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Relationship between fibrinogen levels and cardiovascular events in patients receiving percutaneous coronary intervention:a large single-center study

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Chinese Medical Journal 2019年第8期132卷 914-921页

作者： Ping Jiang Zhan Gao Wei Zhao Ying Song Xiao-Fang Tang Jing-Jing Xu Huan-Huan Wang Lin Jiang Jue Chen Shu-Bin Qiao Yue-Jin Yang Run-Lin Gao Bo Xu Jin-Qing Yuan Department of Cardiology State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China Information center State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Background:It is currently unclear if fibrinogen is a risk factor for adverse events in patients receiving percutaneous coronary intervention(PCI)or merely serves as a marker of pre-existing comorbidities and other causal factors.We therefore investigated the association between fibrinogen levels and 2-year all-cause mortality,and compared the additional predictive value of adding fibrinogen to a basic model including traditional risk factors in patients receiving contemporary PCI.Methods:A total of 6293 patients undergoing PCI with measured baseline fibrinogen levels were enrolied from January to December 2013 in Fuwai Hospital.Patients were divided into three groups according to tertiles of baseline fibrinogen levels:low fibrinogen,<2.98 g/L;medium fibrinogen,2.98 to 3.58 g/L;and high fibrinogen,≥3.58 g/L.Independent predictors of 2-year clinical outcomes were determined by multivariate Cox proportional hazards regression modeling.The increased discriminative value of fibrinogen for predicting all-cause mortality was assessed using the C-statistic and integrated discrimination improvement(IDI).Results:The 2-year all-cause mortality rate was 1.2%.It was significantly higher in the high fibrinogen compared with the low and medium fibrinogen groups according to Kaplan-Meier analyses(1.7%vs.0.9%and 1.7%vs.1.0%,respectively;log-rank,P=0.022).Fibrinogen was significantly associated with all-cause mortality according to multivariate Cox regression(hazard ratio 1.339,95%confidence interval:1.109-1.763,P=0.005),together with traditional risk factors including age,sex,diabetes mellitus,left ventricular ejection fraction,creatinine clearance,and low-density lipoprotein cholesterol.The area under the curve for all-cause mortality in the basic model including traditional risk factors was 0.776,and this value increased to 0.787 when fibrinogen was added to the model(IDI=0.003,Z=0.140,P=0.889).Conclusions:Fibrinogen is associated with 2-year all-cause mortality in patients receiving PCI,but provides no additional information

关键词： Fibrinogen Percutaneous coronary intervention Risk factor Prognosis

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Impact of baseline blood pressure on all-cause mortality in patients with atrial fibrillation:results from a multicenter registry study

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Chinese Medical Journal 2023年第6期136卷 683-689页

作者： Wei Xu Qirui Song Han Zhang Juan Wang Xinghui Shao Shuang Wu Jun Zhu Jun Cai Yanmin Yang Emergency center Fuwai HospitalState Key Laboratory of Cardiovascular Disease of ChinaNational Center for Cardiovascular DiseasesNational Clinical Research Center of Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Hypertension center Fuwai HospitalState Key Laboratory of Cardiovascular Disease of ChinaNational Center for Cardiovascular Diseases of ChinaNational Clinical Research Center of Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

Background:The ideal blood pressure(BP)target for patients with atrial fibrillation(AF)is still unclear.The present study aimed to assess the effect of the baseline BP on all-cause mortality in patients with AF.Methods:This registry study included 20 emergency centers across China and consecutively enrolled patients with AF from 2008 to 2011.All participants were followed for 1 year±1 month.The primary endpoint was all-cause mortality.Results:During the follow-up,276(13.9%)all-cause deaths occurred.Kaplan-Meier curves showed that a systolic blood pressure(SBP)110 mmHg or>160 mmHg was associated with a higher risk of all-cause mortality(log-rank test,P=0.014),and a diastolic blood pressure(DBP)<70 mmHg was associated with the highest risk of all-cause mortality(log-rank test,P=0.002).After adjusting for confounders,the multivariable Cox regression model suggested that the risk of all-cause mortality was increased in the group with SBP110 mmHg(hazard ratio[HR],1.963;95%confidence interval[CI],1.306-2.951),and DBP<70 mmHg(HR,1.628;95%CI,1.163-2.281).In the restricted cubic splines,relations between baseline SBP or DBP and all-cause mortality showed J-shaped associations(non-linear P<0.001 and P=0.010,respectively).The risk of all-cause mortality notably increased at a lower baseline SBP and DBP.Conclusions:Having a baseline SBP110 mmHg or DBP<70 mmHg was associated with a significantly higher risk of all-cause mortality in patients with AF.An excessively low BP may not be an optimal target for patients with AF.

关键词： All-cause death All-cause mortality Atrial fibrillation Blood pressure Diastolic blood pressure Hypertension Systolic blood pressure

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残余胆固醇与心血管、癌症死亡率的相关性:一项全国性队列研究

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Science Bulletin 2024年第4期69卷 526-534页

作者：田原武依戚敏杰宋莉娟陈伯望王椿淇路甲鹏杨阳张小艳崔建兰许巍杨皓贺文彦张岩郑昕张海波郭远林李希 National Clinical Research center of cardiovascular Diseases State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Henan Provincial center for Disease Control and Prevention Zhengzhou 450000China Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Shenzhen center for cardiovascular Diseases Fuwai Hospital Chinese Academy of Medical SciencesShenzhen 501800China Central China Sub-center of the National center for cardiovascular Diseases Zhengzhou 450000China

The health significance of triglyceride-rich lipoproteins,also known as remnant cholesterol,has been increasingly recognized.However,evidence of their associations with cause-specific mortality in the general population was previously insufficient.To explore these associations and their heterogeneities across subgroups,a prospective cohort study was conducted including 3,403,414 community-based participants from China HEART,an ongoing government-funded public health program throughout China,from November 2014 through December 2022.The study assessed mortality risk of all-cause mortality,cardiovascular disease(CVD)mortality(including mortality from ischemic heart diseases(IHD),ischemic stroke(IS),and hemorrhagic stroke(HS),separately),and cancer mortality(including lung cancer,stomach cancer,and liver cancer,separately).During the 4-year follow-up,23,646 individuals died from CVD(including 8807 from IHD,3067 from IS,and 5190 from HS),and 20,318 from cancer(including 6208 from lung cancer,3013 from liver cancer,and 2174 from stomach cancer).Compared with individuals with remnant cholesterolcardiovascular disease mortality,as well as a reduced risk of mortality for certain types of cancer.

关键词： Remnant cholesterol Mortality cardiovascular disease Cancer

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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 study.Patients enrolled were stratified into two categories according to the presence or absence of prior stroke history.The primary endpoint was all-cause death.Secondary endpoints in-cluded stroke and major adverse cardiac and cerebrovascular event(MACCE),a composite of death,myocardial infarction(MI),unplanned revascularization and stroke.RESULTS Prior stroke was present in 888 patients(9.9%).These patients were older and had higher rates of comorbidities.Du-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 P<0.01).Notably,there was a significant interaction between prior stroke his-tory and treatment strategies.Revascularization strategy(PCI or CABG)was associated with a lower incidence of all-cause death and MACCE compared with MT alone,and favorable rates of MACCE,MI and unplanned revascularization in the CABG group compared with the PCI group,but with similar rate of all-cause death regardless of prior stroke history.The prevalence of stroke was significantly higher after CABG when compared with PCI or MT in no prior stroke patients[hazard ratio(HR)=1.429,95%CI:1.132-1.805 for CABG vs.MT;HR=1.703,95%CI:1.371-2.116 for CABG vs.PCI].CONCLUSIONS Patients with TVD and prior stroke have poor clinical outcomes.It 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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Association between clustering of cardiovascular risk factors and resting heart rate in Chinese population:a cross-sectional study

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Journal of Geriatric Cardiology 2022年第6期19卷 418-427页

作者： Fu-Yu JING Xiu-Ling WANG Jia-Li SONG Yan GAO Jian-Lan CUI Wei XU Yang YANG Li-Juan SONG Hai-Bo ZHANG Jia-Peng LU Xi LI Xin ZHENG National Clinical Research center for cardiovascular Diseases NHC Key Laboratory of Clinical Research for Cardiovascular MedicationsState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeNational Center for Cardiovascular DiseasesBeijingChina National Clinical Research center for cardiovascular Diseases ShenzhenCoronary Artery Disease CenterFuwai Hospital Chinese Academy of Medical SciencesShenzhenChina

BACKGROUND Epidemiologic studies have explored the association between a single cardiovascular risk factor(CVRF)and resting heart rate(RHR),but the research on the relation of multiple risk factors with RHR remains scarce.This study aimed to explore the associations between CVRFs clustering and the risk of elevated RHR.METHODS In this cross-sectional study,adults aged 35-75 years from 31 provinces were recruited by the China PEACE Million Persons Projects from September 2015 to August 2020.We focused on seven risk factors:hypertension,diabetes mellitus,dyslipidemia,obesity,smoking,alcohol use,and low physical activity.Multivariate logistic regression was used to calculate odds ratios(OR)for elevated RHR(>80 beats/min).RESULTS Among 1,045,405 participants,the mean age was 55.67±9.86 years,and 60.4%of participants were women.The OR(95%CI)for elevated RHR for the groups with 1,2,3,4 and≥5 risk factor were 1.11(1.08-1.13),1.36(1.33-1.39),1.68(1.64-1.72),2.01(1.96-2.07)and 2.58(2.50-2.67),respectively(Ptrend<0.001).The association between the CVRFs clustering number and elevated RHR was much more pronounced in young males than in other age-sex subgroups.Clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR than those comprising more behavioral risk factors.CONCLUSIONS There was a significant positive association between the CVRFs clustering number and the risk of elevated RHR,particularly in young males.Compared clusters comprising more behavioral risk factors,clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR.RHR may serve as an indicator of the cumulative effect of multiple risk factors.

关键词： elevated cardiovascular sectional

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Surgical treatment of cardiac lipoma: 20 years’ experience in a single center

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Chinese Medical Journal 2023年第5期136卷 565-570页

作者： Linlin Li Jian Meng Xingtong Zhou Chang Liu Hongwei Guo Hongguang Fan center of Cardiac Surgery in Adults State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China State Key Laboratory of cardiovascular Disease Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China center of Heart Rehabilitation State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China center of Structural Heart Disease State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China.

Background: Primary cardiac lipoma is very rare, and no consensus has been developed regarding its ideal treatment strategy. This study reviewed the surgical treatment of cardiac lipomas in 20 patients over 20 years. Methods: Twenty patients with cardiac lipomas were treated at Fuwai Hospital, National center for cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College from January 1, 2002, to January 1, 2022. The patients' clinical data and pathological reports were retrospectively analyzed, and the follow-up with a range of 1 year to 20 years was conducted. Results: The cardiac lipomas were located in the right atrium (RA) or superior vena cava (SVC) in seven patients (35%) (RA in six patients and SVC in one patient), left ventricle in eight patients (40%) (left ventricular chamber in four patients and left ventricular subepicardium and myocardium in four patients), right ventricle in three patients (15%) (right ventricular chamber in one patient and right ventricular subepicardial layer and myocardium in two patients), subepicardial interventricular groove in one patient (5%), and pericardium in one patient (5%). Complete resection was achieved in 14 patients (70%), including seven patients with lipomas in the RA or SVC. Incomplete resection occurred in six patients (30%) with lipomas in the ventricles. No perioperative deaths occurred. Long-term follow-up was conducted for 19 patients (95%), including two (10%) who died. Both patients who died had lipomas incompletely resected due to ventricles involvement, and preoperative malignant arrhythmias persisted post-operatively. Conclusions: The complete resection rate was high, and the long-term prognosis was satisfactory in patients with cardiac lipomas that did not involve the ventricle. The complete resection rate was low in patients with cardiac lipomas in ventricles;and complications, including malignant arrhythmia, were common. Failure of complete resection and post-operative ventricular arrhythmia are correlated with pos

关键词： Cardiac lipoma Surgical treatment Long-term outcomes

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Different clinical characteristics and outcomes of hypertrophic cardiomyopathy with and without hypertension:seeking the truth

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Journal of Geriatric Cardiology 2023年第2期20卷 109-120页

作者： Yu ZHANG Ming-Hao LIU Mo ZHANG Gui-Xin WU Jie LIU Ji-Zheng WANG Xiao-Lu SUN Wen JIANG Dong WANG Lian-Ming KANG Xue-Yi WU Yu-Bao ZOU Lei SONG State Key Laboratory of cardiovascular Disease Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Cardiomyopathy Ward Fuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina National Clinical Research center of cardiovascular Diseases Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

OBJECTIVE To determine the different clinical characteristics and outcomes of hypertrophic cardiomyopathy(HCM)patients with and without hypertension(HT).METHODS A total of 696 HCM patients were included in this study and all HCM diagnoses were confirmed by the genetic test.Patients were analyzed separately in the septal reduction therapy(SRT)cohort and the non-SRT cohort.The primary endpoint was cardiovascular death and the secondary endpoint was all-cause death.Outcome analyses were conducted to evaluate the associations between HT and outcomes in HCM.Medications before enrollment and at discharge were collected in the post-hoc analyses.RESULTS HCM patients without HT were younger,had a lower body mass index,were more likely to have a family history of HCM,and had a smaller left ventricular(LV)end-diastolic diameter than those with HT in both cohorts.A thicker LV wall,a higher level of N-terminal pro-B-type natriuretic peptide,and a higher extent of LV late gadolinium enhancement were additionally observed in patients without HT in the non-SRT cohort.The presence of HT did not alter the distribution pattern of late gadolinium enhancement,as well as the constituent ratio of eight disease-causing sarcomeric gene variants in both cohorts.Outcome analyses showed that in the non-SRT cohort,patients without HT had higher risks of cardiovascular death(HR=2.537,P=0.032)and all-cause death(HR=3.309,P=0.032).While such prognostic divergence was not observed in the SRT cohort.Further post-hoc analyses in the non-SRT cohort found that patients without HT received fewer non-dihydropyridine calcium channel blockers and angiotensinconverting enzyme inhibitors/angiotensin receptor blockers before enrollment and at discharge.CONCLUSIONS HCM patients without HT had worse clinical conditions and higher mortality than patients with HT overall,which may result from active medical therapy in HT patients.Active SRT may have a substantial de-risking effect on patients meeting the indications.

关键词： clinical hypertension cardiomyopathy

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CRISPR-CasRx knock-in mice for RNA degradation

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Science China(Life Sciences) 2022年第11期65卷 2248-2256页

作者： Jiacheng Li Dekun Zhu Shengshou Hu Yu Nie State Key Laboratory of cardiovascular Disease Fuwai Hospital and Cardiovascular InstituteNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100037China National Health Commission Key Laboratory of cardiovascular Regenerative Medicine Fuwai Central-China HospitalCentral-China Branch of National Center for Cardiovascular DiseasesZhengzhou 450046China

The RNA editing tool CRISPR-CasRx has provided a platform for a range of transcriptome analysis tools and therapeutic approaches with its broad efficacy and high specificity.To enable the application of CasRx in vivo,we established a Credependent CasRx knock-in mouse.Using these mice,we specifically knocked down the expression of Meis1 and Hoxb13 in cardiomyocytes,which induced cardiac regeneration after myocardial infarction.We also knocked down the lnc RNA Mhrt in cardiomyocytes with the CasRx knock-in mice,causing hypertrophic cardiomyopathy.In summary,we generated a Credependent CasRx knock-in mouse that can efficiently knock down coding gene and lnc RNA expression in specific somatic cells.This in vivo CRISPR-CasRx system is promising for gene function research and disease modeling.

关键词： CRISPR-CasRx CasRx mice in vivo gene knockdown heart regeneration

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Summary of the 2022 Report on cardiovascular Health and Diseases in China

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Chinese Medical Journal 2023年第24期136卷 2899-2908页

作者： Zengwu Wang Liyuan Ma Mingbo Liu Jing Fan Shengshou Hu on behalf of The Writing Committee of the Report on cardiovascular Health and Diseases in China National center for cardiovascular Diseases Fuwai HospitalBeijing 100037China 不详

Recent decades have seen the remarkable development of China in medical accessibility and quality index,and the application of a number of new advanced cardiovascular technologies benefits more patients.However,according to the Annual Report on cardiovascular Health and Diseases in China published in this article,which was organized and summarized by National center for cardiovascular Diseases,there is still a huge population living with risk factors of cardiovascular diseases(CVD),and the morbidity and mortality of CVD are increasing.It is estimated that there are around 330 million patients suffering from CVD currently,including 245 million of hypertension,13 million of stroke,45.3 million of peripheral artery disease,11.39 million of coronary heart disease(CHD),8.9 million of heart failure,5 million of pulmonary heart disease,4.87 million of atrial fibrillation,2.5 million of rheumatic heart disease,and 2 million of congenital heart disease.Tobacco use,diet and nutrition factors,physical activity,overweight and obesity,and psychological factors are what affect cardiovascular health,while hypertension,dyslipidemia,diabetes,chronic kidney disease,metabolic syndrome,and air pollution are the risk factors for CVD.In this article,in addition to risk factors for CVD,we also report the epidemiological trends of CVD,including CHD,cerebrovascular disease,arrhythmias,valvular heart disease,congenital heart disease,cardiomyopathy,heart failure,pulmonary vascular disease and venous thromboembolism,and aortic and peripheral artery diseases,as well as the basic research and medical device development in CVD.In a word,China has entered a new stage of transforming from high-speed development focusing on scale growth to high-quality development emphasizing on strategic and key technological development to curb the trend of increasing incidence and mortality of CVD.

关键词： Epidemiology cardiovascular disease Mortality Hypertension Valvular heart disease Heart failure Cardiomyopathy

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Triglyceride glucose index predicts in-hospital mortality in patients with ST-segment elevation myocardial infarction who underwent primary angiography

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Journal of Geriatric Cardiology 2023年第3期20卷 185-194页

作者： Rui FU Yan-Yan ZHAO Kong-Yong CUI Jin-Gang YANG Hai-Yan XU Dong YIN Wei-Hua SONG Hong-Jian WANG Cheng-Gang ZHU Lei FENG Zhi-Fang WANG Qing-Sheng WANG Ye LU Ke-Fei DOU Yue-Jin YANG the CAMI Registry Investigators Cardiometabolic Medicine center Department of CardiologyFuwai HospitalNational Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseNational Clinical Research Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Medical Research&Biometrics center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Coronary Heart Disease center Department of CardiologyFuwai HospitalNational Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseNational Clinical Research Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Xinxiang Central Hospitalthe Fourth Clinical College of Xinxiang Medical UniversityHenan ProvinceChina Department of Cardiology Qinhuangdao First HospitalHebei ProvinceChina

OBJECTIVES To assess the correlation between triglyceride glucose(TyG)index and in-hospital mortality in patients with ST-segment elevation myocardial infarction(STEMI).METHODS A total of 2190 patients with STEMI who underwent primary angiography within 12 h from symptom onset were selected from the prospective,nationwide,multicenter CAMI registry.TyG index was calculated with the formula:Ln[fasting triglycerides(mmol/L)×fasting glucose(mmol/L)/2].Patients were divided into three groups according to the tertiles of TyG index.The primary endpoint was in-hospital mortality.RESULTS Overall,46 patients died during hospitalization,in-hospital mortality was 1.5%,2.2%,2.6%for tertile 1,tertile 2,and tertile 3,respectively.However,TyG index was not significantly correlated with in-hospital mortality in single-variable logistic regression analysis.Nonetheless,after adjusting for age and sex,TyG index was significantly associated with higher mortality when regarded as a continuous variable(adjusted OR=1.75,95%CI:1.16-2.63)or categorical variable(tertile 3 vs.tertile 1:adjus-ted OR=2.50,95%CI:1.14-5.49).Furthermore,TyG index,either as a continuous variable(adjusted OR=2.54,95%CI:1.42-4.54)or categorical variable(tertile 3 vs.tertile 1:adjusted OR=3.57,95%CI:1.24-10.29),was an independent predictor of in-hospital mortality after adjusting for multiple confounders in multivariable logistic regression analysis.In subgroup analysis,the pro-gnostic effect of high TyG index was more significant in patients with body mass index<18.5 kg/m2(P interaction=0.006).CONCLUSIONS This study showed that TyG index was positively correlated with in-hospital mortality in STEMI patients who underwent primary angiography,especially in underweight patients.

关键词： patients mortality angiography

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