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Association between coexisting intracranial artery and extracranial carotid artery atherosclerotic diseases and ipsilateral cerebral infarction: a Chinese Atherosclerosis Risk Evaluation (care- ii) study

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Stroke & Vascular Neurology 2021年第4期6卷 595-602页

作者： Chunxiu Jiang Jing Zhang Jianbin Zhu Xianlong Wang Zhibo Wen Xihai Zhao Chun Yuan on behalf of care-ii investigators Department of Radiology Zhujiang HospitalSouthern Medical UniversityGuangzhouChina Department of Radiology Foshan Women and Children Hospital Affiliated to Southern Medical UniversityFoshanChina Center for Biomedical Imaging Research Department of Biomedical EngineeringTsinghua UniversityBeijingChina Department of Radiology University of WashingtonSeattleWashingtonUSA 不详

Background To evaluate the association between coexisting intracranial and extracranial carotid artery atherosclerotic diseases and ipsilateral acute cerebral infarct(ACI)in symptomatic patients by using magnetic resonance(MR)vessel wall *** Symptomatic patients were recruited from a cross-sectional,multicentre study of Chinese Atherosclerosis Risk Evaluation(care-ii).All patients underwent MR imaging for extracranial carotid arterial wall,intracranial artery and *** intracranial stenosis≥50%and extracranial carotid artery mean wall thickness(MWT)≥1 mm and plaque compositions at the same side were evaluated and the ipsilateral ACI was *** association between coexisting atherosclerotic diseases and ACI was evaluated using logistic *** 351 patients were *** with ipsilateral ACI had significantly greater prevalence of coexisting intracranial stenosis≥50%and carotid MWT≥1 mm(20.5%vs 4.9%,p<0.001),calcification(15.1%vs 4.4%,p=0.001)and lipid-rich necrotic core(LRNC)(19.2%vs 7.8%,p=0.002)compared with those *** intracranial artery stenosis≥50%and carotid MWT≥1 mm(OR 5.043,95%CI 2.378 to 10.694;p<0.001),calcification(OR 3.864,95%CI 1.723 to 8.664;p=0.001)and LRNC(OR 2.803,95%CI 1.455 to 5.401;p=0.002)were significantly associated with ipsilateral *** adjusting for confounding factors,the aforementioned associations remained statistically significant(intracranial stenosis≥50%coexisting with carotid MWT≥1 mm:OR 4.313,95%CI 1.937 to 9.601,p<0.001;calcification:OR 3.606,95%CI 1.513 to 8.593,p=0.004;LRNC:OR 2.358,95%CI 1.166 to 4.769,p=0.017).Conclusions Coexistence of intracranial artery severe stenosis and extracranial carotid artery large burden and intraplaque components of calcification and LRNC are independently associated with ipsilateral *** registration number https://***/.Unique identifier:NCT02017756.

关键词： intracranial carotid cerebral

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Chinese Atherosclerosis Risk Evaluation(care ii)study:a novel cross-sectional,multicentre study of the prevalence of high-risk atherosclerotic carotid plaque in Chinese patients with ischaemic cerebrovascular events-design and rationale

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Stroke & Vascular Neurology 2017年第1期2卷 15-20页

作者： Xihai Zhao Rui Li Daniel S Hippe Thomas S Hatsukami Chun Yuan care-ii investigators Department of Biomedical Engineering Center for Biomedical Imaging ResearchTsinghua University School of MedicineBeijingChina Department of Radiology University of WashingtonSeattleWashingtonUSA Department of Surgery University of WashingtonSeattleWashingtonUSA 不详

Background:Carotid atherosclerotic plaque is identified as one of the main sources of ischaemic ***,the prevalence of carotid high-risk atherosclerotic plaque in Chinese patients with ischaemic cerebrovascular events has been inconsistently reported and needs to be investigated in a large ***:The primary objective of care ii study was to determine the prevalence and characteristics of high-risk features of atherosclerotic plaques in the carotid arteries in Chinese patients with recent ischaemic stroke or transient ischaemia attack(TIA).The relationship between carotid plaque features and cerebral infarcts,the differences of carotid plaque patterns among different regions of China and the gender specific characteristics of carotid plaque will be also *** design:The care ii study will enrol 1000 patients with recent ischaemic stroke or TIA and carotid plaque from 13 hospitals and medical centres across *** this cross-sectional,non-randomised,observational,multicentre study,all patients will undergo carotid artery MRI of bilateral carotid arteries and routine brain MRI with standardised *** MRI will be interpreted at core reading centres to evaluate the characteristics of morphology and compositions of carotid ***:This is a cross-sectional,multicentre study to investigate the prevalence and characteristics of high-risk atherosclerotic carotid plaque in Chinese patients with stroke and TIA by using high-resolution MRI of vessel *** trial is sufficiently powered to demonstrate the prevalence of carotid high-risk plaque and to explore regional differences in Chinese patients who suffered stroke.

关键词： prevalence carotid patients

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Association between stress hyperglycemia ratio and in-hospital outcomes:findings from the improving care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)Project

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Journal of Geriatric Cardiology 2024年第6期21卷 658-668页

作者： Wen-Jie WANG Ke-Xin WANG Jia-Long NIU Yi-Xuan LIU Hai-Long GE Hua SHEN On behalf of CCC-ACS investigators Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijingChina

BACKGROUND Stress hyperglycemia ratio(SHR)could provide accurate information on the acute status of *** relationship between SHR and acute coronary syndrome(ACS)prognosis remains *** study was conducted to identity the association between SHR and in-hospital outcomes in patients with *** A total of 12,010 patients were eventually enrolled in the *** relationship between SHR and in-hospital major adverse cardiovascular events(MACEs)was then modeled by restricted cubic spline(RCS)curves,and all patients were divided into three groups according to the *** multivariate logistic regression analysis was used to determine the associations between the SHR and in-hospital outcomes,described as odds ratios(ORs)and 95%confidence intervals(CIs).Subgroup analyses were also performed on different *** The median age of this cohort was 63(54,71)years old,and 8942(74.5%)were *** 1 was defined as SHR1(n=5763).Compared with Group 2,Group 1(OR=1.891,95%CI:1.028-3.479,P<0.001)and Group 3(OR=1.868,95%CI:1.434-2.434,P<0.001)had higher risks of suffering from in-hospital *** was associated with higher risks of in-hospital MACEs in the subgroups of DM[OR=2.282,95%CI:1.477-3.524).CONCLUSIONS Both low and high SHR levels were independently associated with in-hospital *** males with DM,hypertension,and decreased renal function had much higher risks of suffering from SHR-correlated MACEs.

关键词： acute cardiovascular finding

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Practice of reperfusion in patients with ST-segment elevation myocardial infarction in China:findings from the Improving care for Cardiovascular Disease in China–Acute Coronary Syndrome project

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Chinese Medical Journal 2022年第23期135卷 2821-2828页

作者： Yiqian Yang Yongchen Hao Jun Liu Na Yang Danqing Hu Zhaoqing Sun Dong Zhao Jing Liu on behalf of the Improving care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)investigators Department of Epidemiology Beijing An Zhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100029China 不详

Background:Reperfusion therapy is fundamental for ST-segment elevation myocardial infarction(STEMI).However,the details of contemporary practice and factors associated with reperfusion therapy in China are largely ***,this study aimed to explore reperfusion practice and its associated factors among hospitalized patients with STEMI in ***:Patients with STEMI who were admitted to 159 tertiary hospitals from 30 provinces in China were included in the Improving care for Cardiovascular Disease in China–Acute Coronary Syndrome project from November 2014 to December *** associations of the characteristics of patients and hospitals with reperfusion were examined using hierarchical logistic *** associations between therapies and in-hospital major adverse cardiovascular events were examined with a mixed effects Cox regression ***:Among the 59,447 patients,37,485(63.1%)underwent reperfusion,including 4556(7.7%)receiving fibrinolysis and 32,929(55.4%)receiving primary percutaneous coronary intervention(PCI).The reperfusion rate varied across geographical regions(48.0%–73.5%).The overall rate increased from 60.0%to 69.7%from 2014 to 2019,mainly due to an increase in primary PCI within 12 h of symptom *** PCI,but not fibrinolysis alone,was associated with a decreased risk of inhospital major adverse cardiovascular events compared with no reperfusion,with an adjusted hazard ratio(95%confidence interval)of 0.64(0.54,0.76)for primary PCI at<12 h,0.53(0.37,0.74)for primary PCI at 12 to 24 h,0.46(0.25,0.82)for the pharmaco-invasive strategy,and 0.79(0.54,1.15)for fibrinolysis ***:Nationwide quality improvement initiatives should be strengthened to increase the reperfusion rate and reduce inequality in *** registration:***,NCT02306616。

关键词： Acute coronary syndrome Cardiovascular diseases China Fibrinolysis Percutaneous coronary intervention Quality improvement Reperfusion ST elevation myocardial infarction

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Identification of prophylaxis and treatment for hospitalized patients associated with venous thromboembolism

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Chinese Medical Journal 2023年第9期136卷 1111-1113页

作者： Yuanhua Yang Xiaoying Li Zhenguo Zhai Dan Shen Lina Han Peifu Tang On behalf of the Dissolve-investigators Department of Pulmonary and Critical care Medicine Beijing Chao-Yang HospitalCapital Medical UniversityChaoyang DistrictBeijing 100020China The General Hospital of People’s Liberation Army(301 Hospital) Haidian DistrictBeijing 100853China Center of Respiratory Medicine China-Japan Friendship HospitalNational Clinical Research Center for Respiratory DiseasesHepingliBeijing 100029China Sanofi(China)Investment Co. Ltd.Chaoyang DistrictBeijing 100022China Department of Cardiovascular Internal Medicine Nanlou Branch of Chinese PLA General HospitalHaidian DistrictBeijing 100853China Department of Orthopedic Chinese PLA General HospitalHaidian DistrictBeijing 100853China 不详

To the Editor:Venous thromboembolism(VTE)is a collective term consisting of deep venous thrombosis(DVT)and pulmonary embolism(PE).It is a major worldwide health concern as it affects 5%to 15%of hospitalized *** predisposing factors for VTE occurrence include cancer,surgery,prolonged immobilization,fracture,paralysis,oral contraceptive use,and hereditary coagulopathies.

关键词： patients venous embolism

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Taking care of volunteers in a stroke trial: a new assisted-management strategy

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Stroke & Vascular Neurology 2016年第3期1卷 108-114页

作者： Amber C Stuart Jason J Sico Catherine M Viscoli Ashis H Tayal Silvio E Inzucchi Gary A Ford Karen L Furie Robert Cote J David Spence David Tanne Walter N Kernan on behalf of the IRIS Trial investigators Department of Internal Medicine Yale University School of MedicineNew HavenConnecticutUSA Department of Neurology Yale University School of MedicineNew HavenConnecticutUSA Department of Neurology Service Veterans Affairs Connecticut Healthcare SystemWest HavenConnecticutUSA Neuroscience Institute Allegheny Health NetworkPittsburghPennsylvaniaUSA Lewis Katz School of Medicine at Temple University PhiladelphiaPennsylvaniaUSA Division of Medical Sciences Oxford UniversityOxfordUK The Warren Alpert Medical School of Brown University ProvidenceRhode IslandUSA Department of Neurology Neurosurgery and MedicineMcGill UniversityMontrealQuebecCanada University of Western Ontario LondonOntarioCanada 10Sheba Medical CenterTel Aviv UniversityTel AvivIsrael 不详

Background and purpose:Providing participants with evidence-based care for secondary prevention is an ethical and scientific priority for trials in stroke *** optimal strategy,however,is *** report the performance of a new approach for delivering preventive care to trial ***:Participants were enrolled in the Insulin Resistance Intervention after Stroke trial,which examined the insulin sensitiser,pioglitazone versus placebo for prevention of stroke and myocardial infarction after ischaemic stroke or transient ischaemic *** care was the responsibility of the participants’personal healthcare providers,but investigators monitored care and provided feedback *** studied achievement of 8 prevention goals at baseline and 3 annual visits,with a focus on 3 priority goals:blood pressurecare and providing feedback was associated with high average yearly achievement of 3 priority secondary prevention goals,but the majority of trial participants did not persist in being at goal over *** registration number:NCT00091949.

关键词： prevention annually goals

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Dual antiplatelet therapy may increase the risk of non-intracranial haemorrhage in patients with minor strokes: a subgroup analysis of the CHANCE trial

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Stroke & Vascular Neurology 2016年第2期1卷 29-36页

作者： David Wang Li Gui Yi Dong Hao Li Shujuan Li Huaguang Zheng Anxin Wang Xia Meng Li-Ping Liu Yi-Long Wang Guangyao Wang Jing Jing Zixiao Li Xing-Quan Zhao Yong-Jun Wang on behalf of the investigators for the CHANCE trial Illinois Neurological Institute Stroke Network Sisters of the Third Order of St.Francis Healthcare SystemUniversity of Illinois College of MedicinePeoriaIllinoisUSA Southwest Hospital Stroke Center Third Military University of Medical SciencesChongqingChina Department of Neurology Huashan HospitalFudan UniversityShanghaiChina China National Clinical Research Center for Neurological Diseases BeijingChina Chaoyang Hospital Neurology Department Capital Medical UniversityBeijingChina Department of Neurology Beijing Tiantan HospitalTiantan Clinical Trial and Research Center for StrokeCapital Medical UniversityBeijingChina Neurological Intensive care Unit Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Neurology Beijing Tiantan HospitalVascular NeurologyCapital Medical UniversityBeijingChina 不详

Aim:The aim of this study was to explore the difference between haemorrhagic events among those patients on either aspirin or aspirin plus clopidogrel who were enrolled in the Clopidogrel in High-Risk Patients with Acute Non-disabling Ischemic Cerebrovascular Events(CHANCE)***:This was an ad hoc analysis of the CHANCE trial;data on all patients with any haemorrhagic event were reviewed and *** proportional hazards regression was used to determine factors association with any ***:In the CHANCE trial,there were a total of 101(2%)haemorrhagic events reported from 50 different *** clopidogrel–aspirin group had 60(2.3%)cases and the aspirin group had 41(1.6%,p=0.09).Moderate or severe haemorrhagic events occurred in 7 patients(0.3%)in the clopidogrel–aspirin group and in 8(0.3%)in the aspirin group(p=0.73).Of 36(0.7%)cases of intracranial haemorrhages,20(0.4%)were in the clopidogrel–aspirin group and 16(0.3%)in the aspirin *** group had 8(0.3%)cases of symptomatic haemorrhagic *** common haemorrhagic events included 24(0.5%)cases of skin bruises,13(0.3%)gastrointestinal haemorrhages,9(0.2%)gum haemorrhages and 8(0.2%)intraocular ***:There was no overall significant difference in haemorrhagic events(p=0.29),especially in the rate of intracranial haemorrhages between the 2 treatment ***,patients enrolled with minor strokes had an increased risk of haemorrhagic events regardless of treatment group,not seen in patients with high-risk transient ischaemic *** elderly,of male gender and with a history of aspirin or proton pump inhibitor usage were associated with increased risk of *** with higher body mass index had lower risk of haemorrhagic events.

关键词： patients intracranial analysis

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中青年超高危ACS患者低密度脂蛋白胆固醇水平及降胆固醇药物使用现状

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中华心血管病杂志 2022年第12期50卷 1161-1168页

作者：刘军赵冬郝永臣杨娜孙兆庆刘静首都医科大学附属北京安贞医院北京市心肺血管疾病研究所临床与流行病研究中心北京100029

目的了解中国中青年超高危急性冠状动脉综合征(ACS)患者低密度脂蛋白胆固醇(LDL-C)水平及降胆固醇药物使用现状。方法本研究基于中华医学会心血管病学分会(CSC)和美国心脏协会(AHA)合作的中国心血管疾病医疗质量改善(CCC)项目。该项目... 详细信息

目的了解中国中青年超高危急性冠状动脉综合征(ACS)患者低密度脂蛋白胆固醇(LDL-C)水平及降胆固醇药物使用现状。方法本研究基于中华医学会心血管病学分会(CSC)和美国心脏协会(AHA)合作的中国心血管疾病医疗质量改善(CCC)项目。该项目在全国159家三级医院和82家二级医院连续入选ACS住院患者,系统收集患者临床相关信息。本研究纳入CCC项目2014年11月至2019年12月入选的中青年(年龄18~59岁)ACS住院患者,根据CSC《超高危动脉粥样硬化性心血管疾病患者血脂管理中国专家共识》超高危患者的界定标准,分析超高危ACS患者LDL-C平均水平及院前接受调脂治疗情况。结果研究共纳入42230例中青年ACS住院患者,年龄(50.4±6.9)岁,男性86.8%(36676/42230)。86.9%(36687/42230)的患者符合超高危标准。超高危ACS患者入院时LDL-C水平为(2.8±1.0)mmol/L,仅有5.3%(1948/36687)的患者达到1.4 mmol/L的目标值。超高危患者中,17.5%(6430/36687)的患者院前服用调脂药物,其中96.4%(6198/6430)的患者采用他汀单药治疗。接受他汀治疗的超高危患者中,9.9%(626/6323)的患者LDL-C<1.4 mmol/L。结论中青年ACS住院患者中绝大多数属于超高危,需要采用更低的LDL-C降脂治疗目标。超高危患者院前较少服用降胆固醇药物,大部分患者入院时LDL-C水平高于推荐的目标值且距目标值的差距较大。

关键词：急性冠状动脉综合征中青年超高危 LDL-C达标

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Development and validation of a score predicting mortality for older patients with mitral regurgitation

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Journal of Geriatric Cardiology 2023年第8期20卷 577-585页

作者： De-Jing FENG Yun-Qing YE Zhe LI Bin ZHANG Qing-Rong LIU Wei-Wei WANG Zhen-Yan ZHAO Zheng ZHOU Qing-Hao ZHAO Zi-Kai YU Hai-Tong ZHANG Zhen-Ya DUAN Bin-Cheng WANG Jun-Xing LV Shuai GUO Run-Lin GAO Hai-Yan XU Yong-Jian WU on behalf of the China-DVD and China-VHD study investigators Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina

OBJECTIVE To develop and validate a user-friendly risk score for older mitral regurgitation(MR)patients,referred to as the Elder-MR *** The China Senile Valvular Heart Disease(China-DVD)Cohort Study functioned as the development cohort,while the China Valvular Heart Disease(China-VHD)Study was employed for external *** included patients aged 60 years and above receiving medical treatment for moderate or severe MR(2274 patients in the development cohort and 1929 patients in the validation cohort).Candidate predictors were chosen using Cox’s proportional hazards model and stepwise selection with Akaike’s information *** Eight predictors were identified:age≥75 years,body mass indexii,the Elder-MR score demonstrated superior predictive accuracy for one-year mortality in the validation cohort(C-statistic=0.71 vs.0.70,net reclassification improvement=0.320,P<0.01;integrated discrimination improvement=0.029,P<0.01).CONCLUSIONS The Elder-MR score may serve as an effective risk stratification tool to assist clinical decision-making in older MR patients.

关键词： patients mitral score

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Cilostazol and isosorbide mononitrate for the prevention of progression of cerebral small vessel disease:baseline data and statistical analysis plan for the Lacunar Intervention Trial-2(LACI-2)(ISRCTN14911850)

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Stroke & Vascular Neurology 2023年第2期8卷 134-143页

作者： Philip M Bath Iris Mhlanga Lisa J Woodhouse Fergus Doubal Katherine Oatey Alan A Montgomery Joanna M Wardlaw LACI-Trial investigators Stroke Trials Unit University of NottinghamNottinghamUK Centre for Clinical Brain Sciences UK Dementia Research Institute CentreUniversity of EdinburghEdinburghUK Edinburgh Clinical Trials Unit University of EdinburghEdinburghUK Nottingham Clinical Trials Unit University of NottinghamNottinghamUK

Background Cerebral small vessel disease(SVD)causes lacunar strokes(25%of all ischaemic strokes),physical frailty and cognitive impairment and vascular and mixed *** is no specific treatment to prevent progression of *** The LACunar Intervention Trial-2 is an investigator-initiated prospective randomised open-label blinded-endpoint phase ii feasibility study assessing cilostazol and isosorbide mononitrate for preventing SVD *** aimed to recruit 400 patients with clinically evident lacunar ischaemic stroke and randomised to cilostazol,isosorbide mononitrate,both or neither,in addition to guideline secondary ischaemic stroke prevention,in a partial factorial *** primary outcome is feasibility of recruitment and adherence to medication;key secondary outcomes include:drug tolerability;recurrent vascular events,cognition and function at 1 year after randomisation;and safety(bleeding,falls,death).Data are number(%)and median(IQR).Results The trial commenced on 5 February 2018 and ceased recruitment on 31 May 2021 with 363 patients randomised,with the following baseline characteristics:average age 64(56.0,72.0)years,female 112(30.9%),stroke onset to randomisation 79.0(27.0,244.0)days,hypertension 267(73.6%),median blood pressures 143.0(130.0,157.0)/83.0(75.0,90.0)mm Hg,current smokers 67(18.5%),educationally achieved end of school examinations(A-level)or higher 118(32.5%),modified Rankin scale 1.0(0.0,1.0),National Institutes Health stroke scale 1.0(1.4),Montreal Cognitive Assessment 26.0(23.0,28.0)and total SVD score on brain imaging 1.0(0.0,2.0).This publication summarises the baseline data and presents the statistical analysis *** The trial is currently in follow-up which will complete on 31 May 2022 with results expected in October *** registration number ISRCTN14911850.

关键词： nitrate initiated prevention

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