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High prevalence of aspirin resistance in elderly patients with cardiovascular disease and metabolic syndrome

Journal of Geriatric Cardiology 2016年第6期13卷 531-536页

作者： Lin LIU ying-hui GAO Jian CAO hua-xin ZHANG Li FAN Guo-Liang hu yi-xin hu Xiao-Li LI Xiao ZOU Jian-hua LI Nanlou Respiratory Disease Department Chinese PLA General Hospital Beijing China Peking University Hepatology Institute Peking University People's Hospital Peking University Beijing China Nanlou Clinical Lab Chinese PLA General Hospital Beijing China Department of Clinical Laboratory of South Building Chinese PLA General Hospital Beijing China Clinical Department of South Building Chinese PLA General Hospital Beijing China

Background Metabolic syndrome is known to be a prothrombotic state. We undertook this study to examine a hypothesis that aspirin resistance may be associated with metabolic syndrome, and to assess other potential determinants of aspirin resistance in patients with cardiovascular disease （CVD）. Methods A total of 469 elderly patients with CVD were recruited. One hundred and seventy-two patients with metabolic syndrome and 297 without metabolic syndrome （control group） received daily aspirin therapy （〉 75 mg） over one month. Platelet aggregation was measured by light transmission aggregometry （LTA）. Aspirin resistance was defined as 〉 20% arachidonic acid （AA）- and 〉 70% adenosine diphosphate （ADP）-induced aggregation according to LTA. Aspirin semi-responders were defined as meeting one （but not both） of these criteria. Results By LTA, 38 of 469 （8.1%） patients were aspirin resistant. The prevalence of aspirin resistance was higher in the metabolic syndrome group compared with the control group [11.6 % vs. 6.6%, odds ratio （OR） = 2.039; 95% confidence interval （CI）： 1.047-3.973]. In the multivariate logistic regression analysis, metabolic syndrome （OR = 4.951, 95% CI： 1.440-17.019, P = 0.011） was a significant risk factor for aspirin resistance. Conclusions A significant number of patients with CVD and metabolic syndrome are resistant to aspirin therapy. This might further increase the risk of cardiovascular morbidity and mortality in these patients.

关键词： Aspirin resistance Cardiovascular disease Metabolic syndrome

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Prevalence of and risk factors for aspirin resistance in elderly patients with coronary artery disease

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Journal of Geriatric Cardiology 2013年第1期10卷 21-27页

作者： Xian-Feng Liu Jian Cao Li Fan Lin Liu Jian Li Guo-Liang hu yi-xin hu Xiao-Li Li First Geriatric Cardiology Division of South Building Chinese PLA General Hospital 28 Fuxing Road Beijing 100853 China

Objective To assess the prevalence of and related risk factors for aspirin resistance in elderly patients with coronary artery disease (CAD). Methods Two hundred and forty-six elderly patients (75.9 ±7.4 years) with CAD who received daily aspirin therapy (≥75 mg) over one month were recruited. The effect of aspirin was assessed using light transmission aggregometry (LTA) and thrombelastography platelet mapping assay (TEG). Aspirin resistance was defined as ≥20% arachidonic acid (AA)-induced aggregation and ≥70% adenosine diphosphate (ADP)-induced aggregation in the LTA assay. An aspirin semi-responder was defined as meeting one (but not both) of the criteria described above. Based on the results of TEG, aspirin resistance was defined as ≥50% aggregation induced by AA. Results As determined by LTA, 23 (9.3%) of the elderly CAD patients were resistant to aspirin therapy; 91 (37.0%) were semi-responders. As determined by TEG, 61 patients (24.8%) were aspirin resistant. Of the 61 patients who were aspirin resistant by TEG, 19 were aspirin resistant according to LTA results. Twenty-four of 91 semi-responders by LTA were aspirin resistant by TEG. Multivariate logistic regression analysis revealed that elevated fasting serum glucose level (Odds ratio: 1.517; 95% CI: 1.176–1.957; P = 0.001) was a significant risk factor for aspirin resistance as determined by TEG. Conclusions A significant number of elderly patients with CAD are resistant to aspirin therapy. Fasting blood glucose level is closely associatedwith aspirin resistance in elderlyCAD patients.

关键词： Aspirin resistance Coronary artery disease Risk factors

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Establishing a predictive model for aspirin resistance in elderly Chinese patients with chronic cardiovascular disease

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Journal of Geriatric Cardiology 2016年第5期13卷 458-464页

作者： Jian CAO Wei-Jun HAO Ling-Gen GAO Tian-Meng CHEN Lin LIU Yu-Fa SUN Guo-Liang hu yi-xin hu Li FAN Department of Geriatric Cardiology Chinese PLA General Hospital Beijing China Health Division of Guard Bureau General Staff Department of Chinese PLA Beijing China

Background Resistance to anti-platelet therapy is detrimental to patients. Our aim was to establish a predictive model for aspirin resistance to identify high-risk patients and to propose appropriate intervention. Methods Elderly patients （n = 1130） with stable chronic coronary heart disease who were taking aspirin （75 mg） for 〉 2 months were included. Details of their basic characteristics, laboratory test results, and medications were collected. Logistic regression analysis was performed to establish a predictive model for aspirin resistance. Risk score was finally established according to coefficient B and type of variables in logistic regression. The Hosmer-Lemeshow （HL） test and receiver operating characteristic curves were performed to respectively test the calibration and discrimination of the model. Results Seven risk factors were included in our risk score. They were serum creatinine （〉 110 μmol/L, score of 1）; fasting blood glucose （〉 7.0 mmol/L, score of 1）; hyperlipidemia （score of 1）; number of coronary arteries （2 branches, score of 2; 〉 3 branches, score of 4）; body mass index （20-25 kg/m2, score of 2; 〉 25 kg/m2, score of 4）; percutaneous coronary intervention （score of 2）; and smoking （score of 3）. The HL test showed P ≥ 0.05 and area under the receiver operating characteristic curve ≥ 0.70. Conclusions We explored and quantified the risk factors for aspirin resistance. Our predictive model showed good calibration and discriminative power and therefore a good foundation for the further study of patients undergoing anti-platelet therapy.

关键词： Aspirin resistance Cardiovascular disease Predictive model Risk score

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Prevalence of and risk factors for postprandial hypotension in older Chinese men

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Journal of Geriatric Cardiology 2015年第6期12卷 600-604页

作者： Xiao ZOU Jian CAO Jian-hua LI yi-xin hu Yu-Song GUO Quan-Jin SI Li FAN Geriatric Cardiology Department Chinese PLA General Hospital Beijing China Department of Health Care in Nanlou Chinese PLA General Hospital Beijing China Healthcare Department Hainan Branch of Chinese PLA General Hospital Sanya Hainan China

Objective To assess the prevalence of and risk factors for postprandial hypotension （PPH） among old and very old Chinese men. Methods The study included 349 Chinese men aged 65 and older, grouped into two age categories： group 1 （old） included 163 men aged 65 to 80 years; group 2 （very old） included 186 men aged over 80 years. Blood pressure changes after meals were assessed every 15 min by ambulatory blood pressure monitoring. Symptoms after meal ingestion and after standing up and changes in the baseline condition relative to blood pressure changes were observed continuously. Additional baseline data included body mass index, medical history, and medication use Results The prevalence of PPH was 59.3% overall and was significantly higher in group 2 than group 1 （63.4% vs. 54.6%, P 〈 0.05）. In group 2, the prevalence of PPH after breakfast （33.8%） and lunch （32.1%） were higher than that after supper （20.9%）, P 〈 0.05. Hypertension and age were significant risk factors for PPH （OR = 2.188, 95% CI： 1.134-4.223, P = 0.02; OR = 1.86, 95% CI： 1.112-3.11, P = 0.018, respectively）. In contrast, acarbose use was protective against PPH （OR = 0.4, 95% CI： 0.189-0.847, P = 0.017）. The decrease in blood pres- sure during PPH was 20-40 mmHg and the maximum was 90 mmHg. PPH usually occurred at 30-60 min after a meal and lasted 30-120 rnin. Conclusions These findings demonstrate that the prevalence of PPH in men aged over 80 years is significantly higher than those in men aged 65 to 80 years, and the blood pressure decline is also higher for men aged over 80 years. In addition, hypertension and age were main risk factors for PPH in the older men, which suggest that preventing and treating PPH is worthwhile.

关键词： Male Postprandial hypotension Prevalence The elderly

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Causal relationship between feelings and cognitive decline:An univariable and multivariable Mendelian randomization study

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World Journal of Psychiatry 2024年第3期14卷 421-433页

作者： Juan Liu Lin Liu yi-xin hu Jian-hua Li Xiao Zou Hao-Yun Zhang Li Fan Department of Cardiology The Second Medical Center&National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijing 100853China Department of Pulmonary and Critical Care Medicine The Second Medical Center&National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijing 100853China The Fourth Department of Geriatric Health Care The Second Medical Center&National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijing 100853China Department of Anesthesiology First Medical Center of Chinese PLA General HospitalBeijing 100853China

BACKGROUND While the impact of depression on cognition is well-documented,the relationship between feelings and cognition has received limited *** To explore the potential association between feelings and cognition with a twosample Mendelian randomization(MR)*** Our analysis utilized genome-wide association data on various feelings(fed-up feelings,n=453071;worrier/anxious feelings,n=450765;guilty feelings,n=45-0704;nervous feelings,n=450700;sensitivity/hurt feelings,n=449419;miserableness,n=454982;loneliness/isolation,n=455364;happiness,n=152348)in the European population and their impact on cognitive functions(intelligence,n=269867).Conducting a univariable MR(UVMR)analysis to assess the relationship between feelings and *** this analysis,we applied the inverse variance weighting(IVW),weighted median,and MR Egger ***,we performed sensitivity analysis(leave-one-out analysis),assessed heterogeneity(using MR-PRESSO and Cochran’s Q test),and conducted multiple validity test(employing MR-Egger regression).Subsequently,a multivariable MR(MVMR)analysis was employed to examine the impact of feelings on *** served as the primary method in the multivariable analysis,complemented by median-based and MR-Egger *** In this study,UVMR indicated that sensitivity/hurt feelings may have a negative causal effect on cognition(OR=0.63,95%CI:0.43-0.92,P=0.017).After adjustment of other feelings using MVMR,a direct adverse causal effect on cognition was observed(OR_(MVMR)=0.39,95%CI:0.17-0.90,P_(MVMR)=0.027).While a potential increased risk of cognitive decline was observed for fed-up feelings in the UVMR analysis(ORUVMR=0.64,95%CI:0.42-0.97,PUVMR=0.037),this effect disappeared after adjusting for other feelings(OR_(MVMR)=1.42,95%CI:0.43-4.74,P_(MVMR)=0.569).These findings were generally consistent across MV-IVW,median-based,and MR-Egger ***-Egger regression revealed pleiotropy in the impact of worrier/anxious

关键词： Mendelian randomization analysis Feelings Cognition Intelligence

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No association between low-dose reserpine use and depression in older hypertensive patient: result of a multicenter, cross-sectional study

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Journal of Geriatric Cardiology 2019年第8期16卷 608-613页

作者： Guo-hua Zhu Xi-Peng SUN Jing LI Lin PI Hai-Qin TANG Hai-Qing GAO Hong-Liang CONG Peng QU xin-Zheng LU xin-Jun ZHANG Luo-Sha ZHAO yi-Fang GUO Dong-Xia LIU Liang-Qing ZHANG hua TANG yi-xin hu Li FAN Qi huA Department of Cardiology Xuanwu Hospital Capital Medical UniversityBeijingChina Department of Geriatrics Hebei General HospitalShijiazhuangChina Department of Cardiology Hebei General HospitalShijiazhuangChina Department of Cardiology Shanxi Cardiovascular HospitalXianChina Department of Geriatrics Chinese PLA General HospitalBeijingChina Department of Cardiology Chuiyangliu Hospital affiliated to Tsinghua UniversityBeijingChina Department of Cardiology the First Affiliated Hospital of Anhui Medical UniversityHefeiChina Department of Cadre Health Care Qilu Hospital of Shandong UniversityJinanChina Department of Cardiology Tianjin Chest HospitalTianjinChina Department of Cardiology the Second Hospital of Dalian Medical UniversityDalianChina Department of Cardiology Jiangsu Provincial HospitalNanjingChina Department of Geriatrics West China HospitalSichuan UniversityChengduChina Department of Cardiology the First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina

Background Reserpine is currently used by millions of Chinese hypertensive patients, in spite of the continued concern of its depressogenic effect, even when used in low dose. This study aimed to investigate the association between low-dose reserpine use and depression in older Chinese hypertensive patient. Methods In this cross-sectional, case-control study, we recruited patient aged 60 years or over who had regularly taken one or two tables of “compound reserpine and triamterene tablets (CRTTs)” for more than one year (reserpine user) from 26 community health centers located in 10 provinces in China. For each patient who took CRTTs, we selected an age (within five years) and sex matched hypertensive patient who had never taken any drugs containing reserpine (non-reserpine user) as control. Depressive symptoms were evaluated using a Chinese depression scale adapted from the Zung Self-Rating Depression Scale. Demographic, clinical data and laboratory examination results within six months were collected. Results From August 2018 to December 2018, 787 reserpine user and 787 non-reserpine user were recruited. The mean age of all study subjects was 70.3 years, with about equal numbers of males and females. The mean depression score was 40.4 in reserpine users and 40.6 in non-reserpine users (P = 0.7). The majority of study subject had a depression score < 53 (87.6% in reserpine users and 88.2% in non-reserpine users, respectively). There were no significant differences in the prevalence of mild, moderate or severe depression in reserpine users and non-reserpine users. Conclusions There is no association between low-dose reserpine use and depression in older hypertensive patient. The role of reserpine in the treatment and control of hypertension should be reconsidered;and further studies, especially randomized, controlled clinical trials to compare efficacy and safety of reserpine and other widely recommended anti-hypertensive agents are needed.

关键词： Depression Hypertension Reserpine

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Association factors of target organ damage： analysis of 17 682 elderly hypertensive patients in China

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Chinese Medical Journal 2011年第22期124卷 3676-3681页

作者： CUI hua WANG Fan FAN Li hu yi-xin hu Guo-liang LIU Lin HONG Chang-ming Chinese People＇s Liberation Army General Hospital （Fan L） Beijing 100853 China

Background Hypertensive target organ damage （TOD） is the main reason for mortality or disability in elderly hypertensive patients. The studies on TOD of hypertension in Asia, especially in Chinese elderly hypertensive patients, are very limited. The aim of this study was to evaluate the prevalence and correlative factors of TOD in older Chinese hypertensive inpatients. Methods This is a retrospective survey and data were collected from the computerized medical files of hypertensive inpatients from January of 1993 to December of 2008. The analysis was done on 17 682 inpatients, aged 60 years or older, with a diagnosis of essential hypertension （EH）. The evidence of hypertensive TOD and associated factors with TOD were collected. Results The prevalence of any hypertensive target organ involvement among these subjects was high. In multivariable Logistic regressions adjusted for potentially confounding factors, older age, male gender, diabetes, EH grade 3, systolic blood pressure （SBP）, and low-density lipoprotein cholesterol （LDL-C）, were independently associated with coronary artery disease. Age, duration of EH, EH grade 3, SBP, pulse pressure （PP）, and homocysteine （Hcy） were independently associated with cerebrovascular disease. Age, diabetes, duration of EH, EH grade 3, SBP, PP and estimated glomerular filtration rate （eGFR） were independently associated with chronic kidney disease. Male gender, EH grade 3 and SBP were independently associated with aortic dissection. Conclusions The prevalence of hypertensive TOD is high in older Chinese hypertensive inpatients. Various cardiovascular risk factors are associated with hypertensive TOD. The level of SBP and severe hypertension （grade 3 hypertension） are common independent risk factors of TOD.

关键词： hypertension target organ damage risk factors elderly inpatients

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Chinese expert consensus on the management of hypertension in the very elderly

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Journal of Geriatric Cardiology 2016年第12期13卷 945-953页

作者： Jing LI yi-xin hu Wen WANG Ning-Yuan FANG xin-Zheng LU Lin PI Mei-Lin LIU Wei-Min LI Yan-Fang LI Peng QU Qi huA Qing HE Hai-ying WU Yuan-Ming ZHANG Xiao-Ping CHEN Lu-Yuan CHEN Li FAN xing-Sheng ZHAO Zhi-Ming Zhu yi-Nong JIANG yi-Fang GUO Hong YUAN Ping-Jin GAO xin-Juan XU Jun CAI Liang-Di XIE Xuan Wu Hospital Capital Medical University Beijing China Chinese PLA General Hospital Beijing China Chinese Academy of Medical Science Fuwai Hospital Beijing China Renji Hospital Medical College of Shanghai Jiao Tong University ShanghaL China Jiang Su Province People's Hospital Jiangsu China Beijing Chui Yang Liu Hospital Beijing China Peking University First Hospital Beijing China First Affiliated Hospital of Harbin Medical University Heilongjiang China Beijing An Zhen Hospital Capital Medical University Beijing China The Second Affiliated Hospital of Dalian Medical University Liaoning China Beijing Hospital Beijing China The First Hospital of xinjiang Medical University Xinjiang Uygur Autonomous Region China West China Hospital Sichuan University Sichuan China The People's Hospital of Guangdong Province Guangdong China Inner Mongolia Autonomous Region People's Hospital Inner Mongolia Autonomous Region China Daping Hospital the Third Military Medical University Chongqing China The First Affiliated Hospital of Dalian Medical University Liaoning China Hebei Province People's Hospital Hebei China Xiangya Third Hospital Central South University Hunan China Shanghai Hypertension Research Institute Shanghai China The First Hospital of Fujian Medical University Fujian China

Population aging has become a major challenge for the healthcare in China. More than 23 million Chinese are cur- rently ≥ 80 years, with an annual increase of 5%. The Chi- nese population of 80 years or older is expe... 详细信息

关键词： Consensus Geriatric Hypertension Octogenarians

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光纤耦合双光学腔系统的相干动力学

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光子学报 2016年第11期45卷 84-90页

作者：曹德伟张逸新胡征达江南大学理学院轻工光电工程技术研究中心江苏无锡214122

为了研究量子相干性在腔量子电动力学系统中的动力学和分布特性,基于两个各自捕获原子系综的光学腔建立了双光学腔系统,腔与腔之间由光纤耦合.利用相对熵度量的量子相干性,引入量子相干非平衡性的概念,分析了系统中相干动力学和光纤-腔... 详细信息

为了研究量子相干性在腔量子电动力学系统中的动力学和分布特性,基于两个各自捕获原子系综的光学腔建立了双光学腔系统,腔与腔之间由光纤耦合.利用相对熵度量的量子相干性,引入量子相干非平衡性的概念,分析了系统中相干动力学和光纤-腔耦合强度对相干性分布的影响.结果表明:在强耦合极限下,光纤-腔耦合强度的增加有利于保持两腔中的原子的整体相干性;光纤-腔耦合强度、原子-腔耦合强度以及原子数三个参数之间满足特定条件时,腔内的原子相干性可以传输至另一个腔.考虑腔、光纤及原子都存在耗散的情形,对比了不同耗散速率和非耗散情形下的相干性演化,发现耗散使得耦合双腔系统的相干性以及各个腔中的原子相干性发生衰减.

关键词：量子光学量子信息量子相干性退相干腔量子电动力学光纤

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Repetitive transcranial magnetic stimulation in Alzheimer’s disease:effects on neural and synaptic rehabilitation

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Neural Regeneration Research 2025年第2期20卷 326-342页

作者： yi Ji Chaoyi Yang Xuerui Pang yibing Yan Yue Wu Zhi Geng Wenjie hu Panpan hu xingqi Wu Kai Wang Department of Neurology The First Affiliated Hospital of Anhui Medical UniversityHefeiAnhui ProvinceChina Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders HefeiAnhui ProvinceChina Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health HefeiAnhui ProvinceChina Institute of Artificial Intelligence Hefei Comprehensive National Science CenterHefeiAnhui ProvinceChina Department of Psychology and Sleep Medicine The Second Affiliated Hospital of Anhui Medical UniversityHefeiAnhui ProvinceChina

Alzheimer’s disease is a neurodegenerative disease resulting from deficits in synaptic transmission and *** Alzheimer’s disease brain tends to be hyperexcitable and hypersynchronized,thereby causing neurodegeneration and ultimately disrupting the operational abilities in daily life,leaving patients *** transcranial magnetic stimulation is a cost-effective,neuro-modulatory technique used for multiple neurological *** the past two decades,it has been widely used to predict cognitive decline;identify pathophysiological markers;promote neuroplasticity;and assess brain excitability,plasticity,and *** has also been applied to patients with dementia,because it can yield facilitatory effects on cognition and promote brain recovery after a neurological ***,its therapeutic effectiveness at the molecular and synaptic levels has not been elucidated because of a limited number of *** study aimed to characterize the neurobiological changes following repetitive transcranial magnetic stimulation treatment,evaluate its effects on synaptic plasticity,and identify the associated *** review essentially focuses on changes in the pathology,amyloidogenesis,and clearance pathways,given that amyloid deposition is a major hypothesis in the pathogenesis of Alzheimer’s *** mechanisms associated with repetitive transcranial magnetic stimulation procedures and different pathways mediating gene transcription,which are closely related to the neural regeneration process,are also ***,we discuss the outcomes of animal studies in which neuroplasticity is modulated and assessed at the structural and functional levels by using repetitive transcranial magnetic stimulation,with the aim to highlight future directions for better clinical translations.

关键词： Alzheimer’s disease amyloid deposition apoptotic mechanisms biomarker neural regeneration neurodegeneration repetitive transcranial magnetic stimulation synaptic plasticity

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