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Assessment of post-myocardial infarction lipid levels and management:Results from a tertiary care hospital of Pakistan

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World Journal of cardiology 2024年第5期16卷 282-292页

作者： Rubina Rauf Muhammad Ismail Soomro Muhamman Nauman Khan Mukesh Kumar Najia Aslam Soomro Khawar Abbas Kazmi Department of Preventive cardiology National Institute of Cardiovascular DiseasesKarachi 75510Pakistan Department of Adult cardiology National Institute of Cardiovascular DiseasesKarachi 75510Pakistan Department of cardiology Liaquat National HospitalKarachi 74800Pakistan

BACKGROUND Lipid treatment practices and levels in post-acute myocardial infarction(AMI)patients,which are crucial for secondary prevention.AIM To evaluate the lipid treatment practices and lipid levels in post-myocardial infarction(MI)patients at a tertiary care hospital in Pakistan.METHODS In this cross-sectional study,we analyzed patients who had experienced their first AMI event in the past 3 years.We assessed fasting and non-fasting lipid profiles,reviewed statin therapy prescriptions,and examined patient compliance.The recommended dose was defined as rosuvastatin≥20 mg or atorvastatin≥40 mg,with target total cholesterol levels set at<160 mg/dL and target low-density lipoprotein cholesterol(LDL-C)at<55 mg/dL.RESULTS Among 195 patients,71.3%were male,and the mean age was 57.1±10.2 years.The median duration since AMI was 36(interquartile range:10-48)months and 60% were diagnosed with ST-segment elevation MI.Only 13.8% of patients were advised to undergo lipid profile testing after AMI,88.7% of patients were on the recommended statin therapy,and 91.8% of patients were compliant with statin therapy.Only 11.5% had LDL-C within the target range and 71.7% had total cholesterol within the target range.Hospital admission in the past 12 months was reported by 14.4%,and the readmission rate was significantly higher among non-compliant patients(37.5%vs 5.6%).Subsequent AMI event rate was also significantly higher among non-compliant patients(43.8%vs 11.7%).CONCLUSION Our study highlights that while most post-AMI patients received the recommended minimum statin therapy dose,the inadequate practice of lipid assessment may compromise therapy optimization and raise the risk of subsequent events.

关键词： Lipid profile Dyslipidemia Acute myocardial infarction Secondary prevention Lipid lowering therapy

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Atorvastatin, etanercept and the nephrogenic cardiac sympathetic remodeling in chronic renal failure rats

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Journal of Geriatric cardiology 2024年第4期21卷 443-457页

作者： Jing-Yue XU Zheng-Kai XUE Ya-Ru ZHANG Xing LIU Xue ZHANG Xi YANG Tong LIU Kang-Yin CHEN Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of CardiologyTianjin Institute of Cardiologythe Second Hospital of Tianjin Medical UniversityTianjinChina

BACKGROUND Chronic renal failure(CRF) patients are predisposed to arrhythmias, while the detailed mechanisms are unclear. We hypothesized the chronic inflammatory state of CRF patients may lead to cardiac sympathetic remodeling, increasing the incidence of ventricular arrhythmia(VA) and sudden cardiac death. And explored the role of atorvastatin and etanercept in this process.METHODS A total of 48 rats were randomly divided into sham operation group(Sham group), CRF group, CRF + atorvastatin group(CRF + statin group), and CRF + etanercept group(CRF + rhTNFR-Fcgroup). Sympathetic nerve remodeling was assessed by immunofluorescence of growth-associated protein 43(GAP-43) and tyrosine hydroxylase positive area fraction. Electrophysiological testing was performed to assess the incidence of VA by assessing the ventricular effective refractory period and ventricular fibrillation threshold. The levels of tumor necrosis factor-alpha(TNF-α) and interleukin-1beta were determined by Western blotting and enzyme-linked immunosorbent assay.RESULTS Echocardiogram showed that compared with the Sham group, left ventricular end-systolic diameter and ventricular weight/body weight ratio were significantly higher in the CRF group. Hematoxylin-eosin and Masson staining indicated that myocardial fibers were broken, disordered, and fibrotic in the CRF group. Western blotting, enzyme-linked immunosorbent assay,immunofluorescence and electrophysiological examination suggested that compared with the Sham group, GAP-43 and TNF-α proteins were significantly upregulated, GAP-43 and tyrosine hydroxylase positive nerve fiber area was increased, and ventricular fibrillation threshold was significantly decreased in the CRF group. The above effects were inhibited in the CRF + statin group and the CRF + rhTNFR-Fcgroup.CONCLUSIONS In CRF rats, TNF-α was upregulated, cardiac sympathetic remodeling was more severe, and the nephrogenic cardiac sympathetic remodeling existed. Atorvastatin and etanercept could downregulate the expression of TNF-α or inh

关键词： remodeling cardiac inhibited

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Protein C deficiency with venous and arterial thromboembolic events

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World Journal of Clinical Cases 2024年第12期12卷 2000-2003页

作者： Nan Zhang Dong-Kun Sun Xu Tian Xin-Yu Zheng Tong Liu Department of cardiology Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular DiseaseTianjin Institute of CardiologyThe Second Hospital of Tianjin Medical UniversityTianjin 300211China

Protein C(PC)is a key component of the vitamin K-dependent coagulation pathway.It exerts anticoagulant effects by inactivating factors V and VIII.Acquired or inherited PC deficiency results in a prothrombotic state,with presentations varying from asymptomatic to venous thromboembolism.However,there has been an increasing number of reports linking PC deficiency to arterial thromboembolic events,such as myocardial infarction and ischemic stroke.This editorial focuses on the association between PC deficiency and thromboembolism,which may provide some insights for treatment strategy and scientific research.

关键词： Protein C deficiency Venous thromboembolism Myocardial infarction Editorial Arterial thromboembolism

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Relationship between mitochondrial respiratory dysfunction of blood mononuclear cells and heart failure severity

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Journal of Geriatric cardiology 2024年第1期21卷 130-134页

作者： Viacheslav A.Korepanov Tariel A.Atabekov Tatiana Yu.Rebrova Roman E.Batalov Sergey A.Afanasiev cardiology Research institute Tomsk National Research Medical CenterRussian Academy of SciencesTomskRussia

Chronic heart failure(CHF)is a clinical syndrome manifested by reduced pumping ability of the heart,increased pressure in heart chambers in both physical activity and at rest.The symptoms of this syndrome are dyspnea,undue fatigability,peripheral edema,which follow structural and functional changes of the myocardium.[1]The growing incidence of CHF,especially among elderly people,is an urgent problem for medicine in the vast majority of industrialized countries.For instance,in Russian Federation,CHF is diagnosed in about 7%of cardiovascular patients.At the same time,this indicator varies from 0.3%in young people(20-29 years old)to 70%in the older age group.[2,3].

关键词： severity instance pumping

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Tenecteplase versus alteplase in treatment of acute ST-segment elevation myocardial infarction:A randomized non-inferiority trial

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Chinese Medical Journal 2024年第3期137卷 312-319页

作者： Xingshan Zhao Yidan Zhu Zheng Zhang Guizhou Tao Haiyan Xu Guanchang Cheng Wen Gao Liping Ma Liping Qi Xiaoyan Yan Haibo Wang Qingde Xia Yuwang Yang Wanke Li Juwen Rong Limei Wang Yutian Ding Qiang Guo Wanjun Dang Chen Yao Qin Yang Runlin Gao Yangfeng Wu Shubin Qiao Department of cardiology Beijing Jishuitan HospitalCapital Medical UniversityThe Fourth Clinical Medical College of Peking UniversityBeijing 100035China Peking University Clinical Research institute Peking University First HospitalBeijing 100191China Department of cardiology The First Hospital of Lanzhou UniversityLanzhouGansu 730013China Department of cardiology The First Affiliated Hospital of Liaoning Medical UniversityJinzhouLiaoning 110002China Department of cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100037China Department of cardiology Huaihe Hospital of Henan UniversityKaifengHenan 450001China Department of cardiology Bayannur HospitalBayannurInner Mongolia 015208China Department of cardiology Puyang People’s HospitalPuyangHenan 457099China Department of cardiology Xingtai Third HospitalXingtaiHebei 054099China Department of cardiology Lintao County People’s HospitalDingxiGansu 730599China Department of cardiology Dancheng County People’s HospitalZhoukouHenan 477150China Department of cardiology The First People’s Hospital of LingbaoSanmenxiaHenan 472500China Department of cardiology Shanyin County People’s HospitalShuozhouShanxi 036999China Department of cardiology Uxin Banner People’s HospitalOrdosInner Mongolia 017399China Department of cardiology Lingqiu County People’s HospitalDatongShanxi 034499China Department of cardiology Huaibin County People’s HospitalXinyangHenan 464411China Department of cardiology Tianzhu County People’s HospitalWuweiGansu 733200China Guangzhou Recomgen Biotech Co. LtdGuangzhouGuangdong 510530China

Background:A phase II trial on recombinant human tenecteplase tissue-type plasminogen activator(rhTNK-tPA)has previously shown its preliminary efficacy in ST elevation myocardial infarction(STEMI)patients.This study was designed as a pivotal postmarketing trial to compare its efficacy and safety with rrecombinant human tissue-type plasminogen activator alteplase(rt-PA)in Chinese patients with STEMI.Methods:In this multicenter,randomized,open-label,non-inferiority trial,patients with acute STEMI were randomly assigned(1:1)to receive an intravenous bolus of 16 mg rhTNK-tPA or an intravenous bolus of 8 mg rt-PA followed by an infusion of 42 mg in 90 min.The primary endpoint was recanalization defined by thrombolysis in myocardial infarction(TIMI)flow grade 2 or 3.The secondary endpoint was clinically justified recanalization.Other endpoints included 30-day major adverse cardiovascular and cerebrovascular events(MACCEs)and safety endpoints.Results:From July 2016 to September 2019,767 eligible patients were randomly assigned to receive rhTNK-tPA(n=384)or rt-PA(n=383).Among them,369 patients had coronary angiography data on TIMI flow,and 711 patients had data on clinically justified recanalization.Both used a–15%difference as the non-inferiority efficacy margin.In comparison to rt-PA,both the proportion of patients with TIMI grade 2 or 3 flow(78.3%[148/189]vs.81.7%[147/180];differences:–3.4%;95%confidence interval[CI]:–11.5%,4.8%)and clinically justified recanalization(85.4%[305/357]vs.85.9%[304/354];difference:–0.5%;95%CI:–5.6%,4.7%)in the rhTNK-tPA group were non-inferior.The occurrence of 30-day MACCEs(10.2%[39/384]vs.11.0%[42/383];hazard ratio:0.96;95%CI:0.61,1.50)did not differ significantly between groups.No safety outcomes significantly differed between groups.Conclusion:rhTNK-tPA was non-inferior to rt-PA in the effect of improving recanalization of the infarct-related artery,a validated surrogate of clinical outcomes,among Chinese patients with acute STEMI.Trial registration:www.ClinicalTrials.gov(No.NCT028355

关键词： Thrombolytic therapy rhTNK-tPA Randomized controlled trial ST elevation myocardial infarction

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Nε-carboxymethyl-lysine and inflammatory cytokines,markers and mediators of coronary artery disease progression in diabetes

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World Journal of Diabetes 2024年第4期15卷 575-578页

作者： Sonia Eiras Translational cardiology Health Research InstituteUniversity Hospital of Santiago de CompostelaSantiago de Compostela 15706Spain

This editorial refers to the article“Comparative analysis of Nε-carboxymethyllysine and inflammatory markers in diabetic and non-diabetic coronary artery disease patients”,published in the recent issue of the World Journal of Diabetes 2023 is based on glucose metabolism,advanced glycation end products(AGEs),inflammation and adiposity on diabetes and coronary artery disease(CAD).This study has included CAD patients who were stratified according to glycosylated hemoglobin higher than 6.5 and sex-matched.A higher prevalence of hypertension,dyslipidemia,and non-vegetarian diet were found in the diabetic group.These risk factors might influence body weight and adiposity and explain the increment of the left atrium.Although this data was not supported by the study.The diet can also explain the non-enzymatic reactions on lipids,proteins,or nucleic acids and consequently an increment of AGEs.These molecules can emit fluorescence.However,one of the non-fluorescent and most abundant AGEs is Nε-carboxymethyl-lysine(CML).Its association with coronary artery stenosis and severity in the diabetic group might suggest its role as a player in CAD progression.Thus,CML,after binding with its receptor(RAGE),can induce calcification cascade through reactive oxygen species and mitogen-activated protein kinase.Moreover,this interaction AGE-RAGE can cause activation of the transcription nuclear factor-kb and induce inflammatory cytokines.It might explain the relationship between CML and pro-inflammatory cytokines in diabetic and CAD patients.Although this is a population from one center,the determination of CML and inflammatory cytokines might improve the diagnosis of severe and progressive CAD.Future and comparative studies among glycosylated hemoglobin,CML,and other AGE levels according to diagnosis and prognosis value might modify the clinical practice.Although these molecules are irreversible,they can act through a specific receptor inducing a signal transduction that might be modulated by inhibitors,antibodies,or siRNA.Further mech

关键词： Nε-carboxymethyl-lysine Inflammatory cytokines Adiposity Diabetes Coronary artery disease

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Cardiovascular diseases in European ethnic minorities: Beyond the traditional cardiovascular risk factors

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World Journal of cardiology 2024年第3期16卷 98-103页

作者： Mohamed Bamoshmoosh Department of cardiology University of Science and TechnologyAden 0Yemen Department of cardiology Fanfani Clinical Research InstituteFlorence 50100Italy

This editorial is intended to be a reflection on cardiovascular disease(CVD)burden in European ethnic minorities.In some European countries,ethnic minority realities,due to their recent appearance,are still to be studied in depth.The experience of several European countries,where the migration processes started earlier,even more than a century ago,can help by being an example.Many studies have shown that major differences in CVD burden exist not only between countries,but also within the same country when considering different social strata and ethnic groups.The CV risk factors underlying heart disease have been well established.Important epidemiological studies have helped us understand that the underlying causes of heart disease as well as the behaviors that can help prevent them are the same.We are now well aware that CVD should be treated by considering a holistic approach.This is why the social determinants(SDs)of health that may worsen the disease burden or that,vice versa,may improve the treatment,and even more significantly,the prognosis of a patient’s illness should be taken into consideration.For ethnic minority patients,this holistic,hermeneutic approach is of importance.Several SDs of health that influence CVDs have been identified but their relevance for the health of ethnic minorities has not yet been clearly defined.In some European countries,most ethnic minorities are largely also religious minorities.Only a few studies have evaluated the role of religion,which is an important SD that affects the probability of having CV risk factors and diseases.Adolescents,particularly those belonging to the second generation,seem to be the weak link.If we believe that these young people are really citizens of their country of birth,then a way of recognizing their belonging to the community starts from a will to better understand their condition,in order to assist them while they grow physically and mentally.Thinking about safeguarding the health of this population should be more than a health task,rather a goal

关键词： Cardiovascular diseases Cardiovascular risk factors European ethnic minorities Social determinants of health

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Prognostic value of calcium and phosphorus status in elderly heart disease patients with tricuspid regurgitation

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Chinese Medical Journal 2024年第5期137卷 613-615页

作者： Qingrong Liu Kai Cao Ziang Li Yunqing Ye Qian Zhang Hongliang Zhang Haiyan Xu Zhe Li Yongjian Wu CHINA-DVD Collaborators Department of cardiology Beijing Aerospace General HospitalBeijing 100076China Department of cardiology Fuwai HospitalNational Center for Cardiovascular DiseaseChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100037China Department of Beijing institute of Ophthalmology Beijing Tongren HospitalCapital Medical UniversityBeijing 100000China 不详

To the Editor:Tricuspid regurgitation(TR)associated with valve disease is a general medical issue with growing prevalence and socioeconomic burden.TR,especially moderate or severe TR,has been reported to be associated with an increased risk of heart failure and mortality.^([1])Studies have shown that blood calcium levels and blood phosphorus levels have a great influence on the human body,especially on the cardiovascular system.Elevated serum calcium levels were reported to be a risk factor for cardiovascular disease.^([2])A meta-analysis reported that moderate dietary calcium intake protects against cardiovascular and all-cause mortality and that calcium supplementation reduces mortality in women.^([3])

关键词： mortality regurgitation cardiovascular

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Role of angiotensin receptor-neprilysin inhibitor in diabetic complications

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World Journal of Diabetes 2024年第5期15卷 867-875页

作者： Ying Liu Cun-Yu Lu Yi Zheng Yu-Min Zhang Ling-Ling Qian Ku-Lin Li Gary Tse Ru-Xing Wang Tong Liu Department of cardiology Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular DiseaseTianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjin 300211China Department of cardiology Xuzhou No.1 Peoples HospitalXuzhou 221005Jiangsu ProvinceChina Department of cardiology Wuxi 9^(th)People’s Hospital Affiliated to Soochow UniversityWuxi 214062Jiangsu ProvinceChina Department of cardiology Wuxi People’s Hospital Affiliated to Nanjing Medical UniversityWuxi 214023Jiangsu ProvinceChina School of Nursing and Health Studies Metropolitan UniversityHong Kong 999077China Kent and Medway Medical School Kent CT27NTCanterburyUnited Kingdom

Diabetes mellitus is a prevalent disorder with multi-system manifestations,causing a significant burden in terms of disability and deaths globally.Angio-tensin receptor-neprilysin inhibitor(ARNI)belongs to a class of medications for treating heart failure,with the benefits of reducing hospitalization rates and mortality.This review mainly focuses on the clinical and basic investigations related to ARNI and diabetic complications,discussing possible physiological and molecular mechanisms,with insights for future applications.

关键词： Angiotensin receptor-neprilysin inhibitor Diabetic mellitus Complication

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Cardiovascular disease burden in patients with urological cancers:The new discipline of uro-cardio-oncology

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Cancer Innovation 2024年第2期3卷 28-44页

作者： Yi Zheng Ying Liu Ziliang Chen Yunpeng Zhang Zuo Qi Ning Wu Zhiqiang Zhao Gary Tse Yong Wang Hailong Hu Yuanjie Niu Tong Liu Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of CardiologyTianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjinChina School of Nursing and Health Studies Hong Kong Metropolitan UniversityHong KongChina

Cancer remains a major cause of mortality worldwide,and urological cancers are the most common cancers among men.Several therapeutic agents have been used to treat urological cancer,leading to improved survival for patients.However,this has been accompanied by an increase in the frequency of survivors with cardiovascular complications caused by anticancer medications.Here,we propose the novel discipline of uro-cardio-oncology,an evolving subspecialty focused on the complex interactions between cardiovascular disease and urological cancer.In this comprehensive review,we discuss the various cardiovascular toxicities induced by different classes of antineoplastic agents used to treat urological cancers,including androgen deprivation therapy,vascular endothelial growth factor receptor tyrosine kinase inhibitors,immune checkpoint inhibitors,and chemotherapeutics.In addition,we discuss possible mechanisms underlying the cardiovascular toxicity associated with anticancer therapy and outline strategies for the surveillance,diagnosis,and effective management of cardiovascular complications.Finally,we provide an analysis of future perspectives in this emerging specialty,identifying areas in need of further research.

关键词： anticancer therapy cardiovascular toxicity mechanism multidisciplinary management urological cancer

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