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Updates of developments in interventional therapy for elderly patients with cardiovascular diseases

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Journal of Geriatric Cardiology 2024年第1期21卷 1-3页

作者： Hua SHEN Xun-Xun FENG Qian-Yun GUO Yu-Jie ZHOU Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic disease Beijing Institute of Heart Lung and Blood Vessel DiseaseClinical Center for Coronary Heart DiseaseDepartment of CardiologyBeijing Anzhen HospitalCapital Medical UniversityBeijingChina

Cardiovascular diseases(CVD)are the leading cause of death in the world and one of the most common diseases in the elderly,with high prevalence and poor prognosis,which seriously affect the health of the elder *** report showed that global deaths from CVD increased from 12.4 million in 1990 to 19.8 million in 2022,reflecting the global population growth and aging,as well as the impact of metabolic,environmental,and behavioral risks.[1]With the progress of aging population,the burden of CVD in the elderly in China has increased year by year,and factors including multiple complications,organ function decline,and high complication rate have made the interventional treatment of CVD in the elderly one of the difficulties and focuses in the field of cardiology in China.

关键词： diseases patients prognosis

The impact of female sex hormones on cardiovascular disease:from mechanisms to hormone therapy

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Journal of Geriatric Cardiology 2024年第6期21卷 669-681页

作者： Yi KAN Yu-Lu PENG Ze-Hao ZHAO Shu-Tong DONG Yin-Xiao XU Xiao-Teng MA Xiao-Li LIU Yu-Yang LIU 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

Cardiovascular disease remains the leading cause of mortality in women,yet it has not raised the awareness from the *** pathogenesis of cardiovascular disease differs significantly between females and males concerning the effect of sex *** and progestogen impact cardiovascular system through genomic and non-genomic *** menopause,cardiovascular protective effects of estrogens have been well *** were often used in combination with estrogens in hormone *** in sex hormone levels,particularly estrogen deficiency,were considered the specific risk factor in women’s cardiovascular ***,considerable heterogeneity in the impact of hormone therapy was observed in clinical *** heterogeneity is likely closely associated with factors such as the initial time,administration route,dosage,and formulation of hormone *** review will delve into the pathogenesis and hormone therapy,summarizing the effect of female sex hormones on hypertension,pre-eclampsia,coronary heart disease,heart failure with preserved ejection fraction,and cardiovascular risk factors specific to women.

关键词： impact dosage protective

Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation

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Chinese Medical Journal 2024年第2期137卷 172-180页

作者： Jing Lin Deyong Long Chenxi Jiang Caihua Sang Ribo Tang Songnan Li Wei Wang Xueyuan Guo Man Ning Zhaoqing Sun Na Yang Yongchen Hao Jun Liu Jing Liu Xin Du Louise Morgan Gregg C.Fonarow Sidney C.Smith Jr Gregory Y.H.Lip Dong Zhao Jianzeng Dong Changsheng Ma On behalf of CCC-AF investigators department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China National Clinical Research Center for Cardiovascular diseases Beijing 100029 China department of Epidemiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100029China International Quality Improvement department American Heart AssociationDallasTX 07076USA Division of Cardiology Geffen School of Medicine at University of CaliforniaLos Angeles CA 90024USA Division of Cardiology University of North CarolinaChapel HillNC 27599USA department of Cardiology Liverpool Centre for Cardiovascular ScienceUniversity of Liverpool and Liverpool Heart&Chest HospitalLiverpool L143PEUK department of Clinical Medicine Aalborg UniversityAalborg 9000Denmark 不详

Background:Oral anti-coagulants(OAC)are the intervention for the prevention of stroke,which consistently improve clinical outcomes and survival among patients with atrial fibrillation(AF).The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in ***:Using data from the Improving Care for Cardiovascular disease in China-Atrial Fibrillation(CCC-AF)registry,guideline-recommended OAC use in eligible patients was ***:A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019,of whom 38,203 were at a high risk of stroke,9717 were at a moderate risk,and 4610 were at a low *** admission,only 20.0%(6075/30,420)of patients with a diagnosed AF and a high risk of stroke were taking *** use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population(adjusted odds ratio:0.54,95%confidence interval:0.43-0.68;P70%of AF patients were at a high risk of *** poor performance on guideline-recommended OAC use was found in this study,over time the CCC-AF project has made progress in stroke prevention in the Chinese AF ***

关键词： Atrial fibrillation Oral anti-coagulants OAC Stroke prevention Contraindication

Association of serum complement C1q with cardiovascular outcomes among patients with acute coronary syndrome undergoing percutaneous coronary intervention

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Journal of Geriatric Cardiology 2022年第12期19卷 949-959,1007-1010页

作者： Qiu-Xuan LI Xiao-Teng MA Qiao-Yu SHAO Zhi-Qiang YANG Jing LIANG Li-Xia YANG Dong-Mei SHI Yu-Jie ZHOU Zhi-Jian WANG 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

OBJECTIVE To determine the association of serum complement C1q levels with cardiovascular outcomes among patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI),and evaluate the value of C1q modified by high-sensitivity C-reactive protein(hs-CRP)levels as an independent *** As a single-center prospective observational study,we analyzed 1701 patients who had received primary or elective PCI for ACS at Beijing Anzhen Hospital,Capital Medical University,Beijing,China between June 1,2016 and November 30,*** associations of C1q modified by hs-CRP with major adverse cardiovascular events(MACE)were determined in survival *** Patients with the lowest C1q tertile had the highest cumulative risk of MACE(log-rank P=0.007).In fully adjusted Cox regression models,stratifying the total population according to hs-CRP dichotomy,C1q was significantly associated with MACE in patients with hs-CRP levels less than 2 mg/L but not in those with 2 mg/L or more(P_(interaction)=0.02).In patients with hs-CRP levels less than 2 mg/L,with the lowest C1q tertile as reference,the risk of MACE was reduced by 40.0%in the middle C1q tertile[hazard ratio(HR)=0.600,95%CI:0.423–0.852,P=0.004]and by 43.9%in the highest C1q tertile(HR=0.561,95%CI:0.375–0.840,P=0.005).CONCLUSIONS Serum complement C1q is significantly associated with cardiovascular outcomes in patients with ACS undergoing PCI,only when hs-CRP levels are less than 2 mg/*** finding implicates the usefulness of C1q for the risk stratification in ACS patients with reduced systemic inflammation.

关键词： C1q patients coronary

Pre-hospital delay in patients with acute myocardial infarction in China:findings from the Improving Care for Cardiovascular disease in China-Acute Coronary Syndrome(CCC-ACS)project

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Journal of Geriatric Cardiology 2022年第4期19卷 276-283页

作者： Dan-Qing HU Yong-Chen HAO Jun LIU Na YANG Yi-Qian YANG Zhao-Qing SUN Dong ZHAO Jing LIU department of Epidemiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijingChina

OBJECTIVE To describe the duration of the pre-hospital delay time and identify factors associated with prolonged pre-hospital delay in patients with acute myocardial infarction(AMI)in *** Data were collected from November 2014 to December 2019 as part of the Improving Care for Cardiovascular Dis-ease in China-Acute Coronary Syndrome(CCC-ACS)project.A total of 33,386 patients with AMI admitted to the index hospitals were included in this ***-level logistic regression was conducted to explore the factors associated with the pre-hospital delay and the associations between different pre-hospital delay and in-hospital *** Of the 33,386 patients with AMI,70.7%of patients arrived at hospital≥2 h after symptom *** age,female,ru-ral medical insurance,symptom onset at early dawn,and non-use of an ambulance predicted a prolonged pre-hospital delay(all Pheart failure at admission were only significant in predicting a longer delay in patients with ST-seg-ment elevation myocardial infarction(STEMI)(all P<0.05).A pre-hospital delay of≥2 h was associated with an increased risk of mortality[odds ratio(OR)=1.36,95%CI:1.09-1.69,P=0.006]and major adverse cardiovascular events(OR=1.22,95%CI:1.02-1.47,P=0.033)in patients with STEMI compared with a pre-hospital delay of<2 *** Prolonged pre-hospital delay is associated with adverse in-hospital outcomes in patients with STEMI in *** study identifies that patient characteristics,symptom onset time,and type of transportation are associated with pre-hospital delay time,and provides focuses for quality improvement.

关键词： patients infarction admitted

Practice of reperfusion in patients with ST-segment elevation myocardial infarction in China:findings from the Improving Care for Cardiovascular disease in China–Acute Coronary Syndrome project

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Chinese Medical Journal 2022年第23期135卷 2821-2828页

作者： Yiqian Yang Yongchen Hao Jun Liu Na Yang Danqing Hu Zhaoqing Sun Dong Zhao Jing Liu on behalf of the Improving Care for Cardiovascular disease in China-Acute Coronary Syndrome(CCC-ACS)Investigators department of Epidemiology Beijing An Zhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100029China 不详

Background:Reperfusion therapy is fundamental for ST-segment elevation myocardial infarction(STEMI).However,the details of contemporary practice and factors associated with reperfusion therapy in China are largely ***,this study aimed to explore reperfusion practice and its associated factors among hospitalized patients with STEMI in ***:Patients with STEMI who were admitted to 159 tertiary hospitals from 30 provinces in China were included in the Improving Care for Cardiovascular disease in China–Acute Coronary Syndrome project from November 2014 to December *** associations of the characteristics of patients and hospitals with reperfusion were examined using hierarchical logistic *** associations between therapies and in-hospital major adverse cardiovascular events were examined with a mixed effects Cox regression ***:Among the 59,447 patients,37,485(63.1%)underwent reperfusion,including 4556(7.7%)receiving fibrinolysis and 32,929(55.4%)receiving primary percutaneous coronary intervention(PCI).The reperfusion rate varied across geographical regions(48.0%–73.5%).The overall rate increased from 60.0%to 69.7%from 2014 to 2019,mainly due to an increase in primary PCI within 12 h of symptom *** PCI,but not fibrinolysis alone,was associated with a decreased risk of inhospital major adverse cardiovascular events compared with no reperfusion,with an adjusted hazard ratio(95%confidence interval)of 0.64(0.54,0.76)for primary PCI at<12 h,0.53(0.37,0.74)for primary PCI at 12 to 24 h,0.46(0.25,0.82)for the pharmaco-invasive strategy,and 0.79(0.54,1.15)for fibrinolysis ***:Nationwide quality improvement initiatives should be strengthened to increase the reperfusion rate and reduce inequality in *** registration:***,NCT02306616。

关键词： Acute coronary syndrome Cardiovascular diseases China Fibrinolysis Percutaneous coronary intervention Quality improvement Reperfusion ST elevation myocardial infarction

Role of renin-angiotensin system/angiotensin converting enzyme-2 mechanism and enhanced COVID-19 susceptibility in type 2 diabetes mellitus

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World Journal of Diabetes 2024年第4期15卷 606-622页

作者： Ashwin Kumar Shukla Komal Awasthi Kauser Usman Monisha Banerjee molecular and Human Genetics Laboratory Department of ZoologyUniversity of LucknowLucknow 226007Uttar PradeshIndia department of Medicine King Georges’Medical UniversityLucknow 226003Uttar PradeshIndia institute of Advanced molecular Genetics and Infectious Diseases(IAMGID)University of LucknowLucknow 226007Uttar PradeshIndia

Coronavirus disease 2019(COVID-19)is a disease that caused a global pandemic and is caused by infection of severe acute respiratory syndrome coronavirus 2 *** has affected over 768 million people worldwide,resulting in approx-imately 6900000 ***-risk groups,identified by the Centers for disease Control and Prevention,include individuals with conditions like type 2 diabetes mellitus(T2DM),obesity,chronic lung disease,serious heart conditions,and chronic kidney *** indicates that those with T2DM face a hei-ghtened susceptibility to COVID-19 and increased mortality compared to non-diabetic *** the renin-angiotensin system(RAS),a vital regulator of blood pressure and pulmonary stability,reveals the significance of the angiotensin-converting enzyme(ACE)and ACE2 *** converts angiotensin-I to the vasoconstrictor angiotensin-II,while ACE2 counters this by converting angiotensin-II to angiotensin 1-7,a *** ACE2 exp-ression,common in diabetes,intensifies RAS activity,contributing to conditions like inflammation and *** ACE inhibitors and angiotensin receptor blockers can be therapeutically beneficial by increasing ACE2 levels,concerns arise regarding the potential elevation of ACE2 receptors on cell membranes,potentially facilitating COVID-19 *** review explored the role of the RAS/ACE2 mechanism in amplifying severe acute respiratory syndrome cor-onavirus 2 infection and associated complications in *** treatment strategies,including recombinant human ACE2 therapy,broad-spectrum antiviral drugs,and epigenetic signature detection,are discussed as promising avenues in the battle against this pandemic.

关键词： Angiotensin-converting enzyme 2 Angiotensin-converting enzyme inhibitors Angiotensin-II receptor blockers Complex diseases COVID-19 Type 2 diabetes

Circulating biomarker-and magnetic resonance-based nomogram predicting long-term outcomes in dilated cardiomyopathy

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Chinese Medical Journal 2024年第1期137卷 73-81页

作者： Yupeng Liu Wenyao Wang Jingjing Song Jiancheng Wang Yi Fu Yida Tang department of Cardiology Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou 510080China Guangdong Cardiovascular institute Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510080China department of Cardiology Institute of Vascular MedicinePeking University Third HospitalBeijing 100191China department of Cardiology State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Beijing Key Laboratory of molecular Pharmaceutics and New Drug Delivery Systems State Key Laboratory of Natural and Biomimetic DrugsSchool of Pharmaceutical SciencesPeking UniversityBeijing 100083China department of Physiology and Pathophysiology School of Basic Medical SciencesPeking University Health Science CenterBeijing 100083China Key Laboratory of molecular Cardiovascular Science Ministry of EducationBeijing 100191China

Background:Dilated cardiomyopathy(DCM)has a high mortality rate and is the most common indication for heart *** study sought to develop a multiparametric nomogram to assess individualized all-cause mortality or heart transplantation(ACM/HTx)risk in DCM ***:The present study is a retrospective cohort *** demographic,clinical,blood test,and cardiac magnetic resonance imaging(CMRI)data of DCM patients in the tertiary center(Fuwai Hospital)were *** primary endpoint was ACM/*** least absolute shrinkage and selection operator(LASSO)Cox regression model was applied for variable *** Cox regression was used to develop a *** concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curve,and decision curve analysis(DCA)were used to evaluate the performance of the ***:A total of 218 patients were included in the present *** were randomly divided into a training cohort and a validation *** nomogram was established based on eight variables,including mid-wall late gadolinium enhancement,systolic blood pressure,diastolic blood pressure,left ventricular ejection fraction,left ventricular end-diastolic diameter,left ventricular end-diastolic volume index,free triiodothyronine,and N-terminal pro-B type natriuretic *** AUCs regarding 1-year,3-year,and 5-year ACM/HTx events were 0.859,0.831,and 0.840 in the training cohort and 0.770,0.789,and 0.819 in the validation cohort,*** calibration curve and DCA showed good accuracy and clinical utility of the ***:We established and validated a circulating biomarker-and CMRI-based nomogram that could provide a personalized prediction of ACM/HTx for DCM patients,which might help risk stratification and decision-making in clinical practice.

关键词： Cardiomyopathy,dilated heart transplantation Mortality Nomograms Least absolute shrinkage and selection operator Decision curve analysis

First-in-human evaluation of an independently developed Chinese robot-assisted system for percutaneous coronary intervention

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Journal of Geriatric Cardiology 2022年第10期19卷 743-752页

作者： Guang-Yao ZHAI Zheng CHEN Rui-Fang LIU Yong-He GUO Jian-Long WANG Tie-Nan SUN Jing XIE Tao HUANG 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 Beijing WeMed Medical Equipment Co. Ltd.BeijingChina

BACKGROUND Several studies have proved the safety and feasibility of robot-assisted percutaneous coronary intervention(PCI)in reducing the occupational hazards of interventionists while achieving precision ***,an independently developed robot-assisted system for PCI in China has not yet *** study aimed to evaluate the safety and feasibility of a robot-assisted system for elective PCI in *** This preclinical trial included 22 experimental pigs and preliminarily supported the safety and feasibility of the ETcath200 robot-assisted system for ***,eleven patients with coronary heart disease who met the inclusion criteria and had clinical indications for elective PCI were *** was performed using a robot-assisted *** primary outcomes were clinical success(defined as visual estimated residual stenosis<30%after PCI and no major adverse cardiovascular events during hospitalization and within 30 days after PCI)and technical success(defined as the ability to use the robot-assisted system to complete PCI successfully without conversion to the traditional manual PCI).RESULTS Eleven patients were included in this clinical trial.A drug-eluting stent with a diameter of 3 mm(interquartile range:2.75–3.5 mm)and a length of 26 mm(interquartile range:22–28 mm)was deployed in all *** clinical success rate was 100%,with no PCI-related complications and no in-hospital or 30-day major adverse cardiovascular events,and the technical success rate was 100%.CONCLUSIONS The results strongly suggest that the use of the independently developed robot-assisted system in China for elective PCI is feasible,safe,and effective.

关键词： coronary robot system