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Discordance analysis for apolipoprotein and lipid measures for predicting myocardial infarction in statin-treated patients with coronary artery disease:a cohort study

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Journal of Geriatric Cardiology 2023年第12期20卷 845-854页

作者： Tian-Yu LI Pei ZHU Ying SONG Xiao-Fang TANG Zhan gao run-lin gao Jin-Qing YUAN National Clinical Research Center for Cardiovascular Diseases National Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

BACKGROUND The optimal apolipoprotein or lipid measures for identifying statin-treated patients with coronary artery disease(CAD)at residual cardiovascular risk remain *** study aimed to compare the predictive powers of apolipoprotein B(apoB),non-high-density lipoprotein cholesterol(non-HDL-C),low-density lipoprotein cholesterol(LDL-C),apoB/apolipoprotein A-1(apoA-1)and non-HDL-C/HDL-C for myocardial infarction(MI)in CAD patients treated with statins in the setting of secondary *** The study included 9191 statin-treated CAD patients with a five-year median *** measures were anal-yzed as continuous variables and concordance/discordance groups by *** hazard ratio(HR)with 95%CI was estimated by Cox proportional hazards *** were classified by the clinical presentation of CAD for further *** The high-apoB-low-LDL-C and the high-non-HDL-C-low-LDL-C categories yielded HR of 1.40(95%CI:1.04–1.88)and 1.51(95%CI:1.07–2.13)for MI,respectively,whereas discordant high LDL-C with low apoB or non-HDL-C was not associa-ted with the risk of *** association of MI with discordant apoB versus non-HDL-C,apoB/apoA-1 versus apoB,non-HDL-C/HDL-C versus non-HDL-C,or apoB/apoA-1 versus non-HDL-C/HDL-C was *** patterns were found in patients with acute coronary *** contrast,no association was observed between any concordance/discordance category and the risk of MI in patients with chronic coronary *** ApoB and non-HDL-C better predict MI in statin-treated CAD patients than LDL-C,especially in patients with acute coronary ***/apoA-1 and non-HDL-C/HDL-C show no superiority to apoB and non-HDL-C for predict-ing MI.

关键词： patients coronary infarction

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2016 Chinese guidelines for the management of dyslipidemia in adults

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Journal of Geriatric Cardiology 2018年第1期15卷 1-29页

作者： Jun-Ren ZHU run-lin gao Shui-Ping ZHAO Guo-Ping LU Dong ZHAO Jian-Jun LI Joint committee for guideline revision

Abbreviations ACS： acute coronary syndrome ALT： alanine aminotransferase Apo： apolipoprotein ASCVD： atherosclerotic cardiovascular disease AST： aspartate aminotransferase

关键词： Adults Chinese guidelines Dyslipidemia

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Effects of metabolic syndrome on onset age and long-term outcomes in patients with acute coronary syndrome

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World Journal of Emergency Medicine 2021年第1期12卷 36-41页

作者： Jing-jing Xu Ying Song Ping Jiang lin Jiang Xue-yan Zhao Zhan gao Jian-xin Li Shu-bin Qiao run-lin gao Yue-jin Yang Yin Zhang Bo Xu Jin-qing Yuan Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

BACKGROUND: We aim to investigate effects of metabolic syndrome on onset age and long-termoutcomes in patients with acute coronary syndrome (ACS).METHODS: Patients with ACS (n=6,431) who underwent percutaneous coronary interventionfrom January to December 2013 were enrolled. After excluding patients with previous coronary arterydisease, 1,558 patients were diagnosed with early-onset ACS (men aged ≤50 years;women aged≤60 years) and 3,044 patients with late-onset ACS. Baseline characteristics and five-year clinicaloutcomes were ***: Body mass index, triglyceride, low-density lipoprotein cholesterol, and uric acidconcentrations were significantly higher, while the high-density lipoprotein cholesterol (HDL-C)concentration was lower in the early-onset ACS group (P<0.001). Multivariate logistic regression revealedobesity (odds ratio [OR] 1.590, 95% confi dence interval [CI] 1.345–1.881), hypertriglyceridemia (OR 1.403,95% CI 1.185–1.660), and low HDL-C (OR 1.464, 95% CI 1.231–1.742) as independent risk factorsfor early-onset ACS (all P<0.001). The fi ve-year follow-up showed that the incidences of all cause death(1.5% vs. 3.8%, P<0.001), cardiac death (1.1% vs. 2.0%, P=0.023), and recurrent stroke (2.2% vs. 4.2%,P<0.001) were lower, while bleeding events were more frequent in the early-onset ACS group. A subgroupanalysis showed higher incidences of recurrent myocardial infarction (MI) and revascularization in patientswith early-onset ACS and metabolic ***: Obesity, hypertriglyceridemia, and lower HDL-C level are independent riskfactors for early-onset ACS, recurrent MI, and revascularization. The control of metabolic syndromemay reduce the incidence of early-onset ACS and improve the long-term prognosis.

关键词： Age Coronary artery disease Acute coronary syndrome Metabolic syndrome

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Differentiation of pyogenic hepatic abscesses from malignant mimickers using multislice-based texture acquired from contrast-enhanced computed tomography

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Hepatobiliary & Pancreatic Diseases International 2016年第4期15卷 391-398页

作者： Shi-Teng Suo Zhi-Guo Zhuang Meng-Qiu Cao Li-Jun Qian Xin Wang run-lin gao Yu Fan Jian-Rong Xu Department of Radiology Renji-Hospitall School of MedicineShanghai Jiaotong UniversityShanghai 200127China Department of Hepatic Surgery Renji-Hospitall School of MedicineShanghai Jiaotong UniversityShanghai 200127China Department of Pathology Renji-Hospitall School of MedicineShanghai Jiaotong UniversityShanghai 200127China

BACKGROUND： Pyogenic hepatic abscess may mimic primary or secondary carcinoma of the liver on contrast-enhanced computed tomography（CECT）. The present study was to explore the usefulness of the analysis of multislice-based texture acquired from CECT in the differentiation between pyogenic hepatic abscesses and malignant ***： This retrospective study included 25 abscesses in 20 patients and 33 tumors in 26 subjects who underwent CECT. To make comparison, we also enrolled 19 patients with hepatic single simple cyst. The images from CECT were analyzed using a Laplacian of Gaussian band-pass filter（5 filter levels with sigma weighting ranging from 1.0 to 2.5）. We also quantified the uniformity, entropy, kurtosis and skewness of the multislice-based texture at different sigma weightings. Statistical significance for these parameters was tested with oneway ANOVA followed by Tukey honestly significant difference（HSD） test. Diagnostic performance was evaluated using the receiver operating characteristic（ROC） curve ***： There were significant differences in entropy and uniformity at all sigma weightings（P〈0.001） among hepatic abscesses, malignant mimickers and simple cysts. The significant difference in kurtosis and skewness was shown at sigma 1.8 and 2.0 weightings（P=0.002-0.006）. Tukey HSD testshowed that the abscesses had a significantly higher entropy and lower uniformity compared with malignant mimickers（P=0.000-0.004）. Entropy（at a sigma 2.0 weighting） had the largest area under the ROC curve（0.888） in differentiating abscesses from malignant mimickers, with a sensitivity of 81.8% and a specificity of 88.0% when the cutoff value was set to ***： Multislice-based texture analysis may be useful for differentiating pyogenic hepatic abscesses from malignant mimickers.

关键词： texture analysis contrast-enhanced computed tomography liver pyogenic hepatic abscess malignant mimicker

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Effects of chronic obstructive pulmonary disease on longterm prognosis of patients with coronary heart disease postpercutaneous coronary intervention

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Journal of Geriatric Cardiology 2022年第6期19卷 428-434页

作者： Yi YAO Pei ZHU Na XU lin JIANG Xiao-Fang TANG Ying SONG Xue-Yan ZHAO Shu-Bin QIAO Yue-Jin YANG Jin-Qing YUAN run-lin gao Center for Coronary Heart Disease National Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

BACKGROUND Chronic obstructive pulmonary disease(COPD)and cardiovascular diseases are often comorbid conditions,their co-occurrence yields worse outcomes than either condition *** study aimed to investigate COPD impacts on the five-year prognosis of patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).METHODS Patients with CHD who underwent PCI in 2013 were recruited,and divided into COPD group and non-COPD *** events occurring among those groups were recorded during the five-year follow-up period after PCI,including all-cause death and cardiogenic death,myocardial infarction,repeated revascularization,as well as stroke and bleeding *** adverse cardiac and cerebral events were a composite of all-cause death,myocardial infarction,repeated revascularization and *** A total of 9843 patients were consecutively enrolled,of which 229 patients(2.3%)had *** to non-COPD patients,COPD patients were older,along with poorer estimated glomerular filtration rate and lower left ventricular ejection ***-year follow-up results showed that incidences of all-cause death and cardiogenic death,as well as major adverse cardiac and cerebral events,for the COPD group were significantly higher than for non-COPD group(10.5%vs.3.9%,7.4%vs.2.3%,and 30.1%vs.22.6%,respectively).COPD was found under multivariate Cox regression analysis,adjusted for confounding factors,to be an independent predictor of all-cause death[odds ratio(OR)=1.76,95%CI:1.15-2.70,P=0.009]and cardiogenic death(OR=2.02,95%CI:1.21-3.39,P=0.007).CONCLUSIONS COPD is an independent predictive factor for clinical mortality,in which CHD patients with COPD are associated with worse prognosis than CHD patients with non-COPD.

关键词： patients coronary prognosis

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Long-term outcome of percutaneous or surgical revascularization with and without prior stroke in patients with threevessel disease

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Journal of Geriatric Cardiology 2022年第8期19卷 583-593页

作者： Na XU Ce ZHANG lin JIANG Jing-Jing XU Ru LIU Ying SONG Xue-Yan ZHAO Lian-Jun XU run-lin gao Bo XU Jin-Qing YUAN Lei SONG Center for Coronary Heart Disease National Clinical Research Center for Cardiovascular DiseasesNational Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

OBJECTIVE To determine whether high-risk patients with three-vessel disease(TVD)with and without prior stroke preferen-tially benefit from three strategies[percutaneous coronary intervention(PCI),coronary artery bypass grafting(CABG)and medical therapy(MT)].METHODS A total of 8943 patients with TVD were included in the *** enrolled were stratified into two categories according to the presence or absence of prior stroke *** primary endpoint was all-cause *** endpoints in-cluded stroke and major adverse cardiac and cerebrovascular event(MACCE),a composite of death,myocardial infarction(MI),unplanned revascularization and *** Prior stroke was present in 888 patients(9.9%).These patients were older and had higher rates of ***-ring a median follow-up of 7.5 years,patients with prior stroke were strongly associated with increased risks of all-cause death,cardiac death,stroke and MACCE,even after adjusting for confounding variables and results been consistent across either treat-ment subgroup(PCI,CABG and MT)(all adjusted Plinical *** is essential to balance benefit and risk when determining the optimal treatment strategy for TVD with and without prior stroke.

关键词： patients prior founding

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Heart failure and left ventricular dysfunction in older patients with chronic kidney disease: the China Hypertension Survey (2012‒2015)

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Journal of Geriatric Cardiology 2020年第10期17卷 597-603页

作者： Xin WANG Guang HAO Lu CHEN lin-Feng ZHANG Zuo CHEN Yu-Ting KANG Ying YANG Cong-Yi ZHENG Hao-Qi ZHOU Zeng-Wu WANG run-lin gao Division of Prevention and Community Health National Center for Cardiovascular DiseaseNational Clinical Research Center of Cardiovascular DiseaseState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Epidemiology School of MedicineJinan UniversityGuangzhouChina Department of Cardiology Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Background Heart failure(HF)is a leading cause of hospitalization and mortality for older chronic kidney disease(CKD)***,the epidemiological data is *** aimed to determine the prevalence of left ventricular(LV)dysfunction and HF,and to explore the risk factors for HF among those *** This is a cross-sectional analysis of the China Hypertension Survey conducted between October 2012 and December 2015.A total of 5,808 participants aged≥65 years were included in the ***-reported history of HF and any other cardiovascular diseases was acquired.2-D and Doppler echocardiography were used to assess LV *** was defined as either estimated glomerular filtration rate(eGFR)<60 mL/min per 1.73 m2 or urinary albumin to creatinine ratio(ACR)≥30 mg/*** Among CKD patients aged≥65 years,the weighted prevalence of HF,heart failure with preserved ejection fraction(HFpEF),heart failure with mid-range ejection fraction(HFmrEF),and heart failure with reduced ejection fraction(HFrEF)was 4.8%,2.5%,0.8%,and 1.7%,*** weighted prevalence of HF was 5.0%in patients with eGFR<60 mL/min per 1.73 m2,and was 5.9%in patients with ACR≥30 mg/*** prevalence of LV systolic dysfunction was 3.1%,and while it was 8.9%for moderate/severe diastolic *** analysis showed that smoking was significantly associated with the risk of ***,age,smoking,and residents in rural areas were significantly associated with a risk of LV diastolic *** The prevalence of HF and LV dysfunction was high in older patients with CKD,suggesting that particular strategies will be required.

关键词： Chronic kidney disease Heart failure Left ventricular dysfunction Older population

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Recurrent Multivessel Coronary Artery Spasm Presented as Myocardial Infarction

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Chinese Medical Journal 2016年第22期129卷 2753-2756页

作者： Hao Zhang Wen-Jia Zhang Yong-Jian Wu run-lin gao Department of Cardiology Center for Coronary Heart Disease Fuwai Hospital National Center of Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Coronary artery spasm is typically a transient and marked narrowing of a single coronary artery lumen that induces myocardial *** general,patients with coronary spastic angina have a good ***,we described a case of recurrent diffuse multivessel coronary artery spasm presented as myocardial infarction,which was a very rare form of coronary heart *** several similar ones have been reported worldwide,this is the first case rechecked by coronary angiography （CAG） in the follow-up period.

关键词： Cardiogenic Shock Multivessel Coronary Artery Spasm Myocardial Infarction

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Prolonging dual antiplatelet therapy improves the long-term prognosis in patients with diabetes mellitus undergoing complex percutaneous coronary intervention

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Journal of Geriatric Cardiology 2023年第8期20卷 586-595页

作者： Jing-Jing XU Si-Da JIA Pei ZHU Ying SONG De-Shan YUAN Xue-Yan ZHAO Yi YAO lin JIANG Jian-Xin LI Yin ZHANG Lei SONG run-lin gao Ya-ling HAN Jin-Qing YUAN Department of Cardiology National Clinical Research Center for Cardiovascular DiseasesNational Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology General Hospital of Northern Theater CommandShenyangChina

OBJECTIVE To investigate the optimal duration of dual antiplatelet therapy(DAPT)in patients with diabetes mellitus(DM)requiring complex percutaneous coronary intervention(PCI).METHODS A total of 2403 patients with DM who underwent complex PCI from January to December 2013 were consecutively enrolled in this observational cohort study and divided according to DAPT duration into a standard group(11-13 months,n=689)and two prolonged groups(13-24 months,n=1133;>24 months,n=581).RESULTS Baseline characteristics,angiographic findings,and complexity of PCI were comparable regardless of DAPT *** incidence of major adverse cardiac and cerebrovascular event was lower when DAPT was 13-24 months than when it was 11-13 months or>24 months(4.6%vs.8.1%vs.6.0%,P=0.008),as was the incidence of all-cause death(1.9%vs.4.6%vs.2.2%,P=0.002)and cardiac death(1.0%vs.3.0%vs.1.2%,P=0.002).After adjustment for confounders,DAPT for 13-24 months was associated with a lower risk of major adverse cardiac and cerebrovascular event[hazard ratio(HR)=0.544,95%CI:0.373-0.795]and all-cause death(HR=0.605,95%CI:0.387-0.944).DAPT for>24 months was associated with a lower risk of all-cause death(HR=0.681,95%CI:0.493-0.942)and cardiac death(HR=0.620,95%CI:0.403-0.952).The risk of major bleeding was not increased by prolonging DAPT to 13-24 months(HR=1.356,95%CI:0.766-2.401)or>24 months(HR=0.967,95%CI:0.682-1.371).CONCLUSIONS For patients with DM undergoing complex PCI,prolonging DAPT might improve the long-term prognosis by reducing the risk of adverse ischemic events without increasing the bleeding risk.

关键词： patients coronary mellitus

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2023 China Guidelines for Lipid Management

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Journal of Geriatric Cardiology 2023年第9期20卷 621-663页

作者： Jian-Jun LI Shui-Ping ZHAO Dong ZHAO Guo-Ping LU Dao-Quan PENG Jing LIU Zhen-Yue CHEN Yuan-lin GUO Na-Qiong WU Sheng-Kai YAN Zeng-Wu WANG run-lin gao National Center for Cardiovascular Diseases Fuwai HospitalChinese Academy of Medical SciencesBeijingChina The Second Xiangya Hospital of Central South University ChangshaHunanChina Beijing Anzhen Hospital Capital Medical UniversityBeijingChina Ruijin Hospital Shanghai Jiaotong University School of MedicineShanghaiChina Affiliated Hospital of Zunyi Medical University School of Laboratory Medicine of Zunyi Medical UniversityZunyiGuizhouChina

Atherosclerotic cardiovascular disease(ASCVD)is the leading cause of death among urban and rural residents in China,and elevated low-density lipoprotein cholesterol(LDL-C)is a risk factor for *** the increasing burden of ASCVD,lipid management is of the utmost *** recent years,research on blood lipids has made breakthroughs around the world,hence a revision of China guidelines for lipid management is imperative,especially since the target lipid levels in the general population vary in respect to the risk of *** level of LDL-C,which can be regarded as appropriate in a population without frisk factors,can be considered abnormal in people at high risk of developing *** a result,the“Guidelines for the prevention and treatment of dyslipidemia”were adapted into the“China Guidelines for Lipid Management”(henceforth referred to as the new guidelines)by an Experts’committee after careful *** new guidelines still recommend LDL-C as the primary target for lipid control,with CVD risk stratification to determine its target *** guidelines recommend that moderate intensity statin therapy in adjunct with a heart-healthy lifestyle,be used as an initial line of treatment,followed by cholesterol absorption inhibitors or/and proprotein convertase subtilisin/kexin type 9(PCSK9)inhibitors,as *** new guidelines provide guidance for lipid management across various age groups,from children to the *** aim of these guidelines is to comprehensively improve the management of lipids and promote the prevention and treatment of ASCVD by guiding clinical practice.

关键词： Lipid prevention hence

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