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Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction:analysis of a large national database

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Journal of Geriatric Cardiology 2021年第1期18卷 1-9页

作者： Han-Wei TANG Kai CHEN Jian-Feng HOU Xiao-Hong HUANG Sheng LIU Han-Ping MA Sheng-Shou HU Department of cardiovascular Surgery National Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Special Medical Treatment center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina

OBJECTIVE In patients undergoing cardiac surgery,reduced preoperative ejection fraction(EF)and senior age are associated with a worse *** most outcome data available for these patients are mainly from Western surgical populations involving specific surgery types,our aim is to evaluate the real-world characteristics and perioperative outcomes of surgery in senior-aged heart failure patients with reduced EF across a broad range cardiac *** Data were obtained from the China Heart Failure Surgery Registry(China-HFSR)database,a nationwide multicenter registry study in China's *** variable regression analysis was performed in patients over 75 years old to identify risk factors associated with *** From 2012 to 2017,578 senior-aged(>75 years)patients were enrolled in China HFSR,21.1%of whom were *** coronary bypass grafting(CABG)were performed in 71.6%of patients,10.1%of patients underwent isolated valve surgery and 8.7%received CABG combined with valve ***-hospital mortality was 10.6%,and the major complication rate was 17.3%.Multivariate analysis identified diabetes mellitus(odds ratio(OR)=1.985),increased creatinine(OR=1.007),New York Heart Association(NYHA)Class III(OR=1.408),NYHA class IV(OR=1.955),cardiogenic shock(OR,6.271),and preoperative intra-aortic balloon pump insertion(OR=3.426)as independent predictors of in-hospital *** In senior-aged patients,preoperative evaluation should be carefully performed,and strict management of reversible factors needs more ***-aged patients commonly have a more severe disease status combined with more frequent comorbidities,which may lead to a high risk in mortality.

关键词： Western analysis of a large national database Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction

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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 *** were analyzed separately in the septal reduction therapy(SRT)cohort and the non-SRT *** primary endpoint was cardiovascular death and the secondary endpoint was all-cause *** analyses were conducted to evaluate the associations between HT and outcomes in *** before enrollment and at discharge were collected in the post-hoc *** 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 *** 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 *** 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 *** 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 *** 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 *** SRT may have a substantial de-risking effect on patients meeting the indicati

关键词： clinical hypertension cardiomyopathy

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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 *** enrolled were stratified into two categories according to the presence or absence of prior stroke *** primary endpoint was all-cause *** endpoints in-cluded stroke and major adverse cardiac and cerebrovascular event(MACCE),a composite of death,myocardial infarction(MI),unplanned revascularization and *** Prior stroke was present in 888 patients(9.9%).These patients were older and had higher rates of ***-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 *** 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 *** 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 ***;HR=1.703,95%CI:1.371-2.116 for CABG ***].CONCLUSIONS Patients with TVD and prior stroke have poor clinical *** 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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Discordance analysis for apolipoprotein and lipid measures for predicting myocardial infarction in statin-treated patients with coronary artery disease:a cohort study

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Journal of Geriatric Cardiology 2023年第12期20卷 845-854页

作者： Tian-Yu LI Pei ZHU Ying SONG Xiao-Fang TANG Zhan GAO Run-Lin GAO Jin-Qing YUAN National Clinical Research center for cardiovascular Diseases National Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

BACKGROUND The optimal apolipoprotein or lipid measures for identifying statin-treated patients with coronary artery disease(CAD)at residual cardiovascular risk remain *** study aimed to compare the predictive powers of apolipoprotein B(apoB),non-high-density lipoprotein cholesterol(non-HDL-C),low-density lipoprotein cholesterol(LDL-C),apoB/apolipoprotein A-1(apoA-1)and non-HDL-C/HDL-C for myocardial infarction(MI)in CAD patients treated with statins in the setting of secondary *** The study included 9191 statin-treated CAD patients with a five-year median *** measures were anal-yzed as continuous variables and concordance/discordance groups by *** hazard ratio(HR)with 95%CI was estimated by Cox proportional hazards *** were classified by the clinical presentation of CAD for further *** The high-apoB-low-LDL-C and the high-non-HDL-C-low-LDL-C categories yielded HR of 1.40(95%CI:1.04–1.88)and 1.51(95%CI:1.07–2.13)for MI,respectively,whereas discordant high LDL-C with low apoB or non-HDL-C was not associa-ted with the risk of *** association of MI with discordant apoB versus non-HDL-C,apoB/apoA-1 versus apoB,non-HDL-C/HDL-C versus non-HDL-C,or apoB/apoA-1 versus non-HDL-C/HDL-C was *** patterns were found in patients with acute coronary *** contrast,no association was observed between any concordance/discordance category and the risk of MI in patients with chronic coronary *** ApoB and non-HDL-C better predict MI in statin-treated CAD patients than LDL-C,especially in patients with acute coronary ***/apoA-1 and non-HDL-C/HDL-C show no superiority to apoB and non-HDL-C for predict-ing MI.

关键词： patients coronary infarction

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The effect of fasting plasma glucose on in-hospital mortality after acute myocardial infarction in patients with and without diabetes:findings from a prospective,nationwide,and multicenter registry

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Journal of Geriatric Cardiology 2024年第5期21卷 523-533页

作者： Rui FU Ying-Xuan ZHU Kong-Yong CUI Jin-Gang YANG Hai-Yan XU Dong YIN Wei-Hua SONG Hong-Jian WANG Cheng-Gang ZHU Lei FENG Wei WU Kai-HongCHEN Yan-Yan ZHAO Ye LU Ke-Fei DOU Yue-Jin YANG on behalf of the CAMI Registry Investigators Cardiometabolic Medicine center Fuwai 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 Fuwai 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 Guangzhou Traditional Chinese Medical College First Affiliated HospitalGuangdong ProvinceChina Department of Cardiology Longyan Hospital First HospitalFujian ProvinceChina 不详

OBJECTIVES To evaluate the predictive value of fasting plasma glucose(FPG)for in-hospital mortality in patients with acute myocardial infarction(AMI)with different glucose metabolism *** We selected 5,308 participants with AMI from the prospective,nationwide,multicenter CAMI registry,of which 2,081 were diabetic and 3,227 were *** were divided into high FPG and low FPG groups according to the optim-al cutoff values of FPG to predict in-hospital mortality for diabetic and nondiabetic cohorts,*** primary endpoint was in-hospital *** Overall,94 diabetic patients(4.5%)and 131 nondiabetic patients(4.1%)died during hospitalization,and the optimal FPG thresholds for predicting in-hospital death of the two cohorts were 13.2 mmol/L and 6.4 mmol/L,*** with individuals who had low FPG,those with high FPG were significantly associated with higher in-hospital mortality in diabet-ic cohort(10.1%vs.2.8%;odds ratio[OR]=3.862,95%confidence interval[CI]:2.542-5.869)and nondiabetic cohort(7.4%vs.1.7%;HR=4.542,95%CI:3.041-6.782).After adjusting the potential confounders,this significant association was not ***-more,FPG as a continuous variable was positively associated with in-hospital mortality in single-variable and multivariable models regardless of diabetic *** FPG to the original model showed a significant improvement in C-statistic and net reclassification in diabetic and nondiabetic *** This large-scale registry indicated that there is a strong positive association between FPG and in-hospital mor-tality in AMI patients with and without *** might be useful to stratify patients with AMI.

关键词： patients fasting infarction

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The New Strategy for Modulating Dyslipidemia:Consideration from Updated Understanding on High-Density Lipoprotein

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Chinese Journal of Integrative Medicine 2011年第6期17卷 467-470页

作者：文川徐浩 National Integrative Medicine center for cardiovascular Diseases China-Japan Friendship hospital National Integrative Medicine center for cardiovascular Diseases China-Japan.Friendship hospital

With further researches on blood lipids and atherosclerosis,especially after the conception of＂residual cardiovascular risk＂,high-density lipoprotein cholesterol（HDL-C） becomes a new therapeutic target against ***,the failure of ILLUMINATE study that was targeted at raising HDL-C level disappointed cardiologists all over the world,which indicates the limitation of HDL-C concentration in representing HDL *** updated understanding of HDL from＂quantity＂to＂quality＂brings a new cut-in point for integrative Chinese and Western medicine in preventing and treating dyslipidemia and atherosclerosis. In addition to highlighting statins in directly intervening low-density lipoprotein cholesterol,we should make full use of the superiority of Chinese medicine in overall regulation and individualized treatment to promote the self-healing capacity of the patients,which further regulates abnormity of both concentration and function of the whole blood lipid family to *** new strategy for modulating dyslipidemia with mutual complement of advantages from Western and Chinese medicines will no doubt play an important role in future therapies.

关键词： atherosclerosis high-density lipoprotein dyslipidemi integrative medicine

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Down-regulation of eIF5A-2 prevents epithelial-mesenchymal transition in non-small-cell lung cancer cells

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2013年第6期14卷 460-467页

作者： Guo-dong XU Xin-bao SHI Le-bo SUN Qing-yun ZHOU Da-wei ZHENG Huo-shun SHI Yong-liang CHE Zi-shan WANG Guo-feng SHAO Department of Thoracic & cardiovascular Surgery Lihuili HospitalNingbo Medical CenterAffiliated Hospital of Medical SchoolNingbo University Department of Thoracic & cardiovascular Surgery Ningbo First HospitalAffiliated Hospital of Medical SchoolNingbo University

Background:Epithelial-mesenchymal transition(EMT) is believed to be the critical process in malignant tumor invasion and metastases,and has a great influence on improving the survival rate in non-small-cell lung cancer(NSCLC) *** studies suggested that eukaryotic initiation factor 5A-2(eIF5A-2) might serve as an adverse prognostic marker of *** detected eIF5A-2 in NSCLC A549 cells,and found that the invasive capability correlates with the eIF5A-2 ***:Transforming growth factor(TGF)-β1 was used to induce EMT in A549 *** blotting,immunofluorescence,wound healing assay,and transwell-matrigel invasion chambers were used to identify phenotype *** blotting was also used to observe changes of the expression of *** down-regulated the eIF5A-2 expression using an eIF5A-2 siRNA and identified the phenotype changes by western blotting and *** tested the change of migration and invasion capabilities of A549 cells by the wound healing assay and transwell-matrigel invasion ***:After stimulating with TGF-β1,almost all A549 cells changed to the mesenchymal phenotype and acquired more migration and invasion *** cells also had higher eIF5A-2 protein ***-regulation of eIF5A-2 expression with eIF5A-2 siRNA transfection could change the cells from mesenchymal to epithelial phenotype and decrease tumor cell migration and invasive capabilities ***:The expression of eIF5A-2 was up-regulated following EMT phenotype changes in A549 cells,which correlated with enhanced tumor invasion and metastatic ***,in the A549 cell line,the process of EMT phenotype change could be reversed by eIF5A-2 siRNA,with a consequent weakening of both invasive and metastatic capabilities.

关键词： Non-small-cell lung cancer(NSCLC) Epithelial-mesenchymal transition(EMT) Eukaryotic initiation factor 5A-2(eIF5A-2) Transforming growth factor(TGF)-β1 A549

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Association of CDKN2B-AS1 Polymorphisms with Premature Triple-vessel Coronary Disease and Their Sex Specificity in the Chinese Population

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Biomedical and Environmental Sciences 2018年第11期31卷 787-796页

作者： XU Jing Jing JIANG Lin XU Lian Jun GAO Zhan ZHAO Xue Yan ZHANG Yin SONG Ying LIU Ru SUN Kai GAO Run Lin XU Bo SONG Lei YUAN Jin Qing Department of cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Science and Peking Union Medical College State Key Laboratory of cardiovascular Disease Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Science and Peking Union Medical College Department of Hypertension Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Science and Peking Union Medical College

Objective The aim of this study is to establish whether cyclin-dependent kinase inhibitor 2B antisense RNA 1(CDKN2 B-AS1) gene polymorphisms are associated with premature triple-vessel disease(PTVD). Methods Nine single-nucleotide polymorphisms(rs1063192, rs10757274, rs1333042, rs1333049, rs2285327, rs3217986, rs3217992, rs4977574, and rs9632884) were genotyped in 884 PTVD patients and 907 control subjects(males ≤ 50 years old and females ≤ 60 years old) using the improved multiplex ligase detection reaction method. Results The allele frequencies of rs10757274 G, rs1333049 C, rs4977574 G(all P < 0.001), and rs3217986 G(P = 0.040) were significantly higher in the PTVD group than in the control group, but those of rs1063192 A, rs1333042 G, and rs9632884 C(all P < 0.001) were significantly lower in the former than in the latter. Logistic regression analysis revealed that homozygote AA of rs1333042 is associated with decreased risk for PTVD(OR = 0.42, 95% CI: 0.22-0.82, P = 0.011). In addition, the allele frequencies observed differed between genders. The G allele of rs3217986 was associated with increased risk for PTVD in male patients only(OR = 2.94, 95% CI: 1.27-6.80, P = 0.012) in the dominant model, and no positively mutated allele was found in female patients. Conclusion Polymorphisms of the CDKN2 B-AS1 gene are associated with the incidence of PTVD in the Chinese population. Furthermore, the frequencies of mutated alleles differed between genders.

关键词： Premature triple-vessel disease Single-nucleotide polymorphism Risk

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Does ‘super-responder’ patients to cardiac resynchronization therapy still have indications for neuro-hormonal antagonists? Evidence from long-term follow-up in a single center

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Journal of Geriatric Cardiology 2019年第3期16卷 251-258页

作者： Yi-Ran HU Wei HUA Han JIN Min GU Xiao-Han FAN Hong-Xia NIU Li-gang DING Jing WANG Shu ZHANG Cardiac Arrhythmia center State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Background Whether cardiac resynchronization therapy super-responders (CRT-SRs) still have indications for neuro-hormonal antagonists or not remains *** We reviewed clinical data from 376 patients who underwent CRT implantation in Fuwai hospital from 2009 to 2015 and followed up to ***-SRs were defined by an improvement of the New York Heart Association functional class and left ventricular ejection fraction to ≥ 50% in absolute values at 6-month *** CRT-SRs were assigned into two groups on the basis of whether persistently receiving neuro-hormonal antagonists (NHA)(defined as angiotensin-converting enzyme inhibitors/ angiotensin receptor blockers and β-blockers) after 6-month follow-up and then we compared long-term *** A total of 60 patients met criteria for *** of thirteen (7.7%) CRT-SRs without NHA had all-cause death,which also occurred in 2 of 47 (4.3%) in CRT-SRs with NHA (P = 0.526).However,3 of 13 (23.1%) CRT-SRs without NHA had heart failure (HF) hospitalization,1 of 47 (2.1%) CRT-SRs with NHA had this endpoint (P = 0.040).Besides,subgroup analysis indicated that,for ischemic etiology group,CRT-SRs receiving NHA had considerably lower incidence of HF hospitalization than those without NHA (0 vs.75%,P = 0.014),which was not observed in non-ischemic etiology group (2.6% vs.0,P = 1.000) during long-term *** Our study found that for ischemic etiology,compared with CRT-SRs with NHA,CRT-SRs without NHA were associated with a higher risk of HF ***,for non-ischemic etiology,we found that CRT-SRs with NHA or without NHA at follow-up were associated with similar outcomes,which needed further investigation by prospective trials.

关键词： Cardiac resynchronization therapy Heart failure Super-responder Optimal medical therapy

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Comparison of outcomes for percutaneous coronary intervention in men and women with unprotected left main disease

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Journal of Geriatric Cardiology 2021年第3期18卷 168-174页

作者： Sheng-Wen LIU Chang-Dong GUAN Feng-Huan HU Jue CHEN Ke-Fei DOU Wei-Xian YANG Yong-Jian WU Yue-Jin YANG Bo XU Shu-Bin QIAO Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical SciencesBeijingChina Catheterization Laboratories Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical SciencesBeijingChina

BACKGROUND Percutaneous coronary intervention(PCI)in patients with unprotected left main coronary artery disease(ULMCAD)is increasing strategy in coronary artery ***,there is a lack of knowledge on the impact of sex on outcomes of patients undergoing ULMCAD *** From January 2004 to December 2015,there were 3,960 patients undergoing ULMCAD PCI at our institution,including 3,121(78.8%)men and 839(21.2%)*** clinical outcome included the incidence of major adverse cardiac events(MACE)(the composite of all-cause death,myocardial infarction(MI),and revascularization),all-cause death,MI,revascularization at three years *** Compared with men,women had not significantly different MACE(14.7%vs.14.6%,P=0.89),all-cause death(3.5%vs.3.7%,P=0.76),MI(5.0%vs.4.3%,P=0.38),revascularization(9.1%vs.8.9%,P=0.86),*** adjustment,rates of MACE(HR=1.49;95%CI:1.24−1.81;P<0.0001)and all-cause death(HR=1.65;95%CI:1.09−2.48;P=0.017)occurred more frequently in male patients,as well as revascularization(HR=1.46;95%CI:1.16−1.85;P=0.001).CONCLUSION In this analysis,compared to men,women undergoing ULMCAD PCI have better outcomes of MACE,allcause death,and revascularization.

关键词： coronary outcome patients

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