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Assessing Cardiovascular Health Using Life＇s Simple 7 in a Chinese Population Undergoing stroke prevention

Chinese Medical Journal 2015年第18期128卷 2450-2456页

作者： QiongYang Bin Zhang Pan Deng Lu Chen Jing-Ran Wang Dong-Sheng Fan Department of Neurology Peking University Third Hospital Beijing 100191 China

Background： The American Heart Association/American stroke Association proposed a metric called Life＇s Simple 7 （LS7） to define cardiovascular health （CVH）. The presence of a large number of ideal components of CVH is associated with lower cardiovascular disease and all-cause mortality. We aimed to assess CVH using LS7 in a Chinese population undergoing primary and secondary stroke prevention. Methods： Patients with either ischemic stroke or cardiovascular risk factors were enrolled in the study from October 2010 to July 2013. LS7 components were scored as poor （0 points）, intermediate （1 point）, or ideal （2 points）. The overall LS7 score was categorized as inadequate （0-4）, average （5-9）, or optimal （10-14） CVH. The Chi-square test, Mann-Whitney U-test, and Kruskal-Wallis test were used. Results： In total, 706 patients were enrolled. （1） The distribution of the overall LS7 score （n = 255） indicated that 9.4%, 82.4%, and 8.2% of the patients had inadequate, average, and optimal CVH, respectively. The proportion of patients with optimal CVH undergoing secondary stroke prevention was lower than that for patients undergoing primary stroke prevention （3.8% vs. 12.8%, P = 0,005）. The vast laaajority of participants （76.1%） presented with 〈2 ideal health components. （2） The proportions of patients with poor, intermediate, and ideal status, respectively, lbr the following LS7 components were assessed： Total cholesterol （n = 275; 5.1%, 73.8%, and 21.1%）, blood pressure （11 = 351 ; 32.5%. 59.0%, and 8.5%）, blood glucose （n = 280; 9.3%, 39.6%, and 51.1%）, physical activity （n = 540; 90.7%, 8.7%, and 0.6%）, diet （n = 524; 0.2%. 92.4%, and 7.4%）, smoking （n = 619： 20.7%, 2.9%, and 76.4%）, and body mass index （n = 259; 6.6%, 35.5%, and 57.9%）. Conclusions： Few Chinese patients undergoing stroke prevention had optimal CVH （determined using LS7）. Additionally, fewer patients undergoing secondary prevention had optimal CVH than those undergoing primary prevention. In particular, ph

关键词： Cardiovascular Health Life's Simple 7 Lifestyle, Risk Factors stroke prevention

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Efficacy and Safety of the WATCHMAN Left Atrial Appendage System for stroke prevention in Chinese Patients with Nonvalvular Atrial Fibrillation： A Single-center, Prospective, Observational Study

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Chinese Medical Journal 2017年第4期130卷 434-438页

作者： Wei-Ping Huang Yong-Hua Zhang Lei He Xi Su Xin-Wei Yang Zai-Xiong Guo Department of Cardiology Wuhan Asia Heart Hospital Wuhan Hubei 430022 China

Background： In patients with nonvalvular atrial fibrillation （NVAF）, embolic stroke is thought to be associated with left atrial appendage （LAA） thrombi. The WATCHMAN LAA Occlusion Device has been shown to be noninferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with NVAF. This study aimed to evaluate the procedural feasibility, safety and 12-month outcomes of the WATCHMAN LAA Occlusion Device in NVAF patients with high risk for stroke in China. Methods： The clinical data of 106 NVAF patients, who were consecutively underwent LAA closure with the WATCHMAN Device between April 2014 and May 2015, were collected. Patients were followed up at 1,3, 6, and 12 months after discharge. A transesophageal echocardiograph was performed at 45 days after implantation and repeated in case of an unexpected event during the follow-up period. Results： This study included 106 NVAF patients with a mean age of 64.2 ± 8.6 years （ranging from 50 to 88 years）, and the mean CHA,DS,-VASc score of all patients was 3.6 ± 1.6 （ranging from 2 to 9）. Among those 106 NVAF patients, 100 （94.3%） patients were implanted with the device successfully. The procedural success rate was 94.3% （100/106）, and the occlusion rate was 100.0% （100/100）. There were one tamponade, one ischemic stroke, and eight minor pericardial effusions during hospitalization. During 12-month follow-up period, two patients developed a tbrombus layer on the device that resolved with additional anticoagulation： one with visible device-thrombus experienced transient ischemic stroke, and one had a hemorrhagic stroke. There were no deaths in this study. The overall survival rate was 100.0%, and nonmajor adverse event rate was 95.0% （95/100）. In this study, the expected annual rate ofischemic stroke risk in these patients according to the CHA2DS2-VASc score was 4.0%, while the observed ischemic stroke rate was 2.0% per year. Conclusions： LAA closure with the WATCHMAN Device was feasible, effi

关键词： Atrial Fibrillation Left Atrial Appendage Closure stroke prevention

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Developing a Community Based stroke prevention Intervention Course in Minority Communities:The DC Angels Project

Developing a Community Based Stroke Prevention Intervention ...

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第一届上海国际护理大会

作者： Carolyn F. Covington Nathaniel Johnson Isong Joyce King Irnise Fenne Annapurni Jayam-Trouth Annette Evans Howard University

Despite advances in stroke treatment in the United States stroke remains the third leading cause of death among minorities’ populations and the leading cause of serious, long-term disability in the United States. Minority populations are less likely to know all stroke symptoms, and far less likely to know all heart attack symptoms. There are many benefits of early treatment of stroke yet the majority of minorities don’t get this treatment they need because they do not recognize the warning signs, risk factors and prevention of stroke. Objectives: The objectives of this community based stroke prevention intervention course is to develop stroke champions in minority communities to increase knowledge and awareness of stroke warning signs, risk factors and prevention in minority populations living in a major urban community. Methods: The theoretical approach is based on Social Cognitive Theory and the Stages of Change. A multi-site quasi-experimental design was used to（a） significantly increase minority communities knowledge and awareness about stroke, warning signs, risk factors and prevention.（b） Empower minority communities to decide to engage in health promoting behaviors to reduce their risk for stroke. The Behavioral Risk FactorSurveillance Survey（BRFSS） was used to collect data in this study. Blood pressure screenings and referral were also conducted. A convenience sample of 3 males and 13 females participated in this study. Eighty-five percent were black,（12%） white and other（3%）. Results: Most participants in this study perceived their health status as good（56%） or very good（31%）. The Wilcoxon mathched-pairs Signed Rank test indicate that mean scores for knowledge of health promoting behaviors for stroke was(z =.00;p=1.00, knowledge of risk factors for stroke（z =.316;p=.752） and warning signs of stroke（z =-.137;p=.891）. Conclusions: Overall participants did not show increased in knowledge and awareness of stroke warning signs and risk factors and prevention. Lo

关键词： stroke prevention minority communities community health health Promotion

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Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation

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Chinese Medical Journal 2024年第2期137卷 172-180页

作者： Jing Lin Deyong Long Chenxi Jiang Caihua Sang Ribo Tang Songnan Li Wei Wang Xueyuan Guo Man Ning Zhaoqing Sun Na Yang Yongchen Hao Jun Liu Jing Liu Xin Du Louise Morgan Gregg C.Fonarow Sidney C.Smith Jr Gregory Y.H.Lip Dong Zhao Jianzeng Dong Changsheng Ma On behalf of CCC-AF investigators Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China National Clinical Research Center for Cardiovascular Diseases Beijing 100029 China Department of Epidemiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100029China International Quality Improvement Department American Heart AssociationDallasTX 07076USA Division of Cardiology Geffen School of Medicine at University of CaliforniaLos Angeles CA 90024USA Division of Cardiology University of North CarolinaChapel HillNC 27599USA Department of Cardiology Liverpool Centre for Cardiovascular ScienceUniversity of Liverpool and Liverpool Heart&Chest HospitalLiverpool L143PEUK Department of Clinical Medicine Aalborg UniversityAalborg 9000Denmark 不详

Background:Oral anti-coagulants(OAC)are the intervention for the prevention of stroke,which consistently improve clinical outcomes and survival among patients with atrial fibrillation(AF).The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in ***:Using data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation(CCC-AF)registry,guideline-recommended OAC use in eligible patients was ***:A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019,of whom 38,203 were at a high risk of stroke,9717 were at a moderate risk,and 4610 were at a low *** admission,only 20.0%(6075/30,420)of patients with a diagnosed AF and a high risk of stroke were taking *** use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population(adjusted odds ratio:0.54,95%confidence interval:0.43-0.68;Pstroke risk and 60.7%(2778/4578)in eligible patients with low stroke *** utilization in patients with high stroke risk on admission or at discharge both increased largely over time(all P70%of AF patients were at a high risk of *** poor performance on guideline-recommended OAC use was found in this study,over time the CCC-AF project has made progress in stroke prevention in the Chinese AF ***

关键词： Atrial fibrillation Oral anti-coagulants OAC stroke prevention Contraindication

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Pre-ischemia electro-acupuncture potentiates the expression of Bcl-2 and transforming growth factor-beta 1 in rat brains

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Neural Regeneration Research 2012年第24期7卷 1859-1865页

作者： Ka Keung Yip Samuel CL Lo Kwok-fai So Dora MY Poon Mason CP Leung Department of Rehabilitation Sciences the Hong Kong Polytechnic UniversityHung HomHong Kong Special Administrative RegionChina Department of Applied Biology and Chemical Technology the Hong Kong Polytechnic UniversityHung HomHong Kong Special Administrative RegionChina Department of Anatomy the University of Hong KongPokfulamHong Kong Special Administrative RegionChina

The expression of the anti-apoptotic molecules Bcl-2 and transforming growth factor-beta 1 is known to confer protective effects on the cerebral ischemia-reperfusion *** current study investigated the expression levels of Bcl-2 and transforming growth factor-beta 1 in response to multiple pre-ischemia electro-acupuncture at acupoints Zusanli（ST36）and Fengchi（GB20） *** were divided into five groups：uninjured,control,non-acupoint,GB20 and ST36. Rats in the non-acupoint,GB20 and ST36 groups received 30 minutes（3 times or 18 times）of electro-acupuncture stimulation before experimental cerebral ischemia was ***-2 and transforming growth factor-beta 1 were found to be significantly increased in the ST36 groups with either 3 or 18 electro-acupuncture treatments（P〈0.05）.The production was higher with 18 electro-acupuncture treatments in the ST36 groups（P〈0.05）.In the GB20 groups,significant increase was only observed in transforming growth factor-beta 1 with 18 electro-acupuncture treatments（P〈0.05）.No significant elevation of the level of transforming growth factor-beta 1 was observed in the non-acupoint ***,the production of Bcl-2 increased with 18 treatments in the non-acupoint groups（P〈0.05）.The data suggest that multiple pre-ischemia electro-acupuncture at ST36 was effective in conferring neuroprotective effect on the brain by means of upregulation of Bcl-2 and transforming growth factor-beta 1 and the effect was increase with the number of treatment.

关键词： cerebral ischemia stroke prevention electro-acupuncture transforming growth factor-beta 1 Bcl-2 acupoint

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Screening of unknown atrial fibrillation through handheld device in the elderly

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Journal of Geriatric Cardiology 2020年第8期17卷 495-501页

作者： Francesco Rivezzi Riccardo Vio Claudio Bilato Leopoldo Pagliani Giampaolo Pasquetto Salvatore Saccà Roberto Verlato Federico Migliore Sabino Iliceto Vito Bossone Emanuele Bertaglia Department of Cardio-Thoraco-Vascular Sciences and Public Health University of PadovaPadovaItaly Division of Cardiology West Vicenza General HospitalsArzignanoVicenzaItaly ORAS Rehabilitation Hospital Motta di LivenzaTrevisoItaly Division of Cardiology "Riuniti Hospitals Padova Sud"MonselicePadovaItaly Department of Cardiology General HospitalMiranoVeneziaItaly Division of Cardiology Pietro Cosma HospitalCamposampieroPadovaItaly Keiron As.Me.G. Italy

Objective To estimate the prevalence of unknown atrial fibrillation(AF)in the elderly population of the Veneto Region,*** 1820 patients aged≥65 years with no history of AF and not anticoagulated were enrolled in primary-care *** underwent an opportunistic electrocardiogram screening with a handheld device(My Diagnostick)designed to specifically detect *** electrocardiogram recordings were reviewed by the researchers,who confirmed the presence of *** The device detected an arrhythmia in 143 patients,which was confirmed as AF in 101/143(70.6%),with an overall prevalence of AF of 5.5%(101/1820).Prevalence of unknown AF resulted in 3.6%in patients aged 65–74 years,and 7.5%in patients age 75 or older,and increased according to CHA2 DS2-VASc score:3.5%in patients with a score of 1 or 2,5.6%in patients with a score of 3,7.0%in patients with a score of 4,and 7.2%in patients with a score≥*** detection rate was significantly higher in patients with mild symptoms compared to asymptomatic counterparts(24.1%vs.4.0%,P<0.0001).At multivariate analysis,congestive heart failure and age≥75 years-old were independent predictors for screen-detected *** An opportunistic screening with handheld device revealed an unexpectedly high prevalence of unknown AF in elderly patients with mild *** increased with age and CHA2DS2-VASc score.

关键词： Atrial fibrillation Handheld electrocardiogram Primary care Screening stroke prevention

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Statins in acute neurologic disease:which one,which dose,when to start,and when not to stop

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Neuroimmunology and Neuroinflammation 2016年第1期3卷 133-140页

作者： Bong-Su Kang Gene Sung May Kim-Tenser Nerses Sanossian Department of Neurology Korea University Anam HospitalSeoul 136-705South Korea Department of Neurology University of Southern CaliforniaLos AngelesCA 90026USA Department of Roxanna Todd Hodges Comprehensive stroke Clinic University of Southern CaliforniaLos AngelesCA 90026USA

Statins could have physiologic properties that may benefit patients that have been diagnosed with various acute neurological *** review aims tosummarize the literature pertaining to stain use in acute neurological disease such as subarachnoid hemorrhage,intracerebral hemorrhage(ICH),cerebral ischemia(CI),traumatic brain injury,status epilepticus and *** authors reviewed published abstracts and manuscripts pertaining to experimental and clinical trials relevant to statins in acute neurological *** acute statin therapy in the setting of subarachnoid hemorrhage might reduce delayed cerebral ischemia and mortality,it should not be considered standard care at this *** statins therapy has not demonstrated anybenefit yet following an ICH or *** statin withdrawal may worsen outcome in acute *** and case-control studies suggest that pretreatment with statin at time of onset may be associated with better *** though preclinical studies have shown statins to have beneficial effects,there has been no clinical *** conclusion,current published studies have not shown that acute statin therapy has any benefical effects in acute neurologic diseases and therefore further large randomized clinical trials are needed.

关键词： Statin dyslipidemia stroke prevention subarachnoid hemorrhage intracerebral hemorrhage cerebral infarction

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Percutaneous left atrial appendage closure:Technical aspects and prevention of periprocedural complications with the watchman device

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World Journal of Cardiology 2015年第2期7卷 65-75页

作者： Sven M bius-Winkler Nicolas Majunke Marcus Sandri Norman Mangner Axel Linke Gregg W Stone Ingo D hnert Gerhard Schuler Peter B Sick Department of Internal Medicine/Cardiology University of LeipzigHeart Center Columbia University Medical Center Department of Pediatric Cardiology University of LeipzigHeart Center Clinic for Cardiology Hospital Barmherzige Brueder

Transcatheter closure of the left atrial appendage has been developed as an alternative to chronic oral anticoagulation for stroke prevention in patients with atrial fibrillation, and as a primary therapy for patients with contraindications to chronic oral anticoagulation. The promise of this new intervention compared with warfarin has been supported by several, small studies and two pivotal randomized trial with the Watchman Device. The results regarding risk reduction for stroke have been favourable although acute complications were not infrequent. Procedural complications, which are mainly related to transseptal puncture and device implantation, include air embolism, pericardial effusions/tamponade and device embolization. Knowledge of nature, management and prevention of complications should minimize the risk of complications and allow transcatheter left atrial appendage closure to emerge as a therapeutic option for patients with atrial fibrillation at risk for cardioembolic stroke.

关键词： Atrial fibrillation stroke prevention Left atrial appendage WATCHMAN device Complications

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Relationship between serum 25-hydroxyvitamin D level and risk of recurrent stroke

Relationship between serum 25-hydroxyvitamin D level and ris...

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中国营养学会第十五届全国营养科学大会

作者： Guowei Li Gregory Lip Guangdong Second Provincial General Hospital University of Liverpool

Evidence for the association between vitamin D and risk of recurrent stroke remains sparse and limited. We aimed to assess the relationship between serum circulating 25-hydroxyvitamin D(25(OH)D) level and risk of recurrent stroke in patients with a stroke history, and to identify the optimal 25(OH)D level in relation to lowest recurrent stroke risk. Methods Data from the nationwide prospective United Kingdom Biobank were used for analyses. Primary outcome was time to first stroke recurrence requiring a hospital visit during follow-up. We used Cox proportional hazards regression model with restricted cubic splines to explore 25(OH)D level in relation to recurrent stroke. The dose-response relationship between 25(OH)D and recurrent stroke risk was also estimated, taking the level of 10 nmol/L as reference. Results A total of 6,824 participants(mean age: 60.6 years, 40.8% females) with a baseline stroke were included for analyses. There were 388(5.7%) recurrent stroke events documented during a mean follow-up of 7.6 years. Using Cox proportional hazards regression model with restricted cubic splines, a quasi J-shaped relationship between 25(OH)D and risk of recurrent stroke was found, where the lowest recurrent stroke risk lay at the 25(OH)D level of approximate 60 nmol/L. When compared with 10 nmol/L, a 25(OH)D level of 60 nmol/L was related with a 48% reduction in the recurrent stroke risk(hazard ratio = 0.52, 95% confidence interval: 0.33-0.83). Conclusion Based on data from a large-scale prospective cohort, we found a quasi Jshaped relationship between 25(OH)D and risk of recurrent stroke with the lowest risk at around 60 nmol/L. These results may provide some insights into the optimal vitamin D status recommendation for recurrent stroke prevention in patients with a prior stroke history.

关键词： vitamin D recurrent stroke 25-hydroxyvitamin stroke prevention

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