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Journal of Geriatric cardiology 2024年第6期21卷 658-668页

作者： Wen-Jie WANG Ke-Xin WANG Jia-Long NIU Yi-Xuan LIU Hai-Long GE Hua SHEN On behalf of CCC-ACS investigators Department of cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijingChina

BACKGROUND Stress hyperglycemia ratio(SHR)could provide accurate information on the acute status of *** relationship between SHR and acute coronary syndrome(ACS)prognosis remains *** study was conducted to identity the association between SHR and in-hospital outcomes in patients with *** A total of 12,010 patients were eventually enrolled in the *** relationship between SHR and in-hospital major adverse cardiovascular events(MACEs)was then modeled by restricted cubic spline(RCS)curves,and all patients were divided into three groups according to the *** multivariate logistic regression analysis was used to determine the associations between the SHR and in-hospital outcomes,described as odds ratios(ORs)and 95%confidence intervals(CIs).Subgroup analyses were also performed on different *** The median age of this cohort was 63(54,71)years old,and 8942(74.5%)were *** 1 was defined as SHR1(n=5763).Compared with Group 2,Group 1(OR=1.891,95%CI:1.028-3.479,P<0.001)and Group 3(OR=1.868,95%CI:1.434-2.434,P<0.001)had higher risks of suffering from in-hospital *** was associated with higher risks of in-hospital MACEs in the subgroups of DM[OR=2.282,95%CI:1.477-3.524).CONCLUSIONS Both low and high SHR levels were independently associated with in-hospital *** males with DM,hypertension,and decreased renal function had much higher risks of suffering from SHR-correlated MACEs.

关键词： acute cardiovascular finding

Narrative review of latest research progress about robotic percutaneous coronary intervention

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Journal of Geriatric cardiology 2024年第8期21卷 816-825页

作者： Zhen-Yu LIU Guang-Yao ZHAI Department of Clinical Medicine Beijing Luhe HospitalCapital Medical UniversityBeijingChina Department of cardiology Beijing Luhe HospitalCapital Medical UniversityBeijingChina

Robotic percutaneous coronary intervention(R-PCI)is a novel technology in which operators can manipulate guidewires and catheter devices in interventional *** approach provides great benefits to interventional cardiologists in terms of reducing both radiation exposure and orthopedic *** large,high-quality cohort studies have confirmed the short-term safety and high technical success rate of ***,randomized long-term data are still needed before adopting them as part of standard coronary ***,tele-stenting for complex coronary lesions has significant potential for *** need to overcome the present relevant challenges for its application such as inherent delays,bedside care for unstable patients from R-PCIs to manual PCIs(M-PCIs),incompatibility for a thrombus aspiration catheter and heavily calcified *** is a great future in laboratory workflow teams,3D-printed anatomical models and multiple joint collaborative control *** narrative review summarizes the latest developments in R-PCI,with a focus on developments in robotic technology,and discusses the current and future potential use of R-PCI in clinical practice globally.

关键词： coronary injuries unstable

Effect of cytochrome P4502C19(CYP2C19)gene polymorphism and clopidogrel reactivity on long term prognosis of patients with coronary heart disease after PCI

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Journal of Geriatric cardiology 2024年第1期21卷 90-103页

作者： Cheng-Yan HU Yan-Ling WANG Zhen-Xing FAN Xi-Peng SUN Shuai WANG Zhi LIU Department of Geriatrics Fu Xing HospitalCapital Medical UniversityBeijingChina Department of cardiology Xuanwu Hospital Capital Medical UniversityBeijingChina Emergency Department of Xuanwu Hospital Capital Medical UniversityBeijingChina

Objective To investigate the impact of CYP2C19 gene polymorphism on clopidogrel reactivity and its association with longterm clinical outcome in patients with coronary heart disease(CHD)undergoing percutaneous coronary intervention(PCI).Methods In total,675 patients were *** on the platelet inhibition rate,patients were categorized into two groups:clopidogrel low responsiveness(CLR)and normal clopidogrel responsiveness(NCR).The CLR group was divided into ticagrelor and clopidogrel group based on the antiplatelet drugs used in the follow-up *** were classified into three groups(normal metabolizer,intermediate metabolizer,and poor metabolizer)based on the CYP2C19 *** aimed to evaluate the impact of CYP2C19 gene polymorphism on clopidogrel *** cumulative rates of 12-month all-cause deaths,major adverse cardiovascular events(MACCEs),and bleeding events were *** CLR was observed in 44.4%of the overall *** differences were observed in the platelet inhibition rate of clopidogrel among the three metabolic genotypes(P0.05).Conclusions Low response to clopidogrel in CHD patients is correlated with CYP2C19 gene ***2C19 genotyping combined with platelet reactivity is an independent predictor of 12-months MACCEs in patients with clopidogrel treatment after PCI,which is better than either test alone.

关键词： CYP2C19 drugs PCI

Association of prealbumin with short-term and long-term outcomes in patients with acute ST-segment elevation myocardial infarction

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Journal of Geriatric cardiology 2024年第4期21卷 421-430页

作者： Jing TAN Jin SI Ke-Ling XIAO Ying-Hua ZHANG Qi HUA Jing LI Department of cardiology Xuanwu Hospital Capital Medical UniversityBeijingChina Department of Geriatric Medicine Xuanwu Hospital Capital Medical UniversityNational Clinical Research Center for Geriatric DiseasesBeijingChina

BACKGROUND Prealbumin is considered to be a useful indicator of nutritional status. Furthermore, it has been found to be associated with severities and prognosis of a range of diseases. However, limited data on the association of baseline prealbumin level with outcomes of patients with acute ST-segment elevation myocardial infarction(STEMI) are *** We analyzed 2313 patients admitted for acute STEMI between October 2013 and December 2020. In-hospital outcomes and mortality during the 49 months(interquartile range: 26–73 months) follow-up period were compared between patients with the low prealbumin level(< 170 mg/L) and those with the high prealbumin level(≥ 170 mg/L).RESULTS A total of 114 patients(4.9%) died during hospitalization. After propensity score matching, patients with the low prealbumin level than those with the high prealbumin level experienced higher incidences of heart failure with Killip class Ⅲ(9.9%vs. 4.4%, P = 0.034), cardiovascular death(8.4% vs. 3.4%, P = 0.035) and the composite of major adverse cardiovascular events(19.2%vs. 10.3%, P = 0.012). Multivariate logistic regression analysis identified that the low prealbumin level(< 170 mg/L) was an independent predictor of in-hospital major adverse cardiovascular events(odds ratio = 1.918, 95% CI: 1.250–2.942, P = 0.003). The cutoff value of prealbumin level for predicting in-hospital death was 170 mg/L(area under the curve = 0.703, 95% CI: 0.651–0.754, P< 0.001;sensitivity = 0.544, specificity = 0.794). However, after multivariate adjustment of possible confounders, baseline prealbumin level(170 mg/L) was no longer independently associated with 49-month cardiovascular death. After propensity score matching, Kaplan-Meier survival curves revealed consistent *** Decreased prealbumin level closely related to unfavorable short-term outcomes. However, after multivariate adjustment and controlling for baseline differences, baseline prealbumin level was not independently assoc

关键词： patients admitted infarction

The impact of female sex hormones on cardiovascular disease:from mechanisms to hormone therapy

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Journal of Geriatric cardiology 2024年第6期21卷 669-681页

作者： Yi KAN Yu-Lu PENG Ze-Hao ZHAO Shu-Tong DONG Yin-Xiao XU Xiao-Teng MA Xiao-Li LIU Yu-Yang LIU Yu-Jie ZHOU Department of cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of Heart Lung and Blood Vessel DiseaseBeijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic DiseaseClinical Center for Coronary Heart DiseaseCapital Medical UniversityBeijingChina

Cardiovascular disease remains the leading cause of mortality in women,yet it has not raised the awareness from the *** pathogenesis of cardiovascular disease differs significantly between females and males concerning the effect of sex *** and progestogen impact cardiovascular system through genomic and non-genomic *** menopause,cardiovascular protective effects of estrogens have been well *** were often used in combination with estrogens in hormone *** in sex hormone levels,particularly estrogen deficiency,were considered the specific risk factor in women’s cardiovascular ***,considerable heterogeneity in the impact of hormone therapy was observed in clinical *** heterogeneity is likely closely associated with factors such as the initial time,administration route,dosage,and formulation of hormone *** review will delve into the pathogenesis and hormone therapy,summarizing the effect of female sex hormones on hypertension,pre-eclampsia,coronary heart disease,heart failure with preserved ejection fraction,and cardiovascular risk factors specific to women.

关键词： impact dosage protective

One-year direct and indirect costs of ischaemic stroke in China

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Stroke & Vascular Neurology 2024年第4期9卷 380-389,I0032-I0043页

作者： Wei Lv Anxin Wang Qianyi Wang Ruimin Wang Qin Xu Shuqing Wu Yi Han Yong Jiang Jinxi Lin Jing Jing Hao Li Yongjun Wang Xia Meng Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases Beijing Tiantan HospitalCapital Medical UniversityBeijingChina School of Basic Medical Science Capital Medical UniversityBeijingChina Department of cardiology Sun Yat-Sen Memorial Hospital of Sun Yat-Sen UniversityGuangzhouChina Health Economic Research Institute Sun Yat-Sen UniversityGuangzhouChina

Background This is the first real-world study to estimate the direct costs and indirect costs of first-ever ischaemic stroke with 1-year follow-up in China,based on a nationally representative *** Patients were chosen from 20 geographically diverse sites from the nationally representative database China National Stroke Registry-III(CNSR-III).The inclusion criteria were surviving patients who were hospitalised with first-ever ischaemic stroke from February 2017 to February 2018(the index event);aged 18–80 during the index event;no history of other stroke *** primary endpoints were direct medical costs,direct non-medical costs,indirect costs and total cost(ie,the sum of all cost components).Patient characteristics and clinical data were extracted from ***-related in-hospital direct medical costs were collected from hospital electronic medical *** patient survey collected data related to out-of-hospital direct medical costs,direct non-medical costs and indirect *** secondary objective was to explore clinical factors associated with cost outcomes through univariate analysis and multiple *** The study enrolled 520 *** total cost was 57567.48 CNY,with 26612.67 CNY direct medical costs,2787.56 CNY direct non-medical costs and 28167.25 CNY indirect *** analysis showed that longer lengths of stay during the index event,higher National Institutes of Health Stroke Scale(NIHSS)and modified Rankin Scale scores were associated with higher costs in all ***,EuroQol 5 Dimension utility scores were associated with decreased costs except direct non-medical *** regressions showed that higher admission NIHSS scores were independently associated with higher direct medical costs,indirect costs and total *** 3-month utilities were associated with lower total *** This real-world study showed substantial 1-year economic burden following first-ever ischaemic stroke

关键词： indirect costs Dimension

Ablation of drivers in patients with persistent atrial fibrillation refractory to pulmonary vein antral isolation: Target characteristics and 3-year outcomes

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中华医学杂志(英文版) 2024年第14期137卷 1747-1749页

作者： Shi Liang Qi Jie Wang Yanjiang Liao Wenkai Li Xuexun He Shunan Huang Lihong Tian Ying Liu Xingpeng Department of cardiology Beijing Chaoyang Hospital Capital Medical University Beijing China

To the Editor: Pulmonary vein antral isolation (PVAI) is the cornerstone of catheter ablation techniques used in the treatment of patients with atrial fibrillation (AF). However, the outcomes of a PVAI-only strategy for persistent AF have proven suboptimal. The majority of patients with persistent AF may require further atrial ablation beyond PVAI. Ablation of AF drivers, a patient-tailored ablation strategy for persistent AF with a procedural endpoint of AF termination, has garnered increasing attention in recent years. We aimed to determine the electrogram (EGM) characteristics of AF drivers that can predict AF termination.

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Relationship of Retinal Nerve Fiber Layer Thickness and Retinal Vessel Calibers with Cognitive Impairment in the Asymptomatic Polyvascular Abnormalities Population

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Biomedical and Environmental Sciences 2024年第2期37卷 196-203页

作者： WANG Dan Dan WANG An Xin ZHANG Xiao Li WEI Wen Bin WU Shou Ling ZHAO Xing Quan Department of Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China China National Clinical Research Center for Neurological Diseases Beijing 100070China Beijing Tongren Eye Center Beijing Key Laboratory of Ophthalmology and Visual ScienceBeijing Tongren HospitalCapital Medical UniversityBeijing 100005China Department of cardiology Kailuan HospitalTangshan 063001HebeiChina

Objective Cognitive impairment(CI)in older individuals has a high morbidity rate worldwide,with poor diagnostic methods and susceptible population *** study aimed to investigate the relationship between different retinal metrics and CI in a particular population,emphasizing polyvascular *** We collected information from the Asymptomatic Polyvascular Abnormalities Community Study on retinal vessel calibers,retinal nerve fiber layer(RNFL)thickness,and cognitive function of 3,785participants,aged 40 years or *** regression was used to analyze the relationship between retinal metrics and cognitive *** stratified by different vascular statuses were also *** RNFL thickness was significantly thinner in the CI group(odds ratio:0.973,95%confidence interval:0.953–0.994).In the subgroup analysis,the difference still existed in the non-intracranial arterial stenosis,non-extracranial carotid arterial stenosis,and peripheral arterial disease subgroups(P<0.05).Conclusion A thin RNFL is associated with CI,especially in people with non-large vessel *** underlying small vessel change in RNFL and CI should be investigated in the future.

关键词： Retinal nerve fiber layer Cognitive impairment Polyvascular abnormality

Regeneration of the heart:f rom molecular mechanisms to clinical therapeutics

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Military Medical Research 2024年第1期11卷 80-97页

作者： Qian-Yun Guo Jia-Qi Yang Xun-Xun Feng Yu-Jie Zhou Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease Beijing Institute of Heart Lung and Blood Vessel DiseaseClinical Center for Coronary Heart DiseaseDepartment of CardiologyBeijing Anzhen HospitalCapital Medical UniversityBeijing 100029China

Heart injury such as myocardial infarction leads to cardiomyocyte loss,fibrotic tissue deposition,and scar *** changes reduce cardiac contractility,resulting in heart failure,which causes a huge public health *** personnel,compared with civilians,is exposed to more stress,a risk factor for heart diseases,making cardiovascular health management and treatment innovation an important topic for military *** far,medical intervention can slow down cardiovascular disease progression,but not yet induce heart *** the past decades,studies have focused on mechanisms underlying the regenerative capability of the heart and applicable approaches to reverse heart *** have emerged from studies in animal models and early clinical *** interventions show the potential to reduce scar formation and enhance cardiomyocyte proliferation that counteracts the pathogenesis of heart *** this review,we discuss the signaling events controlling the regeneration of heart tissue and summarize current therapeutic approaches to promote heart regeneration after injury.

关键词： Heart regeneration Cardiac disease Therapeutics Signaling mechanisms

Inhibition of the RXRA-PPARα-FABP4 signaling pathway alleviates vascular cellular aging by an SGLT2 inhibitor in an atherosclerotic mice model

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Science China Life Sciences 2024年

作者： Weiwei Zhang Linghuan Wang Yujia Wang Yan Fang Ruihua Cao Zhiyi Fang Dong Han Xu Huang Zhenghui Gu Yingjie Zhang Yan Zhu Yan Ma Feng Cao Department of cardiology The Second Medical Centre Chinese PLA General Hospital National Clinical Research Center for Geriatric Diseases School of Medicine Nankai University Department of cardiology Beijing Friendship Hospital Capital Medical University

Atherosclerosis is the pathological cause of atherosclerotic cardiovascular disease （ASCVD）, which rapidly progresses during the cellular senescence. Sodium-glucose cotransporter 2 inhibitors （SGLT2is） reduce major cardiovascular events in patients with ASCVD and have potential antisenescence effects. Here, we investigate the effects of the SGLT2 inhibitor dapagliflozin on cellular senescence in atherosclerotic mice. Compared with ApoE-/-control mice treated with normal saline, those in the ApoE-/-dapagliflozin group, receiving intragastric dapagliflozin （0.1 mg kg-1d-1） for 14 weeks, exhibited the reduction in the total aortic plaque area （48.8%±6.6%vs. 74.6%±8.0%,P<0.05）, the decrease in the lipid core area (（0.019±0.0037） mm2vs.（0.032±0.0062） mm2, P<0.05) and in the percentage of senescent cells within the plaques （16.4%±3.7%vs. 30.7%±2.0%, P<0.01）, while the increase in the thickness of the fibrous cap (（21.6±2.1）μm vs.（14.6±1.5）μm, P<0.01). Transcriptome sequencing of the aortic arch in the mice revealed the involvement of the PPARα and the fatty acid metabolic signaling pathways in dapagliflozin’s mechanism of ameliorating cellular aging and plaque progression. In vitro, dapagliflozin inhibited the expression of PPARα and its downstream signal FABP4, by which the accumulation of senescent cells in human aortic smooth muscle cells （HASMCs） was reduced under high-fat conditions. This effect was accompanied by a reduction in the intracellular lipid content and alleviation of oxidative stress. However, these beneficial effects of dapagliflozin could be reversed by the PPARα *** analysis and molecular docking simulations revealed that dapagliflozin might exert its effects by directly interacting with the RXRA protein, thereby influencing the expression of the PPARα signaling pathway. In conclusion, the cellular senescence of aortic smooth muscle cells is potentially altered by dapagliflozin through the suppression of the RXRA-PPARα-FABP4 s

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