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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2010年第8期11卷 548-552页

作者： Xin DU Jun-ping KANG Jia-hui WU Qiang LV Chao-shu TANG chang-sheng ma Cardiovascular Division Beijing Anzhen Hospital Copital Medical University Beijing 100029 China Department of Physiology and Pathophysiology School of Basic Medical Sciences Peking University Beijing 100083 China

Objective:Percutaneous coronary intervention(PCI) triggers an acute inflammatory response,while sirolimus is known to have anti-inflammatory properties;the inflammatory system response to PCI after sirolimus-eluting stent placement remains unclear.The purpose of this study is to determine the changes in high sensitive C-reactive protein(hs-CRP) and apelin after PCI procedure and drug-eluting stent implantation in patients with and without reduced left ventricular systolic function.Methods:Forty-eight consecutive patients undergoing PCI at the Beijing Anzhen Hospital between July and September 2006 were recruited.Sirolimus-eluting stents were employed in all patients.Blood samples were drawn immediately before and 24 h after the procedure.Plasma hs-CRP and apelin levels were determined by enzyme immunoassay.Results:Paired t-test revealed a significant increase in both hs-CRP and apelin post-procedure(P=0.006 and Pmal ventricular function [(46.8±10.8) vs.(72.0±8.4) pg/ml,Pmal left ventricular systolic function 24 h after the PCI procedure [(86.7±11.6) vs.(85.1±6.1) pg/ml,P=0.72].Conclusions:hs-CRP and apelin levels increased after PCI and sirolimus-eluting stent implantation.Patients with impaired left ventricular systolic function had significantly lower baseline apelin levels,which increased significantly after PCI.

关键词： apelin C反应蛋白冠状动脉组织支架洗脱植入药物

Scientific statement of the Chinese Society of Cardiology(CSC) on using of renin angiotensin system blockers in patients with cardiovascular disease and COVID-19

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Journal of Geriatric Cardiology 2020年第5期17卷 241-242页

作者： Ya-Ling HAN Yu-Ming LI chang-sheng ma the Editorial Board of Chinese Journal of Cardiology 无不详 the Chinese Society of Cardiology

The coronavirus disease 2019(COVID-19), which is caused by SARS-CoV-2, has become a worldwide public health crisis. Published clinical data from China and other countries have shown a much higher risk of developing COVID-19 and dying from the disease among the elderly, especially among those who had preexisting hypertension, cardiovascular diseases(CVD) and diabetes mellitus[1].

关键词： Angiotensin converting enzyme Cardiovascular disease COVID-19 Scientific statement

Unfractionated Heparin with Sequential Enoxaparin in Patients with Complex Coronary Artery Lesions during Percutaneous Coronary Intervention

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Chinese Medical Journal 2018年第20期131卷 2417-2423页

作者： Zhi-Zhong Li Ying Tao Su Wang Cheng-Qian Yin Yu-Long Gao Yu-Tong Cheng Zhao Li chang-sheng ma Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China

Background： Unfractionated heparin （UFH）, despite its limitations, has been used as the primary anticoagulant alternative during the percutaneous coronary intervention （PCI）. Some studies indicated that intravenous enoxaparin could be an effective and safe option. Our team used enoxaparin alone at one time according to the guidelines （Class IIA） and found a little catheter thrombosis during PCI. We recommend a new anticoagulation strategy using enoxaparin in combination with UFH. Enoxaparin has a more predictable anticoagulant response with no need of repeatedly monitoring anticoagulation during PCI. This retrospective study aimed to evaluate the efficacy and safety of using enoxaparin in combination with UFH in PCI patients with complex coronary artery disease. Methods： Between January 2015 and April 2017, 600 PCI patients who received intravenous UFH at an initial dose of 3000 U plus intravenous enoxaparin at a dose of 0.75 mg/kg （observation group） and 600 PCI patients who received UFH at a dose of 100 U/kg （control group） were consecutively included in this retrospective study. The endpoints were postoperative 48-h thrombolysis in myocardial infarction （TIMI） bleeding and transfusion and 30-day and l-year major adverse cardio-cerebrovascular events （maCCE）. Results： Baseline clinical, angiographic, and procedural characteristics were similar between groups, except there was less stent implantation per patient in the observation group （2.13 vs. 2.25 in the control group, P = 0.002）. TIMI bleeding （3.3% vs. 4.7%） showed no significant difference between the observation group and control group. During the 30-day follow-up, the rate of maCCE was 0.9% in the observation group and 1.5% in the control group. There was no significant difference in the rates of maCCE, death, myocardial infarction, target vessel revascularization, cerebrovascular event, and angina within 30 days and 1 year after PC1 between groups as well as in the subgroup analysis of transfemoral approach. Conclusions： UFH with sequential enoxaparin

关键词： Complex Coronary Heart Disease Enoxaparin Percutaneous Coronary Intervention Unfractionated Heparin

The Use of Direct Oral Anticoagulants for Prevention of Stroke and Systemic Embolic Events in East Asian Patients with Nonvalvular Atrial Fibrillation

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Cardiovascular Innovations and Applications 2018年第B7期3卷 215-226页

作者： chang-sheng ma Department of Cardiology Beijing AnZhen HospitalCapital Medical UniversityBeijingChina

As patients in East Asia age,the prevalence of age-related and chronic disease,including nonvalvular atrial fibrillation,may increase.Although warfarin has been the primary choice of anticoagulant for the prevention of stroke and systemic embolic events,the use of direct oral anticoagulants(DOACs)is increasing.DOACs do not require monitoring of the international normalized ratio to determine the optimal dose,and have a lower potential for food and drug interactions,improved benefi t-risk profiles,and a quicker onset and offset of action relative to warfarin.The pivotal phase 3 trials for each of the DOACs– dabigatran,rivaroxaban,apixaban,and edoxaban– included at least some East Asian patients.Additionally,several clinical trials were conducted specifically for East Asian patients.This review discusses patterns and predictors of anticoagulant use in East Asian patients with nonvalvular atrial fibrillation,summarizes current guideline recommendations for East Asian patients,details the primary results demonstrating the safety and efficacy of DOACs in East Asian patients relative to non– East Asian patients,provides real-world data supporting the phase 3 testing results,and addresses the clinical profile of DOACs in East Asian populations,including patients at high risk of stroke.

关键词： anticoagulant direct oral anticoagulant East Asia stroke

Whether Warfarin Therapy is Associated with Damage on Renal Function in Chinese Patients with Nonvalvular Atrial Fibrillation

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Chinese Medical Journal 2016年第10期129卷 1135-1139页

作者： Yu Kong Xin Du Ri-Bo Tang Ting Zhang Xue-Yuan Guo Jia-Hui Wu Shi-Jun Xia chang-sheng ma Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Background： Warfarin is the most common oral anticoagulant to decrease the stroke risk associated with atrial fibrillation （AF）. There are very few prospective studies that have explored whether warfarin has an association with damage on renal function in Chinese patients with nonvalvular AF （NVAF）. The aim of this study was to evaluate the effects of warfarin on renal function and study the factors associated with kidney dysfunction in Chinese adult NVAF patients without dialysis therapy. Methods： From January 2011 to December 2013, a total of 951 NVAF patients from 18 hospitals were enrolled. The estimated glomerular filtration rate （eGFR） was calculated from baseline and fbllow-up serum creatinine levels. Kaplan-Meier survival curves compared the survival of a 〉25% decline in eGFR （hereafter, endpoint）~ while Cox models estimated hazard ratios （HRs） and 95% confidence intervals for this event after adjustment for age, gender, and selected potential risk factors for renal dysfunction. Cox regression analysis of the various clinical potential variables was performed to identify the predictors of a -〉25% decline in eGFR. Results： After a 58-month follow-up, 951 NVAF patients were divided by observation into warfarin （n = 655） and no anticoagulation groups （n = 296） and 120 （12.6%） patients experienced renal endpoint. Kaplan-Meier survival curves showed that the survival period was not different in the two groups （χ2 = 0.178, log-rank P = 0.67）, but patients with systolic blood pressure （SBP）〈140 mmHg have significant difference with patients with SBP ≥140 mmHg （χ2 = 4.903, log-rank P = 0.03）. Multivariate Cox regression analysis revealed baseline eGFR and SBP as independent predictors of the endpoint, with HRs of 1.00, and 1.02, respectively. Conclusion： In patients with NVAF, eGFR and SBP are associated with the deterioration of kidney function while Warfarin is not the risk factor of the ≥25% decline in eGFR.

关键词： Anticoagulation Estimated Glomerular Filtration Rate： Nonvalvular Atrial Fibrillation Renal Function Warfarin

In-hospital direct costs for thromboembolism and bleeding in Chinese patients with atrial fibrillation

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Chronic Diseases and Translational Medicine 2018年第2期4卷 127-134页

作者： San-Shuai chang Jia-Hui Wu Yi Liu Ting Zhang Xin Du Jian-Zeng Dong Gregory Y.H. Lip chang-sheng ma Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijing 100029China Department of Cardiology Xuzhou Center HospitalXuzhouJiangsu 221000China University of Birmingham Institute of Cardiovascular Sciences City HospitalBirmingham B18 7QHUnited Kingdom

Objective: Limited data are available on the direct costs of hospitalization owing to thromboembolism and bleeding in patients with atrial fibrillation (AF) in China. Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic strategies. This study aimed to provide detailed data regarding in-hospital direct costs for these pa-tients, compare the costs at different scenarios, and identify independent factors that may predict the costs. Methods: We collected data regarding in-hospital direct costs among patients with AF who were hospitalized owing to ischemic stroke (IS), transient ischemic attack (TIA), intracranial hemorrhage (ICH), or major gastrointestinal bleeding. All data were collected from 7 representative tertiary referral hospitals and 3 secondary care hospitals from December 2009 to October 2014. Results: In total, 312 eligible patients with thromboembolism and 143 patients with major bleeding were identified, and their hospital charts were reviewed. The median in-hospital direct costs were 17,857 Chinese Yuan (CNY) for IS and 16,589 CNY for TIA (equivalent to 2907 US dollars and 2701 US dollars, respectively). For patients with major bleeding, the costs were 27,924 CNY for ICH and 18,196 CNY for major gastrointestinal bleeding (equivalent to 4546 US dollars and 2962 US dollars, respec-tively). The direct costs were mainly driven by medications, which accounted for approximately 33.4%-36.1% in different groups of patients. The direct costs were highly related to the hospital level and National Institutes of Health Stroke Scale scores in patients with thromboembolism; in patients with ICH, the factors included hospital level, warfarin treatment before admission, and prior hospitalization for stroke. Conclusions: Given the high prevalence, AF-related thromboembolism and bleeding impose considerable economic burden on the Chinese society. Efforts to improve the management of AF may confer substantial economic benefits.

关键词： Atrial fibrillation Ischemic stroke Bleeding In-hospital direct costs

Reversal of pulmonary vein remodeling after catheter ablation of atrial fibrillation

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Journal of Geriatric Cardiology 2016年第2期13卷 163-168页

作者： Jia-Hui WU Hung-Kei LI Daniel M Couri Philip A Araoz Ying-Hsiang Lee chang-sheng ma Douglas L Packer Yong-Mei CHA Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing China Heart Rhythm Specialists Phoenix Arizona USA Prairie Cardiovascular Consultants Ltd. Springfield Illinois USA Department of Radiology Mayo Clinic Rochester Minnesota USA Department of Cardiovascular Medicine Mackay Memorial Hospital Taipei Taiwan China Division of Cardiovascular Diseases Mayo Clinic Rochester Minnesota USA

BackgroundPulmonary 静脉(PV ) 和正厅经历电、结构在 atrial 纤维性颤动(AF ) 改变。试图决定 PV 和在为 AF 的导管脱离用胸估计了以后，改变的左 atrial (LA ) 颠倒的这研究计算了 .MethodsPV electrophysiologic 学习的断层摄影术(C... 详细信息

BackgroundPulmonary 静脉(PV ) 和正厅经历电、结构在 atrial 纤维性颤动(AF ) 改变。试图决定 PV 和在为 AF 的导管脱离用胸估计了以后，改变的左 atrial (LA ) 颠倒的这研究计算了 .MethodsPV electrophysiologic 学习的断层摄影术(CT ) ，导管脱离在 63 个病人被执行(68% 男性；吝啬的 ±；SD 年龄：56 ±；10 年) 与征兆的 AF (49% 发作性， 51% 坚持) 。胸 CT 以前被执行并且在导管 ablation.ResultsAt 基线以后的 3 个月，有坚持的 AF 的病人有更大的 LA 体积(91 ±；29 厘米 3 对 66 ±；27 厘米 3 ；P = 0.003 ) 并且吝啬的 PV ostial 区域(241 ±；43 公里 2 对 212 ±；47 公里 2 ；P = 0.03 ) 比有发作性的 AF 的病人。在有效倔强的时期和左优异 PV 口的区域之间没有重要关联。在 3 月在脱离以后的后续， 48 个病人(76%) 是在上或离开 antiarrhythmic 药免费的 AF。在 LA 体积有重要减小(77 ±；31 厘米 3 到 70 ±；28 厘米 3 ；P <；0.001 ) 并且吝啬的 PV ostial 区域(224 ±；48 公里 2 到 182 ±；43 公里 2 ；P <；0.001 ) 。有坚持的 AF 的病人在 LA 体积有更多的减小(11.8 ±；12.8 厘米 3 对 4.0 ±；11.2 厘米 3 ；P = 0.04 ) 并且 PV ostial 区域(62 公里 2 对 34 公里 2 ；P = 0.04 ) 比有发作性的 AF 的那些。平均 PV ostial 区域的减小显著地与 LA 体积的减小被相关(r = 0.38， P = 0.03 ) AF 的 .ConclusionsCatheter 脱离改进 PV ostia 和左中庭的结构的改变。这发现在病人是更明显的，坚持的 AF 由导管脱离对待。

关键词：胸导管肺静脉重构心房颤动逆转药物治疗抗心律失常

Catheter ablation versus medical therapy for atrial fibrillation with prior stroke history:a prospective propensity score-matched cohort study

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Journal of Geriatric Cardiology 2023年第10期20卷 707-715,I0006页

作者： Wen-Li DAI Zi-Xu ZHAO Chao JIANG Liu HE Ke-Xin YAO Yu-Feng WANG Ming-Yang GAO Yi-Wei LAI Jing-Rui ZHANG Ming-Xiao LI Song ZUO Xue-Yuan GUO Ri-Bo TANG Song-Nan LI Chen-Xi JIANG Nian LIU De-Yong LONG Xin DU Cai-Hua SANG Jian-Zeng DONG chang-sheng ma Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityNational Clinical Research Center for Cardiovascular DiseasesBeijingChina Heart Health Research Center BeijingChina Department of Cardiovascular Medicine the First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina

BACKGROUND Patients with atrial fibrillation(AF)and prior stroke history have a high risk of cardiovascular events despite anticoagulation therapy.It is unclear whether catheter ablation(CA)has further benefits in these patients.METHODS AF patients with a previous history of stroke or systemic embolism(SE)from the prospective Chinese Atrial Fibrillation Registry study between August 2011 and December 2020 were included in the analysis.Patients were matched in a 1:1 ratio to CA or medical treatment(MT)based on propensity score.The primary outcome was a composite of all-cause death or ischemic stroke(IS)/SE.RESULTS During a total of 4.1±2.3 years of follow-up,the primary outcome occurred in 111 patients in the CA group(3.3 per 100 person-years)and in 229 patients in the MT group(5.7 per 100 person-years).The CA group had a lower risk of the primary outcome compared to the MT group[hazard ratio(HR)=0.59,95%CI:0.47–0.74,P<0.001].There was a significant decreasing risk of all-cause mortality(HR=0.43,95%CI:0.31–0.61,P<0.001),IS/SE(HR=0.73,95%CI:0.54–0.97,P=0.033),cardiovascular mortality(HR=0.32,95%CI:0.19–0.54,P<0.001)and AF recurrence(HR=0.33,95%CI:0.30–0.37,P<0.001)in the CA group compared to that in the MT group.Sensitivity analysis generated consistent results when adjusting for time-dependent usage of anticoagulants.CONCLUSIONS In AF patients with a prior stroke history,CA was associated with a lower combined risk of all-cause death or IS/SE.Further clinical trials are warranted to confirm the benefits of CA in these patients.

关键词： prospective fibrillation matched

Improved myocardial perfusion and cardiac function by controlled-release basic fibroblast growth factor using fibrin glue in a canine infarct model

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2010年第12期11卷 895-904页

作者： Shao-ping NIE Xiao WANG Shi-bin QIAO Qiu-tang ZENG Ju-quan JIANG Xiao-qing LIU Xiang-ming ZHU Guo-xiang CAO chang-sheng ma Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China Union Hospital of Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China

Objective: Angiogenic therapy is emerging as a potential strategy for the treatment of ischemic heart disease but is limited by a relatively short half-life of growth factors.Fibrin glue (FG) provides a reservoir for controlledrelease of growth factors.The aim of this study was to evaluate the effects of basic fibroblast growth factor (bFGF) incorporating FG on angiogenesis and cardiac performance in a canine infarct model.Methods: Acute myocardial infarction was induced by ligation of the left anterior descending coronary artery (LAD).Group I (n=6) underwent ligation of LAD alone.In Group II,transmural channels were created in the infarct area (n=6).In Group III,nontransmural channels were created to locate FG cylinders containing bFGF (n=6).Eight weeks after operation,myocardial perfusion was assessed by single photon emission computed tomography,cardiac function by echocardiography,and vascular development by immunohistochemical staining.Results: Total vascular density and the number of large vessels (internal diameter ≥50 μm) were dramatically higher in Group III than in Groups I and II at eight weeks.Only the controlled-release group exhibited an improvement in regional myocardial perfusion associated with lower defect score.Animals in Group III presented improved cardiac regional systolic and diastolic functions as well as global systolic function in comparison with the other two groups.Conclusions: Enhanced and sustained angiogenic response can be achieved by controlled-release bFGF incorporating FG within transmyocardial laser channels,thus enabling improvement in myocardial perfusion and cardiac function.

关键词： Angiogenesis 基本成纤维细胞生长因素控制版本 Ischemic 心疾病

Chronic kidney disease and risks of adverse clinical events in patients with atrial fibrillation

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Journal of Geriatric Cardiology 2021年第11期18卷 867-876页

作者： Si-Tong LI Chao JIANG Liu HE Qi-Fan LI Zuohan DING Jia-Hui WU Rong HU Qiang LV Xu LI chang-Qi JIA Yan-Fei RUAN man NING Li FENG Rong BAI Ri-Bo TANG Xin DU Jian-Zeng DONG chang-sheng ma Department of Cardiology Beijing Anzhen HospitalCapital Medical University and National Clinical Research Center for Cardiovascular DiseasesBeijingChina University of Edinburgh EdinburghUK Heart Health Research Centre BeijingChina

BACKGROUND Chronic kidney disease(CKD)is highly prevalent in patients with atrial fibrillation(AF).However,the asso-ciation between CKD and clinical consequences in AF patients is still under debate.METHODS We included 19,079 nonvalvular AF patients with available estimated glomerular filtration rate(eGFR)values in the Chinese Atrial Fibrillation Registry from 2011 to 2018.Patients were classified into no CKD(eGFR≥90 mL/min per 1.73 m2),mild CKD(60≤eGFRmajor bleeding,and cardiovascular mortality were estimated with Fine-Gray regression analysis according to CKD status.Cox regression was performed to assess the risk of all-cause mortal-ity associated with CKD.RESULTS Over a mean follow-up of 4.1±1.9 years,there were 985 thromboembolic events,414 major bleeding events,956 car-diovascular deaths,and 1,786 all-cause deaths.After multivariate adjustment,CKD was not an independent risk factor of throm-boembolic events.As compared to patients with no CKD,those with mild CKD,moderate CKD,and severe CKD had a 45%,47%,and 133%higher risk of major bleeding,respectively.There was a graded increased risk of cardiovascular mortality associated with CKD status compared with no CKD group:adjusted hazard ratio[HR]was 1.34(95%CI:1.07−1.68,P=0.011)for mild CKD group,2.17(95%CI:1.67−2.81,Pmajor bleeding and mortality,but didn’t seem to be an independent predictor of thromboembolism in AF patients.

关键词： patients mortality clinical