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Free triiodothyronine level correlates with statin responsiveness in acute myocardial infarction

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Journal of Geriatric Cardiology 2018年第4期15卷 290-297页

作者： Wen-Yao WANG Kuo ZHANG Wei ZHAO A. Martin Gerdes Giorgio Iervasi yi-da tang Departments of Cardiology State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China Department of Biomedtcal Sciences New York Institute of Technology-College of Osteopathic Medicine Northern Blvd. Old Westbury New York USA Clinical Physiology Institute Consiglio Nazionale delle Ricerche (CNR) Pisa Italy

Background Although thyroid hormone （TH） has important effects on lipid metabolism, the relationship between TH and statin responsiveness has never been investigated. We hypothesize that TH plays an important role in statin responsiveness in patients with acute myocardial infarction （AMI）. Methods Consecutive 1091 hospitalized AMI patients in Fuwai hospital （Beijing, China） were enrolled into this current study. The study population was divided into three groups based on the intensity of statin treatment： low-intensity （n = 221）, moderate-intensity （n = 712） and high-intensity （n = 158）. Lipid levels were measured after statin therapy lasting for 10-14 days. The association between TH, lipid profile levels and achievement of low-density lipoprotein cholesterol （LDL-C） lowering goals was explored in patients with AMI on statin therapy. Results By general linear analysis, a significant linear trend between free triiodothyronine （FT3） and LDL-C level （linear coefficient r = -0.082, P = 0.001） and FT3 and total cholesterol （TC） level （r = -0.105, P = 0.031） was observed in the moderate-intensity statin group. A more apparent linear trend was detected in the high-intensity statin group （for LDL-C： r = -0.113, P = 0.005; for TC： r = -0.172, P = 0.029, respectively）. However, no significant correlation was observed in the low-intensity statin group. Compared with the low-FT3 group （defined as FT3 〈 1.79 pg/mL）, the OR （95% CI） for attaining a LDL-C 〈 3.0mmol/L was found to be 2.217 （1.001–4.839） in the higher FT3 group （〉 2.95 pg/mL）. The OR （95% CI） for attaining the more intensive goal （LDL-C 〈 1.8mmol/L） was 2.836 （1.014–5.182）. Conclusions Our study reveals that variation in FT3 levels is related to the cholesterol-lowering responsiveness of statins in AMI patients. These findings suggest that low FT3 may be a factor responsible for lack of LDL-C goal attainment and patients’ poor responsiveness to statin treatment.

关键词： Acute myocardial infarction Free triiodothyronine Hypothyroid Statin

Uric acid is associated with cardiac death in patients with hypertrophic obstructive cardiomyopathy

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Journal of Geriatric Cardiology 2021年第4期18卷 281-288页

作者： Jun GAO Chun-Li SHAO Xiang-Bin MENG Wen-Yao WANG Kuo ZHANG Jing-Jia WANG Ming-Qi ZHENG yi-da tang Heart Center the First Hospital of Hebei Medical UniversityShijiazhuangChina Department of Cardiology State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Fuwai Central China Cardiovascular HospitalCentral China Branch of National Center for Cardiovascular DiseasesZhengzhouChina Department of Cardiology and Institute of Vascular Medicine Peking University Third HospitalNHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesKey Laboratory of Molecular Cardiovascular ScienceMinistry of EducationBeijing Key Laboratory of Cardiovascular Receptors ResearchBeijingChina

BACKGROUND The role of uric acid(UA) in survival of patients with hypertrophic obstructive cardiomyopathy(HOCM) has not been fully evaluated. This study aimed to determine whether UA could be an independent risk factor of cardiac death in patients with *** A total of 317 patients with HOCM, who were receiving conservative treatment in Fuwai Hospital from October2009 to December 2014, all of them completed UA evaluations, were analyzed. Patients were divided into three groups according to the UA levels: Tertile 1(≤ 318 μmol/L, n = 106), Tertile 2(319 to 397 μmol/L, n = 105), and Tertile 3(≥ 398 μmol/L, n = 106).RESULTS During a median follow-up of 45 months, 29 cardiac deaths(9.1%) occurred, including 6 sudden cardiac deaths and23 heart failure-related deaths. Cardiac death in Tertile 3(n = 16, 55.2%) was significantly higher than in Tertile 1(n = 6, 20.7%)and Tertile 2(n = 7, 24.1%). In univariate model, UA level(continuous value) showed predictive value of cardiac death [hazard ratio(HR) = 1.006, 95% CI: 1.003-1.009, P = 0.009]. Univariate Cox survival analysis had shown a significant higher property of cardiac death in patients of Tertile 3 when compared with those of Tertile 1, but cardiac death in patients of Tertile 2 did not show significant prognositic value compared with those of Tertile 1(HR = 3.927, 95% CI: 0.666-23.162, P = 0.131). UA was found to be an independent risk factor(HR = 1.005, 95% CI: 1.001-1.009, P = 0.009) of cardiac death in the multivariate regression analysis after the adjustment for age, body mass index, atrial fibrillation, hemoglobin, creatinine, high-sensitivity C-reactive protein, interventricular septum/left ventricular posterior wall ratio, left ventricular outflow tract and left ventricular ejection *** UA concentration was found to be independently associated with cardiac death in HOCM patients receiving conservative treatment. Randomized trials of UA-lowering agents for HOCM patients are warranted.

关键词： CRP Uric acid is associated with cardiac death in patients with hypertrophic obstructive cardiomyopathy

Association of serum lipoprotein(a) level with the severity and prognosis of calcific aortic valve stenosis: a Chinese cohort study

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Journal of Geriatric Cardiology 2020年第3期17卷 133-140页

作者： Shuo-Lin LIU Rynat Rozi Hui-Wei SHI ying GAO Yuan-Lin GUO yi-da tang Jian-Jun LI Na-Qiong WU Endocrinology&Cardiometabolic Center State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Background There was a causal relationship between elevated lipoprotein(a)[Lp(a)]levels and increased risk of calcific aortic valve stenosis(CAVS)in whites and *** present study aimed to investigate whether Lp(a)levels were associated with aortic stenosis(AS)severity and clinical events in Chinese *** Levels of serum Lp(a)were measured in 652 patients with CAVS,whom all underwent baseline echocardiographic *** clinical endpoint was defined as a composite of aortic valve replacement(AVR)and cardiac *** Patients in the tertile 3 of Lp(a)had a higher percentage of severe AS compared with those in the tertile 1 and 2 of Lp(a)(46.2%vs.33.9%,P=0.005).Moreover,the top tertile of Lp(a)was an independent predictor of severe AS(OR=1.78,95%CI:1.18-2.66,P=0.006).However,there was no significant association between tertile 3 of Lp(a)and clinical events(hazard ratio:0.73;95%CI:0.43-1.24;P=0.239)in the multivariate Cox regression analysis during a mean follow-up time of 3.16±2.74 *** Elevated Lp(a)level was an independent predictor of severe AS by echocardiography in the Chinese population,but was not associated with the increased risk of AVR and cardiac death,suggesting that Lp(a)levels might be helpful in the risk stratification of patients with CAVS.

关键词： Aortic stenosis Calcification Severity Lipoprotein(a) Prognosis

Development and validation of a nomogram predicting oneyear mortality in patients undergoing percutaneous coronary intervention

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Journal of Geriatric Cardiology 2022年第12期19卷 960-969页

作者： Jing-Jing SONG Yu-Peng LIU Wen-Yao WANG Jie YANG Jun WEN Jing CHEN Jun GAO Chun-Li SHAO yi-da tang Department of Cardiology State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Guangdong Cardiovascular InstituteGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouChina Department of Cardiology and Institute of Vascular Medicine Peking University Third Hospital/Key Laboratory of Molecular Cardiovascular ScienceMinistry of EducationBeijingChina

OBJECTIVE To formulate a nomogram to predict the risk of one-year mortality after percutaneous coronary intervention(PCI)based on a large-scale real-world Asian *** This study cohort included consecutive patients undergoing PCI in the National Center for Cardiovascular Diseases of *** endpoint was all-cause *** absolute shrinkage and selection operator Cox regression and backward stepwise regression were used to select potential risk factors.A nomogram based on the predictors was accordingly constructed to predict one-year *** performance of the nomogram was *** were stratified into low-,intermediate-and high-risk groups according to the tertile points in the nomogram and compared by the Kaplan-Meier *** A total of 9603 individuals were included in this study and randomly divided into the derivation cohort(60%)and the validation cohort(40%).Six variables were selected to formulate the nomogram,including age,renal insufficiency,cardiac dysfunction,previous cerebrovascular disease,previous PCI,and TIMI 0–1 before *** area under the curve of this nomogram regarding one-year mortality risks were 0.792 and 0.754 in the derivation cohort and validation cohort,***-Meier curve successfully stratified the patients according to three risk *** nomogram calibrated well and exhibited satisfactory clinical utility in the decision curve *** This study developed and validated a simple-to-use nomogram predicting one-year mortality risk in Asian patients undergoing PCI and could help clinicians make risk-dependent decisions.

关键词： patients nomogram mortality

Invasive versus conservative strategy in consecutive patients aged 80 years or older with non-ST-segment elevation myocardial infarction: a retrospective study in China

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Journal of Geriatric Cardiology 2019年第10期16卷 741-748页

作者： Yong-Gang SUI Si-Yong TENG Jie QIAN Yuan WU Ke-Fei DOU yi-da tang Shu-Bin QIAO Yong-Jian WU Department of Cardiology Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Objective To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. Methods 190 consecutive patients aged 80 years or older with NSTEMI were included in the retrospective study from September 2014 to August 2017, of which 69 patients received conservative strategy and 121 patients received invasive strategy. The primary outcome was death. Multivariate Cox regression models were used to assess the statistical association between strategies and mortality. The survival probability was further analyzed. Results The primary outcome occurred in 17.4% patients in the invasive group and in 42.0% patients in the conservative group (P = 0.0002). The readmission rate in the invasive group (14.9%) was higher than that in the conservative group (7.2%). Creatinine level (OR = 1.01, 95% CI: 0.10–1.03, P = 0.05) and use of diuretic (OR = 3.65, 95% CI: 1.56–8.53, P = 0.003) were independent influential factors for invasive strategy. HRs for multivariate Cox regression models were 3.45 (95% CI: 1.77–6.75, P = 0.0003), 3.02 (95% CI: 1.52–6.01, P = 0.0017), 2.93 (95% CI: 1. 46–5.86, P = 0.0024) and 2.47 (95% CI: 1.20–5.07, P = 0.0137). Compared with the patients received invasive strategy, the conservative group had remarkably reduced survival probability with time since treatment (P < 0.001). Conclusions An invasive strategy is superior to a conservative strategy in reducing mortality of patients aged 80 years or older with NSTEMI. Our results suggest that an invasive strategy is more suitable for the very elderly patients with NSTEMI in China.

关键词： Conservative strategy Death Invasive strategy Non-ST-segment elevation myocardial infarction

INFERIOR-SEPTAL MYOCARDIAL INFARCTION MISDIAGNOSED AS ANTERIOR-SEPTAL MYOCARDIAL INFARCTION:ELECTROCARDIOGRAPHIC,SCINTIGRAPHIC,AND ANGIOGRAPHIC CORRELATIONS

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Chinese Medical Sciences Journal 2007年第4期22卷 228-231页

作者： Ji-lin Chen Zuo-xiang He Zai-jia Chen Jin-qing Yuan Yue-qin Tian Shu-bin Qiao Rong-fang Shi yi-da tang Zong-lang Lu Center for Diagnosis ＆ Treatment of Coronary Heart Disease Cardiovascular Institute ＆ Fuwai Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100037

Objective To explore the infarct sites in patients with inferior wall acute myocardial infarction （AMI） concomitant with ST segment elevation in leads V1-V3 and leads V3R-V5R. Methods Five patients diagnosed as inferior, right ventricular, and anteroseptal walls AMI at admission were enrolled. Electrocardiographic data and results of isotope ^99mTc-methoxyisobutylisonitrile （MIBi） myocardial perfusion imaging and coronary angiography （CAG） were analyzed. Results Electrocardiogram showed that ST segment significantly elevated in standard leads Ⅱ, Ⅲ, aVF, and leads V1-V3, V3R-V5R in all five patients. The magnitude of ST segment elevation was maximal in lead V1 and decreased gradually from lead V1 to V3 and from lead V1 to V3R-V5R. There was isotope ^99mTc-MIBI myocardial perfusion imaging defect in inferior and basal inferior-septal walls. CAG showed that right coronary artery was infarct-related artery. Conclusions The diagnostic criteria for basal inferior-septal wall AMI can be formulated as follows：（ 1 ） ST segment elevates ≥2 mm in lead V1 in the clinical setting of inferior wall AMI; （2） the magnitude of ST segment elevation is the tallest in lead V1 and decreases gradually from lead V1 to V3 and from lead V1 to V3R-V5R. With two conditions above, the basal inferior-septal wall AMI should be diagnosed.

关键词： acute myocardial infarction basal inferior-septal wall electrocardiogram

Assessment of causal direction between thyroid function and cardiometabolic health:a Mendelian randomization study

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Journal of Geriatric Cardiology 2022年第1期19卷 61-70页

作者： Jing-Jia WANG Zhen-Huang ZHUANG Can-Qing YU Wen-Yao WANG Wen-Xiu WANG Kuo ZHANG Xiang-Bin MENG Jun GAO Jian TIAN Ji-Lin ZHENG Jie YANG Tao HUANG Chun-Li SHAO yi-da tang Department of Cardiology State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Epidemiology&Biostatistics School of Public HealthPeking UniversityBeijingChina Center for Intelligent Public Health Academy for Artificial IntelligencePeking UniversityBeijingChina Department of Cardiology and Institute of Vascular Medicine Peking University Third HospitalBeijingChina Key Laboratory of Molecular Cardiovascular Sciences(Peking University) Ministry of EducationBeijingChina

BACKGROUND Growing evidence have demonstrated that thyroid hormones have been involved in the processes of cardiovascular ***,the causal relationship of thyroid function and cardiometabolic health remains partly *** The Mendelian randomization(MR)was used to test genetic,potentially causal relationships between instrumental variables and cardiometabolic *** variants of free thyroxine(FT4)and thyrotropin(TSH)levels within the reference range were used as instrumental *** for genetic associations with cardiometabolic diseases were acquired from the genome-wide association studies of the FinnGen,CARDIoGRAM and CARDIoGRAMplusC4D,CHARGE,and *** study was conducted using summary statistic data from large,previously described *** between thyroid function and essential hypertension(EHTN),secondary hypertension(SHTN),hyperlipidemia(HPL),type 2 diabetes mellitus(T2DM),ischemic heart disease(IHD),myocardial infarction(MI),heart failure(HF),pulmonary heart disease(PHD),stroke,and non-rheumatic valve disease(NRVD)were *** Genetically predicted FT4 levels were associated with SHTN(odds ratio=0.48;95%CI=0.04−0.82,P=0.027),HPL(odds ratio=0.67;95%CI=0.18−0.88,P=0.023),T2DM(odds ratio=0.80;95%CI=0.42−0.86,P=0.005),IHD(odds ratio=0.85;95%CI=0.49−0.98,P=0.039),NRVD(odds ratio=0.75;95%CI=0.27−0.97,P=0.039).Additionally,genetically predicted TSH levels were associated with HF(odds ratio=0.82;95%CI=0.68−0.99,P=0.042),PHD(odds ratio=0.75;95%CI=0.32−0.82,P=0.006),stroke(odds ratio=0.95;95%CI=0.81−0.97,P=0.007).However,genetically predicted thyroid function traits were not associated with EHTN and *** Our study suggests FT4 and TSH are associated with cardiometabolic diseases,underscoring the importance of the pituitary-thyroid-cardiac axis in cardiometabolic health susceptibility.

关键词： cardio function random

The effectiveness and safety of the RESTORE R drug-eluting balloon versus a drug-eluting stent for small coronary vessel disease： study protocol for a multi-center, randomized, controlled trial

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Journal of Geriatric Cardiology 2018年第7期15卷 469-475页

作者： yi-da tang Shu-Bin QIAO Xi SU Yun-dai CHEN Ze-Ning JIN Hui CHEN Biao XU Xiang-Qing KONG Wen-Yue PANG Yong LIU Zai-Xin YU Xue LI Hui LI Yan-Yan ZHAO Wei LI Jian TIAN Chang-Dong GUAN Bo XU Run-Lin GAO Department of Cardiology Fu Wai Hospital National Centerfor Cardiovascular Diseases Chinese Academy of Medical Sciences Beijing China Department of Cardiology Wuhan Asia Heart Hospital Wuhan Hubei China Department of Cardiology Chinese PLA General Hospital Beijing China Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing China Department of Cardiology Beijing Friendship Hospital Capital Medical University Beijing China Department of Cardiology Affiliated Nanjing Drum Tower Hospital of Nanjing University School of Medicine Nanjing Jiangsu China Department of Cardiology Jiangsu Province Hospital the First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu China Department of Cardiology Shengjing Hospital of China Medical University Shenyang Liaoning China Department of Cardiology The Fourth Central Hospital of Tianjin Tianjin China Department of Cardiology Xiangya Hospital of Central South University Changsha Hunan China Department of Cardiology Tangdu Hospital of the Fourth Military Medical University Xi 'an Shannxi China Department of Cardiology Daqing Oilfield General Hospital Daqing Heilongjiang China Division of Biometrics National Center for Cardiovascular Diseases of China Beijing China Catheterization Laboratories Fu Wai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences Beijing China

bjective Small coronary vessel disease （disease affecting coronary vessels with main branch diameters of 〈 2.75 mm） is a common and intractable problem in percutaneous coronary intervention （PCI）. This study was designed to test the theory that the effectiveness and safety of drug-eluting balloons for the treatment of de novo lesions in small coronary vessels are non-inferior to those of drug-eluting stents. Methods We designed a prospective, multicenter, randomized, controlled clinical trial aiming to assess the effectiveness and safety of the RESTORE R （Cardionovum, Bonn, Germany） drug-eluting balloon （DEB） versus the RESOLUTE R （Medtronic, USA） drug-eluting stent （DES） in the treatment of small coronary vessel disease. This trial started in August 2016. A total of 230 patients with a reference vessel diameter （RVD）〉 2.25 mm and 〈 2.75 mm were randomly assigned to treatment with a DEB or a DES at a 1：1 ratio. The study was also designed to enroll 30 patients with an RVD 〉 2.00 mm and 〈 2.25 mm in the tiny vessel cohort. Results The key baseline data include demographic characteristics, relative medical history, baseline angiographic values and baseline procedural characteristics. The primary endpoint is in-segment diameter stenosis at nine months after the index procedure. Secondary endpoints include acute success, all-cause death, myocardial infarction, target vessel revascularization, target lesion revascularization and stent thrombosis. Conclusions The study will evaluate the clinical efficacy, angiographic outcomes, and safety of DEBs compared to DESs in the treatment of de novo coronary artery lesions in small vessels.

关键词： Drag eluting balloon Percutaneous coronary intervention Small vessel disease

Assessment of causal association between thyroid function and lipid metabolism:a Mendelian randomization study

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Chinese Medical Journal 2021年第9期134卷 1064-1069页

作者： Jing-Jia Wang Zhen-Huang Zhuang Chun-Li Shao Can-Qing Yu Wen-Yao Wang Kuo Zhang Xiang-Bin Meng Jun Gao Jian Tian Ji-Lin Zheng Tao Huang yi-da tang Department of Cardiology State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of Epidemiology&Biostatistics School of Public HealthPeking UniversityBeijing 100191China Center for Intelligent Public Health Academy for Artificial IntelligencePeking UniversityBeijing 100191China Department of Cardiology Zhengzhou University People's HospitalCentral China Fuwai HospitalCentral China Branch of the National Cardiovascular CenterHenan Provincial People's HospitalZhengzhouHenan 450003China Department of Cardiology First Affiliated Hospital of Hebei Medical UniversityHebei 050031China Key Laboratory of Molecular Cardiovascular Sciences(Peking University) Ministry of EducationBeijing 100191China department of Cardiology Peking University Third HospitalBeijing 100191China

Background:Thyroid dysfunction is associated with cardiovascular ***,the role of thyroid function in lipid metabolism remains partly *** present study aimed to investigate the causal association between thyroid function and serum lipid metabolism via a genetic analysis termed Mendelian randomization(MR).Methods:The MR approach uses a genetic variant as the instrumental variable in epidemiological studies to mimic a randomized controlled trial.A two-sample MR was performed to assess the causal association,using summary statistics from the Atrial Fibrillation Genetics Consortium(n=537,409)and the Global Lipids Genetics Consortium(n=188,577).The clinical measures of thyroid function include thyrotropin(TSH),free triiodothyronine(FT3)and free thyroxine(FT4)levels,FT3:FT4 ratio and concentration of thyroid peroxidase antibodies(TPOAb).The serum lipid metabolism traits include total cholesterol(TC)and triglycerides,high-density lipoprotein,and low-density lipoprotein(LDL)*** MR estimate and MR inverse variance-weighted method were used to assess the association between thyroid function and serum lipid ***:The results demonstrated that increased TSH levels were significantly associated with higher TC(β=0.052,P=0.002)and LDL(β=0.041,P=0.018)*** addition,the FT3:FT4 ratio was significantly associated with TC(β=0.240,P=0.033)and LDL(β=0.025,P=0.027)***,no significant differences were observed between genetically predicted FT4 and TPOAb and serum ***:Taken together,the results of the present study suggest an association between thyroid function and serum lipid metabolism,highlighting the importance of the pituitary-thyroid-cardiac axis in dyslipidemia susceptibility.

关键词： Dyslipidemia Mendelian randomization Analysis Lipids Thyroid hormones