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Routine invasive strategy and frailty burden in non-ST-segment elevation acute myocardial infarction

Journal of Geriatric cardiology 2024年第10期21卷 954-961页

作者： Albert Ariza-Solé Juan Andrés Bermeo Francesc Formiga Héctor Bueno Gemma Miñana Oriol Alegre David Martí Manuel Martínez-Sellés Laura Domínguez-Pérez Pablo Díez-Villanueva JoséA Barrabés Francisco Marín Adolfo Villa Marcelo Sanmartín Cinta Llibre Alessandro Sionís Antoni Carol Sergio García-Blas María JoséMorales Gallardo Jaime Elízaga Iván Gómez-Blázquez Fernando Alfonso Bruno García Del Blanco Julio Núñez Juan Sanchis cardiology department Hospital Universitari de BellvitgeL’Hospitalet de LlobregatBarcelonaSpain Internal Medicine department Hospital Universitari de BellvitgeL’Hospitalet de LlobregatBarcelonaSpain Centro Nacional de Investigaciones Cardiovasculares(CNIC) MadridSpain.Cardiology DepartmentHospital 12 de Octubreand Instituto de Investigación Sanitaria Hospital 12 de Octubre(imas12)MadridCIBERCVMadridSpain.Universidad ComplutenseMadridSpain cardiology department Hospital Clínico Universitario de ValenciaINCLIVAUniversidad de ValenciaCIBERCVValenciaSpain cardiology department Hospital Central de la DefensaMadridSpain cardiology department Hospital Universitario Gregorio MarañónCIBERCVUniversidad ComplutenseUniversidad EuropeaMadridSpain cardiology department Hospital Universitario La PrincesaIIS-IPCIBERCVMadridSpain cardiology department Hospital Universitari Vall d’HebronCIBERCVBarcelonaSpain cardiology department Hospital Virgen de la ArrixacaCIBERCVEl PalmarMurciaSpain cardiology department Hospital Universitario del SuresteArganda del ReyMadridSpain cardiology department Hospital Ramon y CajalCIBERCVMadridSpain cardiology department Hospital Germans Trias i PujolCIBERCVBadalonaBarcelonaSpain cardiology department Hospital Sant PauCIBERCVBarcelonaSpain cardiology department Hospital Moisés BroggiSant Joan DespíBarcelonaSpain

Objective To assess the prognostic impact of a routine invasive strategy according to the frailty burden in patients with non-ST-segment elevation myocardial infarction(NSTEMI)from the MOSCA-FRAIL clinical *** The MOSCA-FRAIL trial randomized 167 frail patients,defined by a Clinical Frailty Scale(CFS)≥4,with NSTEMI to an invasive or conservative *** primary endpoint was the number of days alive and out of hospital(DAOH)one year after *** this subanalysis,we compared the impact of an invasive strategy on the outcomes between vulnerable(CFS=4,n=43)and frail(CFS>4,n=124)*** Compared to vulnerable patients,frail patients presented lower values of DAOH(289.8 vs.320.6,P=0.146),more read-missions(1.03 vs.0.58,P=0.046)and higher number of days spent at the hospital during the first year(10.8 vs.3.8,P=0.014).The cau-ses of readmission were mostly non-cardiac(56%).Among vulnerable patients,DAOH were similar regardless of strategy(invasive ***:325.7 vs.314.7,P=0.684).Among frailest patients,the invasive group tended to have less DAOH(267.7 vs.311.1,P=0.117).Indeed,patients with CFS>4,invasively managed lived 29 days less than their conservative *** contrast,the-re were no differences in the subgroup with CFS=*** Adult patients with frailty and NSTEMI showed different prognosis according to the degree of frailty.A routine in-vasive strategy does not improve outcomes and might be harmful to the frailest patients.

关键词： routine invasive infarction

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Clinical Significance of Inflammation Factors in Acute Coronary Syndrome from Pathogenic Toxin

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Chinese Journal of Integrative Medicine 2009年第4期15卷 307-312页

作者：冯妍张京春郗瑞席 department of cardiology Xiyuan HospitalChina Academy of Chinese Medical Sciences department of cardiology iyuan HospitalChina Academy of Chinese Medical Sciences

The inflammation factors and roles of them in acute coronary syndrome(ACS)were explored. The similarity between the theory of pathogenic toxin in Chinese Medicine and the inflammation response theory in ACS was *** ex... 详细信息

关键词： pathogenic toxin inflammation factors acute coronary syndrome

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RhoA/ROCK pathway regulates hypoxia-induced myocardial cell apoptosis

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Asian Pacific Journal of Tropical Medicine 2014年第11期7卷 884-888页

作者： Yi Huang Jiang-bin Chen Bo Yang Hui Shen Jin-Jun Liang Qiong Luo department of cardiology Renmin Hospital of Wuhan University department of cardiology Tianyou Hospital Affiliated to Wuhan University of Science&Technology

Objective:To observe the regulatory effects of RhoA/ROCK pathway on the apoptosis of cardiac myocyte induced by anoxia and its ***:The model of cardiac myocyte anoxia was *** beat pulsations and apoptosis rales after 1 h,3 h,6 h,9 h and 12 h of anoxia were recorded and the expressions of RhoA,ROCK1/2,p-PI3 K,p-AKT and caspae-3 were detected,*** apoptosis and the expressions of related proteins were detected after RNAi of RhoA and the inhibition of ROCK by ***:The beat pulsations after 1 h,3 h,6 h.9h and 12 h decreased gradually but the apoptosis rates increased gradually,and the expressions of RhoA,ROCK1/2,p-P13 K,p-AKT and caspase-3 were increasing along with the increasing duration of *** apoptotic rales after 1 h,3 h,6 h.9 h and 12 h of anoxia were(4.36±0.98)%,(8.36±2.12)%,(15.32±3.62)%,(18.68±4.83)%and(24.56±6.22)%.respectively and decreased more significantly than control group in different time points of anoxia(P<0.05).and the expressions of RhoA,ROCK1/2,p-PI3 K,p-AKT and caspase-3 decreased significantly(P<0.05).The apoptosis rate and the expressions of RhoA,ROCK1/2,p-PI3 K,p-AKT and caspase-3 decreased significantly(P<0.05) after the inhibition of ROCK by Y-27632(P<0.05).Conclusions:RhoA/ROCK pathway plays a critical role in the regulation of the apoptosis of cardiac myocyte induced by anoxia,which may be accompanied by regulating the activity of PI3K/AKT/Caspase-3 pathway.

关键词： RhoA ROCK RNA interference Apoptosis Anoxia Cardiac myocyte

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Protocol for the FACE study:frailty and comorbidity in elderly patients—a multicenter,Chinese observational cohort study

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Journal of Geriatric cardiology 2023年第1期20卷 83-90页

作者： Wen ZHENG Xin HUANG Min SUO Xiao WANG Xue-Dong ZHAO Wei GONG Yan YAN Xiao-Na WANG Li SHENG Shao-Ping NIE department of cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijingChina department of cardiology Beijing Shijitan HospitalCapital Medical UniversityBeijingChina department of Geriatric cardiology National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijingChina

The present protocol describes an observational cohort study that was designed to propose a therapeutic scheme and formulate an individualized treatment strategy for frail elderly patients diagnosed with multiple diseases in a Chinese,multicenter *** a 3-year period,we will recruit 30,000 patients from 10 hospitals and collect baseline data including patient demographic information,comorbidity characteristic,FRAIL scale,age-adjusted Charlson comorbidity index(aCCI),relevant blood tests,the results of imaging examination,prescription of drugs,length of hospital stay,number of overall re-hospitalizations and *** patients(≥65 years old)with multimorbidity and receiving hospital care are eligible for this *** collection is being performed at baseline and 3,6,9 and 12 months after *** primary analysis was all-cause death,readmission rate and clinical events(including emergency visits,stroke,heart failure,myocardial infarction,tumor,acute chronic obstructive pulmonary disease,etc).The study is approved by the National Key R&D Program of China(2020YFC2004800).Data will be disseminated in manuscripts submitted to medical journals and in abstracts submitted to international geriatric *** Trial Registration:[***],identifier[ChiCTR2200056070].

关键词： patients morbidity prescription

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Is primary transcatheter aortic valve implantation the new normal?

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Journal of Geriatric cardiology 2024年第4期21卷 458-461页

作者： R.Anantharaman C.Sundar Kamal Kant Jena K.Arun department of cardiology Kauvery HospitalChennaiIndia

Degenerative calcific aortic valve stenosis(AS)is the most common valvular heart disease in elderly.^[1] It is well documented that symptomatic severe AS follows a malignant course leading to cardiogenic shock(CS).

关键词： aortic stenosis implantation

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Shockwave intravascular lithotripsy and drug-coated balloon angioplasty in calcified coronary arteries:preliminary experience in two cases

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Journal of Geriatric cardiology 2021年第8期18卷 689-691页

作者： Hee Hwa Ho Jin Hyun Lee Deanna Zhi Lin Khoo Ko Ko Soe Hpone Ki Fung Cliff Li department of cardiology Tan Tock Seng Hospital

Heavily calcified coronary arteries are extremely difficult to treat as calcium deposits "hardens" the arteries and alter vascular compliance. Intravascular lithotripsy (IVL)is a new technology consisting of a balloon-based system with miniaturized lithotripsy emitters that create a localised field effect to crack calcium in the arterial wall. Drug-coated balloon (DCB) angioplasty is an alternative treatment option in percutaneous coronary intervention (PCI) with an attractive strategy of leaving nothing behind combined with local drug delivery. In this brief clinical report, we described our early experience of using a novel combination of IVL and DCB angioplasty in two elderly patients with good angiographic results.

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Think twice before implanting leads in a swimmer:challenges in lead implantation of an implantable cardioverter-defibrillator

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Journal of Geriatric cardiology 2021年第7期18卷 595-596页

作者： Dimitrios Varvarousis Vasileios Doulamis Nikolaos Parzakonis Georgios Kourgiannidis cardiology department Asklepeion General HospitalAthensGreece cardiology department 251 Air Force General HospitalAthensGreece

An 84-year-old male patient with an implantable cardioverter defibrillator(ICD)was admitted due to an alarming sound of his *** had a left-sided,dual chamber,dual-coil ICD implanted 7 years ago due to ischemic cardiom... 详细信息

关键词： admitted cardiomyopathy implantation

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Comparative analysis of different cyclosporine A doses on protection after myocardial ischemia/reperfusion injury in rat

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Asian Pacific Journal of Tropical Medicine 2014年第2期7卷 144-148页

作者： Kang Huang Shi-Juan Lu Jiang-Hua Zhong Qun Xiang Liu Wang Miao Wu department of cardiology Haikou People's Hospital

Objective:To investigate the protective effect of different cyclosporin A(CsA)doses on myocardial ischemia/reperfusion injury in rat ***:A rat model of myocardial ischemia/reperfusion injury was established in vivo and the rats were randomly divided into four groups:placebo(PBS;T1),low-dose(CsA dose:1.0 mg/kg:T2),medium-dose(CsA dose:2.5 mg/kg:T3),and high-dose(CsA dose:5.0 mg/kg;T4)*** function indexes were monitored at different time points,the extent of myocardial infarction was assessed by Evans Blue-TTC staining,and creatine kinase MB mass and cardiac troponin 1 values were measured by biochemical ***:Compared with the T1 and T2 groups,both the creatine kinase MB mass and cardiac troponin 1 were significantly lower in the T3 and T4 groups(P<0.05).The mean arterial pressure(MAP)and left ventricular systolic pressure(LVSP)decreased sequentially in each group,with the extending reperfusion *** decreases in LVSP and MAP were observed in the T3 and T4 groups as compared to the T1 and T2 group(P<0.05)and the T2 group showed a significantly lower LVSP and MAP decline than the T1 group(P<0.05).Compared with the Tl group,the rats from the T2.T3,and T4 groups suffered from a significantly lower extent of myocardial infarction(P<0.05).Also,the a animals in the T3 and T4 groups had a significantly smaller extent of myocardial infarction than those in the T2 group(P<0.05).Conclusions:Various CsA doses exert different degrees of protection against ischemia/reperfusion injury,and this protective effect peaks at approximately 2.5 mg/kg in rat models.

关键词： Cyclosporin A Myocardial ischemia/reperfusion injury Mitochondrial permeability transition pore

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Safety of digoxin in nonagenarian patients with atrial fibrillation:lessons from the Spanish Multicenter Registry

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Journal of Geriatric cardiology 2021年第10期18卷 809-815页

作者： Pablo Domínguez-Erquicia Sergio Raposeiras-Roubín Emad Abu-Assi María Cespón-Fernández David Alonso-Rodríguez Santiago Jesús Camacho-Freire Naiara Cubelos-Fernández Álvaro López-Masjuán Ríos María Melendo-Viu AndrésÍñiguez-Romo department of cardiology University HospitalÁlvaro CunqueiroVigoSpain Health Research Institute Galicia Sur VigoSpain department of cardiology University Hospital of LeónLeónSpain department of cardiology University Hospital Juan Ramón JiménezHuelvaSpain

BACKGROUND The association between digoxin and mortality is an unclear *** older patients with atrial fibrillation(AF),where use of digoxin is frequent,the evidence of its safety is *** aim is to assess the safety of digoxin in nonagenarian patients with *** We evaluated data from 795 nonagenarian patients with non-valvular AF from the Spanish Multicenter *** analyzed the relationship between digoxin and all-cause mortality with the Cox proportional-hazards *** Follow-up was 27.7±18.3 *** age was 92.5±3.8 years,and 71%of nonagenarian patients were *** was not associated with increased risk of mortality[adjusted hazard ratio(aHR)=1.16,95%CI:0.96−1.41,P=0.130].However,we found a significant increase in mortality in the subgroup with estimated glomerular filtration rate(eGFR)<30 mL/min per 1.73 m^(2)(aHR=2.01,95%CI:1.13−3.57,P=0.018),but not in the other subgroups of eGFR(30−59 mL/min per 1.73 m^(2) and≥60 mL/min per 1.73 m^(2)).When exploring the risk of mortality according to sex,male subgroup was associated with an in-crease in mortality(aHR=1.48,95%CI:1.02−2.14,P=0.041).This was not observed in females subgroup(aHR=1.03,95%CI:0.81−1.29,P=0.829).Based on the presence or absence of heart failure,we did not find significant differences(aHR=1.20,95%CI:0.87−1.65,P=0.268 ***=1.15,95%CI:0.90−1.47,P=0.273,respectively).CONCLUSIONS In our large registry of nonagenarian patients with AF,we did not find an association between digoxin and mortality in the total ***,in the subgroup analyses,we found an increase in mortality with the use of digoxin in men and in patients with an eGFR<30 mL/min per 1.73 m^(2).

关键词： patients digoxin fibrillation

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Pregnancy in Patients with Shone Complex: A Single-Center Case Series

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Congenital Heart Disease 2022年第2期17卷 147-160页

作者： Rachel Gardner Emily Durbak Rachael Baird Katherine Singh Jeff Chapa David Majdalany department of cardiology Cleveland ClinicCleveland44195USA department of Obstetrics Cleveland ClinicCleveland44195USA department of cardiology Mayo ClinicPhoenix85054USA

Background:There is limited literature written on the course and outcomes for pregnant mothers with Shone ***:We describe a case series of five pregnancies in four women with Shone complex within a multidisciplinary cardio-obstetrics clinic from 2016–***:Maternal age ranged from 21–39 *** patients had preserved left ventricular function while one had moderately decreased *** age at presentation ranged from 6–15 *** were three successful pregnancies(mean gestational age=37 weeks,range 35–39 weeks)with one patient accounting for two unsuccessful *** infants were delivered via Cesarean *** infant required a NICU stay,but all other infants delivered were ***:Patients with Shone complex can have successful pregnancies although complications can occur for both the mother and the *** prenatal care,coordinated and consistent management during pregnancy,and tertiary care support can promote positive maternal and fetal outcomes.

关键词： Shone complex pregnancy cardiac disease in pregnancy women’s cardiovascular health

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