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Association of baseline hemoglobin A1c levels with bleeding in patients with non-ST-segment elevation acute coronary syndrome underwent percutaneous coronary intervention:insights of a multicenter cohort study from China

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Journal of Geriatric cardiology 2022年第7期19卷 487-497页

作者： Hua-Lin FAN Li-Huan ZENG Peng-Yuan CHEN Yuan-Hui LIU Chong-Yang DUAN Wen-Fei HE Ning TAN Ji-Yan CHEN Peng-Cheng HE department of cardiology School of MedicineSouth China University of TechnologyGuangzhouChina department of cardiology Guangdong Cardiovascular InstituteGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouChina Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouChina The Second School of Clinical Medicine Southern Medical UniversityGuangzhouChina department of cardiology the Second People’s Hospital of Nanhai DistrictGuangdong Provincial People’s Hospital’s Nanhai HospitalFoshanChina de-partment of Biostatistics School of Public HealthSouthern Medical UniversityGuangzhouChina department of cardiology Heyuan People’s HospitalHeyuanChina

OBJECTIVE To investigate the association between baseline hemoglobin A1c(HbA1c)levels and bleeding in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)who underwent percutaneous coronary intervention(PCI).METHODS This observational cohort study enrolled 6283 consecutive NSTE-ACS patients undergoing PCI from January 1,2010 to december 31,*** on baseline HbA1c levels,the patients were divided into the group with HbA1cdes 3-5)and all-cause death during *** Of patients enrolled,4705(74.9%)were male,and 2143(34.1%)had a history of diabetes mellitus,with a mean(SD)age of 64.13(10.32)*** median follow-up duration was 3.21 *** with the patients with HbA1cdence interval[CI]:1.01-2.44;P=0.044),while the risk of all-cause death during follow-up was not associated with the higher HbA1c levels(adjusted HR=0.88;95%CI:0.66-1.18;P=0.398).CONCLUSIONS Compared with the lower baseline HbA1c levels,the higher baseline HbA1c levels were associated with an increase in long-term bleeding risk in NSTE-ACS patients undergoing PCI,though higher baseline HbA1c levels were not associ-ated with the higher risk in all-cause death.

关键词： patients bleeding coronary

N-terminal pro-B-type natriuretic peptide levels after hospital discharge in patients with acute myocardial infarction for predicting long term outcome

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South China Journal of cardiology 2019年第3期20卷 168-173页

作者： ZHENG Bao-juan CHEN Jian-jia MA dun-liang ZHUO Sheng-qing TIAN Xiang-ting department of cardiology Guangdong Cardiovascu lar InstituteGuangdong Academy of Medical ScienceGuangdong Provincial People's HospitalGuangzhou 510100 de partment of cardiology Lecong HospitalFoshan 528315 department of cardiology Guangdong General Hospital's Nanhai HospitalFoshan 528200China

Background N-terminal-pro-brain natriuretic peptide(NT-pro-BNP)is associated with worse outcome in patients with acute myocardial infarction(AMI). However,the role of short-term follow-up of NT-pro-BNP level remains unclear. Methods Three hundred and sixty-two patients diagnosed with AMI were retrospectively enrolled in this study from March 2014 to March 2017 in our center. Blood samples were obtained at initial admission and again within 1 month after hospital discharge. The univariate and multivariate cox regression analyses including significant covariables were performed on NT-pro-BNP level at admission,discharge,or change from admission to discharge to predict adverse cardiovascular events(MACE)as study endpoints. Results There were 211 cases in NT-pro-BNP decrease group,while 151 cases in NT-pro-BNP increase group. The median follow-up was 365 days(interquartile range[IQR],322-861 days). After adjusting the covariables in the multiple logistic regression analysis,follow-up NT-pro-BNP level was still a significant independent predictor for MACE(OR,1.395;95% CI,1.102-1.869,P=0.005). However,the initial NT-pro-BNP level or change of NT-pro-BNP level had no significant predictive value for MACE. Conclusions A short-term follow-up NT-pro-BNP level after hospital discharge is a powerful prognostic biomarker for MACE in patients with AMI.[S Chin J Cardiol 2019;20(3):168-173]

关键词： N-terminal pro-B-type natriuretic peptide major adverse cardiovascular events prognosis

Ischemia/reperfusion injury and cardioprotective mechanisms:Role of mitochondria and reactive oxygen species

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World Journal of cardiology 2011年第6期3卷 186-200页

作者： Maria-Giulia Perrelli Pasquale Pagliaro Claudia Penna de-partment of Clinical and Biological Sciences University of Turin Claudia Penna Na-tional Institute of Cardiovascular Research

Reperfusion therapy must be applied as soon as possible to attenuate the ischemic insult of acute myocardial infarction(AMI).However reperfusion is responsible for additional myocardial damage,which likely involves opening of the mitochondrial permeability transition pore(mPTP).In reperfusion injury,mitochondrial damage is a determining factor in causing loss of cardiomyocyte function and *** mechanisms of mitochondrial dysfunction include the long lasting opening of mPTPs and the oxidative stress resulting from formation of reactive oxygen species(ROS).Several signaling cardioprotective pathways are activated by stimuli such as preconditioning and postconditioning,obtained with brief intermittent ischemia or with pharmacological *** pathways converge on a common target,the mitochondria,to preserve their function after ischemia/*** present review discusses the role of mitochondria in cardioprotection,especially the involvement of adenosine triphosphate-dependent potassium channels,ROS signaling,and the *** postconditioning has emerged as a new way to target the mitochondria,and to drastically reduce lethal reperfusion *** clinical studies using ischemic postconditioning during angioplasty now support its protective effects,and an interesting alternative is pharmacological *** fact ischemic postconditioning and the mPTP desensitizer,cyclosporine A,have been shown to induce comparable protection in AMI patients.

关键词： Adenosine triphosphate-dependent potas-sium channels Cardioprotection Ischemia-reperfusion injury Mitochondrial permeability transition pore Reac-tive oxygen species

Efficacy of Qingre Huayu Fang (清热化瘀方) on atherosclerotic vulnerable plaque in apolipoprotein E knockout mice:proteasome pathway involvement

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Journal of Traditional Chinese Medicine 2021年第4期41卷 432-437页

作者： PANG Jun CHENG Wenli PENG Jingbing LI Hong WU Qiang LI Ling LIU Chengming LIU Wei HUANG Jing de-partment of cardiology Guizhou Provincial People's HospitalGuiyang 520000China department of Hypertension Beijing Anzhen HospitalBeijing 100029China Institute of Clinical Medicine Beijing China-Japan Friendship HospitalBeijing 100029China Emergency department Guizhou Provincial People's HospitalGuiyang 520000China

OBJECTIVE: To investigate the efficacy and mechanism of the Qingre Huayu Fang(清热化瘀方) on atherosclerotic vulnerable plaque in apolipoprotein E(Apo E) knockout mice through the ubiquitin proteasome ***: Sixty 8-week-old C57BL/6J Apo E knockout mice were fed a high-fat for 12 weeks and randomly divided into four treatment groups(n = 15 each): high-fat control, bortezomib(a proteasome inhibitor), bortezomib combined with Qingre Huayu Fang, and Qingre Huayu Fang alone. Aortic sections were examined for plaque development, inflammatory cell infiltration, type Ⅰ/Ⅲ collagen expression and immunohistochemical staining of CD40L, nuclear factor-kappa B(NF-κB)/P65 and ***: Mice in the high-fat control group had obvious atherosclerosis, with increased aortic plaque area. The degree of atherosclerosis of the atherosclerotic plaque was reduced in all of the treatment groups that received bortezomib and/or Duzhong(Cortex Eucommiae) Qingre Huayu. The expression of NF-?B, CD40L and ubiquitin were all reduced in the group that received combination bortezomib + Qingre Huayu ***: The Qingre Huayu Fang inhibited aortic atherosclerosis in mice through a mechanism that may involve inhibition of the ubiquitin proteasome pathway.

关键词： atherosclerosis plaque atherosclerotic proteasome endopeptidase complex CD40 ligand NF-kappa B Qingre Huayu

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Prediction model of in-hospital mortality in elderly patients with acute heart failure based on retrospective study

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Journal of Geriatric cardiology 2017年第11期14卷 669-678页

作者： Qian JIA Yu-Rong WANG Ping HE Xue-Liang HUANG Wei YAN Yang MU Ktm-Lun HE Ya-Ping TIAN Core Laboratory of Translational Medicine Chinese PLA General Hospital Beijing China department of cardiology School of Medicine Nankai University Tianjin China department of Statistics Peking University Health Science Center Beijing China department of Clinical Biochemistry Chinese PLA General Hospital Beijing China department of cardiology Chinese PLA General Hospital Beijing China

Objectives The aim of this study was to develop a clinical risk model that is predictive of in-hospital mortality in elderly patients hos- pitalized with acute heart failure （AHF）. Methods 2486 patients who were 60 years and older from intensive care units of cardiology de- partment in the hospital were analyzed. Independent risk factors for in-hospital mortality were obtained by binary logistic regression and then used to establish the risk prediction score system （RPSS）. The area under the curve （AUC） of receiver operator characteristic and C-statistic test were adopted to assess the performance of RPSS and to compare with previous get with the guidelines-heart failure （GWTG-HF）. Re- sults By binary logistic regression analysis, heart rate （OR： 1.043, 95% CI： 1.030-1.057, P 〈 0.001）, left ventricular ejection fraction （OR： 0.918, 95% CI： 0.833~）.966, P 〈 0.001）, pH value （OR： 0.001, 95% CI： 0.000-0.002, P 〈 0.001）, renal dysfunction （OR： 0.120, 95% CI： 0.066M）.220, P 〈 0.001） and NT-pro BNP （OR： 3.463, 95% CI： 1.870-6.413, P 〈 0.001） were independent risk factors of in-hospital mortal- ity for elderly AHF patients. Additionally, RPSS, which was composed of all the above-mentioned parameters, provided a better risk predic- tion than GWTG-THF （AUC： 0.873 vs. 0.818, P = 0.016）. Conclusions Our risk prediction model, RPSS, provided a good prediction for in-hospital mortality in elderly patients with A/IF.

关键词： Acute heart failure N-hospital mortality Prediction model Risk factors

Mining twitter to understand the smoking cessation barriers

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World Journal of cardiology 2017年第10期9卷 794-795页

作者： Chayakrit Krittanawong Zhen Wang department of Internal Medicine Icahn School of Medicine at Mount Sinai St.Luke’s and Mount Sinai West department of Cardiovascular Medicine Heart and Vascular Institute Robert D.and Patricia E.Kern Center for the Science of Health Care delivery Division of Health Care Policy and Research De-partment of Health Sciences Research

Smoking cessation is challenging and lack of positive support is a known major barrier to quitting *** studies have suggested that social influences might increase smokers' awareness of social norms for appropriate behavior,which might lead to smoking *** social media use is increasing among young adults in the United States,research on the relationship between social media use and smoking cessation is *** has provided a rich source of information for researchers,but no overview exists as to how the field uses Twitter in smoking cessation *** the best of our knowledge,this study conducted a data mining analysis of Twitter to assess barriers to smoking *** conclusion,Twitter is a cost-effective tool with the potential to disseminate information on the benefits of smoking cessation and updated research to the Twitter community on a global scale.

关键词： Smoking cessation Stop smoking Smoking Twitter Tweets

位点特异性突变的差异对先天性长QT综合征LQT1型的心律失常风险和交感刺激敏感性的影响:日本多中心研究

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 44-44页

作者： Shimizu W. Horie M. Ohno S. 刘豫 Division of cardiology De partment of Internal Medicine National Cardiovascular Center Suita JapanDr.

Objectives We sought to compare the arrhythmic risk and sensitivity to sympath etic stimulation of mutations located in transmembrane regions and C-terminal r egions of the KCNQ1 channel in the LQT1 form of congenital long QT syndrome(LQTS ). Background The LQT1 syndrome is frequently manifested with variable expressiv ity and incomplete penetrance and is much more sensitive to sympathetic stimulat ion than the other forms. Methods Sixty-six LQT1 patients (27 families)-with a total of 19 transmembrane mutations and 29 patients(10 families) with 8 C-term inal mutations were enrolled from five Japanese institutes. Results Patients wit h transmembrane mutations were more frequently affected based on electrocardiogr aphic (ECG) diagnostic criteria (82%vs. 24%, pden cardiac dea th: 15%vs. 0%, p=0.03) than those with C-terminal mutations. Patients with tr ansmembrane mutations had a greater risk of first cardiac events occurring at an earlier age, with a hazard ratio of 3.4(p=0.006) and with an 8%increase in ris k per 10-ms increase in corrected Q-Tend. The baseline ECG parameters, includi ng Q-Tend, Q-Tpeak, and Tpeak-end intervals, were significantly greater in pa tients with transmembrane mutations than in those with C-terminal mutations (p< 0.005) . Moreover, the corrected Q-Tend and Tpeak-end were more prominently i ncreased with exercise in patients with transmembrane mutations (p< 0.005). Conc lusions In this multicenter Japanese population, LQT1 patients with transmembran e mutations are at higher risk of congenital LQTS-related cardiac events and ha ve greater sensitivity to sympathetic stimulation, as compared with patients wit h C-terminal mutations.

关键词： LQT1 位点特异性心脏事件猝死发生率心脏停搏危险比心电图异常外显率神经刺激位点突变

Characterization of a Chinese KCNQ1 mutation （R259H） that shortens repolarization and causes short QT syndrome 2

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Journal of Geriatric cardiology 2015年第4期12卷 394-401页

作者： Zhi-Juan WU Yun HUANG Yi-Cheng FU Xiao-Jing ZHAO Chao ZHU Yu ZHANG Bin XU Qing-Lei ZHU Yang LI department of cardiology Chinese PLA General Hospital 28 Fuxing Road Beijing China department of Gerontology Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China

Objectives To evaluate the association between a KCNQ 1 mutation, R259H, and short QT syndrome （SQTS） and to explore the elec- trophysiological mechanisms underlying their association. Methods We performed genetic screening of SQTS genes in 25 probands and their family members （63 patients）. We used direct sequencing to screen the exons and intron-exon boundaries of candidate genes that en- code ion channels which contribute to the repolarization of the ventricular action potential, including KCNQI, KCNH2, KCNE1, KCNE2, KCNJ2, CACNAlc, CACNB2b and CACNA2D1. In one of the 25 SQTS probands screened, we discovered a KCNQ1 mutation, R259H. We cloned R259H and transiently expressed it in HEK-293 cells; then, currents were recorded using whole cell patch clamp techniques. Results R259H-KCNQ 1 showed significantly increased current density, which was approximately 3-fold larger than that of wild type （WT） after a depolarizing pulse at 1 s. The steady state voltage dependence of the activation and inactivation did not show significant differences between the WT and R259H mutation （P 〉 0.05）, whereas the time constant of deactivation was markedly prolonged in the mutant compared with the WT in terms of the test potentials, which indicated that the deactivation of R259H was markedly slower than that of the WT. These results suggested that the R259H mutation can effectively increase the slowly activated delayed rectifier potassium current （Irs） in phase 3 of the cardiac action potential, which may be an infrequent cause of QT interval shortening. Conclusions R259H is a gain-of-function muta- tion of the KCNQ1 channel that is responsible for SQTS2. This is the first time that the R259H mutation was detected in Chinese people.

关键词： Ion channel KCNQ1 gene Mutation Short QT syndrome Slowly activated delayed rectifier potassium current

冠心病患者置入碳离子注入支架与金属裸支架的随机对比:亚太地区多中心Arthos支架研究(PASS)

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世界核心医学期刊文摘（心脏病学分册） 2005年第9期1卷 26-26页

作者： Kim Y.-H. Lee C. W. Hong M.-K. et al. S.-J. Park 武敏 Dr. de-partment of Medicine College of Medicine University of Ulsan 388-1 Poongnap-dong Songpa-gu Seoul 138-736 South Korea

Background: Heavy metal ions can cause allergic and inflammatory reactions that might be associated with in-stent restenosis. This randomized multicenter clinical study was designed to determine if carbon ion-implanted stents reduce luminal late loss by blocking heavy metal ion diffusion into the surrounding tissue. Methods: A total of 225 patients with 230 native coronary lesions were randomly assigned to receive either a carbon ion-implanted ArthosInert stent(group 1, n=113) or a bare metal Arthos stent(group 2, n=117). The primary endpoint was in-stent luminal late loss at 6-month angiographic follow-up, and the secondary endpoints were the 6-month angiographic restenosis rate and the occurrence of the major adverse cardiac events(MACE) including death, nonfatal myocardial infarction, and target lesion revascularization at 12 months. Results: The baseline characteristics were similar in the 2 groups. In-hospital events did not occur in any patients. Angiographic follow-up at 6 months was obtained in 184 lesions(80%). At follow-up, the luminal late loss was similar in the 2 groups(0.91±0.77mm in group 1 vs 0.88±0.80 mm in group 2, P=.79), and the angiographic restenosis rates were 11.0%in group 1 and 16.1%in group 2(P=.31). The occurrence rates of MACE at 12 months were 9.1%in group 1 and 10.4%in group 2(P=.73). Conclusions: The initial and long-term outcomes of the carbon ion-implanted stent were excellent. However, it did not improve long-term outcomes vs the bare metal stent.

关键词：金属裸支架 Arthos PASS 碳离子再狭窄发生率冠状动脉病心源性死亡非致死性次要终点血运重建