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新型完全生物可吸收封堵器经导管封堵膜周部室间隔缺损:一项多中心前瞻性随机对照研究（英文）

Science Bulletin 2023年第10期 1051-1059页

作者：王首正李泽夫王云兵赵天力莫绪明范太兵李建华尤涛邓润迪欧阳文斌王伟伟张闯年 Gianfranco Butera Ziyad M.Hijazi 逄坤静朱达蒋世良张戈军胡晓鹏谢涌泉张凤文房芳孙静平李萍陈娟骆志玲潘湘斌 Department of Structural Heart Disease Fuwai Hospital & National Center for Cardiovascular Disease Key Laboratory of Innovative Cardiovascular Devices Chinese Academy of Medical Sciences & Peking Union Medical College National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine National Clinical Research Center for Cardiovascular Diseases National Engineering Research Center for Biomaterials Sichuan University Department of cardiovascular Surgery The Second Xiangya Hospital Central South University Department of cardiovascular Surgery Children's Hospital of Nanjing Medical University Department of cardiovascular Surgery Fuwai Central China Cardiovascular Hospital Department of cardiovascular Surgery The Children's Hospital Zhejiang University School of Medicine Department of cardiovascular Surgery Gansu Province Hospital Tianjin Key Laboratory of Biomaterial Research Institute of Biomedical Engineering Chinese Academy of Medical Science & Peking Union Medical College Department of Pediatric and Adult Congenital Heart Disease Evelina London Children's Hospital Guy's and St Thomas' NHS Foundation Trust Department of Pediatrics Sidra Heart Center Sidra Medical & Research Center Department of Echocardiography Fuwai Hospital & National Center for Cardiovascular Disease Chinese Academy of Medical Sciences & Peking Union Medical College National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine National Clinical Research Center for Cardiovascular Diseases Department of Structural Heart Disease Fuwai Yunnan Cardiovascular Hospital cardiology Department The Clinic Cleveland Foundation cardiology Department Fuwai Hospital & National Center for Cardiovascular Disease Chinese Academy of Medical Sciences & Peking Union Medical College National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine National Clinical Research Center for Cardiovascular Diseases Department of cardiovascular Surgery Hefei High-Tech Cardiovascular Hospital De

生物可吸收封堵器的应用有望降低传统金属封堵器并发症的风险.之前研制的生物可吸收封堵器存在不完全降解的局限性并导致新的并发症,因此目前尚未有相关产品获批上市.本研究使用了一种新型完全可吸收封堵器,旨在探索完全可吸收封堵器治...

生物可吸收封堵器的应用有望降低传统金属封堵器并发症的风险.之前研制的生物可吸收封堵器存在不完全降解的局限性并导致新的并发症,因此目前尚未有相关产品获批上市.本研究使用了一种新型完全可吸收封堵器,旨在探索完全可吸收封堵器治疗室间隔缺损的疗效和安全性.从2019年4月到2020年1月,本研究在七个医学中心入组125名膜周部室间隔缺损患者,经筛查后108名患者被纳入研究并随机分为植入生物可吸收封堵器实验组和金属封堵器组.所有受试者均成功植入封堵器并完成24个月的随访.生物可吸收封堵器组患者经胸超声心动图显示高亮回声在24个月内逐渐消失,说明可吸收封堵器在体内实现完全降解.对比金属封堵器,实验组器械相关心律失常发生率(5.56%vs.14.81%,P=0.112)和持续传导阻滞发生率(0/54 vs.6/54,P=0.036)显著降低.本研究提示新型完全可吸收封堵器可以在单纯超声引导下实现成功植入,同时降低术后永久性心律失常的发生率.

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Effects of metabolic syndrome on onset age and long-term outcomes in patients with acute coronary syndrome

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World Journal of Emergency Medicine 2021年第1期12卷 36-41页

作者： Jing-jing Xu Ying Song Ping Jiang Lin Jiang Xue-yan Zhao Zhan Gao Jian-xin Li Shu-bin Qiao Run-lin Gao Yue-jin Yang Yin Zhang Bo Xu Jin-qing Yuan Department of cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

BACKGROUND: We aim to investigate effects of metabolic syndrome on onset age and long-termoutcomes in patients with acute coronary syndrome (ACS).METHODS: Patients with ACS (n=6,431) who underwent percutaneous coronary interventionfrom January to December 2013 were enrolled. After excluding patients with previous coronary arterydisease, 1,558 patients were diagnosed with early-onset ACS (men aged ≤50 years;women aged≤60 years) and 3,044 patients with late-onset ACS. Baseline characteristics and five-year clinicaloutcomes were ***: Body mass index, triglyceride, low-density lipoprotein cholesterol, and uric acidconcentrations were significantly higher, while the high-density lipoprotein cholesterol (HDL-C)concentration was lower in the early-onset ACS group (P<0.001). Multivariate logistic regression revealedobesity (odds ratio [OR] 1.590, 95% confi dence interval [CI] 1.345–1.881), hypertriglyceridemia (OR 1.403,95% CI 1.185–1.660), and low HDL-C (OR 1.464, 95% CI 1.231–1.742) as independent risk factorsfor early-onset ACS (all P<0.001). The fi ve-year follow-up showed that the incidences of all cause death(1.5% vs. 3.8%, P<0.001), cardiac death (1.1% vs. 2.0%, P=0.023), and recurrent stroke (2.2% vs. 4.2%,P<0.001) were lower, while bleeding events were more frequent in the early-onset ACS group. A subgroupanalysis showed higher incidences of recurrent myocardial infarction (MI) and revascularization in patientswith early-onset ACS and metabolic ***: Obesity, hypertriglyceridemia, and lower HDL-C level are independent riskfactors for early-onset ACS, recurrent MI, and revascularization. The control of metabolic syndromemay reduce the incidence of early-onset ACS and improve the long-term prognosis.

关键词： Age Coronary artery disease Acute coronary syndrome Metabolic syndrome

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Sex modification of the association of the radial augmentation index and incident hypertension in a Chinese community-based population

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Journal of Geriatric cardiology 2021年第1期18卷 39-46页

作者： Qiao QIN Fang-Fang FAN Meng-Yuan LIU Bo LIU Jia JIA Long ZHANG Yu-Xi LI Yi-Meng JIANG Peng-Fei SUN Dan-Mei HE Jian-Ping LI Ming CHEN Bo ZHENG Yan ZHANG Department of cardiology Institute of Cardiovascular DiseasePeking University First HospitalBeijingChina

BACKGROUND Arterial stiffness,as assessed by aortic ultrasound and pulse wave velocity,is associated with incident ***,there is still no consensus on whether the augmentation index(AI)affects new onset of *** study investigated the relationship of radial AI(r AI)and incident hypertension in a Chinese community-based population without hypertension at *** A total of 1,615 Chinese non-hypertensive participants from an atherosclerosis cohort in Beijing,China were included in our *** r AI normalized to heart rate of 75 beats/min(r AIp75)was obtained using HEM-9000 ***-onset hypertension was defined as blood pressure≥140/90 mm Hg or self-reported hypertension or taking anti-hypertensive medications at the follow up *** regression models were used to evaluate the impact of r AIp75 on the risk of new-onset *** After a mean 2.35-year follow-up,213(13.19%)participants developed incident *** significant relation between r AIp75 and incident hypertension was observed in the whole population after adjustment for possible confounders(adjusted odds ratio(OR)and 95%confidence interval(CI):1.09[0.95-1.27];P=0.2260).However,r AIp75 was significantly associated with incident hypertension in women,but not in men(adjusted OR and 95%CI:1.29[1.06-1.56],P=0.0113 for women;0.91[0.72-1.15],P=0.4244 for men;P for interaction=0.0133).CONCLUSIONS Sex modified the effect of the r AI on incident hypertension in a Chinese,community-based,non-hypertensive *** of the r AI could be considered in women with a high risk of hypertension for the purpose of primary intervention.

关键词： Sex modification of the association of the radial augmentation index and incident hypertension in a Chinese community-based population

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Relationship between fibrinogen levels and cardiovascular events in patients receiving percutaneous coronary intervention:a large single-center study

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Chinese Medical Journal 2019年第8期132卷 914-921页

作者： Ping Jiang Zhan Gao Wei Zhao Ying Song Xiao-Fang Tang Jing-Jing Xu Huan-Huan Wang Lin Jiang Jue Chen Shu-Bin Qiao Yue-Jin Yang Run-Lin Gao Bo Xu Jin-Qing Yuan Department of cardiology State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China Information 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 100037 China

Background:It is currently unclear if fibrinogen is a risk factor for adverse events in patients receiving percutaneous coronary intervention(PCI)or merely serves as a marker of pre-existing comorbidities and other causal *** therefore investigated the association between fibrinogen levels and 2-year all-cause mortality,and compared the additional predictive value of adding fibrinogen to a basic model including traditional risk factors in patients receiving contemporary ***:A total of 6293 patients undergoing PCI with measured baseline fibrinogen levels were enrolied from January to December 2013 in Fuwai *** were divided into three groups according to tertiles of baseline fibrinogen levels:low fibrinogen,<2.98 g/L;medium fibrinogen,2.98 to 3.58 g/L;and high fibrinogen,≥3.58 g/*** predictors of 2-year clinical outcomes were determined by multivariate Cox proportional hazards regression *** increased discriminative value of fibrinogen for predicting all-cause mortality was assessed using the C-statistic and integrated discrimination improvement(IDI).Results:The 2-year all-cause mortality rate was 1.2%.It was significantly higher in the high fibrinogen compared with the low and medium fibrinogen groups according to Kaplan-Meier analyses(1.7%vs.0.9%and 1.7%vs.1.0%,respectively;log-rank,P=0.022).Fibrinogen was significantly associated with all-cause mortality according to multivariate Cox regression(hazard ratio 1.339,95%confidence interval:1.109-1.763,P=0.005),together with traditional risk factors including age,sex,diabetes mellitus,left ventricular ejection fraction,creatinine clearance,and low-density lipoprotein *** area under the curve for all-cause mortality in the basic model including traditional risk factors was 0.776,and this value increased to 0.787 when fibrinogen was added to the model(IDI=0.003,Z=0.140,P=0.889).Conclusions:Fibrinogen is associated with 2-year all-cause mortality in patients recei

关键词： Fibrinogen Percutaneous coronary intervention Risk factor Prognosis

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Cardiomyocyte-specific knockout of ADAM17 ameliorates left ventricular remodeling and function in diabetic cardiomyopathy of mice

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Signal Transduction and Targeted Therapy 2022年第9期7卷 3468-3483页

作者： Fei Xue Jing Cheng Yanping Liu Cheng Cheng Meng Zhang Wenhai Sui Wenqiang Chen Panpan Hao Yun Zhang Cheng Zhang The Key Laboratory of cardiovascular Remodeling and Function Research Chinese Ministry of EducationChinese National Health Commission and Chinese Academy of Medical SciencesThe State and Shandong Province Joint Key Laboratory of Translational Cardiovascular MedicineDepartment of CardiologyQilu HospitalCheeloo College of MedicineShandong UniversityJinan 250012 ShandongChina Heart Center and Beiling Key Laboratory of Hypertension Being Chayang HospitalCapital Medical UniversityBeijing 100020China Scardiovascular Disease Research Center of Shandong First Medical University Central Hospital Afliated to Shandong First Medical UniversityJinanChina

Angiotensin-converting enzyme 2(ACE2)has proven beneficial in attenuating diabetic cardiomyopathy(DCM)but has been found to be a substrate of a disintegrin and metalloprotease protein-17(ADAM17).However,whether ADAM17 plays a role in the pathogenesis and intervention of DCM is *** this study,we created cardiomyocyte-specific knockout of ADAM17(A17^(α-MHCKO))mice,and left ventricular dimension,function,pathology and molecular biology were assessed in ADAM17^(fl/fl) control,A17^(α-MHCKO) control,ADAM17^(fl/fl) diabetic and A17^(α-MHCKO) diabetic *** differentiated H9c2 cells and neonatal rat cardiomyocytes(NRCMs)were used to explore the molecular mechanisms underlying the effect of ADAM17 on *** results showed that protein expression and activity of ADAM17 were upregulated whereas the protein expression of ACE2 was downregulated in the myocardium of diabetic ***-specific knockout of ADAM17 mitigated cardiac fibrosis and cardiomyocyte apoptosis and ameliorated cardiac dysfunction in mice with *** analyses detected a number of genes enriched in metabolic pathways,in particular the AMPK signaling pathway,expressed differentially between the hearts of A17^(α-MHCKO)and ADAM17^(fl/fl)diabetic *** mechanism may involve activated AMPK pathway,increased autophagosome formation and improved autophagic flux,which reduced the apoptotic response in *** addition,hypoxia-inducible factor-1α(HIF-1α)might act as an upstream mediator of upregulated ADAM17 and ADAM17 might affect AMPK signaling viaα1 A-adrenergic receptor(ADRA1A).These results indicated that ADAM17 activity and ACE2 shedding were enhanced in DCM,which was reversed by cardiomyocyte-specific ADAM17 ***,inhibition of ADAM17 may provide a promising approach to the treatment of DCM.

关键词： ACE2 diabetic ADAM17

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Evaluation of the Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients Bleeding Score for Predicting the Long-term Out-of-hospital Bleeding Risk in Chinese Patients after Percutaneous Coronary Intervention

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Chinese Medical Journal 2018年第12期131卷 1406-1411页

作者： Xue-Yan Zhao Jian-Xin Li Xiao-Fang Tang Jing-Jing Xu Ying Song Lin Jiang Jue Chen Lei Song Li-Jian Gao Zhan Gao Shu-Bin Qiao Yue-Jin Yang Run-Lin Gao Bo Xu Jin-Qing Yuan Department of cardiology State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China Department of Epidemiology State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Background： The Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients （PARIS） bleeding score is a novel score for predicting the out-of-hospital bleeding risk after percutaneous coronary intervention （PCI）. However, whether this score has the same value in non-European and American populations is unclear. This study aimed to assess the PARIS bleeding score＇s predictive value of bleeding in patients alter PCI in the Chinese population. Methods： We perforined a prospective, observational study of 10,724 patients who underwent PCI from January to December 2013, in Fuwai Hospital, China. We defined the primary end point as major bleeding （MB） according to Bleeding Academic Research Consortium definition criteria including Type 2, 3, or 5. The predictive value of the PARIS bleeding score was assessed with the area under the receiver operating characteristic （AUROC） curve. Results： Of 9782 patients, 245 （2.50%） MB events occurred during the 2 years of follow-up. The PAP, IS bleeding score was significantly higher in the MB group than that of non-MB group （4.00 [3.00, 5.00] vs. 3.00 [2.00, 5.00], Z=3.71, P 〈 0.001 ）. According to risk stratification of the PARIS bleeding score, the bleeding risk in the intermediate- and high-risk groups was 1.50 times （hazard ratio [HR]： 1.50; 95% confidence interval [CI]： 1.160-1.950; P=0.002） and 2.27 times higher （HR： 2.27; 95% CI： 1,320-3.900： P=0.003） than that in the low-risk group. The PARIS bleeding score showed a moderate predictive value for MB in the overall population （AUROC： 0.568, 95% CI： 0.532-0.605; P 〈 0.001 ） and acute coronary syndrome （ACS） subgroup （AUROC： 0.578, 95% CI： 0.530-0.626; P = 0.001 ） and tended to be predictive in the non-ACS subgroup （AUROC： 0.556, 95% CI： 0,501 0.611; P = 0.054）.

关键词： Bleeding: Percutaneous Coronary Intervention Prognosis

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Assessing the association of appropriateness of coronary revascularization and 1-year clinical outcomes for patients with stable coronary artery disease in China

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Chinese Medical Journal 2020年第1期133卷 1-8页

作者： Shen Lin Heng Zhang Chen-Fei Rao Si-Peng Chen Shu-Bin Qiao Hong-Bing Yan Ke-Fei Dou Yong-Jian Wu Yi-Da Tang Xin-Chun Yang Zhu-Jun Shen Jian Liu Zhe Zheng National Clinical Research Center of cardiovascular Diseases State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of cardiovascular Surgery Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of Information Center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of cardiology Beijing Chao-Yang HospitalCapital Medical UniversityBeijing 100020China Department of cardiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of cardiology Peking University People's HospitalBeijing 100044China.

Background:The Chinese appropriate use criteria(AUC)for coronary revascularization was released in 2016 to improve the use of coronary *** study aimed to evaluate the association between the appropriateness of coronary revascularization based on the Chinese AUC and 1-year outcomes in stable coronary artery disease(CAD)***:We conducted a prospective,multi-center cohort study of stable CAD patients with coronary lesion stenosis≥50%.After the classification of appropriateness based on Chinese AUC,patients were categorized into the coronary revascularization group or the medical therapy group based on treatment *** primary outcome was a composite of death,myocardial infarction,stroke,repeated revascularization,and ischemic symptoms with hospital ***:From August 2016 to August 2017,6085 patients were consecutively *** revascularization was associated with a lower adjusted hazard of 1-year major adverse cardiovascular and cerebrovascular events(MACCEs;hazard ratio[HR]:0.62;95%confidence interval[CI]:0.45-0.86;P=0.004)than medical therapy in patients with appropriate indications(n=1617).No significant benefit in 1-year MACCEs was found after revascularization compared to after medical therapy in patients with uncertain indications(n=2658,HR:0.81;95%CI:0.52-1.25;P=0.338)and inappropriate indications(n=1810,HR:0.80;95%CI:0.51-1.23;P=0.308).Conclusions:In patients with appropriate indications according to Chinese AUC,coronary revascularization was associated with significantly lower risk of MACCEs at 1 *** benefit was found in coronary revascularization in patients with inappropriate *** findings provide evidence for using Chinese AUC to guide clinical decision-making.

关键词： Stable coronary artery disease Appropriate use criteria Coronary revascularization

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Effects of Tongxinluo-facilitated cellular cardiomyoplasty with autologous bone marrow-mesenchymal stem cells on postinfarct swine hearts

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Chinese Medical Journal 2007年第16期120卷 1416-1425页

作者： QIAN Hai-yan YANG Yue-jin HUANG Ji GAO Run-lin DOU Ke-fei YANG Guo-sheng LI Jian-jun SHEN Rui HE Zuo-xiang LU Min-jie ZHAO Shi-hua Department of cardiology Fuwai Hospital and Cardiovascular Institute Peking Union Medical-College and Chinese Academy of Medical Sciences Beijing 100037 China Department of Nuclear Medicine Fuwai Hospital and Cardiovascular Institute Peking Union Medical-College and Chinese Academy of Medical Sciences Beijing 100037 China Department of Radiology Fuwai Hospital and Cardiovascular Institute Peking Union Medical-College and Chinese Academy of Medical Sciences Beijing 100037 China Department of cardiology Renmin Hospital of Wuhan University Wuhan 430063 China

Background Treatment of ischemic heart disease remains an important challenge, though there have been enormous progresses in cardiovascular therapeutics. This study was conducted to evaluate whether Tongxinluo （TXL） treatment around the transplantation of mesenchymal stem cells （MSCs） can improve survival and subsequent activities of implanted cells in swine hearts with acute myocardial infarction （AMI） and reperfusion. Methods Twenty-eight Chinese mini-pigs were divided into four groups including a control group （n=7）; group 2, administration of low-close TXL alone from the 3rd day prior to AMI to the 4th day post transplantation （n=-7）; group 3, MSCs alone （n=-7） and group 4, TXL ＋ MSCs （n=7）. AMI models were made by occlusion of the left anterior descending coronary artery for 90 minutes. Autologous bone marrow-MSCs （3×10^7 cells/animal） were then injected into the post-infarct myocardium immediately after AMI and reperfusion. The survival and differentiation of implanted cells in vivo were detected by immunofluorescent analysis. The data of cardiac function were obtained at baseline （1 week after transplantation） and endpoint （6 weeks after transplantation） by single photon emission computed tomography （SPECT） and magnetic resonance imaging （MRI）. Apoptosis was detected by TUNEL assay and the oxidative stress level was investigated in the post-infarct myocardium at endpoint. Results At endpoint, there was less fibrosis and inflammatory cell infiltration with more surviving myocardium in group 4 than in the control group. In group 4 the survival and differentiation of implanted MSCs were significantly improved more than that seen in group 3 alone （P〈0.0001）; the capillary density was also significantly greater than in the control group, group 2 or 3 both in the infarcted zone （P〈0.0001） and the peri-infarct zone （P〈0.0001）. MRI showed that parameters at baseline were not significantly different between the 4 groups. At endpoint, regional wall thickening and t

关键词： mesenchymal stem cells acute myocardial infarction transplantation Tongxinluo

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Association of interleukin-18 gene polymorphisms with Takayasu arteritis in a Chinese Han population

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Chinese Medical Journal 2020年第19期133卷 2315-2320页

作者： Dan Wen Xian-Liang Zhou Xin Du Jian-Zeng Dong Chang-Sheng Ma Department of cardiology Beijing Anzhen HospitalCapital Medical UniversityNational Clinical Research Center for Cardiovascular DiseasesBeijing Advanced Innovation Center for Big Data-Based Precision Medicine for Cardiovascular DiseasesBeijing 100029China Department of cardiology Fuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100037China.

Background:Interleukin-18(IL18)gene polymorphisms are related to many inflammatory and autoimmune ***,a correlation analysis between IL18-607C/A and-137G/C gene polymorphisms and Takayasu arteritis(TA)is ***:This study enrolled 200 patients with TA as the case group and 334 region-,age-,and sex-matched healthy subjects as the control *** genotyped alleles and genotypes at positions-607 and-137 of the IL18 gene and analyzed the distribution ***-Whitney U test,t test,Chi-squared test and Hardy-Weinberg equilibrium were ***:After adjusting for risk factors,the adjusted odds ratios and 95%confidence intervals at position-607C/A were 0.533,0.391 to 0.880(P=0.010);0.266,0.586 to 1.002(P=0.051);and 0.122,0.552 to 1.420(P=0.613)under the dominant,additive,and recessive models,*** the-137G/C polymorphism,the adjusted odds ratios and 95%confidence intervals were 1.571,1.068 to 2.311(P=0.022);1.467,1.086 to 1.980(P=0.012);and 1.815,0.901 to 3.656(P=0.095)under the dominant,additive,and recessive models,***,regardless of the model used,we found no statistical difference in distribution frequency between the active and quiescent states of TA for the-607C/A(P=0.355,0.631,and 0.705,respectively)and-137G/C polymorphisms(P=0.205,0.385,and 0.208,respectively).Conclusions:The IL18-607C/A gene polymorphism may decrease the risk of TA,and thus is a protective factor,whereas-137G/C may increase the risk of TA,and thus is a risk ***,neither polymorphism was related to activity(active ***)of TA.

关键词： Gene polymorphism Interleukin-18 Takayasu arteritis

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Effect of pre-procedural statin therapy on myocardial no-reflow following percutaneous coronary intervention： a meta analysis

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Chinese Medical Journal 2013年第9期126卷 1755-1760页

作者： LI Xiang-dong YANG Yue-jin HAO Yong-chen YANG Ying ZHAO Jing-lin DOU Ke-fei GU Dong-feng Department of Evidence Based Medicine Department of and Cardiology Fuwai Hospital and Cardiovascular Institute Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100037 China

Background Successful revascularization of coronary artery disease, especially ST-elevation myocardial infarction （STEMI）, does not always mean optimal myocardial reperfusion in a portion of patients because of no-reflow phenomenon. We hypothesized that statins might attenuate the incidence of myocardial no-reflow when used before percutaneous coronary intervention （PCI）. The purpose of this study was to summarize the evidence of pre-procedural statin therapy to reduce myocardial no-reflow after PCI. Methods We searched the MEDLINE, Cochrane, and *** databases from inception to October 2012 for clinical trials that examined statin therapy before PCI. We required that studies initiated statins before PCI and reported myocardial no-reflow. A DerSimonian-Laird model was used to construct random-effects summary risk ratios. Results In all, 7 studies with 3086 patients met our selection criteria. The use of pre-procedural statins significantly reduced post-procedural no-reflow by 4.2% in all PCI patients （risk ratio （RR） 0.56, 95% confidence interval （CI） 0.35 to 0.90, P=0.016）, and attenuated by 5.0% in non-STEMI patients （RR 0.41, 95% CI 0.18 to 0.94, P=0.035）. This benefit was mainly observed in the early or acute intensive statin therapy populations （RR 0.43, 95% CI 0.26 to 0.71, P=0.001）. Conclusions Acute intensive statin therapy before PCI significantly reduces the hazard of post-procedural no-reflow phenomenon. The routine use of statins before PCI should be considered.

关键词： statin coronary artery disease percutaneous coronary intervention no-reflow

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