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Geriatric cardiology and the Great Wall International Congress of Cardiology 2015

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Journal of Geriatric Cardiology 2016年第4期13卷 279-281页

作者： Nanette K Wenger chang-sheng ma Emory University School of Medicine Atlanta GA USA Department of Cardiology Beij'ing Anzhen Hospital Capital Medical University Beijing China

The burgeoning geriatric population worldwide has resulted in an unprecedented challenge to the cardiology community. Cardiovascular disease is the major cause of morbidity and mortality in the elderly population, but its recognition and management are characteristically confounded by substantial comorbidities, polypharmacy, and other complexities of care, not encountered in younger cardiac patients.

关键词： Acute coronary syndrome GWICC 2015 ST- elevation myocardial infarction The elderly

Culprit vessel only versus ＂one-week＂ staged percutaneous coronary intervention for multivessel disease in patients presenting with ST-segment elevation myocardial infarction

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Journal of Geriatric Cardiology 2015年第3期12卷 226-231页

作者： Li-Xiang ma Zhen-Hua LU Le WANG Xin DU chang-sheng ma Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beo'ing China

Objective To explore the impact of a ＂one-week＂ staged muhivessel percutaneous coronary intervention （PCI） versus culprit-only PCI on deaths and major adverse cardiac events （maCE）. Methods We retrospectively analyzed 447 patients with multivessel disease who experienced a ST-segment elevation myocardial infarction （STEMI） within 12 h before undergoing PCI between July 26, 2008 and Septem- ber 25, 201 l. After completion of PCI in the infarct artery, 201 patients still in the hospital agreed to undergo PCI in non-infarct arteries with more than 70% stenosis for a ＂one-week＂ staged multivessel PCI. A total of 246 patients only received intervention for the culprit vessel. Follow-up ended on September 9, 2014. This study examined the differences in deaths from any cause （i.e., cardiac and noncardiac） and maCE between the two treatment groups. Results Compared to a culprit-only PCI treatment approach, the ＂one-week＂ staged multivessel PCI was strongly associated with greater benefits for 55-month all cause death [41 （16.7%） vs. 13 （6.5%）, P = 0.004] and maCE [82 （33.3%） vs. 40 （19.9%）, P = 0.002] rates. In addition, there were significant differences in the number of myocardial infarctions [43 （17.5%） vs. 20 （10.0%）, P = 0.023], coronary-artery bypass grafting [CABG; 20 （8.1%） vs. 6 （3.0%）, P = 0.021], and PCI [31 （12.6%） vs. 12 （6.0%）, P - 0.018]. Patients undergoing culprit-only PCI compared to ＂one-week＂ PCI had the same number of stent thrombosis events [7 （2.8%） vs. 3 （1.5%）, P - 0.522]. Conclusions Compared to a culprit-only PCI treatment approach, ＂one-week＂ staged multi-vessel PCI was a safe and effective selection for STEMI and multi-vessel PCL

关键词： ST-segment elevation myocardial infarction Percutaneous coronary intervention Multivessel revascularization

Immediate bail-out TAP-stenting for the treatment of iatrogenic aortocoronary dissection involving left main bifurcation

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Journal of Geriatric Cardiology 2013年第2期10卷 202-204页

作者： Edmundo Patricio Lopes Lao Shao-Ping Nie chang-sheng ma Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Iatrogenic aortocoronary dissection is a rare but potentially disastrous complication of percutaneous coronary intervention. The left main dissection extending into distal bifurcation involving both the left anterior descending and left circumflex is a complex and vital complication, which is classified as Eshtehardi Type II dissection. We presented a case of iatrogenic left main coronary artery dissection with upcoming closure of both major branches, which was successfully managed by immediate bail-out TAP-stenting. The 77-year-old patient was discharged without any complication, and 1-year follow-up indicated stent patency and favorable clinical result. Immediate bail-out stenting is a feasible and reasonable initial management for this lethal complication.

关键词： Aorta Bail-out stenting Coronary artery Dissection Percutaneous coronary intervention

Long term outcomes of saphaneous vein graft intervention in elderly patients with prior coronary artery bypass graft

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Journal of Geriatric Cardiology 2014年第1期11卷 26-31页

作者： Ji-Hong WANG Wei LIU Xin DU chang-sheng ma Xue-Si WU Department of Cardiology Beijing An-Zhen Hospital Capital Medical University Beijing 100029 China Department of Cardiology Beijing Ji-Shui-Tan Hospital the 4th Clinical College of Peking University Health Science Center Beo'ing 100035 China

Objectives To investigate the procedure characteristics and long term follow-up ofpercutaneous coronary intervention （PCI） for sa phaneous vein graft （SVG） lesions in the elderly patients. Methods From December 2005 to December 201 l, 84 graft lesions were treated percumneously. Seventeen were located at proximal anastomosis, 48 were located at SVG body, 19 were located at distal anastomosis. Pri mary endpoint was defined as major adverse cardiovascular events （maCE, composite of cardiac death, target vessel revascularization, acute myocardial infarction）. Results The graft age was 6.7 i 4.0 years. Most anastomosis lesions （80.0%） presented within one year post coro-nary artery bypass grafting （CABG）. Proximal anastomosis lesion had the lowest successful rate for PCI compared with graft body and distal anastomosis lesions （70.6% vs. 91.7%, 79.0%, P 〈 0.05）. The distal embolic protection device was used in 19.1% of patients, most frequently used in body graft PCI （29.2%, P 〈 0.01）. The diameter of the stent was smallest in distal anastomosis group （2.9 ±0.4 mm, P 〈 0.05）. The highest post dilatation pressure was required in the proximal anastomosis （17.8 ± 2.7 atm, P 〈 0.05）. The patients were followed up for 24.3 ±16.9 months. maCE occurred in 18.57% of patients. Incidence of maCE was highest among proximal anastomosis PCI （47.1% vs. body graft PCI 16.7%, distal anastomosis PCI 21.1%; P 〈 0.05）. Old myocardial infarction was the predictive factor for the poor clinical outcomes （P〈 0.04）. Conclusions PCI of SVG lesions is feasible with lower success rate. PCI of ostial graft anastomosis lesions had the lowest procedure success rate and highest maCE rate compared with graft body and distal anastomosis lesions. Old myocardial infarction was a predictive factor of poor outcomes.

关键词： Graft Anastomosis Percutaneous coronary intervention Coronary artery bypass grafting

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

Elevated high sensitive C-reactive protein and apelin levels after percutaneous coronary intervention and drug-eluting stent implantation

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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 *** 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 ***:Forty-eight consecutive patients undergoing PCI at the Beijing Anzhen Hospital between July and September 2006 were ***-eluting stents were employed in all *** samples were drawn immediately before and 24 h after the *** hs-CRP and apelin levels were determined by enzyme ***: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 *** with impaired left ventricular systolic function had significantly lower baseline apelin levels,which increased significantly after PCI.

关键词： High sensitive C-reactive protein (hs-CRP) Apelin Percutaneous colonary intervention (PCl)

Association of frailty with in-hospital outcomes in elderly patients with heart failure

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World Journal of Clinical Cases 2021年第36期9卷 11208-11219页

作者： Yun-Peng Kang Li-Ying Chen Jia-Jia Zhu Wen-Xian Liu chang-sheng ma Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityNational Clinical Research Center for Cardiovascular DiseasesBeijing 100029China

BACKGROUND Frailty is prevalent in elderly patients with cardiovascular ***,the association between frailty and in-hospital outcomes for elderly patients with heart failure and reduced ejection(HFrEF)remains *** To evaluate the predictive efficacy of frailty,compared with pre-frailty,for adverse events in these *** Elderly patients(≥60 years)with HFrEF were *** was evaluated with the Fried phenotype criteria,and physical performance was evaluated based on handgrip strength and the short physical performance battery(SPPB).The composite incidence of adverse events,including all-cause death,multiple organ failure,cardiac shock,and malignant arrhythmia,during hospitalization was *** Overall,252 elderly individuals with HFrEF[mean age:69.4±6.7 years,male:169(67.0%)]were *** hundred and thirty-five(53.6%)patients were frail and 93(36.9%)were *** patients were older,more likely to be female,to have a lower blood pressure,and to present with left ventricular thrombosis(P allmale gender(OR=0.422),aging(OR=1.090),poor cardiac functional class(OR=2.167),frailty(OR=2.379),and lower handgrip strength(OR=1.106)were independent predictors of in-hospital adverse events(P allmay be associated with poor in-hospital outcomes for elderly patients with *** influence of frailty on long-term prognosis in these patients deserves further investigation.

关键词： Heart failure with reduced ejection fraction Frailty Elderly Adverse events

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 *** 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 *** 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 *** pivotal phase 3 trials for each of the DOACs– dabigatran,rivaroxaban,apixaban,and edoxaban– included at least some East Asian ***,several clinical trials were conducted specifically for East Asian *** 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

Relationship between red blood cell distribution width and intermediate-term mortality in elderly patients after percutaneous coronary intervention

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Journal of Geriatric Cardiology 2015年第1期12卷 17-22页

作者： Xin-Min LIU chang-sheng ma Xiao-Hui LIU Xin DU Jun-Ping KANG Yin ZHANG Jia-Hui WU Department of Cardiology Beijing An Zhen Hospital Capital Medical University Beijing 100029 China

Background Large-scale clinical research on the relationship between red blood cell distribution width （RDW） and intermediate-term prognosis in elderly patients with coronary artery disease （CAD） is lacking. Thus, this study investigated the effects of RDW on the intermediate-term mortality of elderly patients who underwent elective percutaneous coronary intervention （PCI）. Methods Data from 1891 patients 〉 65 years old underwent elective PCI from July 2009 to September 2011 were collected. Based on preoperative median RDW （12.3%）, the patients were divided into two groups. The low RDW group （RDW 〈 12.3%） had 899 cases; the high RDW group （RDW 〉 12.3%） had 992 cases. The all-cause mortality rates of the two groups were compared. Results Patients in the high RDW group were more likely to be female and accompanied with diabetes, had lower hemoglobin level. The mean follow-up period was 527 days. During follow-up, 61 patients died （3.2%）. The postoperative mortality of the high RDW group was significantly higher than that of the low RDW group （4.3% vs. 2.0%, P = 0.004）. After adjusting other factors, multivariate Cox regression analysis revealed that preoperative high RDW was significantly associated with postoperative all-cause mortality （hazard ratio： 2.301, 95% confidence interval： 1.106-4.785, P = 0.026）. Conclusions Increased RDW was an independent predictor of the increased intermediate-term all-cause mortality in elderly CAD patients after elective PCI.

关键词： Coronary artery disease Elderly patients Percutaneous coronary intervention Red blood cell distribution width