < 0.05), while LINC00926 overexpression partially reversed the effects of ELAVL1 knockdown. CONCLUSION LINC00926 promotes pyroptosis of hypoxia-induced HUVECs by recruiting ELAVL1.
Collapse
Affiliation(s)
- Y Jiang
- Department of Laboratory Medicine, Jilin Medical University, Jilin 132013, China
| | - W Ge
- Department of Laboratory Medicine, Jilin Medical University, Jilin 132013, China
| | - Y Zhao
- Department of Cardiology, Jilin Central Hospital, Jilin 132011, China
| | - Y Wu
- Department of Laboratory Medicine, Jilin Medical University, Jilin 132013, China
| | - Y Huo
- Department of Laboratory Medicine, Jilin Medical University, Jilin 132013, China
| | - L Pan
- Department of Laboratory Medicine, Jilin Medical University, Jilin 132013, China
| | - S Cao
- College of Clinical Medicine, Jilin Medical University, Jilin 132013, China
| |
Collapse
|
34
|
Xue X, Hu J, Xiang D, Li H, Jiang Y, Fang W, Yan H, Chen J, Wang W, Su X, Yu B, Wang Y, Xu Y, Wang L, Li C, Chen Y, Zhao D, Kan H, Ge J, Huo Y, Chen R. Hourly air pollution exposure and the onset of symptomatic arrhythmia: an individual-level case-crossover study in 322 Chinese cities. CMAJ 2023; 195:E601-E611. [PMID: 37127306 PMCID: PMC10151095 DOI: 10.1503/cmaj.220929] [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] [Accepted: 04/03/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Few studies have explored the relationship between air pollution and arrhythmia onset at the hourly level. We aimed to examine the association of exposure to air pollution with the onset of acute symptomatic arrhythmia at an hourly level. METHODS We conducted a nationwide, time-stratified, case-crossover study in China between 2015 and 2021. We obtained hourly information on the onset of symptomatic arrhythmia (including atrial fibrillation, atrial flutter, atrial and ventricular premature beats and supraventricular tachycardia) from the Chinese Cardiovascular Association Database - Chest Pain Center (including 2025 certified hospitals in 322 cities). We obtained data on hourly concentrations of 6 air pollutants from the nearest monitors, including fine particles (PM2.5), coarse particles (PM2.5-10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone. For each patient, we matched the case period to 3 or 4 control periods during the same hour, day of week, month and year. We used conditional logistic regression models to analyze the data. RESULTS We included a total of 190 115 patients with acute onset of symptomatic arrhythmia. Air pollution was associated with increased risk of onset of symptomatic arrhythmia within the first few hours of exposure; this risk attenuated substantially after 24 hours. An interquartile range increase in PM2.5, NO2, SO2 and CO in the first 24 hours after exposure (i.e., lag period 0-24 h) was associated with significantly higher odds of atrial fibrillation (1.7%-3.4%), atrial flutter (8.1%-11.4%) and supraventricular tachycardia (3.4%-8.9%). Exposure to PM2.5-10 was associated with significantly higher odds of atrial flutter (8.7%) and supraventricular tachycardia (5.4%), and exposure to ozone was associated with higher odds of supraventricular tachycardia (3.4%). The exposure-response relationships were approximately linear, without discernible concentration thresholds. INTERPRETATION Exposure to air pollution was associated with the onset of symptomatic arrhythmia shortly after exposure. This finding highlights the importance of further reducing air pollution and taking prompt protective measures for susceptible populations during periods of elevated levels of air pollutants.
Collapse
Affiliation(s)
- Xiaowei Xue
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Jialu Hu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Dingcheng Xiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Huichu Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Weiyi Fang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Hongbing Yan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Jiyan Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Weimin Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Xi Su
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Bo Yu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Yan Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Yawei Xu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Lefeng Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Chunjie Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Yundai Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Dong Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Junbo Ge
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Yong Huo
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment (Xue, Jiang, Kan, R. Chen), Fudan University, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine (Hu, Ge), Shanghai, China; Department of Cardiology (Xiang), General Hospital of Southern Theater Command of PLA, Guangzhou, China; Department of Environmental Health (H. Li), Harvard T.H. Chan School of Public Health, Boston, Mass.; Department of Cardiology (Fang), Huadong Hospital, Fudan University, Shanghai, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China; Center for Coronary Artery Diseases (Yan), Chinese Academy of Medical Sciences, Beijing, China; Department of Cardiology (J. Chen), Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Cardiology (W. Wang), Peking University People's Hospital, Beijing, China; Department of Cardiology (Su), Wuhan ASIA General Hospital, Wuhan, China; Department of Cardiology (Yu), The 2nd Affiliated Hospital, Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Department of Cardiology (Y. Wang), Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China; Department of Cardiology (Xu), Shanghai Tenth People's Hospital, Shanghai, China; Heart Center and Beijing Key Laboratory of Hypertension (L. Wang), Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Emergency (C. Li), Tianjin Chest Hospital, Tianjin, China; Senior Department of Cardiology (Y. Chen), the Sixth Medical Center of PLA General Hospital, Beijing, China; Department of Epidemiology (Zhao), Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases (Zhao), Beijing, China; Department of Cardiology (Huo), Peking University First Hospital, Beijing, China
| |
Collapse
|
35
|
Weng H, Li Y, Nie X, He C, Feng P, Zhao F, Chen Q, Sun W, Jiang J, Zhang Y, Huo Y, Li J. Comparative effectiveness and safety of bolus vs. continuous infusion of loop diuretics: Results from the MIMIC-III Database. Am J Med Sci 2023; 365:353-360. [PMID: 36572341 DOI: 10.1016/j.amjms.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 07/31/2022] [Accepted: 12/14/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND It is unclear whether fluid management goals are best achieved by bolus injection or continuous infusion of loop diuretics. In this study, we compared the effectiveness and safety of a continuous infusion with that of a bolus injection when an increased loop diuretic dosage is required in intensive care unit (ICU) patients. METHODS We obtained data from the MIMIC-III database for patients who were first-time ICU admissions and required an increased diuretic dosage. Patients were excluded if they had an estimated glomerular filtration rate <15 ml/min/1.73 m2, were receiving renal replacement therapy, had a baseline systolic blood pressure <80 mmHg, or required a furosemide dose <120 mg. The patients were divided into a continuous group and a bolus group. Propensity score matching was used to balance patients' background characteristics. RESULTS The final dataset included 807 patients (continuous group, n = 409; bolus group, n = 398). After propensity score matching, there were 253 patients in the bolus group and 231 in the continuous group. The 24 h urine output per 40 mg of furosemide was significantly greater in the continuous group than in the bolus group (234.66 ml [95% confidence interval (CI) 152.13-317.18, p < 0.01]). There was no significant between-group difference in the incidence of acute kidney injury (odds ratio 0.96, 95% CI 0.66-1.41, p = 0.85). CONCLUSIONS Our results indicate that a continuous infusion of loop diuretics may be more effective than a bolus injection and does not increase the risk of acute kidney injury in patients who need an increased diuretic dosage in the ICU.
Collapse
Affiliation(s)
- Haoyu Weng
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yuxi Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Xiaolu Nie
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Beijing, China
| | - Chunhui He
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Beijing, China
| | | | | | - Qingjie Chen
- Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, China
| | - Wen Sun
- Department of Respiration and Critical Care, Peking University First Hospital, Beijing, China
| | - Jie Jiang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China.
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China.
| |
Collapse
|
36
|
Bai F, Pu J, Che W, Chen J, Chen M, Chen W, Chen X, Chen Y, Cheng X, Cheng X, Cong H, Dai C, Fan D, Fu G, Gao L, Gao C, Gao W, Ge J, He B, Hu T, Huang C, Huang J, Huo Y, Jia S, Jiang J, Jing Z, Kong X, Li L, Li Y, Li Y, Li Z, Liang C, Lin X, Liu X, Liu X, Lu C, Ma G, Ma Y, Mao W, Mei X, Ning Z, Ou J, Slaj S, Shen C, Shi H, Shi H, Shi B, Su X, Sun N, Tang Q, Wang F, Wang C, Wang J, Wu Y, Wu Y, Xia Y, Xiang D, Xiao P, Xie P, Xiong D, Xu Y, Yang J, Yang L, Yu Z, Yuan Z, Yuan H, Zhang G, Zhang H, Zhang J, Zhang L, Zhang R, Zhang S, Zhang S, Zhang Z, Zhao G, Zhao X, Zheng J, Zheng H, Zhou D, Zhou S, Zhou Y. 2023 Chinese expert consensus on the impact of COVID-19 on the management of cardiovascular diseases. Cardiol Plus 2023; 8:82-102. [PMID: 37486153 PMCID: PMC10358441 DOI: 10.1097/cp9.0000000000000043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/14/2023] [Indexed: 07/25/2023] Open
Abstract
The primary site of infection in COVID-19 exhibit is the respiratory system, but multiple organ systems could be affected. The virus could directly invade cardiomyocytes. Alternatively, cytokine storm could lead to myocardial injury. More importantly, the management of existing cardiovascular diseases must be re-examined in COVID-19 due to, for example, interaction between antiviral agents and with a wide variety of pharmacological agents. The Branch of Cardiovascular Physicians of Chinese Medical Doctor Association organized a panel of experts in cardiovascular and related fields to discuss this important issue, and formulated the "2023 Chinese Expert Consensus on the Impact of COVID-19 on the Management of Cardiovascular Diseases." The Consensus was drafted on the basis of systematic review of existing evidence and diagnosis and treatment experience, and covers three major aspects: myocardial injury caused by COVID-10 and COVID-19 vaccine, the impact of COVID-19 on patients with cardiovascular disease, and the impact of COVID-19 on the cardiovascular system of healthy people, and rehabilitation guidance recommendations. The Consensus involves 11 core clinical issues, including incidence, pathogenesis, clinical manifestations, treatment strategies, prognosis, and rehabilitation. It is our hope that this Consensus will provide a practical guidance to cardiologists in the management of cardiovascular diseases in the new era of COVID-19 pandemic.
Collapse
|
37
|
Chen H, Cui Z, Lu W, Wang P, Wang J, Zhou Z, Zhang N, Wang Z, Lin T, Song Y, Liu L, Huang X, Chen P, Tang G, Duan Y, Wang B, Li J, Zhang Y, Huo Y, Zhang H, Xu X, Qin X, Yang Y. Correction to: Geographical, Sex, Age, and Seasonal Differences in Serum Manganese Status Among Chinese Adults with Hypertension. Biol Trace Elem Res 2023; 201:2101-2102. [PMID: 35524919 DOI: 10.1007/s12011-022-03278-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hong Chen
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, 518106, China
| | - Zhixin Cui
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, 518106, China
| | - Wenhai Lu
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, 518106, China
- Pingdi Public Health Service Center, Shenzhen, 518117, China
| | - Ping Wang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, 518106, China
| | - Jia Wang
- Department of Cardiovascular Medicine, Binzhou Medical University Hospital, Binzhou, 256603, China
| | - Ziyi Zhou
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, 518055, China
- Shenzhen Evergreen Medical Institute, Shenzhen, 518057, China
| | - Nan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Zhuo Wang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
| | - Tengfei Lin
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
- College of Pharmacy, Jinan University, Guangzhou, 510630, China
| | - Yun Song
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Lishun Liu
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, 518055, China
- Shenzhen Evergreen Medical Institute, Shenzhen, 518057, China
| | - Xiao Huang
- Department of Cardiology, The Second Afliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Ping Chen
- College of Pharmacy, Jinan University, Guangzhou, 510630, China
| | - Genfu Tang
- School of Heath Administration, Anhui Medical University, Hefei, 230032, China
| | - Yong Duan
- Yunnan Key Laboratory of Laboratory Medicine, Kunming, 650032, China
- Department of Clinical Laboratory, the First Afliated Hospital of Kunming Medical University, Kunming, 650032, China
| | - Binyan Wang
- Shenzhen Evergreen Medical Institute, Shenzhen, 518057, China
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Hao Zhang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
| | - Xiping Xu
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Xianhui Qin
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China.
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Yan Yang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, 518106, China.
- Guangdong Provincial Key Laboratory of Food, Guangdong Province, Nutrition and Health, Guangzhou, 510080, China.
- Guangdong Provincial Engineering Laboratory for Nutrition Translation, Guangdong Province, Guangzhou, 510080, China.
| |
Collapse
|
38
|
Wang J, Sun N, Ge J, Jiang H, Yin Y, Chen M, Wang Y, Yao C, Yan X, Sobotka PA, Huo Y. Rationale and Design of Sympathetic Mapping/Ablation of Renal Nerves Trial (SMART) for the Treatment of Hypertension: a Prospective, Multicenter, Single-Blind, Randomized and Sham Procedure-Controlled Study. J Cardiovasc Transl Res 2023; 16:358-370. [PMID: 36042146 DOI: 10.1007/s12265-022-10307-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/18/2022] [Indexed: 10/14/2022]
Abstract
Renal denervation (RDN) is proposed as a durable and patient compliance independent treatment for hypertension. However, 20-30% non-responder after RDN treatment weakened the therapeutic effect, which may be due to blind ablation. The renal nerve mapping/selective ablation system developed by SyMap Medical Ltd (Suzhou), China, has the function of mapping renal sympathetic/parasympathetic nerve sites and selectively removing renal sympathetic nerves and is expected to meet the urgent unmet clinical need of targeted RDN. The "Sympathetic Mapping/Ablation of Renal Nerves Trial" (SMART) is a prospective, multicenter, randomized, single-blinded, sham procedure-controlled trial, to evaluate the safety and efficacy of targeted renal sympathetic denervation in patients with essential and uncontrolled hypertension. The study is the first clinical registry trial using a targeted RDN for the treatment of uncontrolled hypertension; the dual-endpoint design can answer the question of how many antihypertensive drugs can be reduced in patients after RDN. The trial is registered on clinicaltrials.gov NCT02761811.
Collapse
Affiliation(s)
- Jie Wang
- Division of Cardiology, Department of Medicine, College of Physician and Surgeons, Columbia University, New York, NY, 10032, USA.
- Academy of Clinical and Translational Research Jiangsu Province, The First Affiliated Hospital With Nanjing Medical University, Nanjing, 210029, China.
| | - Ningling Sun
- Department of Hypertension, Heart Center, Peking University People's Hospital, Beijing, 100044, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Hong Jiang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yuehui Yin
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Minglong Chen
- Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Nanjing, 210029, China
| | - Yue Wang
- Academy of Clinical and Translational Research Jiangsu Province, The First Affiliated Hospital With Nanjing Medical University, Nanjing, 210029, China
| | - Chen Yao
- Peking University Clinical Research Institute, Beijing, 100191, China
- Department of Biostatistics, Peking University First Hospital, Beijing, 100034, China
| | - Xiaoyan Yan
- Peking University Clinical Research Institute, Beijing, 100191, China
| | | | - Yong Huo
- Division of Cardiology, Peking University First Hospital, Beijing, 100034, China.
| |
Collapse
|
39
|
Su X, Liu J, Sun N, Huo Y. Hyperuricemia is associated with more cardiometabolic risk factors in hypertensive younger Chinese adults than in elderly. Front Cardiovasc Med 2023; 10:1133724. [PMID: 37008332 PMCID: PMC10063877 DOI: 10.3389/fcvm.2023.1133724] [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] [Received: 12/29/2022] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
BackgroundNumerous studies have shown that hyperuricemia (HUA) is associated with cardiovascular and renal outcomes, but few studies specifically explored the effect of age on this relationship. Therefore, our study aimed to explore the relationship between HUA and other cardiometabolic risk factors in different age groups.MethodsThis cross-section study used the data from Survey on uric acid in Chinese subjects with essential hypertension (SUCCESS). We performed multivariate logistic regressions in different age groups.ResultsAfter adjusting for potential confounders, among young and middle-aged adults less than 60, HUA was associated with higher body mass index (BMI, adjusted OR = 1.114, 95% CI: 1.057–1.174), higher fasting blood glucose (FBG, adjusted OR = 1.099, 95% CI: 1.003–1.205), triglycerides (TG, adjusted OR = 1.425, 95% CI: 1.247–1.629), higher low-density lipoprotein cholesterol (LDL-C, adjusted OR = 1.171, 95% CI: 1.025–1.337), and lower estimated glomerular filtration rate (eGFR, adjusted OR = 0.992, 95% CI: 0.988–0.996). Among elderly adults 60 years or older, HUA was associated with higher SBP (adjusted OR = 1.024, 95% CI: 1.005–1.042), higher TG (adjusted OR = 1.716, 95% CI: 1.466–2.009), and higher LDL-C (adjusted OR = 1.595, 95% CI: 1.366–1.863).ConclusionHUA is associated with more cardiometabolic risk factors in younger adults with hypertension (HT). Comprehensive management of HT with HUA is needed in clinical settings.
Collapse
Affiliation(s)
- Xiaofeng Su
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
- Cardio-Metabolic Laboratory, Peking University People's Hospital, Beijing, China
| | - Jing Liu
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
- Cardio-Metabolic Laboratory, Peking University People's Hospital, Beijing, China
- Correspondence: Jing Liu Yong Huo
| | - Ningling Sun
- Department of Hypertension, Peking University People’s Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Correspondence: Jing Liu Yong Huo
| | | |
Collapse
|
40
|
He P, Li H, Zhang Z, Zhang Y, Lin T, Song Y, Liu L, Liang M, Nie J, Wang B, Huo Y, Hou FF, Xu X, Qin X. Change in the Estimated Glomerular Filtration Rate Over Time and Risk of First Stroke in Hypertensive Patients. J Epidemiol 2023; 33:142-149. [PMID: 35400712 PMCID: PMC9909174 DOI: 10.2188/jea.je20210242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The association between changes in estimated glomerular filtration rate (eGFR) over time and the risk of stroke remains inconclusive. We aimed to evaluate the relation of eGFR change during the China Stroke Primary Prevention Trial (CSPPT) with the risk of first stroke during the subsequent post-trial follow-up. METHODS A total of 11,742 hypertensive participants with two eGFR measurements (median measure interval, 4.4; interquartile range, 4.2-4.6 years) and without a history of stroke from the CSPPT were included in this analysis. RESULTS Over a median post-trial follow-up of 4.4 years, 729 first strokes were identified, of which 635 were ischemic, 88 were hemorrhagic, and 6 were uncertain types of strokes. Compared with those with 1 to <2% per year increase in eGFR (with the lowest stroke risk), those with an increase in eGFR of ≥4% per year had significantly increased risks of first stroke (adjusted hazard ratio [HR] 1.96; 95% confidence interval [CI], 1.10-3.50) and first ischemic stroke (adjusted HR 2.14; 95% CI, 1.17-3.90). Similarly, those with a decline in eGFR of ≥5% per year also had significantly increased first stroke (adjusted HR 2.13; 95% CI, 1.37-3.31) and first ischemic stroke (adjusted HR 1.89; 95% CI, 1.19-3.02) risk. However, there was no significant association between eGFR change and first hemorrhagic stroke. A similar result was found when the change in eGFR was quantified as an absolute annual change. CONCLUSION In Chinese hypertensive patients, both the decline and increase of eGFR levels were independently associated with the risks of first stroke or first ischemic stroke.
Collapse
Affiliation(s)
- Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Huan Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Tengfei Lin
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University.,Institute of Biomedicine, Anhui Medical University
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University
| | - Min Liang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Jing Nie
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University.,Shenzhen Evergreen Medical Institute
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital
| | - Fan Fan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| | - Xiping Xu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory.,Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory
| |
Collapse
|
41
|
Yi T, Gao L, Fan F, Jiang Y, Jia J, Zhang Y, Li J, Huo Y. Association between pulse wave velocity and the 10-year risk of atherosclerotic cardiovascular disease in the Chinese population: A community-based study. J Clin Hypertens (Greenwich) 2023; 25:278-285. [PMID: 36794419 PMCID: PMC9994158 DOI: 10.1111/jch.14642] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/04/2023] [Accepted: 01/19/2023] [Indexed: 02/17/2023]
Abstract
Accumulated evidence has shown that carotid-femoral and brachial-ankle PWV well predict cardiovascular events but it is still unclear if the predictability is same or not. In this cross-sectional study based on a community atherosclerosis cohort in Beijing, China, a total of 5282 participants without previous coronary heart disease and stroke were enrolled from a community atherosclerosis cohort in Beijing, China. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk were calculated by the China-PAR model, and < 5%, 5%-10% and > 10% were defined as low, intermediate, and high risk, respectively. The average baPWV and cfPWV values were 16.63 ± 3.35 m/s and 8.45 ± 1.78 m/s, respectively. The mean 10-year ASCVD risk was 6.98% (interquartile range: 3.90%-12.01%). The patients with low, intermediate, and high 10-year ASCVD risk accounted for 34.84% (1840), 31.94% (1687),, and 33.23% (1755) respectively. Multivariate analysis showed that for every 1 m/s increase in baPWV and cfPWV, the 10-year ASCVD risk increased by 0.60% (95% confidence interval: 0.56%-0.65%, p < .001) and 1.17% (95% confidence interval: 1.09%-1.25%, p < .001), respectively. The diagnostic ability of the baPWV was comparable to the cfPWV (area under the curve: 0.870 [0.860-0.879] vs. 0.871 [0.861-0.881], p = .497). In conclusion, baPWV and cfPWV are positively associated with the 10-year risk of ASCVD in the Chinese community-based population, with a nearly identical association with a high 10-year risk of ASCVD.
Collapse
Affiliation(s)
- Tieci Yi
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Lan Gao
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Yimeng Jiang
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Jia Jia
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.,Hypertension Precision Diagnosis and Treatment Research Center, Peking University First Hospital, Beijing, China
| |
Collapse
|
42
|
Li J, Zhang W, Zhao L, Zhang J, She H, Meng Y, Zhang Y, Gu X, Zhang Y, Li J, Qin X, Wang B, Xu X, Hou F, Tang G, Liao R, Liu L, Huang M, Bai X, Huo Y, Yang L. Positive correlation between hypertensive retinopathy and albuminuria in hypertensive adults. BMC Ophthalmol 2023; 23:66. [PMID: 36782153 PMCID: PMC9923927 DOI: 10.1186/s12886-023-02807-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
PURPOSE We investigated the association between albuminuria and hypertensive retinopathy (HR) in hypertensive adults. METHODS This was a cross-sectional subgroup analysis of data from the China Stroke Primary Prevention Trial. We enrolled 2,964 hypertensive adults in this study. Keith-Wagener-Barker stages was used to assess HR. The urinary albumin to creatinine ratio (UACR) was calculated to evaluate albuminuria. RESULTS HR was found in 76.6% (n = 2, 271) of the participants, albuminuria was found in 11.1% (n = 330). The UACR levels were significantly higher in subjects with HR than in those without HR (grade 1, β = 1.42, 95% confidence intervals [CI]: -0.12, 2.95, p = 0.070; grade 2, β = 2.62, 95% CI: 0.56, 4.67, p = 0.013; grade 3, β = 5.17, 95% CI: 1.13, 9.20, p = 0.012). In the subgroup analyses, the association between HR and UACR was stronger in current smokers (p for interaction = 0.014). The correlation between HR grades 1 and 2 and UACR was stronger in subjects with higher triglyceride levels (≥ 1.7 mmol/L), but for grade 3 HR, this correlation was stronger in subjects with lower triglycerides levels (< 1.7 mmol/L, p for interaction = 0.023). The odds of albuminuria were significantly higher in subjects with HR than in those without HR (grade 1, odds ratio [OR] = 1.57, 95% CI: 1.08, 2.29, p = 0.019; grade 2, OR = 2.02, 95% CI: 1.28, 3.18, p = 0.002; grade 3, OR = 2.12, 95% CI: 0.99, 4.55, p = 0.053). In the subgroup analyses, the association between HR grades 1 and 2 and albuminuria was stronger in subjects with higher triglycerides levels (≥ 1.7 mmol/L), but for grade 3 HR, this correlation was stronger in subjects with lower triglyceride levels (< 1.7 mmol/L, p for interaction = 0.014). CONCLUSION HR was positively correlated with albuminuria in hypertensive Chinese adults. This correlation was more remarkable when the population was stratified by triglycerides levels and smoking status. HR can be used as an indicator of early renal injury.
Collapse
Affiliation(s)
- Jun Li
- grid.411472.50000 0004 1764 1621Department of Ophthalmology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034 China
| | - Wenbo Zhang
- Department of Ophthalmology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| | - Liang Zhao
- grid.411472.50000 0004 1764 1621Department of Ophthalmology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034 China
| | - Jing Zhang
- grid.411472.50000 0004 1764 1621Department of Ophthalmology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034 China
| | - Haicheng She
- grid.414373.60000 0004 1758 1243Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ying Meng
- grid.449412.eDepartment of Ophthalmology, Peking University International Hospital, Beijing, China
| | - Yadi Zhang
- grid.411472.50000 0004 1764 1621Department of Ophthalmology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034 China
| | - Xiaopeng Gu
- grid.411472.50000 0004 1764 1621Department of Ophthalmology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034 China
| | - Yan Zhang
- grid.411472.50000 0004 1764 1621Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034 China
| | - Jianping Li
- grid.411472.50000 0004 1764 1621Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034 China
| | - Xianhui Qin
- grid.416466.70000 0004 1757 959XNational Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Binyan Wang
- grid.186775.a0000 0000 9490 772XInstitute of Biomedicine, Anhui Medical University, Hefei, China
| | - Xiping Xu
- grid.416466.70000 0004 1757 959XNational Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China ,grid.22935.3f0000 0004 0530 8290Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Fanfan Hou
- grid.416466.70000 0004 1757 959XNational Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research; Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Genfu Tang
- grid.252245.60000 0001 0085 4987School of Health Administration, Anhui University, Hefei, China
| | - Rongfeng Liao
- grid.412679.f0000 0004 1771 3402Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lishun Liu
- grid.12527.330000 0001 0662 3178Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
| | - Meiqing Huang
- Data Management Center, Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Xinlei Bai
- grid.254147.10000 0000 9776 7793China Pharmaceutical University, Nanjing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| | - Liu Yang
- Department of Ophthalmology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| |
Collapse
|
43
|
Yin XL, Zhang JP, Ye J, Huo Y, Li XX, Liu ZP, Liang XM. Changes in integrins αv and α5 with Nogo-A in the rat retina after optic nerve injury. Eur Rev Med Pharmacol Sci 2023; 27:935-941. [PMID: 36808339 DOI: 10.26355/eurrev_202302_31186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate whether integrin levels are associated with axon regeneration after central nervous system (CNS) injury. MATERIALS AND METHODS By using immunohistochemistry, we performed a detailed investigation of the changes in and colocalization of integrins αv and α5, with Nogo-A in the retina after optic nerve injury. RESULTS We confirmed that integrins αv and α5 were expressed in the rat retina and colocalized with Nogo-A. After optic nerve transection, we found that integrin α5 levels increased over 7 days, but integrin αv levels remained unchanged, while Nogo-A levels increased. CONCLUSIONS It seems that the inhibition of axonal regeneration by the Amino-Nogo-integrin signaling pathway may not occur via changes in integrin levels.
Collapse
Affiliation(s)
- X-L Yin
- Department of Ophthalmology, Department of Medical Administration, The 305 Hospital of PLA, Beijing, China.
| | | | | | | | | | | | | |
Collapse
|
44
|
Chen H, Cui Z, Lu W, Wang P, Wang J, Zhou Z, Zhang N, Wang Z, Lin T, Song Y, Liu L, Huang X, Chen P, Tang G, Duan Y, Wang B, Li J, Zhang Y, Huo Y, Zhang H, Xu X, Qin X, Yang Y. Geographical, Sex, Age, and Seasonal Differences in Serum Manganese Status Among Chinese Adults with Hypertension. Biol Trace Elem Res 2023; 201:41-50. [PMID: 35092579 DOI: 10.1007/s12011-022-03135-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/23/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Manganese (Mn) is an essential trace metal element required for optimal human health. However, few studies have assessed the Mn status in hypertensive patients, especially in China. Moreover, factors associated with Mn status have not yet been thoroughly explored. Therefore, we aimed to assess the serum Mn status of adults with hypertension in China and its association with demographic factors. METHODS An observational, cross-sectional study was conducted to assess serum Mn concentrations in 14 provinces of China. A total of 2597 patients with hypertension were randomly identified by sex, age, and district, and serum Mn concentrations were quantified using inductively coupled plasma mass spectrometry (ICP-MS). RESULTS In our study population, the median serum Mn levels were 1.60 (interquartile range (IQR), 0.94-2.85) µg/L for males and 1.51 (IQR, 0.86-2.69) µg/L for females. In adjusted linear regression models, significantly higher serum Mn concentrations were found in summer (compared with spring, β, 1.06 µg/L, 95% CI: 0.62 to 1.50), and those living in Guangxi (compared with Heilongjiang, β, 0.81, 95% CI: 0.06 to 1.56), Shanxi (compared with Heilongjiang, β, 0.75, 95% CI: 0.01 to 1.50), and Liaoning (compared with Heilongjiang, β, 1.65, 95% CI: 0.91 to 2.38), and significantly lower serum Mn concentrations were found in patients who aged 60-70 years (compared with those aged < 60 years, β, - 0.40 μg/L, 95% CI: - 0.76 to - 0.05). CONCLUSION Our findings observed high serum Mn status among Chinese adults with hypertension, and revealed the association between terms of age, region, and season with serum Mn.
Collapse
Affiliation(s)
- Hong Chen
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, 518106, China
| | - Zhixin Cui
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, 518106, China
| | - Wenhai Lu
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, 518106, China
- Pingdi Public Health Service Center, Shenzhen, 518117, China
| | - Ping Wang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, 518106, China
| | - Jia Wang
- Department of Cardiovascular Medicine, Binzhou Medical University Hospital, Binzhou, 256603, China
| | - Ziyi Zhou
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, 518055, China
- Shenzhen Evergreen Medical Institute, Shenzhen, 518057, China
| | - Nan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Zhuo Wang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
| | - Tengfei Lin
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
- College of Pharmacy, Jinan University, Guangzhou, 510630, China
| | - Yun Song
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Lishun Liu
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, 518055, China
- Shenzhen Evergreen Medical Institute, Shenzhen, 518057, China
| | - Xiao Huang
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Ping Chen
- College of Pharmacy, Jinan University, Guangzhou, 510630, China
| | - Genfu Tang
- School of Heath Administration, Anhui Medical University, Hefei, 230032, China
| | - Yong Duan
- Yunnan Key Laboratory of Laboratory Medicine, Kunming, 650032, China
- Department of Clinical Laboratory, the First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China
| | - Binyan Wang
- Shenzhen Evergreen Medical Institute, Shenzhen, 518057, China
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Hao Zhang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
| | - Xiping Xu
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Xianhui Qin
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China.
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Yan Yang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, 518106, China.
- Guangdong Provincial Key Laboratory of Food, Guangdong Province, Nutrition and Health, Guangzhou, 510080, China.
- Guangdong Provincial Engineering Laboratory for Nutrition Translation, Guangdong Province, Guangzhou, 510080, China.
| |
Collapse
|
45
|
Gao L, Ma W, Li M, Yang Y, Qi L, Zhang B, Wang C, Zhang Y, Huo Y. Association between basal septal hypertrophy and left ventricular geometry in a community population. BMC Cardiovasc Disord 2022; 22:579. [PMID: 36587201 PMCID: PMC9805678 DOI: 10.1186/s12872-022-03004-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 12/12/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Left ventricular (LV) geometry is closely associated with cardiovascular disease; however, few studies have evaluated the relationship between basal septal hypertrophy (BSH) and LV geometry. In this study, we examined the relationship between BSH and LV geometry in a Beijing community population. METHODS The clinical and echocardiographic data of 1032 participants from a community in Beijing were analyzed. BSH was defined as a basal interventricular septal thickness ≥ 14 mm and a basal septal thickness/mid-septal thickness ≥ 1.3. On the basis of their echocardiographic characteristics, patients were described as having a normal geometry, concentric remodeling, concentric hypertrophy, or eccentric hypertrophy. Multivariable logistic regression was used to analyze the relationship between BSH, LV mass index (LVMI), and relative wall thickness (RWT). RESULTS The prevalence of BSH was 7.4% (95% confidence interval [CI] 5.8-9.0%). Basal and middle interventricular septal thickness, LV posterior wall thickness, and RWT were greater, while LVMI and LV end-diastolic dimension were lower in the BSH group than in the non-BSH group (p < 0.05). The BSH group accounted for the highest proportion of patients with concentric remodeling. A multivariable regression analysis showed that BSH increased by 3.99-times (odds ratio [OR] 3.99, 95% CI 2.05-7.78, p < 0.01) when RWT was > 0.42, but not when LVMI increased (OR 0.16, 95% CI 0.02-1.19, p = 0.07). There were no interactions between BSH and age, body mass index, sex, diabetes mellitus, coronary heart disease, stroke, and smoking in relation to an RWT > 0.42. CONCLUSION BSH was independently associated with an RWT > 0.42.
Collapse
Affiliation(s)
- Lan Gao
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.411472.50000 0004 1764 1621Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Wei Ma
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.411472.50000 0004 1764 1621Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Min Li
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China
| | - Ying Yang
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.411472.50000 0004 1764 1621Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Litong Qi
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.411472.50000 0004 1764 1621Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Baowei Zhang
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.411472.50000 0004 1764 1621Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking University First Hospital, Beijing, China
| | - Chonghui Wang
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China
| | - Yan Zhang
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Yong Huo
- grid.411472.50000 0004 1764 1621Division of Cardiology, Department of Cardiovascular Disease, Peking University First Hospital, Dahongluochang Street, Xicheng District, Beijing, 100034 China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| |
Collapse
|
46
|
Lu Q, Zhang JN, Huo Y, Xia Q, Jiao JY, Li M. [Susceptibility and mechanism of sodium salicylate-induced tinnitus model in low estrogen rats]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:1479-1483. [PMID: 36707953 DOI: 10.3760/cma.j.cn115330-20220322-00125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Objective: The susceptibility of tinnitus rats with low estrogen level induced by sodium salicylate and the changes of tumor necrosis factor α (TNF-α) in serum were observed to investigate the relationship between tinnitus occurrence and estrogen level. Methods: Forty-two healthy female Wistar rats were randomly divided into control group(n=6), normal group(n=6), sham operation group(n=6) and ovariectomized group(n=24). Control group was intraperitoneally injected with normal saline 200 mg/kg for 14 consecutive days. Normal group, sham operation group and ovariectomized group were intraperitoneally injected with sodium salicylate 200 mg/kg for 14 consecutive days. Before and after sodium salicylate induction, the tinnitus behavior of rats in each group was detected by prepulse inhibition (PPI) and gap pre-pulse inhibition of the acoustic startle (GPIAS) test. Before and after sodium salicylate induction, blood samples were collected from eyeballs of rats in each group, and serum levels of estradiol and TNF-α were detected by ELISA. SPSS 25.0 software was used to analyze the data. Results: (1) Following 14 days of sodium salicylate intervention, there was no significant difference in PPI inhibition rate between groups or within groups(all P>0.05). (2)There was no significant difference in the inhibition rate of GPIAS in the four groups before sodium salicylate injection(F=0.217, P>0.05). With sodium salicylate injected for 14 days, the inhibition rate of GPIAS in ovariectomized group (30.88%±15.40%) was significantly lower than that in the other three groups (44.11%±21.06%, 38.27%±10.92%, 51.59%±11.34%), and the difference was statistically significant(F=3.533, P<0.05). The inhibition rate of GPIAS in ovariectomized group with sodium salicylate injected for 14 days was significantly lower than that before injection, and the difference was statistically significant(t=2.977, P<0.05).There was no significant difference in GPIAS inhibition rate between the other three groups before and after sodium salicylate injection(P>0.05). (3)The level of TNF-α in ovariectomized rats was significantly higher than that in the other three groups, the difference was statistically significant(all P<0.05). With sodium salicylate injection for 14 days, TNF-α level in the ovariectomized group increased more significantly than that in the other three groups, the difference was statistically significant(F=8.045, P<0.05). TNF-α levels increased following salicylate injection in normal group, sham operation group and ovariectomized group, and the differences were statistically significant(t value was -4.843, -4.932 and -5.965 respectively, each P<0.05). There was no significant difference in TNF-α levels before and after normal saline injection in control group(all P>0.05). Conclusion: Low estrogen levels increase susceptibility to sodium salicylate-induced tinnitus. Decreased estrogen levels may increase susceptibility to tinnitus through the increased expression of pro-inflammatory factor TNF-α.
Collapse
Affiliation(s)
- Q Lu
- Department of Otolaryngology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - J N Zhang
- Department of Otolaryngology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Y Huo
- Department of Otolaryngology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Q Xia
- Department of Otolaryngology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - J Y Jiao
- Department of Otolaryngology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - M Li
- Department of Otolaryngology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| |
Collapse
|
47
|
Wang W, Li J, Liu Y, Ye P, Xu C, Yin P, Liu J, Qi J, You J, Lin L, Song Z, Wang L, Wang L, Huo Y, Zhou M. Spatiotemporal trends and ecological determinants of cardiovascular mortality among 2844 counties in mainland China, 2006-2020: a Bayesian modeling study of national mortality registries. BMC Med 2022; 20:467. [PMID: 36451190 PMCID: PMC9714200 DOI: 10.1186/s12916-022-02613-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/17/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death in China. No previous study has reported CVD mortality at county-level, and little was known about the nonmedical ecological factors of CVD mortality at such small scale in mainland China. Understanding the spatiotemporal variations of CVD mortality and examining its nonmedical ecological factors would be of great importance to tailor local public health policies. METHODS By using national mortality registration data in China, this study used hierarchical spatiotemporal Bayesian model to demonstrate spatiotemporal distribution of CVD mortality in 2844 counties during 2006 to 2020 and investigate how nonmedical ecological determinants have affected CVD mortality inequities from the spatial perspectives. RESULTS During 2006-2020, the age-standardized mortality rate (ASMR) of CVD decreased from 284.77 per 100,000 in 2006 to 241.34 per 100,000 in 2020. Among 2844 counties, 1144 (40.22%) were hot spots counties with a higher CVD mortality risk compared to the national average and located mostly in northeast, north central, and westernmost regions; on the contrary, 1551 (54.53%) were cold spots counties and located mostly in south and southeast coastal counties. CVD mortality risk decreased from 2006 to 2020 was larger in counties where CVD mortality rate had been higher in 2006 in most of the counties, vice versa. Nationwide, nighttime light intensity (NTL) was the major influencing factor of CVD mortality, a higher NTL appeared to be negatively associated with a lower CVD mortality, with one unit increase in NTL, and the CVD mortality risk will decrease 11% (relative risk of NTL was estimated as 0.89 with 95% confidence interval of 0.83-0.94). CONCLUSIONS Substantial between-county discrepancies of CVD mortality distribution were observed during past 15 years in mainland China. Nonmedical ecological determinants were estimated to significantly explain the overall and local spatiotemporal patterns of this CVD mortality risk. Targeted considerations are needed to integrate primary care with clinical care through intensifying further strategies to narrow unequally distribution of CVD mortality at local scale. The approach to county-level analysis with small area models has the potential to provide novel insights into Chinese disease-specific mortality burden.
Collapse
Affiliation(s)
- Wei Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Junming Li
- School of Statistics, Shanxi University of Finance and Economics, Taiyuan, Shanxi, China
| | - Yunning Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Pengpeng Ye
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China.,The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Chengdong Xu
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Jinlei Qi
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Jinling You
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Lin Lin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Ziwei Song
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, China.
| |
Collapse
|
48
|
Liu L, Zhang B, Yang Y, Qi L, Wang S, Meng L, Ma W, Huo Y. Reduced left atrial contractile strain with speckle tracking analysis predicts abnormal plasma NTproBNP in an asymptomatic community population. Cardiovasc Ultrasound 2022; 20:27. [PMID: 36434713 PMCID: PMC9701031 DOI: 10.1186/s12947-022-00297-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 10/30/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The left atrium (LA) is closely related to left ventricular diastolic function. Two-dimensional speckle tracking strain and strain rate (SR) imaging has been applied in the study of LA function. We intended to explore the relationship between global LA deformation parameters and plasma NTproBNP levels in asymptomatic community residents with normal ejection fraction and normal LA volume. METHODS A cross-sectional sample of Beijing residents underwent comprehensive Doppler echocardiography and medical record review in 2009. Global LA longitudinal strain and SR indexes were obtained in the apical four-chamber view. LA stiffness index (LASI) was calculated as the ratio of early diastolic velocity of transmitral flow/early diastolic mitral annular motion velocity (E/E') to LA reservoir strain. RESULTS A total of 620 individuals (mean age = 65.8 years, left ventricular ejection fraction = 70.8%, LA volume index = 17.9 ml/m2) were investigated in our study. 117 individuals had increased plasma NTproBNP (≥ 125 pg/ml). LA reservoir and contractile function by LA strain and SR indexes were significantly reduced in the abnormal NTproBNP group compared with the normal NTproBNP group. Multiple regression analysis indicated that LA contractile strain was a negative predictor of plasma NTproBNP in addition to indexed LA volume and E/E'. LASI was higher in the abnormal NTproBNP group and was significantly correlated with NTproBNP (r = 0.342, P < 0.001). The area under ROC analysis for LASI in predicting elevated plasma NTproBNP was 0.690, similar with LA contractile strain, E/E' and LAVI. The cut-off value of LASI was 0.612. CONCLUSIONS LA reservoir and contractile functions demonstrated by LA strain and SR were significantly impaired in the community-based population with increased plasma NTproBNP levels. LA contractile strain adds incremental information in predicting abnormal NTproBNP levels. As a single index, LASI showed similar diagnostic value with LAVI and E/E' in predicting abnormal NTproBNP.
Collapse
Affiliation(s)
- Lin Liu
- grid.411472.50000 0004 1764 1621Department of Cardiology, Central Laboratory of Echocardiography, Peking University First Hospital, No. 1, Dahongluochang Street, West District, Beijing, 100034 People’s Republic of China
| | - Baowei Zhang
- grid.411472.50000 0004 1764 1621Department of Cardiology, Central Laboratory of Echocardiography, Peking University First Hospital, No. 1, Dahongluochang Street, West District, Beijing, 100034 People’s Republic of China
| | - Ying Yang
- grid.411472.50000 0004 1764 1621Department of Cardiology, Central Laboratory of Echocardiography, Peking University First Hospital, No. 1, Dahongluochang Street, West District, Beijing, 100034 People’s Republic of China
| | - Litong Qi
- grid.411472.50000 0004 1764 1621Department of Cardiology, Central Laboratory of Echocardiography, Peking University First Hospital, No. 1, Dahongluochang Street, West District, Beijing, 100034 People’s Republic of China
| | - Shuo Wang
- grid.452694.80000 0004 0644 5625Department of Cardiology, Peking University Shougang Hospital, Beijing, China
| | - Lei Meng
- grid.411472.50000 0004 1764 1621Department of Cardiology, Central Laboratory of Echocardiography, Peking University First Hospital, No. 1, Dahongluochang Street, West District, Beijing, 100034 People’s Republic of China
| | - Wei Ma
- grid.411472.50000 0004 1764 1621Department of Cardiology, Central Laboratory of Echocardiography, Peking University First Hospital, No. 1, Dahongluochang Street, West District, Beijing, 100034 People’s Republic of China
| | - Yong Huo
- grid.411472.50000 0004 1764 1621Department of Cardiology, Central Laboratory of Echocardiography, Peking University First Hospital, No. 1, Dahongluochang Street, West District, Beijing, 100034 People’s Republic of China ,grid.512689.1Beijing Hypertension League Institute, Beijing, China
| |
Collapse
|
49
|
Liu B, Gao L, Zheng B, Yang Y, Jia J, Sun P, Jiang Y, Li K, Liu J, Chen C, Li J, Fan F, Zhang Y, Huo Y. Comparison of carotid-femoral and brachial-ankle pulse wave velocity in association with carotid plaque in a Chinese community-based population. J Clin Hypertens (Greenwich) 2022; 24:1568-1576. [PMID: 36428228 PMCID: PMC9731589 DOI: 10.1111/jch.14602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/20/2022] [Accepted: 11/04/2022] [Indexed: 11/28/2022]
Abstract
Pulse wave velocity (PWV) is the most widely used measurement of arterial stiffness in clinical practice. This study aimed to evaluate and compare the relationships between carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle PWV (baPWV) and the presence of carotid plaque. This study was designed cross-sectionally and included 6027 participants from a community-based cohort in Beijing. Logistic regression analyses were performed to evaluate and compare the associations of cfPWV and baPWV with the presence of carotid plaque. The mean (SD) cfPWV and baPWV were 8.55 ± 1.83 and 16.79 ± 3.36, respectively. The prevalence of carotid plaque was 45.26% (n = 2728). Both cfPWV (per 1 m/s increase: OR = 1.11, 95% CI: 1.07-1.16) and baPWV (OR = 1.04, 95% CI: 1.02-1.06) were independently associated with carotid plaque after adjusting for various confounders. Compared with bottom quartile (cfPWV ≤7.31 m/s and baPWV ≤14.44 m/s), the top quartile of cfPWV and baPWV had a significantly higher prevalence of carotid plaque (for cfPWV: OR = 1.59, 95% CI: 1.32-1.92; for baPWV: OR = 1.53, 95% CI: 1.26-1.86). However, the relationship of baPWV and carotid plaque was nonlinear, with a positive trend only when baPWV < 16.85 m/s. When comparing relationships between PWV indices and carotid plaque in one model, both cfPWV and baPWV were significantly associated with carotid plaque in participants with baPWV < 16.85 m/s; however, only cfPWV was independently associated with carotid plaque in participants with baPWV ≥16.85 m/s. Both cfPWV and baPWV were significantly associated with carotid plaque in the Chinese community-based population. Furthermore, cfPWV was more strongly correlated with carotid plaque than baPWV in participants with baseline baPWV ≥16.85 m/s.
Collapse
Affiliation(s)
- Bo Liu
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Lan Gao
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Bo Zheng
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Ying Yang
- Department of CardiologyPeking University First HospitalBeijingChina,Echocardiography Core LabInstitute of Cardiovascular Disease at Peking University First HospitalBeijingChina
| | - Jia Jia
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Pengfei Sun
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Yimeng Jiang
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Kaiyin Li
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Jiahui Liu
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Chuyun Chen
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Jianping Li
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Fangfang Fan
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Yan Zhang
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| | - Yong Huo
- Department of CardiologyPeking University First HospitalBeijingChina,Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina
| |
Collapse
|
50
|
Dong X, Ding F, Zhou S, Ma J, Li N, Maimaitiming M, Xu Y, Guo Z, Jia S, Li C, Luo S, Bian H, Luobu G, Yuan Z, Shi H, Zheng ZJ, Jin Y, Huo Y. Optimizing an Emergency Medical Dispatch System to Improve Prehospital Diagnosis and Treatment of Acute Coronary Syndrome: Nationwide Retrospective Study in China. J Med Internet Res 2022; 24:e36929. [DOI: 10.2196/36929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 10/04/2022] [Accepted: 10/20/2022] [Indexed: 11/24/2022] Open
Abstract
Background
Acute coronary syndrome (ACS) is the most time-sensitive acute cardiac event that requires rapid dispatching and response. The medical priority dispatch system (MPDS), one of the most extensively used types of emergency dispatch systems, is hypothesized to provide better-quality prehospital emergency treatment. However, few studies have revealed the impact of MPDS use on the process of ACS care.
Objective
This study aimed to investigate whether the use of MPDS was associated with higher prehospital diagnosis accuracy and shorter prehospital delay for patients with ACS transferred by an emergency medical service (EMS), using a national database in China.
Methods
This retrospective analysis was based on an integrated database of China’s MPDS and hospital registry. From January 1, 2016, to December 31, 2020, EMS-treated ACS cases were divided into before MPDS and after MPDS groups in accordance with the MPDS launch time at each EMS center. The primary outcomes included diagnosis consistency between hospital admission and discharge, and prehospital delay. Multivariable logistic regression and propensity score–matching analysis were performed to compare outcomes between the 2 groups for total ACS and subtypes.
Results
A total of 9806 ACS cases (3561 before MPDS and 6245 after MPDS) treated by 43 EMS centers were included. The overall diagnosis consistency of the after MPDS group (Cohen κ=0.918, P<.001) was higher than that of the before MPDS group (Cohen κ=0.889, P<.001). After the use of the MPDS, the call-to-EMS arrival time was shortened in the matched ACS cases (20.0 vs 16.0 min, P<.001; adjusted difference: –1.67, 95% CI –2.33 to –1.02; P<.001) and in the subtype of ST-elevation myocardial infarction (adjusted difference: –3.81, 95% CI –4.63 to –2.98, P<.001), while the EMS arrival-to-door time (20.0 vs 20.0 min, P=.31) was not significantly different in all ACS cases and subtypes.
Conclusions
The optimized use of MPDS in China was associated with increased diagnosis consistency and a reduced call-to-EMS arrival time among EMS-treated patients with ACS. An emergency medical dispatch system should be designed specifically to fit into different prehospital modes in the EMS system on a regional basis.
Collapse
|