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cardiovascular events in hyperuricemia population and a cardiovascular benefit-risk assessment of urate-lowering therapies:a systematic review and meta-analysis

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Chinese Medical Journal 2020年第8期133卷 982-993页

作者： Li Zhao Ling Cao Tian-Yi Zhao Xue Yang Xiao-Xia Zhu He-Jian Zou Wei-Guo Wan Yu Xue Department of Rheumatology Huashan HospitalFudan UniversityShanghai 200040China Institute of Rheumatology Immunology and AllergyFudan UniversityShanghai 200040China

Background:Hyperuricemia and gout have become public health concerns;many important guidelines have recommended xanthine oxidase inhibitors(XOIs)as the first-line urate-lowering therapies(ULTs)to treat chronic gout with hyperuricemia.However,whether treating hyperuricemia and gout with ULTs modifies cardiovascular risks remains controversial.The aim of this study was to assess the incident risk of cardiovascular(CV)events(CVE)in hyperuricemia population,assess the cardiovascular benefit-risk of ULTs in hyperuricemia patients with or without gout in diverse cardiovascular risk sub-groups,and specify the safety of different ULTs.Methods:We searched PubMed,Embase,the Cochrane Library,Wanfang,Chongqing VIP(CQVIP,***),and China National Knowledge Infrastructure Database for prospective cohort studies and randomized controlled trials(RCTs)in English and Chinese.Potential medications included XOIs,and uricosurics.RCTs were divided into sub-groups analysis based on blinding status and patients’history of CV diseases.Risk ratios(RRs)were calculated and were reported with corresponding 95%confidence intervals(CIs)by fixed-effects or random-effects model.Results:Seven prospective cohort studies and 17 RCT studies were included.The risks of both major adverse cardiovascular events(MACE)(RR=1.72,95%CI 1.28-2.33)and CVE(RR=1.35,95%CI 1.12-1.62)were higher in the hyperuricemia population than non-hyperuricemia one.In seven RCT studies where XOIs were compared with no-treatment or placebo,the results of five low CV risk studies showed that XOIs lowered the risks of both MACE(RR=0.35,95%CI 0.20-0.62)and CVE(RR=0.61,95%CI 0.44-0.85);whereas two high CV risk studies showed that XOIs lowered the risk of CVE(RR=0.69,95%CI 0.54-0.88)rather than MACE(RR=0.62,95%CI 0.29-1.35).In nine RCT studies where the cardiovascular safety between febuxostat and allopurinol were compared,no statistical difference was found in the risk of MACE or CVE.Conclusions:The hyperuricemia population does have a higher incidence of CVE,and the results suggeste

关键词： Hyperuricemia Gout cardiovascular event Febuxostat Allopurinol

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Serum interleukin-10 levels and adverse events in patients with acute coronary syndrome： a systematic review and meta-analysis

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Chinese Medical Journal 2014年第1期127卷 150-156页

作者： Liu Jun Jia Yanjun Li Xiaolin Xu Ruixia Zhu Chenggang Guo Yuanlin Wu Naqiong Li Jianjun Division of Dyslipidemia Cardiovascular Medicine Fu Wai HospitalState Key Laboratory of Cardiovascular Disease National Centerfor Cardiovascular Diseases Chinese Academy of Medical SciencesPeking Union Medical College Beijing 100037 China

Background Several studies investigating the prognostic utility of interleukin-10 （IL-10） in patients with acute coronary syndrome （ACS） have provided conflicting findings.The aim of the study was to assess the existing evidence regarding association between serum IL-10 levels and adverse events.Methods Literature search was performed in PubMed,EMBASE,and Cochrane Trials Register databases from their inception to September 30,2012.In addition,reference lists of the included articles and their related citations in PubMed were also reviewed for additional pertinent studies.Results A total of 12 eligible studies comprising a total of 5882 patients were identified.The pooled relative risks for both studies reporting the risk estimates by IL-10 categories and studies reporting the risk estimates by unit IL-10 indicated an association between high IL-10 levels and adverse events.Sensitivity and subgroup analysis indicated that the results obtained in IL-10 categories were not stable.Conclusions Data from our meta-analysis supported the existence of a relationship between high serum IL-10 levels and adverse events in patients with ACS.Large study with longer follow-up is needed to confirm the findings.

关键词： interleukins acute coronary syndrome cardiovascular event meta-analysis

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World Journal of Anesthesiology 2020年第1期9卷 7-11页

作者： Zhen-Zhen Xu Huai-Jin Li Xue Li Hong Zhang Department of Anesthesiology and Critical Medicine Peking University First HospitalBeijing 100034China

BACKGROUND Cement-related embolism is a rare but potentially fatal complication in spinal surgery.Cardiac echocardiography can provide valuable information for the early identification.CASE SUMMARY A 66-year-old woman who underwent lumbar vertebroplasty and internal fixation under general anesthesia experienced an episode of supraventricular tachycardia and ventricular tachycardia at the end of surgery.Point-of-care echocardiogram revealed a foreign body in the right heart.After conservative treatment in the intensive care unit,her family decided on comfort care and she expired.CONCLUSION Transthoracic echocardiography may provide early valuable information in patients undergoing vertebroplasty,and mild-moderate pericardial effusion may be a significant sign of a poor outcome.

关键词： Cement embolism Vertebroplasty Transthoracic echocardiography Pericardial effusion Perioperative management cardiovascular event Case report

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Effects of Statins on cardiovascular Diseases in the Elderly:Possible Role of Vascular Calcification

Effects of Statins on Cardiovascular Diseases in the Elderly...

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The 8th Asia/Oceania Regional Congress of Gerontology and Geriatrics

作者： Katsuya lijima University of Tokyo Department of Geriatric Medicine

＜正＞Many epidemiological studies have shown that a major characteristic of atherosclerosis in the elderly is an increase in arterial stiffness,which is resulted from vascular calcification.Arterial calcification is anatomically seen in two different sites,such as media and atherosclerotic plaque,and is strongly correlated with an increase

关键词： Vascular Calcification elderly cardiovascular event statin prevention

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