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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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sDR5-Fc inhibits macrophage M1 polarization by blocking the glycolysis

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Journal of Geriatric Cardiology 2021年第4期18卷 271-280页

作者： Guang-Yao ZHAI Shu-Yan QIE Qian-Yun GUO Yue QI 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 Department of Rehabilitation Beijing Rehabilitation Hospital of Capital Medical UniversityBeijingChina Department of Epidemiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of Heart Lung and Blood Vessel DiseaseBeijingChina

BACKGROUND M1 polarization of macrophages is an important pathological process in myocardial ischemia reperfusion injury, which is the major obstacle for the treatment of acute myocardial infarction. Currently, the strategies and mechanisms of inhibiting M1 polarization are poorly explored. This study aims to investigate the role of soluble death receptor 5-Fc(s DR5-Fc) in regulating M1 polarization of macrophages under extreme conditions and explore the mechanisms from the aspect of *** Extreme conditions were induced in RAW264.7 cells. Real-time quantitative polymerase chain reaction and western blot were used to detect the expression of m RNA and proteins, respectively. Cell counting kit-8 was used to investigate the proliferation activity of cells. Expression levels of inflammatory cytokines were determined by enzyme-linked immunosorbent *** We found that s DR5-Fc rescues the proliferation of macrophages under extreme conditions, including nutrition deficiency, excessive peroxide, and ultraviolet irradiation. In addition, administration of s DR5-Fc inhibits the M1 polarization of macrophages induced by lipopolysaccharide(LPS) and interferon-gamma(IFN-γ), as the expression of M1 polarization markers CD86, CXC motif chemokine ligand 10, matrix metalloproteinase 9, and tumor necrosis factor-α, as well as the secretion of inflammatory factors interleukin(IL)-1β and IL-6, were significantly decreased. By further investigation of the mechanisms, the results showed that s DR5-Fc can recover the LPS and IFN-γ induced p H reduction, lactic acid elevation, and increased expression of hexokinase 2 and glucose transporter 1, which were markers of glycolysis in *** s DR5-Fc inhibits the M1 polarization of macrophages by blocking the glycolysis, which provides a new direction for the development of strategies in the treatment of myocardial ischemia reperfusion injury.

关键词： RNA IFN sDR5-Fc inhibits macrophage M1 polarization by blocking the glycolysis

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Minimally invasive thoracoscopic left atrial appendage occlusion compared with transcatheter left atrial appendage closure for stroke prevention in recurrent nonvalvular atrial fibrillation patients after radiofrequency ablation:a prospective cohort study

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Journal of Geriatric Cardiology 2021年第11期18卷 877-885页

作者： Jian-Long WANG Kuo ZHOU Zheng QIN Wan-Jun CHENG Ling-Zhi ZHANG Yu-Jie ZHOU Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijingChina Interventional Department Luanzhou People’s HospitalTangshanChina Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of Heart Lung and Blood Vessel DiseaseBeijing Key Laboratory of Precision Medicine of Coronary Atherosclerot1ic DiseaseClinical Center for Coronary Heart DiseaseBeijingChina

BACKGROUND Tanscatheter left atrial appendage(LAA)closure and minimally invasive thoracoscopic LAA occlusion are local interventions of LAA for stroke prevention in patients with nonvalvular atrial fibrillation(NVAF).However,the safety and efficacy of these methods have not been *** prospective cohort study aimed to assess the safety and efficacy of those two treatment approaches for stroke prevention in NVAF *** Two hundred and nine recurrent NVAF patients who received radiofrequency ablation were *** pa-tients were treated with transcatheter LAA closure or thoracoscopic LAA *** patients were followed up from the first postoperative day and evaluated for efficacy endpoints(stroke/transient ischemic attack(TIA),systemic embolism(SE),and death)and a safety endpoint(bleeding events).Perioperative complications were *** After a median follow-up of 1.8 years(383 patient-years),the overall rate of the composite efficacy endpoints was similar between the two groups(3.8 vs.2.7 events per 100 patient-years;HR=0.71;95%CI:0.225−2.237;P=0.559).However,regarding primary safety endpoint,there were 1.5 bleeding events per 100 patient-years in the thoracoscopic LAA occlusion group,com-pared with 6.4 in transcatheter LAA closure group(HR=0.246;95%CI:0.074−0.819;P=0.022).The incidence of operative com-plications was 3/138(2.17%)in thoracoscopic LAA occlusion group and 1/71(1.41%)in transcatheter LAA closure *** Thoracoscopic LAA occlusion and transcatheter LAA closure have similar efficacy in preventing stroke in NVAF ***,the thoracoscopic group had fewer bleeding events than the transcatheter group,but the former group required a longer hospital stay.

关键词： prevention patients transcatheter

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Prognostic Significance of HbA1c Level in Asian Patients with Prediabetes and coronary Artery disease

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Cardiovascular Innovations and Applications 2022年第1期6卷 147-160页

作者： Yang Liu Xunxun Feng Jiaqi Yang Tienan Sun Guangyao Zhai Qianyun Guo Yujie 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

Background:Measuring glycosylated hemoglobin(HbA1c)is a simple way to assess patients with prediabetes or diabetes *** has been shown that HbA1c level predicts prognosis in patients with coronary artery disease(CAD)and the incidence of diabetes ***,the prognostic significance of HbA1c level in Asian patients with prediabetes and CAD is not yet *** study aimed to determine the relationship between HbA1c level and major adverse cardiovascular events(MACE)in patients with prediabetes and ***:We enrolled 1367 patients with prediabetes and CAD in the final analysis,and grouped them according to the HbA1c *** end points included nonfatal myocardial infarction,hospitalization for unstable angina,and ischemia-driven *** proportional-hazards regression analysis was used to determine the relation-ship between HbA1c level and MACE after our accounting for confounding ***:A total of 1367 patients(age 58.8±10.3 years;71.6%men)were *** 43 months of follow-up,197 patients experienced at least one primary end point *** Cox proportional-hazards regression analy-sis showed in comparison of HbA1c levels that the hazard ratio for primary end points was 4.110,with a 95%confidence interval of 2.097-6.011(P<0.001).Conclusions:HbA1c level positively correlated with MACE,demonstrating it is a valuable indicator for indepen-dently predicting MACE in Asian patients with prediabetes and CAD.

关键词： Glycosylated hemoglobin adverse cardiovascular outcomes prediabetes coronary artery disease

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Effects of PEAR1 gene polymorphism on big endothelin-1 levels in Chinese patients with acute myocardial infarction after percutaneous coronary intervention

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World Journal of Emergency Medicine 2024年第3期15卷 229-231页

作者： Yi Yao Na Xu Xiaofang Tang Ce Zhang Sida Jia Jingjing Xu Ying Song Xueyan Zhao Runlin Gao Jinqing Yuan center for coronary heart disease National Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

Acute myocardial infarction (AMI) has been associated with poor prognosis,even after revascularization with percutaneous coronary intervention (PCI),likely due to coronary endothelial cell dysfunction and injury.^([1,2])Endothelin-1 (ET-1),a peptide that serves as a vasoconstrictor of smooth muscle cell proliferation,can reflect endothelial cell functional *** to low circulation levels and short plasma half-life time,measuring plasma ET-1 levels is *** contrast,big ET-1.

关键词： coronary percutaneous endothelin

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The aging burden of hospitalization for heart failure in Chinese populations:evidence from the Macao heart Failure Study

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Journal of Geriatric Cardiology 2020年第9期17卷 533-543页

作者： Zhi-Nan LU Mario Evora Edmundo Lao Man Ieng Pun Weng Hong Pun Monica Pon Kong Chu Pui I Ieong Toi-Meng Mok Yong-Jian WU coronary heart disease center Cardiology DepartmentFuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina 2Centro Hospitalar Conde de São JanuárioMacaoSARChina

Objective To assess the aging burden of hospitalization for heart failure in Chinese populations in *** The Macao heart Failure Study consists of patients hospitalized with a diagnosis of acute heart failure(AHF)at Centro Hospitalar Conde de São Januário(the only public hospital that provides medical care for the approximately 600,000 residents of Macao)from January 2014 to December ***,we investigated the relationship between socioeconomic development and epidemiological characteristics of HF in *** we assessed the patients’clinical features and outcomes according to the age *** A total of 967 patients were included in the final *** median age at admission was 82 years *** advanced age at the admission of HF in Macao was significantly associated with a high-income level and the aging population *** heterogeneity existed in the epidemiological characteristics,clinical features,utilization of evidence-based therapies,short-and long-term outcomes,and prognostic utility of clinical variables among the different age *** Rapid economic development and significantly aging populations have produced a profound impact on the epidemiological characteristics of HF in Chinese *** decompensated heart failure(ADHF)is predominantly a disease of the elderly in Macao,and a significant heterogeneity exists in the clinical features,managements,and outcomes among different age ***-based risk stratification models and multidisciplinary HF teams are urgently needed to improve the management and outcomes of hospitalized heart failure(HHF)patients.

关键词： Cardiac risk factors and prevention heart failure The elderly

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Effect of advanced age on plasma homocysteine levels and its association with ischemic stroke in non-valvular atrial fibrillation

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Journal of Geriatric Cardiology 2017年第12期14卷 743-749页

作者： Yan YAO Li-Jian GAO Yong ZHOU Jing-Hua ZHAO Qiang LV Jian-Zeng DONG Mei-Sheng SHANG Department of Cardiology Beijing Anzhen Hospital CapitalMedical University Beijing China center for coronary heart disease Department of Cardiology Cardiovascular Institute & Fuwai Hospital CAMS & PUMC National Center for Heart Dis- ease Beijing China Beijing Institute of heart Lung and Blood Vessel Diseases Beijing Anzhen Hospital Capital Medical University Beijing China

Background Elevated homocysteine （Hcy） has been reported to be associated with cardiovascular events in atrial fibrillation （AF） pa- tients, while the age-related expression pattern of plasma Hcy in AF remains unknown. The study was aimed to investigate the effect of ad- vanced age on plasma Hcy levels and its association with ischemic stroke in non-valvular AF patients. Methods A total of 2562 consecu- tive patients with non-valvular AF and 535 controls were enrolled and divided into six age groups. Plasma Hcy levels were analyzed among different age groups, and the effect of advanced age on Hcy was investigated. Results Plasma Hcy levels did not show any difference among groups aged below 65 years, while it increased sharply in patients aged 65-74 years and aged over 75 years （15.7 ±4.6 μmol/L, 17.1 ±4.9 μmol/L, both P 〈 0.01 compared with the first four age groups）. Hcy was much higher in AF patients than in controls at the same age group （all P 〈 0.05）. The proportion of patients with hyperhomocysteinemia increased gradually with age from 32.3%, 29.2%, 31.2%, 32.4%, 45.9%, to 51.4% in six age groups. The concentration of Hcy in AF patients with ischemic stroke increased progressively with age, and was higher than those without stroke at the same age. Logistic regression analysis demonstrated that age 65-74 years [odds ratios （OR）： 1.742, 95% confidence interval （CI）： 1.223-2.482, P = 0.002] and age ≥ 75 years （OR： 2.637, 95% CI： 1.605-4.335, P 〈 0.001） were significantly independent predictors of elevated plasma Hcy levels. Conclusions Advanced age was significantly associated with elevated Hcy levels, which may provide a possible explanation for the progressive increase in ischemic stroke especially in elderly AF patients.

关键词： Advanced age Atrial fibrillation Homocysteine Ischemic stroke

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COMPARISON OF SHORT- AND LONG-TERM OUTCOMES BETWEEN CYPHER AND TAXUS DRUG-ELUTING STENTS FOR IN-STENT RESTENOSIS

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Chinese Medical Sciences Journal 2007年第1期22卷 5-8页

作者： Ji-lin Chen Yue-jin Yang Shu-bin Qiao Min Yao Xue-wen Qin Bo Xu Hai-bo Liu Yong-jian Wu Jin-qing Yuan Jue Chen Shi-jie You Jun Dai Jian-jun Li Run-lin Gao center for Diagnosis ＆ Treatment of coronary heart disease Cardiovascular Institute and Fuwai Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100037

Objective To compare the short- and long-term clinical outcomes between sirolimus-eluting stent （ Cypher stent） and paclitaxel-eluting stent （TAXUS stent） in patients with in-stent restenosis （ISR） lesions of the coronary arteries. Methods From December 2002 to March 2005, 253 patients with ISR lesions of the coronary arteries were selected and divided into two groups. Cypher group （152 cases） was treated with Cypher or Cypher Select stents, and TAXUS group （101 cases） with TAXUS stents. A total of 262 ISR lesions in these patients were treated with 308 drog-eluring stents （DESs）, including 176 Cypher or Cypher Select stents and 132 TAXUS stents. All patients were followed up for 10 months. Procedure success rates of DES implantation in both groups were observed. Major adverse cardiac events （MACE） rates in hospital and at 10 months follow-up, as well as in-DES restenosis observed using coronary angiography at follow-up were compared between two groups. Results Success rate of DES implantation was 100% in both groups. No significant difference in MACE rate during hospitalization was found between the two groups. However, at 10 months follow-up, MACE rate was higher in TAXUS group than in Cypher group （ 16.00% vs. 6.67%, P =0. 031 ）. As for coronary angiography at 10 months follow-up, we observed an increasing tendency of in-DES restenosis rate in TAXUS group compared with Cypher group （29.41% vs. 14.04%, P=0.075）. Conclusions Cypher and TAXUS DESs both have good short- and long-term outcomes in treating ISR. Cypher DES proved better long-term clinical outcome than TAXUS DES.

关键词： in-stent restenosis drug-eluting stent outcome

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INFERIOR-SEPTAL MYOCARDIAL INFARCTION MISDIAGNOSED AS ANTERIOR-SEPTAL MYOCARDIAL INFARCTION:ELECTROCARDIOGRAPHIC,SCINTIGRAPHIC,AND ANGIOGRAPHIC CORRELATIONS

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Chinese Medical Sciences Journal 2007年第4期22卷 228-231页

作者： Ji-lin Chen Zuo-xiang He Zai-jia Chen Jin-qing Yuan Yue-qin Tian Shu-bin Qiao Rong-fang Shi Yi-da Tang Zong-lang Lu center for Diagnosis ＆ Treatment of coronary heart disease Cardiovascular Institute ＆ Fuwai Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100037

Objective To explore the infarct sites in patients with inferior wall acute myocardial infarction （AMI） concomitant with ST segment elevation in leads V1-V3 and leads V3R-V5R. Methods Five patients diagnosed as inferior, right ventricular, and anteroseptal walls AMI at admission were enrolled. Electrocardiographic data and results of isotope ^99mTc-methoxyisobutylisonitrile （MIBi） myocardial perfusion imaging and coronary angiography （CAG） were analyzed. Results Electrocardiogram showed that ST segment significantly elevated in standard leads Ⅱ, Ⅲ, aVF, and leads V1-V3, V3R-V5R in all five patients. The magnitude of ST segment elevation was maximal in lead V1 and decreased gradually from lead V1 to V3 and from lead V1 to V3R-V5R. There was isotope ^99mTc-MIBI myocardial perfusion imaging defect in inferior and basal inferior-septal walls. CAG showed that right coronary artery was infarct-related artery. Conclusions The diagnostic criteria for basal inferior-septal wall AMI can be formulated as follows：（ 1 ） ST segment elevates ≥2 mm in lead V1 in the clinical setting of inferior wall AMI; （2） the magnitude of ST segment elevation is the tallest in lead V1 and decreases gradually from lead V1 to V3 and from lead V1 to V3R-V5R. With two conditions above, the basal inferior-septal wall AMI should be diagnosed.

关键词： acute myocardial infarction basal inferior-septal wall electrocardiogram

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Long-term outcome of patients with atrial myxoma after surgical intervention: analysis of 403 cases

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Journal of Geriatric Cardiology 2019年第4期16卷 338-343页

作者： Chen-Xi JIANG Jian-Gang WANG Rui-Dong QI Wei WANG Li-Jian GAO Jing-Hua ZHAO Chun-Xiao ZHANG Meng-Chen ZHOU Xin TU Mei-Sheng SHANG Yan YAO Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijingChina Department of Cardiovascular Surgery Beijing Anzhen HospitalCapital Medical UniversityBeijingChina center for coronary heart disease Department of CardiologyCardiovascular Institute & Fuwai HospitalCAMS & PUMCNational Center for Heart DiseaseBeijingChina College of Life Science and Technology Huazhong University of Science and TechnologyWuhanChina

Objective To assess long-term survival and late cardiovascular events in patients with atrial myxoma after surgical intervention. Methods Retrospective analysis of 403 patients undergoing resection of atrial myxoma from January 2002 to December 2016 was conducted with a median follow-up period of 4.5 (range: 0.5?15) years. Results The cross-clamp time and cardiopulmonary bypass times were 41.1 ± 21.4 and 65.2 ± 27.3 min,respectively. A diagnosis of myxoma was histopathologically confirmed in all cases. The early in-hospital mortality rate was 0.7%(n = 3). During the follow-up period,tumor recurrence occurred in six patients and cerebral infarction in nine. There were 48 (11.9%) patients with late onset atrial fibrillation (AF). By multivariate analysis,age (HR = 1.05,95% CI: 1.02–1.09,P < 0.001),left atrial diameter (HR = 1.23,95% CI: 1.08–1.36,P = 0.012),and mitral valve surgery (HR = 1.17,95% CI: 1.05–1.29,P = 0.027) were independent predictors of late onset AF. Twenty-one (5.2%) patients died during the follow-up period. Advanced age (HR = 1.07,95% CI: 1.04–1.10,P = 0.003) and multiple surgical procedures (HR = 1.18,95% CI: 1.06–1.29,P = 0.012) were significantly associated with overall mortality. Conclusions Atrial myxoma can be resected with good long-term survival. Late onset AF is common after surgery in patients with atrial myxoma. Advanced age,left atrial diameter,and mitral valve surgery were independent predictors of outcomes.

关键词： Atrial fibrillation Atrial myxoma Embolism Survival

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