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Journal of Geriatric Cardiology 2024年第7期21卷 713-715页

作者： Jian-Jun LI Cardiometabolic center National Center for Cardiovascular DiseaseChinese Academy of Medical ScienceFuwai HospitalBeijingChina

It is well-known that elevated low-density lipoprotein cholesterol(LDL-C)is a causal risk factor for atheroscler-otic cardiovascular disease(ASCVD),statins are cornerstone drugs for the cause-based treatment of ASCVD,which has created a new era for ASCVD ***,statin intolerance is not clinically uncommon,which there are several issues with confu-sion and ***,a file named Chinese Expert Consensus on the Diagnosis and Management Strategy of Pa-tients With Statin Intolerance,like a navigator,has recently been published written by a team of experts from the cardiovascular Metabolic Medicine Professional Committee,Expert Committee of the National center for cardiovascular Diseases aiming to en-hance the standardized clinical application of statins and improve the prevention and clinical *** this article,author briefly summarized the key points of above consensus in order to helping to comprehending the content of the consensus sugges-tions.

关键词： Expert Strategy corners

Beta-blockers and 1-year clinical outcomes in hospitalized heart failure patients with atrial fibrillation

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Journal of Geriatric Cardiology 2021年第9期18卷 728-738页

作者： Fu-Wei XING Li-Hua ZHANG Hai-Bo ZHANG Xue-Ke BAI Dan-Li HU Xin ZHENG Jing LI 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

OBJECTIVE To assess the association between beta-blockers and 1-year clinical outcomes in heart failure(HF)patients with atrial fibrillation(AF),and further explore this association that differs by left ventricular ejection fraction(LVEF)*** We enrolled hospitalized HF patients with AF from China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure *** proportional hazard regression models were employed to calculate hazard ratio of *** primary outcome was all-cause *** Among 1762 HF patients with AF(756 women[41.4%]),1041(56%)received beta-blockers at discharge and 1272(72.2%)had an LVEF>40%.During one year follow up,all-cause death occurred in 305(17.3%),cardiovascular death occurred in203 patients(11.5%),and rehospitalizations for HF occurred in 622 patients(35.2%).After adjusting for demographic characteristics,social economic status,smoking status,medical history,anthropometric characteristics,and medications used at discharge,the use of beta-blockers at discharge was not associated with all-cause death[hazard ratio(HR):0.86;95%Confidence Interval(CI):0.65-1.12;P=0.256],cardiovascular death(HR:0.76,95%CI:0.52-1.11;P=0.160),or the composite outcome of all-cause death and HF rehospitalization(HR:0.97,95%CI:0.82-1.14;P=0.687)in the entire *** were no significant interactions between use of beta-blockers at discharge and LVEF with respect to all-cause death,cardiovascular death,or composite *** the adjusted models,the use of beta-blockers at discharge was not associated with all-cause death,cardiovascular death,or composite outcome across the different levels of LVEF:reduced(<40%),mid-range(40%-49%),or preserved LVEF(≥50%).CONCLUSION Among HF patients with AF,the use of beta-blockers at discharge was not associated with 1-year clinical outcomes,regardless of LVEF.

关键词： Beta-blockers and 1-year clinical outcomes in hospitalized heart failure patients with atrial fibrillation

Prognostic Values of Serum Chloride and Sodium Levels in Patients with Three-vessel Disease

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Biomedical and Environmental Sciences 2019年第4期32卷 250-259页

作者： ZHANG Ce WANG Dong HOU Bing Jie JIANG Lin XU Lian Jun TIAN Jian ZHAO Yan Yan ZHAO Xue Yan FENG Xin Xing ZHANG Yin SUN Kai XU Bo ZHAO Wei HUI Ru Tai GAO Run Lin LOU Hui Ling YUAN Jin Qing SONG Lei Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical College State Key Laboratory of cardiovascular Disease Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical College Department of Internal Medicine The People's Hospital of Tang County Medical Research & Biometrics center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical College Department of Endocrinology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical College Information center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical College Department of Geriatrics Guangzhou First People's HospitalSchool of MedicineSouth China University of Technology

Objective Identification of new risk factors is needed to improve prediction of adverse outcomes in patients with three-vessel disease(TVD). The present study aimed to evaluate the prognostic values of serum chloride and sodium levels in patients with TVD. Methods We used data from a prospective cohort of consecutive patients with angiographically confirmed TVD. The primary endpoint was all-cause death. Cox proportional hazard regression was used to analyze the relationship of serum chloride and sodium levels with long-term outcomes of TVD patients. Results A total of 8,318 participants with available serum chloride and sodium data were included in this analysis. At baseline, patients in the low tertiles group of serum chloride level(≤ 102.0 mmol/L) or serum sodium level(≤ 139.0 mmol/L) had more severe disease conditions. During a median follow-up of 7.5-year, both low serum chloride level and low serum sodium level were found to be associated with an increased risk for mortality in univariate analysis. However, when both parameters were incorporated into a multivariate model, only low serum sodium level remained to be an independent predictor of all-cause death(hazard ratio: 1.16, 95% confidence interval: 1.01-1.34, P = 0.041). Modest but significant improvement of discrimination was observed after incorporating serum sodium level into the Synergy between percutaneous coronary intervention(PCI) with Taxus and Cardiac Surgery score. Conclusion Serum sodium level is more strongly associated with long-term outcomes of TVD patients compared with serum chloride level. Low serum sodium level is an independent risk factor for mortality, but only provides modest prognostic information beyond an established risk model.

关键词： Coronary disease Prognosis Biomarkers

China cardiovascular diseases report 2018: an updated summary

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Journal of Geriatric Cardiology 2020年第1期17卷 1-8页

作者： Li-Yuan MA Wei-Wei CHEN Run-Lin GAO Li-Sheng LIU Man-Lu ZHU Yong-Jun WANG Zhao-Su WU Hui-Jun LI Dong-Feng GU Yue-Jin YANG Zhe ZHENG Sheng-Shou HU National center for cardiovascular Diseases BeijingChina Beijing Tiantan hospital BeijingChina Beijing Anzhen hospital BeiingChina

1 Introduction Rapid socioeconomic progress has greatly affected the lifestyle in ***,owing to lifestyle changes,urbanization,and accelerated population aging,the risk of cardiovascular diseases(CVD)has *** incidence of CVD has been increasing continuously and this upward trend is projected to continue in the next *** growing burden of CVD has become a major public health issue.

关键词： cardiovascular diseases Heart failure Risk factors

Precision cardiovascular medicine in China

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Journal of Geriatric Cardiology 2020年第10期17卷 638-641页

作者： Jie LIU Ru-Tai HUI 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 National Clinical Research Center for Cardiovascular DiseasesFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

1 Introduction In China's Mainland,hospitalization expenses for patients with cardiovascular and cerebrovascular diseases have rapidly increased since 2004 and currently exceed the growth rate of the national gross domestic product.[1]One reason for these high expenses is that the traditional"one-size-for-all"medical model results in low treatment *** and individualized medical models may help reduce the medical burden and provide a sustainable medical model.

关键词： cardiovascular disease Challenges Precision medicine Progress

Prognostic Value of NT-proBNP in Stable Coronary Artery Disease in Chinese Patients after Percutaneous Coronary Intervention in the Drug-eluting Stent Era

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Biomedical and Environmental Sciences 2018年第12期31卷 859-866页

作者： ZHAO Xue Yan LI Jian Xin TANG Xiao Fang XU Jing Jing SONG Ying JIANG Lin CHEN Jue SONG Lei GAO Li Jian GAO Zhan QIAO Shu Bin YANG Yue Jin GAO Run Lin XU Bo YUAN Jin Qing State Key Laboratory of cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Objective The predictive value of N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with stable coronary artery disease(SCAD) in the drug-eluting stent era is not yet clear. We aimed to evaluate the prognostic value of NT-proBNP in SCAD patients after percutaneous coronary intervention(PCI). Methods We examined 4,293 consecutive SCAD patients who underwent PCI between January 2013 and December 2013 in Fuwai hospital, China. The primary endpoint was all-cause death. NT-proBNP levels were measured before PCI using Elisa kits(Biomedica, Austria). The indication for PCI was based on the degree of coronary stenosis and evidence of ischemia. Results Among 3,187 SCAD patients with NT-proBNP data, after a 2-year follow-up, NT-proBNP levels were predictive for all-cause death in the SCAD population [area under the receiver operating characteristic curve, 0.768; 95% confidence interval(CI), 0.687-0.849; P < 0.001]. At the optimum cutoff point of 732 pg/mL, the sensitivity and specificity of death was 75.0% and 72.3%, respectively. In a multivariable Cox regression model, the death hazard ratio was 6.43(95% CI, 2.99-13.82; P < 0.001) for patients with NT-proBNP levels ≥ 732 pg/mL, compared with < 732 pg/mL. Conclusion NT-proBNP is a strong predictor of 2-year death with SCAD after PCI in the drug-eluting stent era.

关键词： NT-proBNP Stable coronary disease Death Prognosis Percutaneous coronary intervention

Predictors of super-response to cardiac resynchronization therapy： the significance of heart failure medication, pre-implant left ventricular geometry and high percentage of biventricular pacing

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Journal of Geriatric Cardiology 2017年第12期14卷 737-742页

作者： Han JIN Min GU Wei HUA Xiao-Han FAN Hong-Xia NIU Li-Gang DING Jing WANG Cong XUE Shu ZHANG The 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 Beijing China

Background Super-responders （SRs） are defined as patients who show crucial cardiac function improvement after cardiac resynchro- nization therapy （CRT）. The purpose of this study is to identify and validate predictors of SRs after CRT. Methods This study enrolled 201 patients who underwent CRT during the period from 2010 to 2014. Clinical and echocardiographic evaluations were conducted before CRT and 6 months after. Patients with a decrease in New York Heart Association （NYHA） fimctional class 〉 1, a decrease in left ventricular end-systolic volume （LVESV） ≥ 15%, and a final left ventricular ejection fraction （LVEF） ≥ 45% were classified as SRs. Results 29% of the 201 patients who underwent CRT were identified as SRs. At baseline, SRs had significantly smaller left atrial diameter （LAD）, LVESV, left ventricular end-diastolic volume （LVEDV） and higher LVEF than the non-super-responders （non-SRs）. The percentage of patients using angiotensin-converting enzyme inhibitors or angiotensin receptor blockers （ACEI/ARB） was higher in SRs than non-SRs. Most SRs had Biventricular （BiV） pacing percentage greater than 98% six months after CRT. In the multivariate logistic regression analysis, the independ- ent predictors of SRs were lower LVEDV [odd ratios （OR）： 0.93; confidence intervals （CI）： 0.90-0.97], use of ACEI/ARB （OR： 0.33; CI： 0.13~3.82） and BiV pacing percentage greater than 98% （OR： 0.29; CI： 0.16~.87）. Conclusion Patients with a better compliance of ACEI/ARB and a less ectatic ventricular geometry before CRT tends to have a greater probability of becoming SRs. Higher percentage of BiV pacing is essential for becoming SRs.

关键词： Biventricular pacing Cardiac resynchronization therapy Heart failure Super-responders

The influence of metabolic syndrome on atrial fibrillation recurrence: five-year outcomes after a single cryoballoon ablation procedure

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Journal of Geriatric Cardiology 2021年第12期18卷 1019-1028页

作者： Yu XIA Xiao-Feng LI Jun LIU Miao YU Pi-Hua FANG Shu ZHANG State Key Laboratory of cardiovascular Disease Cardiac Arrhythmia CenterFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

BACKGROUND Metabolic syndrome(MetS)has been reported as a risk factor of atrial fibrillation(AF)recurrence after radi-ofrequency catheter *** study aimed to investigate the long-term influence of MetS on paroxysmal AF recurrence after a single cryoballoon ablation procedure,which was scarcely investigated yet in Chinese *** In total,137 paroxysmal AF patients who had successfully completed a single cryoballoon ablation procedure at Fuwai hospital,Beijing,China from December 2013 to October 2015 were *** for patients with AF recurrence,all patients were followed up for no less than five *** predictors of AF recurrence were determined by Cox propor-tional hazards regression *** Among 137 paroxysmal AF patients,91 patients(66.4%)had successfully achieved overall five-year follow-up after a single cryoballoon ablation procedure,and 44 patients(32.1%)had *** with MetS had a significant lower incidence of freedom from AF recurrence than those without MetS(50.0%vs.74.2%,log-rank P<0.01)during the five-year ***(HR=1.95,95%CI:1.069−3.551,P=0.030)was an independent predictor of AF recurrence after adjusting for multiple *** the second year post cryoballoon ablation procedure,the recurrence rate of AF gradually increased in patients with MetS,in con-trast,decreased recurrence rate of AF in patients without *** MetS is an independent predictor for five-year AF recurrence after a single cryoballoon ablation procedure in paroxysmal AF *** therapy of AF and MetS may improve the long-term outcomes of AF patients.

关键词： balloon fibrillation atrial

Clinical outcome of cardiac resynchronization therapy in dilated-phase hypertrophic cardiomyopathy

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Journal of Geriatric Cardiology 2017年第4期14卷 238-244页

作者： Min GU Han JIN Wei HUA Xiao-Han FAN Hong-Xia NIU Tao TIAN Li-Gang DING Jing WANG Cong XUE 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 Beijing China

Backgrounds Clinical trials have demonstrated that cardiac resynchronization therapy （CRT） is effective in patients with ＂non-is- chemic cardiomyopathy＂. However, patients with dilated-phase hypertrophic cardiomyopathy （DHCM） have been generally excluded from such trials. We aimed to compare the clinical outcome of CRT in patients with DHCM, idiopathic dilated cardiomyopathy （IDCM）, or ischemic cardiomyopathy （ICM）. Methods A total of 312 consecutive patients （DHCM： n = 16; IDCM： n = 231; ICM： n = 65） undergoing CRT in Fuwai hospital were studied respectively. Response to CRT was defmed as reduction in left ventricular end-systolic volume （LVESV） _〉 15% at 6-month follow-up. Results Compared with DHCM, IDCM was associated with a lower total mortality （HR： 0.35, 95% CI： 0.13-0.90）, cardiac mortality （HR： 0.29; 95% CI： 0.11-0.77）, and total mortality or heart failure （HF） hospitalizations （HR： 0.34, 95% CI： 0.17-0.69）, independent of known confounders. Compared with DHCM, the total mortality, cardiac mortality and total mortality or HF hospitalizations favored ICM but were not statistically significant （HR： 0.59, 95% CI： 0.22-1.61; HR： 0.59, 95% CI： 0.21-1.63; HR： 0.54, 95% CI： 0.26-1.15; respectively）. Response rate to CRT was lower in the DHCM group than the other two groups although the differences didn＇t reach statistical significance. Conclusions Compared with IDCM, DHCM was associated with a worse outcome after CRT. The clinical outcome of DHCM patients receiving CRT was similar to or even worse than that of ICM patients. These indicate that DHCM behaves very differently after CRT.

关键词： Cardiac resynchronization therapy Dilated-phase hypertrophic cardiomyopathy Idiopathic dilated cardiomyopathy Ischemic cardiomyopathy

Uric acid is associated with cardiac death in patients with hypertrophic obstructive cardiomyopathy

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Journal of Geriatric Cardiology 2021年第4期18卷 281-288页

作者： Jun GAO Chun-Li SHAO Xiang-Bin MENG Wen-Yao WANG Kuo ZHANG Jing-Jia WANG Ming-Qi ZHENG Yi-Da TANG Heart center the First Hospital of Hebei Medical UniversityShijiazhuangChina Department of Cardiology State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Fuwai Central China Cardiovascular HospitalCentral China Branch of National Center for Cardiovascular DiseasesZhengzhouChina Department of Cardiology and Institute of Vascular Medicine Peking University Third HospitalNHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory PeptidesKey Laboratory of Molecular Cardiovascular ScienceMinistry of EducationBeijing Key Laboratory of Cardiovascular Receptors ResearchBeijingChina

BACKGROUND The role of uric acid(UA) in survival of patients with hypertrophic obstructive cardiomyopathy(HOCM) has not been fully evaluated. This study aimed to determine whether UA could be an independent risk factor of cardiac death in patients with *** A total of 317 patients with HOCM, who were receiving conservative treatment in Fuwai hospital from October2009 to December 2014, all of them completed UA evaluations, were analyzed. Patients were divided into three groups according to the UA levels: Tertile 1(≤ 318 μmol/L, n = 106), Tertile 2(319 to 397 μmol/L, n = 105), and Tertile 3(≥ 398 μmol/L, n = 106).RESULTS During a median follow-up of 45 months, 29 cardiac deaths(9.1%) occurred, including 6 sudden cardiac deaths and23 heart failure-related deaths. Cardiac death in Tertile 3(n = 16, 55.2%) was significantly higher than in Tertile 1(n = 6, 20.7%)and Tertile 2(n = 7, 24.1%). In univariate model, UA level(continuous value) showed predictive value of cardiac death [hazard ratio(HR) = 1.006, 95% CI: 1.003-1.009, P = 0.009]. Univariate Cox survival analysis had shown a significant higher property of cardiac death in patients of Tertile 3 when compared with those of Tertile 1, but cardiac death in patients of Tertile 2 did not show significant prognositic value compared with those of Tertile 1(HR = 3.927, 95% CI: 0.666-23.162, P = 0.131). UA was found to be an independent risk factor(HR = 1.005, 95% CI: 1.001-1.009, P = 0.009) of cardiac death in the multivariate regression analysis after the adjustment for age, body mass index, atrial fibrillation, hemoglobin, creatinine, high-sensitivity C-reactive protein, interventricular septum/left ventricular posterior wall ratio, left ventricular outflow tract and left ventricular ejection *** UA concentration was found to be independently associated with cardiac death in HOCM patients receiving conservative treatment. Randomized trials of UA-lowering agents for HOCM patients are warranted.

关键词： CRP Uric acid is associated with cardiac death in patients with hypertrophic obstructive cardiomyopathy