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Association between non-alcoholic fatty liver disease and coronary artery disease severity

Chinese Medical Journal 2011年第6期124卷 867-872页

作者： SUN Ling lu shu-zheng Department of Cardiology Fushun Central Hospital FushunLiaoning 113006 China Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Background Both non-alcoholic fatty liver disease （NAFLD） and coronary artery disease （CAD） are closely associated with many metabolic disorders. Invasive coronary angiography （CAG） is a common approach as an intervention for ***, the association between angiographic severity of coronary artery and NAFLD remains controversial. This study aimed to evaluate the relationship between NAFLD and *** Totally 542 consecutive patients who planned to undergo CAG due to a suspected CAD were *** computed tomography （CT） was performed before angiography to detect NAFLD. CAD was defined as stenosis of at least 50% in at least one major coronary artery. The severity of CAD was assessed by the number of vessels affected and the vessel score multiplied by the severity score （Gensini score）. Significant stenosis was defined as 70% or greater reduction in lumen diameter. A probability value of P 〈0.05 was considered statistically *** Of 542 patients studied, 248 （45.8%） were found to have NAFLD by abdominal CT, and 382 patients （88%）were found to have significant CAD by CAG. Age, diabetes mellitus, waist circumference, body mass index, and obesity were associated with NAFLD. According to the results of Logistic regression analysis, the presence of NAFLD independently increased the risk for CAD, as seen in CAG （odds ratio （OR）, 95% confidence interval （CI）： 7.585（4.617-12.461）; P 〈0.001）. NAFLD was significantly more common in patients as CAD severity increased （P〈0.001）.Conclusions The presence of NAFLD is associated with high severity of CAD, requiring that patients with abdominal obesity be also investigated for NAFLD. Patients with NAFLD should be closely followed up for the presence and severity of CAD.

关键词： non-alcoholic fatty liver disease coronary artery disease computed tomography

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Effectiveness of Integrative Medicine Therapy on Coronary Artery Disease Prognosis: A Real-World Study

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Chinese Journal of Integrative Medicine 2019年第1期25卷 9-15页

作者： ZHAO Kang TIAN Jin-fan ZHAO Cong YUAN Fei GAO Zhu-ye LI Li-zhi LIU Hong-xu WANG Xian GE Chang-jiang lu shu-zheng Department of Cardiology Beijing Anzhen Hospital Affiliated to Capital Medical University-Beijing Institute of Heart Lung and Blood Vessel Diseases Center for Cardiovascular Diseases Xiyuan Hospital China Academy of Chinese Medical Sciences Department of Cardiology Beijing Chinese Medicine Hospital Affiliated to Capital Medical University Department of Cardiology Dongzhimen Hospital Affiliated to Beijing University of Traditional Chinese Medicine

Objective: To evaluate the effectiveness of integrative medicine(IM) on patients with coronary artery disease(CAD) and investigate the prognostic factors of CAD in a real-world setting. Methods: A total of 1,087 hospitalized patients with CAD from four hospitals in Beijing, China were consecutively selected between August 2011 and February 2012. The patients were assigned to two groups based on the treatment: Chinese medicine(CM) plus conventional treatment, i.e., IM therapy(IM group); or conventional treatment alone(CT group). The endpoint was major adverse cardiac events [MACE; including cardiac death, myocardial infarction(MI), and revascularization]. Results: A total of 1,040 patients finished the 2-year follow-up. Of them, 49.4%(514/1,040) received IM therapy. During the 2-year follow-up, the total incidence of MACE was 11.3%. Most of the events involved revascularization(9.3%). Cardiac death/MI occurred in 3.0% of cases. For revascularization, logistic stepwise regression analysis revealed that age 65 years [odds ratio(OR), 2.224], MI(OR, 2.561), diabetes mellitus(OR, 1.650), multi-vessel lesions(OR, 2.554), baseline high sensitivity C-reactive protein level 3 mg/L(OR, 1.678), and moderate or severe anxiety/depression(OR, 1.849) were negative predictors(Plure(OR, 7.969) were negative predictors(Plusion: In a real-world setting, for patients with CAD, IM therapy was associated with a decreased incidence of revascularization and showed a potential benefit in reducing the incidence of cardiac death or MI.

关键词： coronary artery disease Chinese medicine integrative medicine effectiveness real-world study

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Gender based differences in patients with acute coronary syndrome:findings from Chinese Registry of Acute Coronary Events (CRACE)

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Chinese Medical Journal 2007年第12期120卷 1063-1067页

作者： SONG Xian-tao CHEN Yun-dai PAN Wei-qi lu shu-zheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Background Many studies have examined gender related differences in the presenting symptoms, management and prognosis of patients with acute coronary syndrome （ACS）. Much data are available from industrialized countries, in which ACS is a major cause of morbidity and mortality, but relatively little information has been obtained from China, where an epidemic of cardiovascular disease is starting to emerge. The purpose of this study was to assess the differences in clinical practice in a national Chinese sample. Methods A total of 12 medical teaching hospitals participated in CRACE. Data collection began in 2001 and continued until 2004, 1301 patients with ACS were enrolled into the study. We compared the clinical demographics, different therapies and outcomes in hospitals between female and male patients with ACS. Results Patients had an average age of 63.13 years （ranging from 27 to 93 years） and 318 female and 983 male subjects were enrolled. Female subjects were older than male patients （67.23 years vs 61.80 years, P〈0.0001）. The incidence of angina, heart failure, diabetes mellitus and hypertension in the female group was higher than in male group （73.6% vs 62.3%, P〈0.0001; 8.2% vs 5.7%, P=-0.031; 30.8% vs 18.6%, P〈0.0001 and 66.4% vs 56.8%, P=-0.001 respectively）, but the incidence of smoking was less in the female group than in the male group （6.6% vs 66.2%, P〈0.0001）. More male patients presented with ST-segment elevation myocardial infarction （STEMI） compared with female patients （48.5% vs 39%, P=0.002）. With the exception of β-blocker administration, no differences were found among medications including aspirin, ACEI, lipid lowering agents and low-molecular-weight heparin （LMWH） between female and male patients presenting with ACS in hospitals. Compared with male patients with non-ST-segment elevation （NSTE） ACS, female subjects were more prone to receive β-blockers （75.1% vs 63.4%, P=0.001）. Among STEMI and NSTE-ACS patients, fewer female subjects rece

关键词： gender acute coronary syndrome Chinese

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Successful treatment with biventricular pacing in a patient with hypertrophic obstructive cardiomyopathy

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Chinese Medical Journal 2011年第7期124卷 1105-1108页

作者： HE Ji-qiang JIANG Teng-yong WANG Yun-long WANG Yan lu shu-zheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University & Institute of Beijing Heart Lung and Vascular Disease Beijing 100029 China

We report the effects of biventricular pacing in a patient with hypertrophic obstructive cardiomyopathy （HOCM） refractory to medical therapy. A 58-year-old man with HOCM had suffered from dyspnea, chest pain and palpitation for 5 years. Cardiac catheterization showed a left ventricular outflow tract （LVOT） gradient of 80 mmHg. He refused septal myomectomy and the septal ablation was not available. Based on intraoperative pressure measurements, he was implanted with biventricular pacing and LVOT gradient decreased to 10 mmHg. During the follow-up period of 6 months, the patient＇s symptoms were markedly improved. Biventricular pacing may be an alternative therapy for patients with HOCM.

关键词： hypertrophic obstructive cardiomyopathy biventricular pacing

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Coronary spasm, a pathogenic trigger of vulnerable plaque rupture

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Chinese Medical Journal 2011年第23期124卷 4071-4078页

作者： WANG Li-xin lu shu-zheng ZHANG Wei-jun SONG Xian-tao CHEN Hui ZHANG Li-jie Department of Cardiology Beijing Anzhen Hospital Capital University of Medical Sciences Beijing 100029 China

Objective This coronary artery spasm review aimed to explore the most possible pathogenic trigger mechanism of vulnerable plaque rupture. Data sources Data used in this coronary artery spasm review were mainly from Medline and Pubmed in English. Study selection These reports from major review on coronary artery spasm .and these research included coronary artery conception, pathogenesis of spasm, mechanisms of plaque rupture, epidemiological evidence, clinical manifestation and the relationship between coronary artery spasm and vulnerable plaque rupture. Results Coronary artery spasm is somehow related to the presence of atherosclerotic intima disease in the coronary artery. However, chronic low-grade inflammation causes coronary vessel smooth muscle cell hypersensitivity, which can directely cause coronary artery spasm. Myocardial infarction and sudden cardiac death may be initiated by a sudden intense localized contraction of coronary artery smooth muscle. Conclusion Coronary artery spasm may be one trigger that can initiate and exacerbate vulnerable plaque rupture.

关键词： coronary spasm vulnerable plaque rupture pathogenic trigger

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Proliferation, migration and apoptosis activities of endothelial progenitor cells in acute coronary syndrome

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Chinese Medical Journal 2010年第19期123卷 2655-2661页

作者： ZHANG Li-jie LIU Wen-xian CHEN Yun-dai SONG Xian-tao JIN Ze-ning lu shu-zheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China Department of Cardiology Chinese People's Liberation Army General Hospital Beijing .100853 China

Background There are numerous articles on the endothelial progenitor cells （EPCs） in different disease conditions. However, the functional properties of EPCs in acute coronary syndrome （ACS） are still uncertain. Here we aimed to study the number and functions of EPCs in ACS patients. Methods Patients were enrolled with admitted ACS （n=25） and another 25 gender-, age-, atherosclerotic risk factors-matched stable coronary artery disease （CAD） controls. EPCs were defined as CD34＋/CD133＋/VEGFR-2＋ and quantified by flow cytometry. Moreover, functional properties of EPCs including colony-forming unit （CFU）, proliferation, migration as well as apoptosis were evaluated and compared between the two groups. Plasma matrix metalloproteinase-9 （MMP-9） was detected in all patients as well. Results The two groups had similar medication and clinical characteristics on admission. The EPCs in ACS patients were more than 2.6 times that in stable CAD subjects （15.6±2.7 vs. 6.0±0.8 /100 000 events, P 〈0.01）. CFU was not statistically different between the two groups （10.8±2.9 vs. 8.2±1.8, number/well, P 〉0.05）. Furthermore, EPCs isolated from ACS patients were significantly impaired in their proliferation （0.498±0.035 vs. 0.895±0.067, OD value, P〈0.01） and migration capacity （20.5±3.4 vs. 30.7±4.3, number/well, P 〈0.01） compared with controls. Moreover, the apoptosis cell in cultured EPCs was drastically increased in ACS group （（18.3±2.. 1 ）% vs. （7.8±0.4）%, P 〈0.01）. Conclusions Patients with ACS exhibited apparently increased circulating EPCs as well as cultured apoptosis percentage together with a remarkable impairment of proliferation and migration activities compared with stable CAD subjects.

关键词： endothelial progenitor cells acute coronary syndromes number function

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Comparision of high sensitivity C-reactive protein and matrix metalloproteinase 9 in patients with unstable angina between with and without significant coronary artery plaques

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Chinese Medical Journal 2011年第11期000卷 1657-1661页

作者： WANG Li-xin lu shu-zheng ZHANG Wei-jun SONG Xian-tao CHEN Hui ZHANG Li-jie Department of Cardiology Beijing Anzhen Hospital CapitalMedical University Beijing 100029 China Institute of Biomedical Engineering Capital Medical UniversityBeijing 100069 China

Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein （CRP） is the most reliable and accessible test method for clinical use for identifying coronary artery disease event. Matrix metalloproteinase 9 （MMP-9） is highly over-expressed in the vulnerable regions of a plaque. Our aim was to evaluate the plasma levels of MMP-9 and hsCRP in subjects with both unstable angina and coronary plaques, as well as in those with unstable angina without coronary plaques.

关键词： unstable angina high sensitivity C-reactive protein matrix metalloproteinase 9 coronary artery stenosis angiography

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Evaluation of neointimal coverage of overlapping sirolimus- eluting stents by optical coherence tomography

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Chinese Medical Journal 2009年第6期122卷 670-674页

作者： TIAN Feng CHEN Yun-dai SUN Zhi-jun CHEN Lian YUAN Fei SONG Xian-tao lu shu-zheng Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China Department of Cardiology Chinese General Hospital of PLA Beijing 100853 China

Background Although overlapping sirolimus-eluting stents are often used in long lesions during percutaneous coronary intervention, it was not clear how intimal hyperplasia at the overlapping segments compares with that of single-layer sirolimus-eluting stents.Methods Optical coherence tomography （OCT） examinations were performed on 22 patients in whom overlapping sirolimus-eluting stents （SESs） were implanted. OCT images were analyzed off-line after the procedure. Still frames were selected and classified, and the length of overlap, lumen loss, and average neointimal thickness on the strut were measured. The stent strut was classified into well-apposed to vessel wall with apparent neointimat coverage （type A）, well-apposed to vessel wall without neointimal coverage （type B）, malapposed to the vessel wall without neointimal coveraae （tvDe C）, and strut located at a major side branch （type D）.Results Tlqere was no statistically significant difference between strut coverage types within overlapping and non-overlapping segments, but a greater percentage of type C struts were observed within the overlapping segments （5.2% vs 1.4%, P 〉0.05）. Neither neointimal thickness （（175.0±59.9） μm vs （168.3±90.2）μm, P=0.715） nor lumen loss （（1.61±0.55） mm^2 vs （1.48±0.37） mm^2, P=0.397） was statistically different between the two segments. One patient was diagnosed with suspected in-stent thrombosis at 6 months. Although no specific characteristics of thrombosis were seen on the OCT images, a greater number of malapposed struts without neointima coverage were observed.Conclusions About 90% struts were completely covered by neointimal proliferation at 12 months follow-up, and the thicknesses of neointima on overlapping and non-overlapping segments were similar. Most of type C struts at the overlapping segments were found on the inside layer stents. Delayed antiplatelet therapy was beneficial for the patients with incompletely covered struts.

关键词： sirolimus-eluting stent coronary artery disease overlapping optical coherence tomography

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Long-term outcome of native artery versus bypass graft intervention in prior coronary artery bypass graft patients with ST-segment elevation myocardial infarction

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Chinese Medical Journal 2013年第12期126卷 2281-2285页

作者： LIU Wei LIU Yu-yang Venkata K. Mukku SHI Dong-mei lu shu-zheng ZHOU Yu-jie Department of Cardiology Beijing An Zhen Hospital Capital Medical University Beijing 100029 China

Background Patients with prior coronary artery bypass graft （CABG） have a poor outcome after acute myocardial infarction （AMI）.Little is known about the treatment strategy and outcome of percutaneous coronary intervention （PCI） in these *** purpose of this study was to investigate the impact of graft versus native artery PCI on the outcomes of prior CABG patients with *** Between September 2005 and October 2011,a total of 140 consecutive patients with previous CABG undergoing PCI for the treatment of AMI were ***/procedural characteristics and long-term clinical outcomes were compared between graft and native artery PCI *** The mean time interval to prior CABG was （5.6±4.2） *** patients received graft PCI,success rate being 90%.One hundred and ten patients received native artery PCI,success rate being 90.7% （P 〉0.05）.There were no significant differences in the basic characteristics between the two *** patients received drug eluting stents （DESs）.Three patients died during hospitalization in the graft-PCI group （10% *** PCI 0,P 〈0.05）.After a median followup of two years,major adverse cardiac events （MACE）（myocardial infarction,target vessel revascularization,total death） were 20% with no significant difference between the two *** regression analysis showed that both diabetes mellitus （DM,HR 3.57,95% CI 1.03-5.75,P 〈0.05） and primary PCI （HR 5.932,95% Cl 1.91-18.4,P 〈0.05） were independent predictors of *** More patients with prior CABG underwent native artery PCI for *** to culprit graft vessels had higher in-hospital *** and primary PCI,but not graft PCI,were predictors for adverse long-term outcome.

关键词： coronary artery bypass graft percutaneous coronary intervention acute myocardial infarction

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Combined effect of atorvastatin and probucol on plasma cystatin C levels and severity of coronary lesion in patients with borderline coronary lesion

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Chinese Medical Journal 2012年第14期125卷 2472-2476页

作者： GE Chang-jiang lu shu-zheng FENG Li-xia HUO Yong SONG Xian-tao CHEN Xin MENG Kang YUAN Fei Department of Cardiology Beijing Anzhen Hospital CapitalMedical University Beijing 100029 China Department of Cardiology. Peking University First Hospital Beijing 100034 China

Background The plasma cystatin C concentration （PcyC） has been demonstrated to have prognostic value in acute coronary syndrome, but the study of PcyC in patients with borderline coronary lesions is limited. Moreover, the effects of atorvastatin and probucol on PcyC and the severity of coronary lesions are unknown. This study was to evaluate the effects of the combination of atorvastatin and probucol on PcyC and severity of coronary lesion in patients with borderline coronary lesions. Methods One hundred and thirty consecutive patients with borderline coronary lesions （40% to 60% isolated single stenosis assessed by quantitative coronary angiography） were enrolled into the borderline coronary lesion （BCL） group, and one hundred and thirty-six subjects without coronary lesions comprised the controls （CTR）. The subjects in the BCL group were randomized into routine treatment （RTT, n=60）, and combined treatment with atorvastatin 20 mg plus probucol 1.0 g daily added to routine medication （CBT, n=70）, both groups were treated for 6 months continuously. The levels of PcyC, high-sensitive C-reactive protein （hs-CRP）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, and triglycerides （TG） were determined. One hundred and four subjects in the BCL group were rechecked by coronary angiography. Results PcyC levels were significantly higher in the BCL group than in the CTR group; （2003.26＋825.73） ng/ml vs. （1897.83＋664.46） ng/ml （P 〈0.01）. Compared with patients in the RTT group, the levels of PcyC, TC, LDL-C, TG and hs-CRP were significantly lower in the CBT group （P 〈0.05）. Moreover, there was a trend towards a slight decrease in the RTT patients, （54.38＋10.67）% vs. （50.29＋9.89）% （P 〉0.05）, and a significant decrease in the CBT patients, （53.65＋9.48%） vs. （40.38＋12.93）% （P 〈0.05）, in the mean percent stenosis of borderline coronary lesions before and after six months of treatment. Conclusions Cystatin C played

关键词： cystatin C coronary artery disease," borderline coronary lesion

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