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Wang G, Xia M, Liang C, Pu F, Liu S, Jia D. Prognostic value of elevated lipoprotein (a) in patients with acute coronary syndromes: a systematic review and meta-analysis. Front Cardiovasc Med 2024; 11:1362893. [PMID: 38784168 PMCID: PMC11112025 DOI: 10.3389/fcvm.2024.1362893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Background Elevated lipoprotein (a) level was recognized as an independent risk factor for significant adverse cardiovascular events in acute coronary syndrome (ACS) patients. Despite this recognition, the consensus in the literature regarding the prognostic significance of elevated lipoprotein (a) in ACS was also limited. Consequently, we conducted a thorough systematic review and meta-analysis to evaluate the prognostic relevance of elevated lipoprotein (a) level in individuals diagnosed with ACS. Methods and results A thorough literature review was conducted by systematically searching PubMed, Embase, and Cochrane databases until September 2023. This review specifically examined cohort studies exploring the prognostic implications of elevated lipoprotein (a) level in relation to major adverse cardiovascular events (MACE), including death, stroke, non-fatal myocardial infarction (MI), and coronary revascularization, in patients with ACS. The meta-analysis utilized aggregated multivariable hazard ratios (HR) and their respective 95% confidence intervals (CI) to evaluate prognostic implications between high and low lipoprotein (a) levels [the cut-off of high lipoprotein (a) level varies from 12.5 to 60 mg/dl]. Among 18,168 patients in the identified studies, elevated lipoprotein (a) was independently associated with increased MACE risk (HR 1.26; 95% CI: 1.17-1.35, P < 0.00001) and all-cause mortality (HR 1.36; 95% CI: 1.05-1.76, P = 0.02) in ACS patients. In summary, elevated lipoprotein (a) levels independently forecast MACE and all-cause mortality in ACS patients. Assessing lipoprotein (a) levels appears promising for risk stratification in ACS, offering valuable insights for tailoring secondary prevention strategies. Systematic Review Registration PROSPERO (CRD42023476543).
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Affiliation(s)
- Guochun Wang
- The Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Maoyin Xia
- The Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Cai Liang
- The Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Feng Pu
- The Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Sitai Liu
- Department of General Practice, Sichuan Mianyang 404 Hospital, The Second Affiliated Hospital of North Sichuan Medical College, Mianyang, Sichuan, China
| | - Dongxia Jia
- Department of General Practice, Sichuan Mianyang 404 Hospital, The Second Affiliated Hospital of North Sichuan Medical College, Mianyang, Sichuan, China
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Wu L, Liu H, Xu X, Huang C, Li Y, Xiao X, Zhan Y, Gao C. Serum N-glycomic profiling identifies candidate biomarker panels for assessing coronary artery stenosis severity. Heliyon 2024; 10:e29443. [PMID: 38633623 PMCID: PMC11021961 DOI: 10.1016/j.heliyon.2024.e29443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024] Open
Abstract
Stenosis severity may escalate over the course of coronary artery disease (CAD), increasing the risk of death for the patient. Conventionally, the assessment of stenosis degree relies on invasive coronary angiography (ICA), an invasive examination unsuitable for patients in poor physical condition or those with contrast allergies and one that imposes a psychological burden on patients. Although abnormal serum N-glycan profiles have exhibited robust associations with various cardiovascular diseases, including CAD, their potential in diagnosing CAD stenosis remains to be determined. In this study, we performed a comprehensive analysis of serum N-glycome from 132 patients who underwent ICA and 27 healthy controls using MALDI-TOF-mass spectrometry. The patients who underwent ICA examination were categorized into four groups based on stenosis severity: no/mild/moderate/severe stenosis. Twenty-seven N-glycans were directly quantified, and 47 derived glycan traits were obtained. Notably, among these 74 glycan features, 18 exhibited variations across the study groups. Using a combination of least absolute shrinkage and selection operator and logistic regression analyses, we developed five diagnostic models for recognizing stenosis degree. Our results suggested that alterations in serum N-glycosylation modifications might be valuable for identifying stenosis degree and monitoring disease progression in individuals with CAD. It is expected to offer a noninvasive alternative for those who could not undergo ICA because of various reasons. However, the diagnostic potential of serum N-glycan panels as biomarkers requires multicenter, large cohort validation in the future.
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Affiliation(s)
- Linlin Wu
- Department of Clinical Laboratory Medicine Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, China
| | - Haoqi Liu
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, China
| | - Xuewen Xu
- Department of Clinical Laboratory Medicine Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, China
| | - Chenjun Huang
- Department of Clinical Laboratory Medicine Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, China
| | - Yueyue Li
- Shanghai Cancer Center and Institutes of Biomedical Sciences and Department of Chemistry and NHC Key Laboratory of Glycoconjugates Research, Fudan University, China
| | - Xiao Xiao
- Department of Clinical Laboratory Medicine Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, China
| | - Yueping Zhan
- Department of Clinical Laboratory Medicine Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, China
| | - Chunfang Gao
- Department of Clinical Laboratory Medicine Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, China
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Li T, Jiang H, Ding J. The role of exercise-based cardiac rehabilitation after percutaneous coronary intervention in patients with coronary artery disease: a meta-analysis of randomised controlled trials. Acta Cardiol 2024; 79:127-135. [PMID: 38465795 DOI: 10.1080/00015385.2023.2266650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/29/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND this study was designed to analyse patient outcomes using a combination of PCI and exercise-based cardiac rehabilitation compared with PCI alone. METHODS PCI can improve the survival rate of patients with coronary artery disease, but it can also cause vascular endothelial cell injury, thrombosis, and even restenosis. Early cardiac rehabilitation exercise is crucial for patients with coronary heart disease after PCI. Five databases were examined for randomised controlled trials involving early cardiac rehabilitation exercise and standard treatment in patients with coronary heart disease after PCI. The search period lasted from the creation of the database (2006) until December 2022. The outcomes including angina, arrhythmia, coronary restenosis, left ventricular ejection fraction, left ventricular end diastolic diameter, 6-min walk distance, total cholesterol, heart rate, systolic blood pressure and diastolic blood pressure. RevMan 5.3 was used to analyse the data, and the Cochrane Collaboration was used to assess the quality of evidence. RESULTS A total of 1231 patients were enrolled in this study. Angina pectoris (RR = 0.24, 95% CI [0.10, 0.57], p = 0.001), Arrhythmia (RR = 0.17, 95% CI [0.05, 0.55], p = 0.003), Coronary artery restenosis (RR = 0.10, 95% CI [0.01, 0.76], p = 0.03). CONCLUSION Exercise after PCI improves LVEF, enhances 6MWD, lowers HR and minimises the risk of angina, arrhythmia and coronary artery restenosis in CHD patients. Exercise had no discernible effect on LVEDD, TC, SBP, or DBP.
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Affiliation(s)
- Tong Li
- China-Japan Union Hospital of JiLin University, Changchun City, P.R. China
| | - Han Jiang
- China-Japan Union Hospital of JiLin University, Changchun City, P.R. China
| | - Jun Ding
- China-Japan Union Hospital of JiLin University, Changchun City, P.R. China
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Ren J, Royse C, Siderakis C, Srivastav N, Royse A. Long-term observational angiographic patency and perfect patency of radial artery compared with saphenous vein or internal mammary artery in coronary bypass surgery. J Thorac Cardiovasc Surg 2024; 167:1293-1302.e4. [PMID: 36229295 DOI: 10.1016/j.jtcvs.2022.08.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/26/2022] [Accepted: 08/21/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES It is uncertain if the long-term biological behavior of the radial artery as a conduit for coronary bypass surgery has a similar resistance to the development of atherosclerosis as for the internal mammary artery. We aimed to examine long-term angiographic patency and disease-free patency (perfect patency) for internal mammary artery, radial artery, and saphenous vein grafts. METHODS A retrospective, single-center, individual patient cohort study of angiographic observations from patients' latest postoperative angiogram from 1997 to 2020 was performed. Analysis was per anastomosis and assessed for patency and perfect patency. A generalized linear mixed model premised upon logistic regression was used to minimize confounding bias. RESULTS A total of 983 patients with 3064 grafts were included, with a median follow-up of 8.6 (interquartile range, 4.4-12.6) years after the operation. Multivariable analysis revealed differences for radial (patency, 86.9%; perfect patency, 86.4%) and internal mammary artery (patency, 93.9%; perfect patency, 93.5%) versus saphenous vein graft (patency, 72.8%; perfect patency, 46.2%). There were no differences between the 2 arterial conduits for patency (odds ratio, 1.40; 95% CI, 0.85-2.33; P = .189) and perfect patency (odds ratio, 1.14; 95% CI, 0.71-1.84; P = .578). If a conduit was patent, then 99.4% of radial artery, 99.6% of internal mammary artery, and 63.5% of saphenous vein graft were reported as perfectly patent. CONCLUSIONS Radial artery and internal mammary artery had similar patency and perfect patency while both were superior to saphenous vein graft.
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Affiliation(s)
- Justin Ren
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Colin Royse
- Department of Surgery, University of Melbourne, Melbourne, Australia; Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia; Outcomes Research Consortium, Cleveland Clinic, Cleveland, Ohio
| | | | - Nilesh Srivastav
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Alistair Royse
- Department of Surgery, University of Melbourne, Melbourne, Australia; Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, Australia.
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Zhu X, Zhang P, Jiang H, Kuang J, Wu L. Using the Super Learner algorithm to predict risk of major adverse cardiovascular events after percutaneous coronary intervention in patients with myocardial infarction. BMC Med Res Methodol 2024; 24:59. [PMID: 38459490 PMCID: PMC10921576 DOI: 10.1186/s12874-024-02179-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/14/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND The primary treatment for patients with myocardial infarction (MI) is percutaneous coronary intervention (PCI). Despite this, the incidence of major adverse cardiovascular events (MACEs) remains a significant concern. Our study seeks to optimize PCI predictive modeling by employing an ensemble learning approach to identify the most effective combination of predictive variables. METHODS AND RESULTS We conducted a retrospective, non-interventional analysis of MI patient data from 2018 to 2021, focusing on those who underwent PCI. Our principal metric was the occurrence of 1-year postoperative MACEs. Variable selection was performed using lasso regression, and predictive models were developed using the Super Learner (SL) algorithm. Model performance was appraised by the area under the receiver operating characteristic curve (AUC) and the average precision (AP) score. Our cohort included 3,880 PCI patients, with 475 (12.2%) experiencing MACEs within one year. The SL model exhibited superior discriminative performance, achieving a validated AUC of 0.982 and an AP of 0.971, which markedly surpassed the traditional logistic regression models (AUC: 0.826, AP: 0.626) in the test cohort. Thirteen variables were significantly associated with the occurrence of 1-year MACEs. CONCLUSION Implementing the Super Learner algorithm has substantially enhanced the predictive accuracy for the risk of MACEs in MI patients. This advancement presents a promising tool for clinicians to craft individualized, data-driven interventions to better patient outcomes.
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Affiliation(s)
- Xiang Zhu
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461 BaYi St, Nanchang, 330006, People's Republic of China
| | - Pin Zhang
- School of Public Health and Management, Nanchang Medical College, Nanchang, People's Republic of China
| | - Han Jiang
- Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, 330006, People's Republic of China
| | - Jie Kuang
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461 BaYi St, Nanchang, 330006, People's Republic of China
| | - Lei Wu
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 461 BaYi St, Nanchang, 330006, People's Republic of China.
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Nohria R, Antono B. Acute Coronary Syndrome. Prim Care 2024; 51:53-64. [PMID: 38278573 DOI: 10.1016/j.pop.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
One percent of primary care visits are due to chest pain. It is critical for the primary care physician to have a high index of suspicion for acute coronary syndrome and understand the management of this important condition. This article reviews the outpatient evaluation and management of chest pain and summarizes the key points of inpatient evaluation and treatment of acute coronary syndrome.
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Affiliation(s)
- Raman Nohria
- Department of Family Medicine and Community Health, Duke University School of Medicine, 2100 Erwin Road, Durham, NC 27705, USA.
| | - Brian Antono
- Department of Family Medicine and Community Health, Duke University School of Medicine, 2100 Erwin Road, Durham, NC 27705, USA
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Zeng Y, Xu J, Deng Y, Li X, Chen W, Tang Y. Drug-eluting stents for coronary artery disease in the perspective of bibliometric analysis. Front Cardiovasc Med 2024; 11:1288659. [PMID: 38440210 PMCID: PMC10910058 DOI: 10.3389/fcvm.2024.1288659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/30/2024] [Indexed: 03/06/2024] Open
Abstract
Drug-eluting stents (DES) play a crucial role in treating coronary artery disease (CAD) by preventing restenosis. These stents are coated with drug carriers that release antiproliferative drugs within the vessel. Over the past two decades, DES have been employed in clinical practice using various materials, polymers, and drug types. Despite optimizations in their design and materials to enhance biocompatibility and antithrombotic properties, evaluating their long-term efficacy and safety necessitates improved clinical follow-up and monitoring. To delineate future research directions, this study employs a bibliometric analysis approach. We comprehensively surveyed two decades' worth of literature on DES for CAD using the Web of Science Core Collection (WOSCC). Out of 5,778 articles, we meticulously screened them based on predefined inclusion and exclusion criteria. Subsequently, we conducted an in-depth analysis encompassing annual publication trends, authorship affiliations, journal affiliations, keywords, and more. Employing tools such as Excel 2021, CiteSpace 6.2R3, VOSviewer 1.6.19, and Pajek 5.17, we harnessed bibliometric methods to derive insights from this corpus. Analysis of annual publication data indicates a recent stabilisation or even a downward trend in research output in this area. The United States emerged as the leading contributor, with Columbia University and CRF at the forefront in both publication output and citation impact. The most cited document pertained to standardized definitions for clinical endpoints in coronary stent trials. Our author analysis identifies Patrick W. Serruys as the most prolific contributor, underscoring a dynamic exchange of knowledge within the field.Moreover, the dual chart overlay illustrates a close interrelation between journals in the "Medicine," "Medical," and "Clinical" domains and those in "Health," "Nursing," and "Medicine." Frequently recurring keywords in this research landscape include DES coronary artery disease, percutaneous coronary intervention, implantation, and restenosis. This study presents a comprehensive panorama encompassing countries, research institutions, journals, keyword distributions, and contributions within the realm of DES therapy for CAD. By highlighting keywords exhibiting recent surges in frequency, we elucidate current research hotspots and frontiers, thereby furnishing novel insights to guide future researchers in this evolving field.
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Affiliation(s)
- Ying Zeng
- Jiangxi Medical College, Nanchang University, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jiawei Xu
- Jiangxi Medical College, Nanchang University, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Yuxuan Deng
- Department of Endocrinology and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Xiaoxing Li
- The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Wen Chen
- Jiangxi Cancer Hospital, Nanchang, China
| | - Yu Tang
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
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Li F, Rasmy L, Xiang Y, Feng J, Abdelhameed A, Hu X, Sun Z, Aguilar D, Dhoble A, Du J, Wang Q, Niu S, Dang Y, Zhang X, Xie Z, Nian Y, He J, Zhou Y, Li J, Prosperi M, Bian J, Zhi D, Tao C. Dynamic Prognosis Prediction for Patients on DAPT After Drug-Eluting Stent Implantation: Model Development and Validation. J Am Heart Assoc 2024; 13:e029900. [PMID: 38293921 PMCID: PMC11056175 DOI: 10.1161/jaha.123.029900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 12/01/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND The rapid evolution of artificial intelligence (AI) in conjunction with recent updates in dual antiplatelet therapy (DAPT) management guidelines emphasizes the necessity for innovative models to predict ischemic or bleeding events after drug-eluting stent implantation. Leveraging AI for dynamic prediction has the potential to revolutionize risk stratification and provide personalized decision support for DAPT management. METHODS AND RESULTS We developed and validated a new AI-based pipeline using retrospective data of drug-eluting stent-treated patients, sourced from the Cerner Health Facts data set (n=98 236) and Optum's de-identified Clinformatics Data Mart Database (n=9978). The 36 months following drug-eluting stent implantation were designated as our primary forecasting interval, further segmented into 6 sequential prediction windows. We evaluated 5 distinct AI algorithms for their precision in predicting ischemic and bleeding risks. Model discriminative accuracy was assessed using the area under the receiver operating characteristic curve, among other metrics. The weighted light gradient boosting machine stood out as the preeminent model, thus earning its place as our AI-DAPT model. The AI-DAPT demonstrated peak accuracy in the 30 to 36 months window, charting an area under the receiver operating characteristic curve of 90% [95% CI, 88%-92%] for ischemia and 84% [95% CI, 82%-87%] for bleeding predictions. CONCLUSIONS Our AI-DAPT excels in formulating iterative, refined dynamic predictions by assimilating ongoing updates from patients' clinical profiles, holding value as a novel smart clinical tool to facilitate optimal DAPT duration management with high accuracy and adaptability.
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Affiliation(s)
- Fang Li
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
- Department of Artificial Intelligence and InformaticsMayo ClinicJacksonvilleFLUSA
| | - Laila Rasmy
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Yang Xiang
- Peng Cheng LaboratoryShenzhenGuangdongChina
| | - Jingna Feng
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
- Department of Artificial Intelligence and InformaticsMayo ClinicJacksonvilleFLUSA
| | - Ahmed Abdelhameed
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
- Department of Artificial Intelligence and InformaticsMayo ClinicJacksonvilleFLUSA
| | - Xinyue Hu
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
- Department of Artificial Intelligence and InformaticsMayo ClinicJacksonvilleFLUSA
| | - Zenan Sun
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - David Aguilar
- Department of Internal Medicine, McGovern Medical SchoolUniversity of Texas Health Science Center at HoustonHoustonTXUSA
- LSU School of Medicine, LSU Health New OrleansNew OrleansLAUSA
| | - Abhijeet Dhoble
- Department of Internal Medicine, McGovern Medical SchoolUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Jingcheng Du
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Qing Wang
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Shuteng Niu
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Yifang Dang
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Xinyuan Zhang
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Ziqian Xie
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Yi Nian
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - JianPing He
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Yujia Zhou
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Jianfu Li
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
- Department of Artificial Intelligence and InformaticsMayo ClinicJacksonvilleFLUSA
| | - Mattia Prosperi
- Data Intelligence Systems Lab, Department of Epidemiology, College of Public Health and Health Professions & College of MedicineUniversity of FloridaGainesvilleFLUSA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFLUSA
| | - Degui Zhi
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Cui Tao
- McWilliams School of Biomedical InformaticsUniversity of Texas Health Science Center at HoustonHoustonTXUSA
- Department of Artificial Intelligence and InformaticsMayo ClinicJacksonvilleFLUSA
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Deng W, Wang D, Wan Y, Lai S, Ding Y, Wang X. Prediction models for major adverse cardiovascular events after percutaneous coronary intervention: a systematic review. Front Cardiovasc Med 2024; 10:1287434. [PMID: 38259313 PMCID: PMC10800829 DOI: 10.3389/fcvm.2023.1287434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Background The number of models developed for predicting major adverse cardiovascular events (MACE) in patients undergoing percutaneous coronary intervention (PCI) is increasing, but the performance of these models is unknown. The purpose of this systematic review is to evaluate, describe, and compare existing models and analyze the factors that can predict outcomes. Methods We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 during the execution of this review. Databases including Embase, PubMed, The Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, and SINOMED were comprehensively searched for identifying studies published from 1977 to 19 May 2023. Model development studies specifically designed for assessing the occurrence of MACE after PCI with or without external validation were included. Bias and transparency were evaluated by the Prediction Model Risk Of Bias Assessment Tool (PROBAST) and Transparent Reporting of a multivariate Individual Prognosis Or Diagnosis (TRIPOD) statement. The key findings were narratively summarized and presented in tables. Results A total of 5,234 articles were retrieved, and after thorough screening, 23 studies that met the predefined inclusion criteria were ultimately included. The models were mainly constructed using data from individuals diagnosed with ST-segment elevation myocardial infarction (STEMI). The discrimination of the models, as measured by the area under the curve (AUC) or C-index, varied between 0.638 and 0.96. The commonly used predictor variables include LVEF, age, Killip classification, diabetes, and various others. All models were determined to have a high risk of bias, and their adherence to the TRIPOD items was reported to be over 60%. Conclusion The existing models show some predictive ability, but all have a high risk of bias due to methodological shortcomings. This suggests that investigators should follow guidelines to develop high-quality models for better clinical service and dissemination. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=400835, Identifier CRD42023400835.
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Affiliation(s)
- Wenqi Deng
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Dayang Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Institute of Cardiovascular Diseases, Beijing University of Chinese Medicine, Beijing, China
| | - Yandi Wan
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Sijia Lai
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yukun Ding
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xian Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Institute of Cardiovascular Diseases, Beijing University of Chinese Medicine, Beijing, China
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10
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Krishnamurthy SN, Pocock S, Kaul P, Owen R, Goodman SG, Granger CB, Nicolau JC, Simon T, Westermann D, Yasuda S, Andersson K, Brandrup-Wognsen G, Hunt PR, Brieger DB, Cohen MG. Comparing the long-term outcomes in chronic coronary syndrome patients with prior ST-segment and non-ST-segment elevation myocardial infarction: findings from the TIGRIS registry. BMJ Open 2023; 13:e070237. [PMID: 38110389 DOI: 10.1136/bmjopen-2022-070237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2023] Open
Abstract
OBJECTIVES Compared with ST-segment elevation myocardial infarction (STEMI) patients, non-STEMI (NSTEMI) patients have more comorbidities and extensive coronary artery disease. Contemporary comparative data on the long-term prognosis of stable post-myocardial infarction subtypes are needed. DESIGN Long-Term rIsk, clinical manaGement and healthcare Resource utilisation of stable coronary artery dISease (TIGRIS) was a multinational, observational and longitudinal cohort study. SETTING Patients were enrolled from 350 centres, with >95% coming from cardiology practices across 24 countries, from 19 June 2013 to 31 March 2017. PARTICIPANTS This study enrolled 8277 stable patients 1-3 years after myocardial infarction with ≥1 additional risk factor. OUTCOME MEASURES Over a 2 year follow-up, cardiovascular events and deaths and self-reported health using the EuroQol 5-dimension questionnaire score were recorded. Relative risk of clinical events and health resource utilisation in STEMI and NSTEMI patients were compared using multivariable Poisson regression models, adjusting for prognostically relevant patient factors. RESULTS Of 7752 patients with known myocardial infarction type, 46% had NSTEMI; NSTEMI patients were older with more comorbidities than STEMI patients. NSTEMI patients had significantly poorer self-reported health and lower prevalence of dual antiplatelet therapy at hospital discharge and at enrolment 1-3 years later. NSTEMI patients had a higher incidence of combined myocardial infarction, stroke and cardiovascular death (5.6% vs 3.9%, p<0.001) and higher all-cause mortality (4.2% vs 2.6%, p<0.001) compared with STEMI patients. Risks were attenuated after adjusting for other patient characteristics. Health resource utilisation was higher in NSTEMI patients, although STEMI patients had more cardiologist visits. CONCLUSIONS Post-NSTEMI chronic coronary syndrome patients had a less favourable risk factor profile, poorer self-reported health and more adverse cardiovascular events during long-term follow-up than individuals post STEMI. Efforts are needed to recognise the risks of stable patients after NSTEMI and optimise secondary prevention and care. TRIAL REGISTRATION NUMBER NCT01866904.
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Affiliation(s)
- Sibi N Krishnamurthy
- Cardiovascular Division Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Stuart Pocock
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Prashant Kaul
- Interventional Cardiology, Piedmont Heart Institute, Atlanta, Georgia, USA
| | - Ruth Owen
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Shaun G Goodman
- Division of Cardiology, Department of Medicine, Terrence Donnelly Heart Centre, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Christopher B Granger
- Division of Cardiology, Department of Medicine, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Jose Carlos Nicolau
- Instituto do Coracao (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Tabassome Simon
- Department of Clinical Pharmacology, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Dirk Westermann
- Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | | | | | | | - David B Brieger
- Concord Hospital and University of Sydney, Sydney, New South Wales, Australia
| | - Mauricio G Cohen
- Heart, Vascular & Thoracic Institute, Cleveland Clinic Florida, Weston, Florida, USA
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11
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Liu W, Ding K, Bao J, Hu Y, Gui Y, Ye L, Wang L. Relationship between uric acid to albumin ratio and in-stent restenosis in patients with coronary artery disease undergoing drug-eluting stenting. Coron Artery Dis 2023; 34:589-594. [PMID: 37855441 PMCID: PMC10602219 DOI: 10.1097/mca.0000000000001300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND In-stent restenosis (ISR) in patients undergoing percutaneous coronary intervention (PCI) to treat coronary artery disease (CAD) is an urgent issue in clinical practice. Recent studies have highlighted uric acid-albumin ratio (UAR) as a new marker for evaluating inflammation and oxidative stress, capable of predicting cardiovascular ailments. We aimed to examine the correlation between UAR levels and ISR in patients who underwent drug-eluting stent (DES) implantation. METHODS We included 503 patients with CAD who underwent initial DES implantation and angiography during the follow-up period. Based on coronary angiographic findings, the patients were categorized into ISR (n = 73) and non-ISR groups (n = 430). Before angiography, laboratory parameters were measured for all enrolled patients. To ascertain the influential factors linked to ISR, multivariate logistic regression analysis was performed. The predictive capability of UAR in determining ISR was assessed using receiver operating characteristic (ROC) curve analysis. Statistical significance was set at P < 0.05. RESULTS Multivariate logistic regression analysis revealed that diabetes mellitus, stent length, UAR, albumin levels, and C-reactive protein levels independently predicted ISR. ROC curve analysis revealed that UAR had an area under the curve of 0.767 (95% CI: 0.709 - 0.826) for predicting ISR and demonstrated that UAR outperformed the individual predictive abilities of uric acid and albumin for ISR. CONCLUSION UAR was associated with ISR in patients with CAD undergoing PCI with DES implantation. Moreover, ROC curve analysis demonstrated that UAR exhibited superior predictive accuracy for ISR compared with evaluating uric acid and albumin levels separately.
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Affiliation(s)
- Wenquan Liu
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Kun Ding
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jiaqi Bao
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yilan Hu
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yang Gui
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Lifang Ye
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Lihong Wang
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
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12
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Fu H, Wang L, Ying S, Zhao Z, Zhang P. Preventive effect and mechanism of compound Danshen dripping pills on contrast-induced nephropathy after percutaneous coronary interventional. Front Cardiovasc Med 2023; 10:1211982. [PMID: 38124888 PMCID: PMC10731959 DOI: 10.3389/fcvm.2023.1211982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/16/2023] [Indexed: 12/23/2023] Open
Abstract
Background Contrast-induced nephropathy (CIN) is one of the most common complications after coronary stent implantation due to the extensive development of coronary catheterization technology. Compound Danshen dripping pills (CDDP) are clinically used as cardiovascular drugs, relieving systemic inflammatory response. Previous studies have observed that CDDP can decrease CIN incidence after coronary stent implantation with uncertain effectiveness. Methods We conducted a prospective, randomized, single-center, single-blind, controlled trial. We enrolled patients 18 years and older with unstable angina pectoris and NSTEMI who underwent PCI at the Tianjin Chest Hospital between November 1, 2021, and November 31, 2022, and followed for 30 days. Patients were randomized to CDDP and hydration therapy (10 capsules three times/day; N = 411) or hydration only (N = 411). The primary outcome was the contrast nephropathy incidence, defined as an elevation in serum creatinine by more than 25% or 44 μmol/L from baseline within 48-72 h of contrast exposure. Secondary outcomes included major adverse cardiovascular events post-surgery and during follow-up. Results After 48 h of operation, the two groups had statistical significance in Scr and BUN values (80.0 ± 12.59 vs. 84.43 ± 13.49, P < 0.05; 6.22 ± 1.01 vs. 6.40 ± 0.93, P < 0.05). The difference in Scr in 72 h between the two groups was statistically significant (76.42 ± 10.92 vs. 79.06 ± 11.58, P < 0.05). The CIN incidence was significantly lower in the CDDP group than in the hydration group. The CIN risk was significantly elevated in patients with LVEF <50%, contrast volume ≥160 ml, and hypertension, after 48 and 72 h of operation. The serum inflammation index levels NGAL, TNF-α, oxidative stress indexes SOD, and MDA significantly differed between the two groups. However, there was no significant difference in serum apoptosis indexes Bax, Bcl-2, and Casepase-9. Conclusions CDDP pre-treatment could prevent contrast-induced nephropathy. Inflammatory response and oxidative stress could be significant in the CDDP mechanism.
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Affiliation(s)
- Han Fu
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Graduate School of Tianjin Medical University, Tianjin, China
| | - Linrui Wang
- Sheng Jing Hospital Affiliated, China Medical University, Shenyang, China
| | - Shuo Ying
- Department of Cardiology, Tianjin Chest Hospital, Tianjin University, Tianjin, China
| | - Zhicheng Zhao
- Graduate School of Tianjin Medical University, Tianjin, China
| | - Peng Zhang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin University, Tianjin, China
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13
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Fu M, Li X, Hu Z, Yin C, Dai W, Song H. Serum levels of 25-OH vitamin D levels predict cognitive impairments among acute coronary syndrome patients. J Cardiovasc Med (Hagerstown) 2023; 24:737-745. [PMID: 37642948 DOI: 10.2459/jcm.0000000000001542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND The cognitive impairment after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) has become a crucial clinical concern that cannot be ignored. However, studies on the early warning factors of cognitive impairment after PCI are still insufficient. METHODS This study reviewed the postoperative cognitive function of 284 patients who underwent PCI in our hospital from June 2019 to June 2022. During the 21-day follow-up, all participants included in the analysis were divided into the cognitive impairment (CI) group (n = 82) and the noncognitive impairment (NCI) group (n = 186) according to their Montreal cognitive assessment (MoCA) scale. Participants' serum 25(OH)D3 levels on admission and serum neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP) and S100β levels were measured 21 days after surgery. RESULTS Age more than 65 years, hypertension, operation time longer than 60 min, left ventricular ejection fraction less than 50% and serum 25(OH)D3 less than 31.41 ng/ml were the risk factors for cognitive dysfunction in ACS patients 21 days after PCI. Serum levels of 25(OH)D3, NSE, S100β and GFAP were significantly higher in patients with cognitive impairment than in patients without cognitive impairment. CONCLUSION Postoperative serum NSE, S100β and GFAP levels were significantly negatively correlated with serum 25(OH)D3 levels at admission. The serum 25(OH)D3 level is a risk factor and predictor of cognitive impairment in patients with ACS after PCI.
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Affiliation(s)
| | | | - Zhenzhen Hu
- Department of Education, Jiangnan University Medical Center, JUMC, Jiangsu
| | - Caixia Yin
- Department of Neurology, Tongzhou District People's Hospital, Nantong
| | - Wenzhuo Dai
- Department of Neurology, Jiangnan University Medical Center, JUMC, Wuxi, Jiangsu, China
| | - Huihui Song
- Department of Neurology, Jiangnan University Medical Center, JUMC, Wuxi, Jiangsu, China
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14
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Hou J, Zheng G, Han L, Shu Z, Wang H, Yuan Z, Peng J, Gong X. Coronary computed tomography angiography imaging features combined with computed tomography-fractional flow reserve, pericoronary fat attenuation index, and radiomics for the prediction of myocardial ischemia. J Nucl Cardiol 2023; 30:1838-1850. [PMID: 36859595 DOI: 10.1007/s12350-023-03221-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/19/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND This study aimed to predict myocardial ischemia (MIS) by constructing models with imaging features, CT-fractional flow reserve (CT-FFR), pericoronary fat attenuation index (pFAI), and radiomics based on coronary computed tomography angiography (CCTA). METHODS AND RESULTS This study included 96 patients who underwent CCTA and single photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI). According to SPECT-MPI results, there were 72 vessels with MIS in corresponding supply area and 105 vessels with no-MIS. The conventional model [lesion length (LL), MDS (maximum stenosis diameter × 100% / reference vessel diameter), MAS (maximum stenosis area × 100% / reference vessel area) and CT value], radiomics model (radiomics features), and multi-faceted model (all features) were constructed using support vector machine. Conventional and radiomics models showed similar predictive efficacy [AUC: 0.76, CI 0.62-0.90 vs. 0.74, CI 0.61-0.88; p > 0.05]. Adding pFAI to the conventional model showed better predictive efficacy than adding CT-FFR (AUC: 0.88, CI 0.79-0.97 vs. 0.80, CI 0.68-0.92; p < 0.05). Compared with conventional and radiomics model, the multi-faceted model showed the highest predictive efficacy (AUC: 0.92, CI 0.82-0.98, p < 0.05). CONCLUSION pFAI is more effective for predicting MIS than CT-FFR. A multi-faceted model combining imaging features, CT-FFR, pFAI, and radiomics is a potential diagnostic tool for MIS.
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Affiliation(s)
- Jie Hou
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
- Heart Center, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Address: No. 158 Shangtang Road, Hanghzou City, 310014, Zhejiang Province, China
| | - Guangying Zheng
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Lu Han
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Zhenyu Shu
- Heart Center, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Address: No. 158 Shangtang Road, Hanghzou City, 310014, Zhejiang Province, China
| | - Haochu Wang
- Heart Center, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Address: No. 158 Shangtang Road, Hanghzou City, 310014, Zhejiang Province, China
| | - Zhongyu Yuan
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Jiaxuan Peng
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Xiangyang Gong
- Heart Center, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Address: No. 158 Shangtang Road, Hanghzou City, 310014, Zhejiang Province, China.
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15
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Gao ST, Wang Y, Ma L. Effect of ticagrelor and clopidogrel dual antiplatelet therapy on MPVLR, MAADP, and AA inhibition rate in acute coronary syndrome patients after percutaneous coronary intervention. Medicine (Baltimore) 2023; 102:e34974. [PMID: 37713840 PMCID: PMC10508414 DOI: 10.1097/md.0000000000034974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/07/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE To explore the effects of ticagrelor and clopidogrel dual antiplatelet therapy on the mean platelet volume-to-lymphocyte ratio (MPVLR), maximum amplitude of adenosine diphosphate-induced platelet-fibrin clots (MAADP), and arachidonic acid (AA) inhibition rates in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). METHODS A total of 120 patients with ACS undergoing elective PCI in our hospital between March 2020 and November 2021 were recruited. Patients were divided into 2 groups using the random number table method, with 60 patients in each group. The control group received clopidogrel + aspirin dual antiplatelet therapy, while the study group received ticagrelor + aspirin dual antiplatelet therapy. MPVLR, MAADP, and AA inhibition rates were compared between the 2 groups. Platelet activation indices, platelet micro PNA-223, and platelet gelsolin levels were measured before and 4 weeks after PCI. Changes in cardiac function indices, bleeding rates, and major adverse cardiovascular events (MACE) were compared between groups. RESULTS The MAADP score of the study group was lower than that of the control group 3 days after surgery (P < .05). Compared with before surgery, CD62p, CD63, miR-223, PAC-1, platelet membrane glycoprotein IIb/IIIa complex, and gelsolin levels markedly decreased in both groups 4 weeks after surgery (P < .05). The platelet activation index and platelet miR-223 and gelsolin levels were significantly lower in the study group than in the control group 4 weeks after surgery (P < .05). The overall platelet inhibition effect was significantly better in the study group than in the control group (P < .05). Compared with before surgery, the left ventricular ejection fraction and stroke volume were significantly increased, and the left ventricular end-diastolic volume and left ventricular end-diastolic diameter significantly decreased in both groups 4 weeks after surgery (P < .05). No significant differences were found between the 2 groups in terms of the incidence of bleeding events or MACE (P > .05). CONCLUSION Ticagrelor is more effective than clopidogrel for platelet inhibition after PCI in patients with ACS and is worthy of clinical recommendation.
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Affiliation(s)
- Song-Tao Gao
- Department of Cardiology, Dingzhou People’s Hospital, Dingzhou, Hebei, China
| | - Yu Wang
- Department of Cardiology, Dingzhou People’s Hospital, Dingzhou, Hebei, China
| | - Lei Ma
- Department of Cardiology, Dingzhou People’s Hospital, Dingzhou, Hebei, China
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16
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Comoglu M, Acehan F, Katipoglu B, Demir BF, Guven Cetin Z, Ates I. Is eGFR ≥60 mL/min/1.73 m 2 in Patients Undergoing Coronary Angiography Really Safe for Contrast Nephropathy? Angiology 2023:33197231174497. [PMID: 37144892 DOI: 10.1177/00033197231174497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The aim of the present study was to define the risk factors associated with contrast-induced acute kidney injury (CI-AKI) in patients who underwent coronary artery angiography (CAG). In this retrospective cohort study, patients who underwent CAG between March 2014 and January 2022 were evaluated. A total of 2923 eligible patients were included in the study. Univariate and multivariate logistic regression analysis was used to identify the predictive factors. CI-AKI developed in 77 (2.6%) of 2923 patients. In multivariate analysis, diabetes mellitus (DM), chronic kidney disease (CKD), and estimated glomerular filtration rate (eGFR) were found to be independent factors associated with CI-AKI. In the subgroup analysis of patients with eGFR ≥60 mL/min/1.73 m2, eGFR remained a predictor of CI-AKI (Odds ratio (OR): .89, 95% CI: .84-.93; that is, a lower eGFR remains a risk factor for CI-AKI). In the receiving operating characteristic (ROC) analysis of patients with eGFR ≥60 mL/min/1.73 m2, the area under the curve of the eGFR was .826. Using the ROC curve based on Youden's index, the eGFR cut-off was found to be 70 mL/min/1.73 m2 for patients with eGFR ≥60 mL/min/1.73 m2. eGFR is also an important risk factor in patients with eGFR 60-70 mL/min/1.73 m2.
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Affiliation(s)
- Mustafa Comoglu
- Department of Internal Medicine, Ankara City Hospital, Cankaya, Turkey
| | - Fatih Acehan
- Department of Internal Medicine, Ankara City Hospital, Cankaya, Turkey
| | - Bilal Katipoglu
- Department of Geriatrics, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Burak F Demir
- Department of Internal Medicine, Ankara City Hospital, Cankaya, Turkey
| | | | - Ihsan Ates
- Department of Internal Medicine, Ankara City Hospital, Cankaya, Turkey
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17
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Hussain Z, Iqbal J, Liu H, Zhou HD. Exploring the role of lipoprotein(a) in cardiovascular diseases and diabetes in Chinese population. Int J Biol Macromol 2023; 233:123586. [PMID: 36758756 DOI: 10.1016/j.ijbiomac.2023.123586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023]
Abstract
A high level of lipoprotein (a) in the plasma has been associated with a variety of cardiovascular diseases and is considered to be an independent predictor of some other diseases. Based on recent studies, the concentration levels of Lp(a) in the Chinese population exhibit a distinctive variation from other populations. In the Chinese population, a high level of Lp(a) indicates a higher incidence of revascularization, platelet aggregation, and thrombogenicity following PCI. Increased risk of atherosclerotic cardiovascular disease (ASCVD) in Chinese population has been linked to higher levels of Lp(a), according to studies. More specifically, it has been found that in Chinese populations, higher levels of Lp(a) were linked to an increased risk of coronary heart disease, severe aortic valve stenosis, deep vein thrombosis in patients with spinal cord injuries, central vein thrombosis in patients receiving hemodialysis, and stroke. Furthermore, new and consistent data retrieved from several clinical trials also suggest that Lp (a) might also play an essential role in some other conditions, including metabolic syndrome, type 2 diabetes and cancers. This review explores the clinical and epidemiological relationships among Lp(a), cardiovascular diseases and diabetes in the Chinese population as well as potential Lp(a) underlying mechanisms in these diseases. However, further research is needed to better understand the role of Lp(a) in cardiovascular diseases and especially diabetes in the Chinese population.
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Affiliation(s)
- Zubair Hussain
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, 450000, Zhengzhou, China; Department of Pathophysiology, Academy of Medical Science, College of Medicine, Zhengzhou University, 450000, Zhengzhou, China; China-US (Henan) Hormel Cancer Institute, 450000, Zhengzhou, China
| | - Junaid Iqbal
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Hongcai Liu
- Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China; Suzhou Institute of Systems Medicine, Suzhou 215123, China
| | - Hou-De Zhou
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, China.
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Li B, Feng Q, Yu C, Yang J, Qin X, Li X, Cao J, Xu X, Yang C, Jin Y. Predictive value of serum HIF-1α and VEGF for arrhythmia in acute coronary syndrome patients. Exp Biol Med (Maywood) 2023; 248:685-690. [PMID: 37350444 PMCID: PMC10291207 DOI: 10.1177/15353702231171902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/22/2023] [Indexed: 06/24/2023] Open
Abstract
Percutaneous coronary intervention (PCI) has been widely used in the alleviation of myocardial ischemia in patients with acute coronary syndrome (ACS). However, the incidence of reperfusion arrhythmia (RA) after PCI is high, which seriously affects the prognosis of ACS patients. Therefore, this study aimed to study the predictive value of serum HIF-1α and VEGF levels before PCI for RA in ACS patients post PCI. A total of 200 ACS patients who underwent PCI were selected and divided into those with RA after PCI (RA, n = 93) and those without RA after PCI (non-RA, n = 107) according to Lown grade. Spearman correlation analysis was applied for the relationship between serum hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) levels and Lown grade. Patients with RA after PCI tended to have higher levels of creatine kinase muscle and brain isoenzyme (CK-MB), serum HIF-1α and VEGF before surgery. Low left ventricular ejection fraction (LVEF), high CK-MB, high serum VEGF and HIF-1α were risk factors for RA in ACS patients within 24 h after PCI. Receiver operating characteristic (ROC) analysis revealed that serum HIF-1α and VEGF levels could predict RA in ACS patients after PCI, and the combined detection could increase the sensitivity of single HIF-1α detection and the specificity of single VEGF detection. Lown grade was positively correlated with the serum HIF-1α and VEGF concentrations. In conclusion, serum HIF-1α and VEGF levels before PCI are risk factors for the occurrence of RA in ACS patients after PCI, and have certain predictive values for the occurrence of RA in ACS patients after PCI.
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Affiliation(s)
- Bin Li
- Wuxi No.2 People’s Hospital, The Affiliated Wuxi Clinical College of Nantong University, Wuxi 214002, China
| | - Qiuting Feng
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Cheng Yu
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Jun Yang
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Xian Qin
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Xing Li
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Jianing Cao
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Xin Xu
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Chenjian Yang
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
| | - Yan Jin
- Wuxi No.2 People’s Hospital, The Affiliated Wuxi Clinical College of Nantong University, Wuxi 214002, China
- Department of Cardiology, Jiangnan University Medical Center (JUMC), Wuxi 214002, China
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ZANG GY, YIN Q, SHAO C, SUN Z, ZHANG LL, XU Y, LI LH, WANG ZQ. CD137 signaling aggravates myocardial ischemia-reperfusion injury by inhibiting mitophagy mediated NLRP3 inflammasome activation. J Geriatr Cardiol 2023; 20:223-237. [PMID: 37091265 PMCID: PMC10114197 DOI: 10.26599/1671-5411.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND The inflammatory response caused by the NLRP3 is closely related to the formation of myocardial ischemia-reperfusion injury. Costimulatory receptor CD137 and its ligand play a crucial role in regulating the inflammatory immune response in atherosclerosis, which is the fundamental cause of cardiovascular diseases. However, the roles of CD137 signaling in the process of myocardial ischaemia-reperfusion (IR) injury remain unknown. METHODS Genetic ablation was used to determine the functional significance of CD137 in myocardial IR injury. Expression of CD137 was examined by Western-blot, quantitative real-time polymerase chain reaction, and immunohistochemistry in a murine IR model by coronary artery ligation. Even's blue-TTC staining and echocardiography to evaluate the severity of myocardial IR injury. Furthermore, HL-1 cardiomyocytes treated with agonist-CD137 recombinant protein were used to explore the underlying mechanism in CD137 signaling-induced NLRP3 inflammasome activation in response to hypoxia/reoxygenation or LPS/ATP. RESULTS We demonstrated that CD137 knockout significantly improved cardiac function, accompanied by a markedly reduced NLRP3-mediated inflammatory response and IA/AAR which were reversed by mitophagy inhibitor Mdivi-1. Activating CD137 signaling significantly inhibited mitophagy and provoked NLRP3-mediated inflammatory response in H/R-injured or LPS-primed and ATP-stimulated HL-1 cardiomyocytes, the effects of which could be abolished by either anti-CD137 or mitophagy activator FCCP. Besides, mitochondrial ROS was augmented by activating CD137 signaling through the suppression of mitophagy. CONCLUSIONS Our results reveal that activating CD137 signaling aggravates myocardial IR injury by upregulating NLRP3 inflammasome activation via suppressing mitophagy and promoting mtROS generation.
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Affiliation(s)
- Guang-Yao ZANG
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Qing YIN
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Chen SHAO
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Zhen SUN
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Li-Li ZHANG
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yao XU
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Li-Hua LI
- Department of Pathology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Zhong-Qun WANG
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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20
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Li J. Lipoprotein(a) and Atherosclerotic Cardiovascular Diseases: Evidence from Chinese Population. CARDIOLOGY DISCOVERY 2023; 3:40-47. [DOI: 10.1097/cd9.0000000000000059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Multiple factors are involved in CVD, and emerging data indicate that lipoprotein(a) (Lp(a)) may be associated with atherosclerotic cardiovascular disease (ASCVD) independent of other traditional risk factors. Lp(a) has been identified as a novel therapeutic target. Previous studies on the influence of Lp(a) in CVD have mainly used in western populations. In this review, the association of plasma Lp(a) concentration with ASCVD was summarized, with regards to epidemiological, population-based observational, and pathological studies in Chinese populations. Lp(a) mutations and copy number variations in Chinese populations are also explored. Finally, the impact of plasma Lp(a) levels on patients with type 2 diabetes mellitus, cancer, and familial hypercholesterolemia are discussed.
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Affiliation(s)
- Jianjun Li
- Cardiometabolic Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China
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21
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Zhong W, Fu C, Xu L, Sun X, Wang S, He C, Wei Q. Effects of home-based cardiac telerehabilitation programs in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis. BMC Cardiovasc Disord 2023; 23:101. [PMID: 36814188 PMCID: PMC9945630 DOI: 10.1186/s12872-023-03120-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Recent advances in telecommunications technology have raised the possibility of telehealth intervention delivering cardiac telerehabilitation, which may provide the efficacy of health services in patients after percutaneous coronary intervention (PCI). This study aimed to investigate the effects of home-based cardiac telerehabilitation (HBCTR) in patients undergoing PCI. METHODS We performed a comprehensive search of the following electronic databases: PubMed, Cochrane Central, Web of Science, Embase, CNKI, and WANFANG. For the prespecified outcomes, the primary outcomes were results of physical function (the six-minute walking test, 6MWT) and quality of life (QoL) of the participants. The secondary outcomes were results of (1) blood pressure; (2) full lipid profile (3) reliable assessment of anxiety and depression in patients. RESULTS All studies were conducted between 2013 and 2022, and a total of 5 articles could be included in the quantitative meta-analysis. The results showed that there was a statistically significant difference between the HBCTR intervention group and the control group in 6WMT (MD 16.59, 95%CI 7.13 to 26.06, P = 0.0006), but there was no difference in QoL (SMD - 0.25, 95%CI - 1.63 to 1.13, P = 0.73). According to the fixed effects model, there was a statistically significant difference between the HBCTR group versus the control group (MD - 2.88, 95%CI - 5.19 to - 0.57, P = 0.01), but not in diastolic blood pressure. Likewise, significant improvements of triglycerides and in low-density lipoprotein cholesterol were observed in HBTCR groups, but no significant differences were observed regarding total cholesterol and high-density lipoprotein cholesterol. CONCLUSION This systematic review and meta-analysis have proven that the HBCTR is one of the promisingly effective cardiac rehabilitation strategies that improve cardiorespiratory fitness and reduce cardiovascular disease risk factors. With the continuous improvement of the telerehabilitation network, it is expected to serve in clinical.
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Affiliation(s)
- Wen Zhong
- Department of Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Chenying Fu
- State Key Laboratory of Biotherapy and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Aging and Geriatric Mechanism Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Lin Xu
- Department of Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Xin Sun
- Department of Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Shiqi Wang
- Department of Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Chengqi He
- Department of Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China
| | - Quan Wei
- Department of Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China. .,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, People's Republic of China.
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Curtis E, Fernandez R, Khoo J, Weaver J, Lee A, Halcomb L. Clinical predictors and management for radial artery spasm: an Australian cross-sectional study. BMC Cardiovasc Disord 2023; 23:33. [PMID: 36653743 PMCID: PMC9847059 DOI: 10.1186/s12872-023-03042-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The transradial approach for coronary artery catheterisation has increased in popularity compared to the transfemoral approach for patients undergoing percutaneous coronary interventions. However, radial artery spasm continues to be a major complication of the procedure. Current management strategies vary concerning radial artery spasm and there is limited evidence of practice in the Australian context. AIM To identify the predictors of radial artery spasm and the medications used for its prevention and management. METHODS A descriptive cross-sectional study was carried out over a three-month period in two tertiary hospitals in NSW, Australia. A self-administered pre-procedural survey was completed by patients undergoing coronary artery catheterisation. This survey collected socio-demographic data and assessed anxiety using the Spielberger State-Trait Anxiety Inventory. Procedural data, including length of procedure, equipment used, occurrence of radial artery spasm, and medications given, were collected post-procedure by the interventionalist. RESULTS Of the 169 participants, over half were male (59.8%) and aged 66 years or older (56.8%). Radial artery spasm was reported in 24 (14.2%) participants. Rates of spasm were significantly higher among females (66.6%, p = 0.004), those aged under 65 years (62.5%, p = 0.001) and those who reported a medical history of anxiety (33.3%, p = 0.0004). There were no significant differences in State and Trait anxiety scores among those who had RAS and those who did not. Logistic regression identified younger age as the only statistically significant predictor of RAS (OR 0.536; 95% CI 0.171-1.684; p = 0.005). To prevent radial artery spasm most patients received midazolam (n = 158; 93.5%), nitrates (n = 133; 78.7%) and/or fentanyl (n = 124; 73.4%) prophylactically. Nitrates were the most frequently administered medication to treat radial artery spasm (78.7%). CONCLUSION This study highlights that there is a need to develop a clearer understanding of the predictors of RAS, as identifying patients at risk can ensure prophylactic measures are implemented. This study identified nitrates as the preferred vasodilator as a preventative measure along with the use of sedation.
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Affiliation(s)
- Elizabeth Curtis
- Faculty of Science, Medicine and Health, University of Wollongong, Building 41 Office 220, Northfields Ave, Keiraville, NSW, 2500, Australia.
| | - Ritin Fernandez
- grid.1007.60000 0004 0486 528XFaculty of Science, Medicine and Health, University of Wollongong, Building 41 Office 220, Northfields Ave, Keiraville, NSW 2500 Australia ,grid.416398.10000 0004 0417 5393Centre for Research in Nursing and Health, St George Hospital, 28 Gray Street, Kogarah, NSW 2217 Australia
| | - John Khoo
- grid.416398.10000 0004 0417 5393Cardiology Department, St George Hospital, Grey Street, Kogarah, NSW 2217 Australia
| | - James Weaver
- grid.416398.10000 0004 0417 5393Cardiology Department, St George Hospital, Grey Street, Kogarah, NSW 2217 Australia
| | - Astin Lee
- grid.1007.60000 0004 0486 528XFaculty of Science, Medicine and Health, University of Wollongong, Building 41 Office 220, Northfields Ave, Keiraville, NSW 2500 Australia ,grid.417154.20000 0000 9781 7439Cardiology Department, The Wollongong Hospital, Crown Street, Wollongong, NSW 2500 Australia
| | - Liz Halcomb
- grid.1007.60000 0004 0486 528XFaculty of Science, Medicine and Health, University of Wollongong, Building 41 Office 220, Northfields Ave, Keiraville, NSW 2500 Australia
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Kang J, Han JK, Yang HM, Park KW, Kang HJ, Koo BK, Choo EH, Lee JY, Park SD, Lim YH, Kim HM, Heo JH, Kim HS. Real-world evidence of switching P2Y12 receptor-inhibiting therapies to prasugrel after PCI in patients with ACS: results from EFF-K registry. BMC Cardiovasc Disord 2023; 23:6. [PMID: 36624388 PMCID: PMC9827633 DOI: 10.1186/s12872-022-03034-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 12/29/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Potent P2Y12 inhibitors are recommended for up to 12 months after percutaneous coronary intervention (PCI) in patients diagnosed with acute coronary syndrome (ACS). However, the prescription pattern is diverse in real world practice, which includes various switching between antiplatelet regimens. In this study, we analyzed the prescription patterns of prasugrel, and assessed the safety and effectiveness of P2Y12 inhibitors switching patterns in a real world registry of patients subjected to PCI after ACS. METHODS The EFF-K study included 3077 ACS patients receiving prasugrel-based dual antiplatelet therapy. The cohort was divided into those who were administered with prasugrel as the primary antiplatelet treatment (naïve cohort) or as a substitute agent after clopidogrel or ticagrelor pre-treatment (switch cohort). The primary endpoint was a net adverse clinical event (NACE; a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or TIMI major bleeding unrelated to coronary-artery bypass grafting). RESULTS A total of 3077 patients diagnosed with ACS were included in the analysis. Among the total population, 726 patients (23.6%) were classed as the naïve cohort and 2351 patients (76.4%) as the switch cohort. Baseline characteristics showed that the switch cohort had more comorbidities, such as hypertension, diabetes mellitus, heart failure and previous PCI. The major cause of switching to prasugrel in the switch cohort was the necessity for a more potent antiplatelet agent (56.3%). During a 12-month follow-up period, 51 patients (1.7%) experienced at least one NACE. The incidence of NACE did not differ between the naïve and switch cohort (1.5% vs. 1.7%, Hazard ratio 1.17, 95% Confidence interval 0.56-2.43, P = 0.677). In subgroup analysis, no significant interaction was observed between the treatment strategy and the incidence of NACE across various subgroups. CONCLUSIONS Dual antiplatelet therapy with prasugrel seems to be safe and effective both as a primary treatment and as a substitute for other P2Y12 inhibitors in a real world registry of Asian ACS patients receiving PCI. TRIAL REGISTRATION KCT0002356, registered June 13, 2017.
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Affiliation(s)
- Jeehoon Kang
- grid.412484.f0000 0001 0302 820XCardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea ,grid.412484.f0000 0001 0302 820XDepartment of Critical Care Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung-Kyu Han
- grid.412484.f0000 0001 0302 820XCardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea
| | - Han-Mo Yang
- grid.412484.f0000 0001 0302 820XCardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea
| | - Kyung Woo Park
- grid.412484.f0000 0001 0302 820XCardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea
| | - Hyun-Jae Kang
- grid.412484.f0000 0001 0302 820XCardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea
| | - Bon-Kwon Koo
- grid.412484.f0000 0001 0302 820XCardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea
| | - Eun Ho Choo
- grid.414966.80000 0004 0647 5752Department of Internal Medicine, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
| | - Jong-Young Lee
- grid.264381.a0000 0001 2181 989XDepartment of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Don Park
- grid.411605.70000 0004 0648 0025Department of Internal Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Young-Hyo Lim
- grid.49606.3d0000 0001 1364 9317Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Hyung-Min Kim
- grid.497772.8Daiichi Sankyo Korea Co., Ltd., Seoul, Republic of Korea
| | - Ji-Hyun Heo
- grid.497772.8Daiichi Sankyo Korea Co., Ltd., Seoul, Republic of Korea
| | - Hyo-Soo Kim
- grid.412484.f0000 0001 0302 820XCardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea
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Motovska Z, Hlinomaz O, Aschermann M, Jarkovsky J, Želízko M, Kala P, Groch L, Svoboda M, Hromadka M, Widimsky P. Trends in outcomes of women with myocardial infarction undergoing primary angioplasty-Analysis of randomized trials. Front Cardiovasc Med 2023; 9:953567. [PMID: 36684569 PMCID: PMC9845716 DOI: 10.3389/fcvm.2022.953567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 12/07/2022] [Indexed: 01/06/2023] Open
Abstract
Background Sex- and gender-associated differences determine the disease response to treatment. Aim The study aimed to explore the hypothesis that progress in the management of STE-myocardial infarction (STEMI) overcomes the worse outcome in women. Methods and results We performed an analysis of three randomized trials enrolling patients treated with primary PCI more than 10 years apart. PRAGUE-1,-2 validated the preference of transport for primary PCI over on-site fibrinolysis. PRAGUE-18 enrollment was ongoing at the time of the functional network of 24/7PCI centers, and the intervention was supported by intensive antiplatelets. The proportion of patients with an initial Killip ≥ 3 was substantially higher in the more recent study (0.6 vs. 6.7%, p = 0.004). Median time from symptom onset to the door of the PCI center shortened from 3.8 to 3.0 h, p < 0.001. The proportion of women having total ischemic time ≤3 h was higher in the PRAGUE-18 (OR [95% C.I.] 2.65 [2.03-3.47]). However, the percentage of patients with time-to-reperfusion >6 h was still significant (22.3 vs. 27.2% in PRAGUE-18). There was an increase in probability for an initial TIMI flow >0 in the later study (1.49 [1.0-2.23]), and also for an optimal procedural result (4.24 [2.12-8.49], p < 0.001). The risk of 30-day mortality decreased by 61% (0.39 [0.17-0.91], p = 0.029). Conclusion The prognosis of women with MI treated with primary PCI improved substantially with 24/7 regional availability of mechanical reperfusion, performance-enhancing technical progress, and intensive adjuvant antithrombotic therapy. A major modifiable hindrance to achieving this benefit in a broad population of women is the timely diagnosis by health professional services.
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Affiliation(s)
- Zuzana Motovska
- Cardiocentre, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia,*Correspondence: Zuzana Motovska,
| | - Ota Hlinomaz
- Department of Cardioangiology, International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czechia
| | - Michael Aschermann
- Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czechia
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses Ltd., Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Michael Želízko
- Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czechia
| | - Petr Kala
- Department of Internal and Cardiology, Faculty of Medicine, Masaryk University and University Hospital Brno-Bohunice, Brno, Czechia
| | - Ladislav Groch
- Department of Cardioangiology, International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czechia
| | - Michal Svoboda
- Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czechia
| | - Milan Hromadka
- Department of Cardiology, Charles University, University Hospital in Pilsen, Pilsen, Czechia
| | - Petr Widimsky
- Cardiocentre, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia
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25
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Hao Q, Yuanyuan Z, Lijuan C. The Prognostic Value of the Triglyceride Glucose Index in Patients With Acute Myocardial Infarction. J Cardiovasc Pharmacol Ther 2023; 28:10742484231181846. [PMID: 37335126 DOI: 10.1177/10742484231181846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Objective: The triglyceride-glucose (TyG) index is a simple and reliable surrogate for insulin resistance. Recent studies have suggested that the TyG index is an independent predictor of cardiovascular disease. However, the prognostic value of the TyG index in patients with acute myocardial infarction (AMI) remains uncertain. Thus, this study aimed to evaluate the prognostic value of the TyG index in patients with AMI. Methods: AMI patients admitted to Zhongda Hospital from 2018 to 2020 were successively enrolled. After screening the inclusion criteria, 1144 patients were divided into three groups according to the tertiles of the TyG index distribution. Patients were followed up for 1 year as outpatients or contacted via telephone, and the occurrence and timing of all-cause deaths were recorded. Results: The TyG index was significantly correlated with heart failure (HF) in AMI patients. Patients with a high TyG index (group 3) (odds ratio: 9.070, 95% confidence interval [CI] 4.359-18.875, P<.001) had a significantly higher incidence of HF compared with patients with median TyG index (group 2). Similarly, the incidence of all-cause death in group 3 was significantly higher than that in group 2 during the 1-year follow-up (hazard ratio: 2.996, 95% CI 1.058-8.487, P = .039). Conclusion: The TyG index is closely related to HF and may be a valuable indicator to predict the long-term prognosis of patients with AMI.
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Affiliation(s)
- Qian Hao
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Zhao Yuanyuan
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Chen Lijuan
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China
- Department of Cardiology, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China
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26
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Zhang SS, Hu WY, Li YJ, Yu J, Sang S, Alsalman ZM, Xie DQ. Lipoprotein (a) variability is associated with mean follow-up C-reactive protein in patients with coronary artery disease following percutaneous coronary intervention. World J Clin Cases 2022; 10:12909-12919. [PMID: 36569022 PMCID: PMC9782931 DOI: 10.12998/wjcc.v10.i35.12909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/12/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Increased lipoprotein (a) [lp (a)] has proinflammatory effects, which increase the risk of coronary artery disease. However, the association between lp (a) variability and follow-up C-reactive protein (CRP) level in patients undergoing percutaneous coronary intervention (PCI) has not been investigated.
AIM To explore the association between lp (a) variability and mean CRP levels within the 1st year post-PCI.
METHODS Results of lp (a) and CRP measurements from at least three follow-up visits of patients who had received PCI were retrospectively analyzed. Standard deviation (SD), coefficient of variation (CV), and variability independent of the mean (VIM) are presented for the variability for lp (a) and linear regression analysis was conducted to correlate lp (a) variability and mean follow-up CRP level. The relationship of lp (a) variability and inflammation status was analyzed by restricted cubic spline analysis. Finally, exploratory analysis was performed to test the consistency of results in different populations.
RESULTS A total of 2712 patients were enrolled. Patients with higher variability of lp (a) had a higher level of mean follow-up CRP (P < 0.001). lp (a) variability was positively correlated with the mean follow-up CRP (SD: β = 0.023, P < 0.001; CV: β = 0.929, P < 0.001; VIM: β = 1.648, P < 0.001) by multivariable linear regression analysis. Exploratory analysis showed that the positive association remained consistent in most subpopulations.
CONCLUSION Lp (a) variability correlated with mean follow-up CRP level and high variability could be considered an independent risk factor for increased post-PCI CRP level.
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Affiliation(s)
- Si-Si Zhang
- Department of Cardiology, Ningbo Ninth Hospital, Ningbo 315300, Zhejiang Province, China
| | - Wen-Yi Hu
- Department of Cardiology, Ningbo Ninth Hospital, Ningbo 315300, Zhejiang Province, China
| | - Yi-Jing Li
- Department of Cardiology, Ningbo Ninth Hospital, Ningbo 315300, Zhejiang Province, China
| | - Juan Yu
- Department of Cardiology, Ningbo Ninth Hospital, Ningbo 315300, Zhejiang Province, China
| | - Shang Sang
- Department of Cardiology, Ningbo Ninth Hospital, Ningbo 315300, Zhejiang Province, China
| | - Zakareya M Alsalman
- Department of Cardiology, Ningbo Ninth Hospital, Ningbo 315300, Zhejiang Province, China
| | - Da-Qi Xie
- Department of Cardiology, Ningbo Ninth Hospital, Ningbo 315300, Zhejiang Province, China
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Bernardi M, Morello A, Galli M. Complex percutaneous coronary intervention: what is the role of new-generation scoring balloons? Minerva Cardiol Angiol 2022; 70:686-688. [PMID: 36256437 DOI: 10.23736/s2724-5683.22.06123-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Marco Bernardi
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - Alberto Morello
- Interventional Cardiovascular Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
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Wang Z, Shao L, Cai X, Zhou Y, Hong L, Li S. The potential function of SP1 and CPPED1 in restenosis after percutaneous coronary intervention. J Card Surg 2022; 37:5111-5119. [PMID: 36378884 DOI: 10.1111/jocs.17218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Impacts of molecular pathways have been discussed recently on restenosis after percutaneous coronary intervention (PCI). Hence, this study aimed to explore the impact of calcineurin-like phosphoesterase domain containing 1 (CPPED1) and specificity protein 1 (SP1) on restenosis after PCI. METHODS A carotid balloon injury rat model was established, followed by western blot analysis of SP1 and CPPED1 expression in carotid artery (CA) tissues. After SP1 and CPPED1 were overexpressed, the neointimal hyperplasia and luminal stenosis were assessed. In addition, EPC underwent hypoxia/reoxygenation (H/R) treatment to construct an endothelial injury cell model. Then, cell proliferation, apoptosis, intracellular reactive oxygen species (ROS), and Ca2+ concentration were detected with cell counting kit-8 (CCK-8), flow cytometry, Chloromethyl-2'7'-dichlorofluorescein diacetate (CM-H2DCFDA) penetrant, and Fluo-4 AM staining, respectively. The binding relationship between SP1 and CPPED1 was verified by dual-luciferase reporter and chromatin immunoprecipitation (ChIP) assays. RESULTS SP1 and CPPED1 were lowly expressed in the model rats with carotid balloon injury. Mechanistically, SP1 bound to the promoter region of CPPED1 to activate CPPED1 expression. Overexpressing SP1 or CPPED1 lowered neointimal formation and restenosis rate, thus promoting the recovery of carotid balloon injury in rats. Meanwhile, SP1 and CPPED1 upregulation reduced ROS levels, Ca2+ concentration, and apoptosis of EPCs, accompanied by accelerated EPC viability. CONCLUSIONS SP1 or CPPED1 overexpression reduced neointimal formation and restenosis rate in carotid balloon injury.
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Affiliation(s)
- Zhiyong Wang
- Department of Elderly Medical, First People's Hospital of Fuzhou, Fuzhou, Jiangxi, People's Republic of China
| | - Liang Shao
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, People's Republic of China
| | - Xinyong Cai
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, People's Republic of China
| | - Yuxuan Zhou
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, People's Republic of China
| | - Lang Hong
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, People's Republic of China
| | - Sanjun Li
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, People's Republic of China
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Xue W, Ma J, Yu X, Ruan Z, Sun Y, Wu T, Zhang X, Wu L. Analysis of the incidence and influencing factors associated with binary restenosis of target lesions after drug-coated balloon angioplasty for patients with in-stent restenosis. BMC Cardiovasc Disord 2022; 22:493. [PMID: 36404303 PMCID: PMC9677633 DOI: 10.1186/s12872-022-02923-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/27/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Drug-coated balloon (DCB) is a novel and effective device for coronary artery disease patients with in-stent restenosis (ISR). However, the incidence and possible influencing factors associated with binary restenosis have not yet been adequately assessed. METHODS The data are extracted from a prospective, multicenter, randomized controlled trial. A total of 211 patients with ISR were enrolled at 13 centers from August 2017 to October 2018 and treated with DCB. At the 9-month coronary angiographic follow-up, patients were divided into restenosis and non-restenosis groups, and demographic data, lesion features, and laboratory tests were retrospectively reviewed. Furthermore, logistic regression analysis was used to identify possible influencing factors. RESULTS All patients successfully underwent treatment, and 166 patients with 190 lesions took part in angiography follow-ups at 9 months. Of these, 41 patients with 44 target lesions developed restenosis following treatment, and the incidence of ISR was 24.7%. There were significant differences in the average length of target lesions and the number of multivessel lesions and fasting plasma glucose (FBG) between the two groups (p < 0.05). Demographic data, cardiac risk factors, left ventricular ejection fractions (LVEF), blood routine tests, biochemical tests, and other features of devices and lesions showed no difference. Logistic regression analyses showed that FBG > 6.1 mmol/L (OR: 7.185 95% CI: 2.939-17.567 P < 0.001) and length of lesion (OR:1.046 95% CI: 1.001-1.093 P = 0.046) were associated risk factors. CONCLUSIONS The longer length of lesions, more target lesions and FBG > 6.1 mmol/L per individual may be characteristics of patients showing ISR following treatment. Studies with larger sample size, and more complete follow-up data are needed in the future to expend on these findings. TRIAL REGISTRATION No.: NCT04213378, first posted date (30/12/2019).
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Affiliation(s)
- Weihao Xue
- grid.417384.d0000 0004 1764 2632Department of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027 China
| | - Jun Ma
- grid.417384.d0000 0004 1764 2632Department of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027 China
| | - Xiaojie Yu
- grid.417384.d0000 0004 1764 2632Department of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027 China
| | - Zhisheng Ruan
- grid.417384.d0000 0004 1764 2632Department of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027 China
| | - Yuanxue Sun
- grid.417384.d0000 0004 1764 2632Department of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027 China
| | - Tianbo Wu
- grid.417384.d0000 0004 1764 2632Department of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027 China
| | - Xinmin Zhang
- grid.417384.d0000 0004 1764 2632Department of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027 China
| | - Lianpin Wu
- grid.417384.d0000 0004 1764 2632Department of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027 China
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Liu L, Zhang Y, Du Y, Li H, Wang M, Lv J. The therapeutic effect and targets of cellulose polysaccharide on coronary heart disease (CHD) and the construction of a prognostic signature based on network pharmacology. Front Nutr 2022; 9:986639. [PMID: 36299990 PMCID: PMC9592078 DOI: 10.3389/fnut.2022.986639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
Cellulose is the first rich biological polysaccharide in nature and has many excellent properties, so it is being developed as a variety of drug carriers. Moreover, applications in drug delivery, biosensors/bioanalysis, immobilization of enzymes and cells, stem cell therapy, and skin tissue repair are also highlighted by many studies. Coronary heart disease, as one of the diseases with the highest incidence, is urgent to enhance the survival outcome and life quality of patients with coronary heart disease, whereas the mechanism of cellulose's interaction with the human body remains unclear. However, the mechanism of cellulose's interaction with the human body remains unclear. We obtained 92 genes associated with cellulose and coronary heart disease through the intersection of different databases. Ten key genes were identified: HRAS, STAT3, HSP90AA1, FGF2, VEGFA, CXCR4, TERT, IL2, BCL2L1, and CDK1. Molecular docking of the 10 genes revealed their association with their respective receptors. Analysis by KEGG and GO has discovered that these related targets were more enriched in metabolic- and activation-related functions, which further confirmed that cellulose polysaccharides can also interact with cardiovascular diseases as molecules. In the end, we screened out six key genes that were more associated with the prognosis (CDK1, HSP90AA1, CXCR4, IL2, VEGFA, and TERT) and constructed a signature, which has a good predictive effect and has significant statistical significance. Our study is the first study to explore the interaction targets of cellulose and CHD and to construct a prognostic model. Our findings provide insights for future molecular design, drug development, and clinical trials.
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Affiliation(s)
- Lang Liu
- Department of Cardiology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Yundi Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuxin Du
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan University, Shanghai, China
| | - Haoyue Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingzhao Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianfeng Lv
- Department of Cardiology, Affiliated RenHe Hospital of China, Second Clinical Medical College, Three Gorges University, Yichang, China,*Correspondence: Jianfeng Lv
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Zhang YB, Liu HD, Xing JH, Chen BW, Zhao YY, Gu HP, Tao HL. Safety and Efficacy of Drug-Coated Balloons in Patients with Acute Coronary Syndromes and Vulnerable Plaque. Clin Appl Thromb Hemost 2022; 28:10760296221130063. [PMID: 36198017 PMCID: PMC9537494 DOI: 10.1177/10760296221130063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) is the main treatment option for acute coronary syndromes (ACS) often related to the progression and rupture of vulnerable plaques. While drug-eluting stents (DES) are now routinely used in PCI, drug-coated balloons (DCB) are a new strategy to PCI and their practice in the treatment of ACS with vulnerable plaques has not been reported. This study aimed to evaluate the safety and efficacy of DCB in ACS complicated with vulnerable plaque lesions. METHODS 123 patients were retrospectively analyzed and diagnosed with ACS and given PCI in our Cardiology Department from December 2020 to July 2022. Vulnerable plaques were confirmed by intravenous ultrasound (IVUS) in all patients. According to individual treatment plan, patients were entered into either DCB (n = 55) or DES (n = 68) groups. The results of coronary angiography and IVUS before and immediately after percutaneous coronary intervention were analyzed. The occurrence of major adverse cardiovascular events (MACE) and the results of coronary angiography were also evaluated during follow-up. RESULTS There were no significant differences in baseline clinical characteristics, preoperative minimal luminal diameter (MLD), and preoperative diameter stenosis (DS) between the two groups. Also, there were no differences in IVUS plaque burden (PB), vessel area, and lumen area in the two groups before and immediately after PCI. The efficacy analysis showed that immediately after PCI, the DCB group had smaller MLD and higher degrees of lumen stenosis than the DES group (P < 0.05). However, during follow-up, no significant differences in MLD and DS were seen in two groups; relatively, late loss in luminal diameter(LLL)in the DCB group was smaller (P<0.05). Safety analysis showed that during follow-up, 9 patients developed restenosis after DCB implantation while restenosis occurred in 10 patients with DES treatment, no statistical difference in the incidence of restenosis in the two groups. Besides, there was no statistical difference in the incidence of major adverse cardiac events(MACE)during hospitalization and follow-up in the DCB group (7.3% (4/55)) and the DES group (8.8% (6/68)). CONCLUSION DCB is safe and effective for ACS complicated with vulnerable plaque and has an advantage over DES in LLL.
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Affiliation(s)
- Yu-Bin Zhang
- Department of Cardiology, Zhengzhou University First Affiliated
Hospital, Zhengzhou, Henan, China
| | - Heng-Dao Liu
- Department of Cardiology, Zhengzhou University First Affiliated
Hospital, Zhengzhou, Henan, China
| | - Jun-Hui Xing
- Department of Cardiology, Zhengzhou University First Affiliated
Hospital, Zhengzhou, Henan, China
| | - Bo-Wen Chen
- Department of Cardiology, Zhengzhou University First Affiliated
Hospital, Zhengzhou, Henan, China
| | - Yan-Yan Zhao
- Department of Cardiology, Zhengzhou University First Affiliated
Hospital, Zhengzhou, Henan, China
| | - He-Ping Gu
- Department of Cardiology, Zhengzhou University First Affiliated
Hospital, Zhengzhou, Henan, China
| | - Hai-Long Tao
- Department of Cardiology, Zhengzhou University First Affiliated
Hospital, Zhengzhou, Henan, China,Hai-Long Tao, MD, Department of Cardiology,
the First Affiliated Hospital of Zhengzhou University, Zhengzhou City, Henan
Province 450052, China.
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Li D, Chen Z, He W, Lin L, Xu T, Jiang H, Liu L, Fu G, Chen Z, Zhang W. The association between nutritional risk and contrast-induced acute kidney injury in patients undergoing coronary angiography: a cross-sectional study. Nutr J 2022; 21:56. [PMID: 36114539 PMCID: PMC9479352 DOI: 10.1186/s12937-022-00810-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Nutritional risk is prevalent in various diseases, but its association with contrast-induced acute kidney injury (CI-AKI) remains unclear. This study aimed to explore this association in patients undergoing coronary angiography (CAG).
Methods
In this retrospective cross-sectional study, 4386 patients undergoing CAG were enrolled. Nutritional risks were estimated by nutritional risk screening 2002 (NRS-2002), controlling nutritional status (CONUT), prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI), respectively. CI-AKI was determined by the elevation of serum creatinine (Scr). Multivariable logistic regression analyses and receiver operator characteristic (ROC) analyses were conducted. Subgroup analyses were performed according to age (< 70/≥70 years), gender (male/female), percutaneous coronary intervention (with/without), and estimated glomerular filtration rate (< 60/≥60 ml/min/1.73m2).
Results
Overall, 787 (17.9%) patients were diagnosed with CI-AKI. The median score of NRS-2002, CONUT, PNI, and GNRI was 1.0, 3.0, 45.8, and 98.6, respectively. Nutritional risk was proven to be associated with CI-AKI when four different nutritional tools were employed, including NRS-2002 ([3–7 vs. 0]: odds ratio [95% confidence interval], OR [95%CI] = 4.026 [2.732 to 5.932], P < 0.001), CONUT ([6–12 vs. 0–1]: OR [95%CI] = 2.230 [1.586 to 3.136], P < 0.001), PNI ([< 38 vs. ≥52]: OR [95%CI] = 2.349 [1.529 to 3.610], P < 0.001), and GNRI ([< 90 vs. ≥104]: OR [95%CI] = 1.822 [1.229 to 2.702], P = 0.003). This is consistent when subgroup analyses were performed. Furthermore, nutritional scores were proved to be accurate in predicting CI-AKI (area under ROC curve: NRS-2002, 0.625; CONUT, 0.609; PNI, 0.629; and GNRI, 0.603).
Conclusions
Nutritional risks (high scores of NRS-2002 and CONUT; low scores of PNI and GNRI) were associated with CI-AKI in patients undergoing CAG.
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Wang L, Lai S, Zou H, Zhou X, Wan Q, Luo Y, Wu Q, Wan L, Liu J, Huang H. Ischemic preconditioning/ischemic postconditioning alleviates anoxia/reoxygenation injury via the Notch1/Hes1/VDAC1 axis. J Biochem Mol Toxicol 2022; 36:e23199. [PMID: 35975741 DOI: 10.1002/jbt.23199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 07/06/2022] [Accepted: 08/05/2022] [Indexed: 11/07/2022]
Abstract
Ischemic preconditioning (IPC), and ischemic postconditioning (IPost) have a significant protective effect on myocardial ischemia/reperfusion (MI/R) injury by alleviating oxidative stress and mitochondrial disturbances, although the underlying molecular mechanisms are unclear. The study was to demonstrate that cardioprotection against anoxia/reoxygenation (A/R) injury is transduced via the Notch1/Hes1/VDAC1 signaling pathway. Using mass spectrometry and tandem affinity purification (TAP), to screen for differentially expressed proteins associated with Hes1, followed by standard bioinformatics analysis. The co-immunoprecipitation (Co-IP) assay confirmed an interaction between Hes1 and VDAC1 proteins. H9c2 cells were transfected with Hes1 adenoviral N-terminal TAP vector (AD-NTAP/Hes1) and Hes1-short hairpin RNA adenoviral vector (AD-Hes1-shRNA) to establish A/R injury, IPC, and IPost models, respectively. The expression of Hes1 and VDAC1 proteins were measured by western blot analysis, while the levels of reactive oxygen species (ROS), mitochondrial membrane potential (ΔΨm), and apoptosis were evaluated by flow cytometry. AD-NTAP/Hes1 can activate the exogenous protein expression of Hes1, thus decreasing creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) activity and promoting cell viability. The study found that VDAC1 was a potential target protein for Hes1 and the overexpression of Hes1 protein expression downregulated protein expression levels of VDAC1, reduced ROS production, stabilized ΔΨm, and inhibited apoptosis in H9c2 cells. Additionally, downregulation of Hes1 protein expression also upregulated VDAC1 protein expression, increased ROS production, imbalanced ΔΨm, promoted cell apoptosis, and attenuated the cardioprotection afforded by IPC and IPost. The Notch1/Hes1 signaling pathway activated by IPC/IPost can directly downregulate the protein expression of VDAC1 and consequently relieve A/R injury.
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Affiliation(s)
- Lijun Wang
- Department of Cardiac Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Department of Cardiac Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | | | - Huaxi Zou
- Department of Cardiac Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Department of Cardiac Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xueliang Zhou
- Department of Cardiac Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Qing Wan
- Department of Pharmacy, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yong Luo
- Central Laboratory, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi, China
| | - Qicai Wu
- Department of Cardiac Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Li Wan
- Department of Cardiac Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jichun Liu
- Department of Cardiac Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Department of Cardiac Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huang Huang
- Department of Cardiac Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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He P, Zhang M, Zhao M, Zhang M, Ma B, Lv H, Han Y, Wu D, Zhong Z, Zhao W. A Novel Polysaccharide From Chuanminshen violaceum and Its Protective Effect Against Myocardial Injury. Front Nutr 2022; 9:961182. [PMID: 35911096 PMCID: PMC9330552 DOI: 10.3389/fnut.2022.961182] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 06/22/2022] [Indexed: 12/17/2022] Open
Abstract
We isolated and purified a novel polysaccharide from the root of Chuanminshen violaceum, namely, Chuanminshen violaceumis polysaccharide (CVP) and confirmed its structure and molecular weight. Furthermore, in vivo experiment, CVP’s protective effect against myocardial ischemia-reperfusion (I/R) injury in mice was evidenced by significantly reducing I/R-induced myocardial infarction (MI) size, decreasing the secretion of heart damage biomarkers, and improving cardiac function. Then, the myocardial anoxia/reoxygenation (A/R) injury model was established to mimic reperfusion injury. Noticeably, ferroptosis was the major death manner for A/R-damaged H9c2 cells. Meanwhile, CVP significantly inhibited ferroptosis by decreasing intracellular Fe2+ level, enhancing GPX4 expression, and suppressing lipid peroxidation to confront A/R injury. In conclusion, CVP, with a clear structure, ameliorated I/R injury by inhibiting ferroptosis.
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Affiliation(s)
- Peng He
- School of Basic Medical Sciences, Qingdao University, Qingdao, China
| | - Mi Zhang
- School of Basic Medical Sciences, Qingdao University, Qingdao, China
| | - Meng Zhao
- School of Nursing, Qingdao University, Qingdao, China
| | - Mengyao Zhang
- School of Basic Medical Sciences, Qingdao University, Qingdao, China
| | - Benxu Ma
- The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao, China
| | - Hongyu Lv
- School of Basic Medical Sciences, Qingdao University, Qingdao, China
| | - Yantao Han
- School of Basic Medical Sciences, Qingdao University, Qingdao, China
| | - Dingtao Wu
- Key Laboratory of Coarse Cereal Processing (Ministry of Agriculture and Rural Affairs), Sichuan Engineering & Technology Research Center of Coarse Cereal Industralization, School of Food and Biological Engineering, Chengdu University, Chengdu, China
| | - Zhangfeng Zhong
- Macau Centre for Research and Development in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Zhuhai, Macao SAR, China
- Zhangfeng Zhong,
| | - Wenwen Zhao
- School of Basic Medical Sciences, Qingdao University, Qingdao, China
- Macau Centre for Research and Development in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Zhuhai, Macao SAR, China
- *Correspondence: Wenwen Zhao,
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Cai M, Liu E, Bai P, Zhang N, Wang S, Li W, Lin H, Lin X. The Chasm in Percutaneous Coronary Intervention and In-Hospital Mortality Rates Among Acute Myocardial Infarction Patients in Rural and Urban Hospitals in China: A Mediation Analysis. Int J Public Health 2022; 67:1604846. [PMID: 35872707 PMCID: PMC9302370 DOI: 10.3389/ijph.2022.1604846] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: To determine to what extent the inequality in the ability to provide percutaneous coronary intervention (PCI) translates into outcomes for AMI patients in China.Methods: We identified 82,677 patients who had primary diagnoses of AMI and were hospitalized in Shanxi Province, China, between 2013 and 2017. We applied logistic regressions with inverse probability weighting based on propensity scores and mediation analyses to examine the association of hospital rurality with in-hospital mortality and the potential mediating effects of PCI.Results: In multivariate models where PCI was not adjusted for, rural hospitals were associated with a significantly higher risk of in-hospital mortality (odds ratio [OR]: 1.19, 95% confidence interval [CI]: 1.03–1.37). However, this association was nullified (OR: 0.94, 95% CI: 0.81–1.08) when PCI was included as a covariate. Mediation analyses revealed that PCI significantly mediated 132.3% (95% CI: 104.1–256.6%) of the effect of hospital rurality on in-hospital mortality. The direct effect of hospital rurality on in-hospital mortality was insignificant.Conclusion: The results highlight the need to improve rural hospitals’ infrastructure and address the inequalities of treatments and outcomes in rural and urban hospitals.
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Affiliation(s)
- Miao Cai
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Echu Liu
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, United States
| | - Peng Bai
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Zhang
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorder, Wuhan, China
| | - Siyu Wang
- Center for Genome Sciences and Systems Biology, School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
| | - Wei Li
- Department of Data Science, Zhejiang University of Finance and Economics Dongfang College, Haining, China
| | - Hualiang Lin
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaojun Lin
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
- *Correspondence: Xiaojun Lin,
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Chen C, Ma J, Xu Z, Chen L, Sun B, Shi Y, Miao Y, Wu T, Qin M, Zhang Y, Zhang M, Cao X. Rosmarinic Acid Inhibits Platelet Aggregation and Neointimal Hyperplasia In Vivo and Vascular Smooth Muscle Cell Dedifferentiation, Proliferation, and Migration In Vitro via Activation of the Keap1-Nrf2-ARE Antioxidant System. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:7420-7440. [PMID: 35687823 DOI: 10.1021/acs.jafc.2c01176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The activation of platelets and proliferation of vascular smooth muscle cells (VSMCs) in the vascular intima play an essential role in the pathological mechanism of vascular restenosis (RS). Rosmarinic acid (RA) is a natural phenolic acid compound. However, its mechanism of action on platelets and VSMCs is still unclear. This study investigated the effects of RA on platelet function, VSMCs phenotypic conversion, proliferation, and migration in vascular remodeling with a specific focus on the Keap1-Nrf2-ARE signaling pathway. RA inhibited platelet aggregation and Ca2+ release and significantly reduced the release of platelet microvesicles. In addition, RA inhibited the phenotypic transition of VSMCs in vitro and in vivo. In vitro experiments showed that RA could effectively inhibit the proliferation and migration of VSMCs induced by the platelet-derived growth factor (PDGF)-BB. PDGF-BB triggered ROS generation and a decrease in mitochondrial membrane potential, which were inhibited by RA. Mechanistically, after artery injury or treatment with PDGF-BB, VSMCs presented with inhibition of the Nrf2/antioxidant response element (ARE) signaling pathway. RA treatment reversed this profile by activating the Nrf2/ARE signaling pathway; stabilizing Keap1 protein; upregulating HO-1, NQO1, GCLM, and GST protein levels; promoting typical Nrf2 nuclear translocation; and preventing VSMCs from oxidative stress damage. On the other hand, RA also inhibited the NF-κB pathway to reduce inflammation. In summary, these results indicate that RA inhibits platelet function and attenuates the proliferation, migration, and phenotypic transition of VSMCs induced by PDGF-BB in vitro and vascular remodeling in vivo. Therefore, RA treatment may be a potential therapy for preventing or treating RS.
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Affiliation(s)
- Chen Chen
- Department of Pharmacology, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
| | - Jiulong Ma
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
| | - Zhiping Xu
- Department of Pharmacology, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
| | - Liang Chen
- Department of Pharmacology, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
| | - Bo Sun
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
| | - Yan Shi
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
| | - Yujia Miao
- Department of Pharmacology, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
| | - Tianlong Wu
- Department of Pharmacology, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
| | - Meng Qin
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
| | - Yang Zhang
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
| | - Ming Zhang
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
| | - Xia Cao
- Department of Pharmacology, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun 13002, Jilin, China
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Chen Z, Li D, Lin M, Jiang H, Xu T, Shan Y, Fu G, Wang M, Zhang W. Association of Hemoglobin Glycation Index With Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary Angiography: A Retrospective Study. Front Physiol 2022; 13:870694. [PMID: 35669583 PMCID: PMC9163394 DOI: 10.3389/fphys.2022.870694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The hemoglobin glycation index (HGI) quantifies interindividual variation in glycation and is positively associated with cardiovascular diseases. However, the association between HGI and contrast-induced acute kidney injury (CI-AKI) remains unclear. Therefore, this study aimed to assess the association of HGI with CI-AKI. Methods: In this observational study, a total of 3,142 patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) were included. The HGI was calculated as the difference between the measured glycated hemoglobin (HbA1c) and predicted HbA1c. CI-AKI was defined as an increase of either 25% or 0.5 mg/dl (44.2 μmol/L) in the serum creatinine (SCr) level within 72 h following the exposure to contrast medium. Piecewise linear regression analysis was conducted to testify the association of HGI with the proportion of SCr elevation. Modified Poisson’s regression analysis was performed to determine the association between HGI and CI-AKI. Exploratory analysis was also performed according to the stratification of HbA1c levels. Results: Among 3,142 patients, the average age was 66.9 years and 483 of them (15.4%) suffered CI-AKI. Piecewise linear regression analysis demonstrated the linear association of HGI with the proportion of SCr elevation on both positive and negative sides of HGI [HGI <0: β = −9.537, 95% CI (−12.057 to −7.017), p < 0.001; HGI ≥0: β = 1.655, 95% CI (0.125 to 3.186), p = 0.034]. Modified Poisson’s regression analysis showed that the higher absolute value of HGI was strongly associated with higher incidence of CI-AKI [(<−1.0 vs. −0.2 to 0.2): aRR = 1.897, 95% CI [1.467 to 2.452], p < 0.001 (≥1.0 vs. −0.2 to 0.2): aRR = 1.545, 95% CI (1.171 to 2.037), p = 0.002]. Furthermore, the results in exploratory analysis showed that such association still remained irrespective of HbA1c levels. Conclusion: The higher absolute value of HGI was strongly associated with higher incidence of CI-AKI in patients undergoing CAG and PCI.
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Affiliation(s)
- Zhezhe Chen
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Duanbin Li
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Maoning Lin
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Hangpan Jiang
- Department of Cardiology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, China
| | - Tian Xu
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Yu Shan
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Guosheng Fu
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
| | - Min Wang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
- *Correspondence: Min Wang, ; Wenbin Zhang,
| | - Wenbin Zhang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China
- *Correspondence: Min Wang, ; Wenbin Zhang,
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Li J, Liu B, Wang Z, El-Ansary D, Adams R, Han J, Meng S. Efficacy of a 6-Week Home-Based Online Supervised Exercise Program Conducted During COVID-19 in Patients With Post Percutaneous Coronary Intervention: A Single-Blind Randomized Controlled Trial. Front Cardiovasc Med 2022; 9:853376. [PMID: 35463794 PMCID: PMC9021490 DOI: 10.3389/fcvm.2022.853376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/07/2022] [Indexed: 01/02/2023] Open
Abstract
Objective The aim of this study was to assess the efficacy of a 6-week cardiac rehabilitation (CR) program designed for patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI) that involved an online supervised exercise program that they could access during COVID-19. Methods One hundred patients were randomly allocated into control group (CG) and supervision group (SG). CG accepted conventional health education with a home exercise program booklet delivered before discharge, SG had an additional home-based online supervised exercise program (HOSEP). Questionnaires, motor function and lipid profile were administered at baseline. Questionnaires included the Godin-Shephard Leisure-Time Physical Activity questionnaire (GSLTPAQ) and Bandura's Exercise Self-efficacy (ESE). Motor function included: 6-min walk test (6 MWT), timed up and go test (TUG), 30-s sit to stand (30-s STS), and Hand Grip Strength (HG). Lipid profile included: low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC) and triglycerides (TG). The questionnaires were re-administered after 2-weeks, all tests were re-evaluated after 6-weeks. Results the questionnaire results showed that scores on GSLTPAQ and ESE were significantly improved in the SG. The changes in GSLTPAQ scores from baseline to 2- and 6-weeks in the SG were significantly higher than in the CG (2-week: 6.9 ± 13.0 for SG and 0.2 ± 10.2 for CG, p = 0.005; 6-week: 9.4 ± 18.1 for SG and 0.2 ± 11.8 for CG, p = 0.003). in terms of motor function, both the CG and SG improved TUG and 6 MWT performance, with the 6 MWT improvement being significantly greater in the SG than CG (43.7 ± 39.2 m for SG and 16.6 ± 39.1 m for CG, p = 0.001). Improvement in the 30-s STS was significantly greater in the SG than CG (2.4 ± 3.6 repetitions for SG and 0.4 ± 3.5 repetitions for CG, p = 0.007). the lipid profile level significantly improved over baseline in both SG and CG after 6-week intervention, and these changes were not statistically different between groups. Conclusion This pilot randomized control study demonstrated that a 6-week HOSEP, when added to education delivered pre-hospital discharge for CAD patients following PCI, was beneficial with respect to exercise self-efficacy, exercise behavior, motor function and lipid profile. Supervised exercise programs delivered online in addition to education providing effective and accessible CR during COVID-19.
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Affiliation(s)
- Jiajia Li
- Department of Sport Rehabilitation, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Bo Liu
- Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zheng Wang
- Department of Sport Rehabilitation, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Doa El-Ansary
- Department of Sport Rehabilitation, School of Kinesiology, Shanghai University of Sport, Shanghai, China
- Department of Health Professions, Faculty of Art, Health and Design, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
- *Correspondence: Jia Han
| | - Shu Meng
- Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shu Meng
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Salehin S, Hasan SM, Hossain MD, Gilani S, Khalife W. Short term dual antiplatelet therapy after percutaneous coronary intervention with drug eluting stents: A comprehensive review of literature. Curr Probl Cardiol 2022:101234. [DOI: 10.1016/j.cpcardiol.2022.101234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 04/24/2022] [Indexed: 11/17/2022]
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Shi F, Zhang Y, Sun LX, Long S. Life-threatening subclavian artery bleeding following percutaneous coronary intervention with stent implantation: A case report and review of literature. World J Clin Cases 2022; 10:1937-1945. [PMID: 35317135 PMCID: PMC8891778 DOI: 10.12998/wjcc.v10.i6.1937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/26/2021] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Vascular complications of transradial percutaneous coronary intervention (PCI) are rare and usually occur at the access site below the elbow. Life-threatening vascular complications during transradial PCI therapy, such as vessel perforation and dissection in the brachiocephalic, subclavian, internal mammary, and thyrocervical arteries, are rarely reported. Subclavian artery bleeding is a potentially serious complication of vascular interventional procedures leading to tracheal obstruction, hemothorax, respiratory failure, hemorrhagic shock, and death if not diagnosed early and treated promptly.
CASE SUMMARY A male patient with typical angina pectoris underwent coronary angiography and stent implantation. During the procedure, the patient felt pharyngeal pain and tightness, which we mistook for myocardial ischemia. After PCI, swelling in the right neck and supraclavicular area was observed. The patient experienced dyspnea, emergency endotracheal intubation was performed, and then a sudden drop in blood pressure was observed. Ultrasound and contrast-enhanced computed tomography scans demonstrated a cervical hematoma severely compressing the trachea due to subclavian artery bleeding. Brachiocephalic angiography revealed a vascular injury site at the root of the right subclavian artery at the intersection of the right common carotid artery. A covered stent was deployed to the right subclavian artery with successful sealing of the perforation, and a bare stent was implanted in the junction of the right common carotid and brachiocephalic arteries to prevent obstruction of blood flow to the brain.
CONCLUSION Subclavian artery bleeding is a lifethreatening complication of PCI. Early prevention, rapid recognition, and prompt treatment may improve the prognosis.
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Affiliation(s)
- Fei Shi
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China
| | - Ying Zhang
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China
| | - Li-Xian Sun
- Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China
| | - Sen Long
- Traditional Chinese Medicine, The Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China
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Lv L, Yuan X, Jiang L. Effects of compound Danshen dropping pills on adverse cardiovascular events and quality of life after percutaneous coronary intervention in patients with coronary heart disease: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28994. [PMID: 35212312 PMCID: PMC8878783 DOI: 10.1097/md.0000000000028994] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) is an important means for the treatment of coronary atherosclerotic heart disease and has effectively reduced the mortality of coronary heart disease. However, reperfusion can also cause certain damage to the vascular endothelium, leading to the major adverse cardiovascular events. Compound Danshen dropping pill is a Chinese patent medicine preparation. At present, many studies have evaluated the effect of compound Danshen dropping pill in reducing the incidence of adverse cardiovascular events after PCI. This study systematically evaluated the effect of compound Danshen dropping pills on major adverse cardiovascular events and quality of life after PCI and provides a reference for clinical application and research. METHODS All randomized controlled trials on the effects of compound Danshen dropping pills on adverse cardiovascular events and quality of life after PCI for coronary heart disease were searched for. The search was conducted from database inception to January 2022. Data extraction and quality assessment were performed by 2 reviewers according to the Protocol Guidelines for Systematic Reviews and Meta-analyses Protocols statement guidelines. Meta-analysis was performed using Review Manager Version 5.4 software and Stata 16 software. RESULTS The results of this study will allow for systematically evaluation of the effects of compound Danshen dropping pills on adverse cardiovascular events and quality of life after PCI for coronary heart disease. CONCLUSION This study will provide objective evidence of a basis for compound Danshen dropping pills reducing adverse cardiovascular events and improving quality of life after PCI.
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Affiliation(s)
- Lina Lv
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Xianying Yuan
- Department of First Clinical Nursing, School of Nursing, Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Lihong Jiang
- Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
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Zhang R, Tao Z, Gong J, Ji Z, Yang M, Ma G, Li Y. Albumin to Globulin Ratio was associated with in-stent restenosis and revascularization events after percutaneous coronary intervention. Clin Transl Sci 2022; 15:1187-1195. [PMID: 35195938 PMCID: PMC9099125 DOI: 10.1111/cts.13236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 01/09/2023] Open
Abstract
In-stent restenosis is a common complication after percutaneous coronary intervention (PCI) for coronary heart disease requiring revascularization. We performed a retrospective analysis to assess the value of inflammatory biomarker Albumin to Globulin Ratio (AGR) in clinical prognosis of percutaneous coronary intervention (PCI). In total, 992 coronary heart disease (CHD) patients who underwent the first drug-eluting stent implantation and reexamination angiography in our hospital were enrolled in this study. Albumin to Globulin Ratio was measured. At mean follow-up of 11.2 ± 4 months, the in-stent restenosis (ISR) and revascularization events (including target lesion revascularization, target vessel revascularization, and revascularization of de novo lesions) occurred in 127 and 284 patients respectively. Compared with the non-ISR or non-event group, AGR was significantly lower in the ISR group and events group. Beyond that, albumin was significantly lower, while urea nitrogen, glucose and gensini score, as well as the proportions of a history of diabetes and peripheral vascular diseases, were significantly higher in the ISR group and events group. Age, heart rate, white blood cell, neutrophils, lymphocyte, monocyte and incidence of ischemic stroke were significantly higher in the events group. Multivariate cox regression analysis showed that AGR was independently associated with ISR (P = 0.032) and events (P = 0.024). Besides, Kaplan-Meier analysis indicated that the higher quartile of AGR had a lower rate of ISR (P = 0.038) and events (p ≤ 0.001). Finally, the receiver operating characteristic (ROC) curve for AGR in diagnosing ISR and events indicated that the area under the curve (AUC) were 0.56 and 0.57 respectively. Therefore, AGR is one of the most important factors that independently associate with the ISR and revascularization events after PCI.
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Affiliation(s)
- Rui Zhang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zaixiao Tao
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jing Gong
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhenjun Ji
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Mingming Yang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Genshan Ma
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yongjun Li
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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Abstract
IMPORTANCE Acute coronary syndromes (ACS) are characterized by a sudden reduction in blood supply to the heart and include ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), and unstable angina. Each year, an estimated more than 7 million people in the world are diagnosed with ACS, including more than 1 million patients hospitalized in the US. OBSERVATIONS Chest discomfort at rest is the most common presenting symptom of ACS and affects approximately 79% of men and 74% of women presenting with ACS, although approximately 40% of men and 48% of women present with nonspecific symptoms, such as dyspnea, either in isolation or, more commonly, in combination with chest pain. For patients presenting with possible ACS, electrocardiography should be performed immediately (within 10 minutes of presentation) and can distinguish between STEMI and non-ST-segment elevation ACS (NSTE-ACS). STEMI is caused by complete coronary artery occlusion and accounts for approximately 30% of ACS. ACS without significant ST-segment elevation on electrocardiography, termed NSTE-ACS, account for approximately 70% of ACS, are caused by partial or intermittent occlusion of the artery and are associated with ST-segment depressions (approximately 31%), T-wave inversions (approximately 12%), ST-segment depressions combined with T-wave inversions (16%), or neither (approximately 41%). When electrocardiography suggests STEMI, rapid reperfusion with primary percutaneous coronary intervention (PCI) within 120 minutes reduces mortality from 9% to 7%. If PCI within 120 minutes is not possible, fibrinolytic therapy with alteplase, reteplase, or tenecteplase at full dose should be administered for patients younger than 75 years without contraindications and at half dose for patients 75 years or older (or streptokinase at full dose if cost is a consideration), followed by transfer to a facility with the goal of PCI within the next 24 hours. High-sensitivity troponin measurements are the preferred test to evaluate for NSTEMI. In high-risk patients with NSTE-ACS and no contraindications, prompt invasive coronary angiography and percutaneous or surgical revascularization within 24 to 48 hours are associated with a reduction in death from 6.5% to 4.9%. CONCLUSIONS AND RELEVANCE Each year, an estimated more than 7 million people are diagnosed with ACS worldwide. For patients with STEMI, coronary catheterization and PCI within 2 hours of presentation reduces mortality, with fibrinolytic therapy reserved for patients without access to immediate PCI. For high-risk patients with NSTE-ACS without contraindications, prompt invasive coronary angiography followed by percutaneous or surgical revascularization is associated with lower rates of death.
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Affiliation(s)
- Deepak L Bhatt
- Brigham and Women's Hospital Heart and Vascular Institute, Harvard Medical School, Boston, Massachusetts
| | - Renato D Lopes
- Division of Cardiology, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
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Li G, Tian Y, Zhang Q, Jin Z, Song Y. The Predictive Effect of Negative Psychological Emotions of Anxiety and Depression on the Poor Prognosis of CHD Patients with Stent Implantation and the Improvement of Clinical Intervention Measures. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2534277. [PMID: 35136415 PMCID: PMC8818400 DOI: 10.1155/2022/2534277] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/05/2022] [Accepted: 01/08/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To explore the predictive effect of negative emotions such as anxiety and depression on the poor prognosis of coronary heart disease (CHD) patients with stent implantation and to seek the improvement of clinical intervention measures. METHODS A total of 303 patients with CHD and PCI were recruited from February 2019 to April 2021. The risk factors of CHD such as anxiety and depression, age, sex, smoking and drinking, BMI, hypertension, diabetes, dyslipidemia, and family history of CHD were collected. Meanwhile, clinical data such as laboratory examination, angiography, diseased vessels, and stent types were collected. The patients were followed up for 1 year, and the medical records, hospitalization records, or death records were checked by telephone interview once a month. Major adverse cardiovascular events (MACE) such as emergency and causes, readmission times and causes, new nonfatal myocardial infarction, stent restenosis, heart failure, arrhythmia, and death were recorded. The incidence of anxiety and depression in patients after PCI was counted, and Cox regression was applied to analyze the influence and prediction of anxiety and depression on MACE in patients with CHD stent implantation and improve clinical intervention measures. RESULTS Compared with those without MACE, anxiety (56.25% vs 30.63%), depression (62.5% vs 22.88%, P < 0.01), anxiety combined with depression (46.88% vs 15.50%, P < 0.01), and hypertension history (71.8% vs 39.11%, P < 0.01) were more common in patients with MACE. Uncorrected Cox proportional hazard regression found that people with anxiety had a higher risk of developing MACE than those without anxiety (HR 3.181, P < 0.01). Multiple Cox proportional hazard regression analysis of anxiety showed that anxiety was an independent predictor of cumulative MACE (P < 0.01). The risk of developing MACE in patients with anxiety was 3.742 times higher than that in patients without anxiety (P < 0.01). Uncorrected Cox hazard regression analysis showed that people with depression had a higher risk of developing MACE than those without depression (HR 5.434, P < 0.01). Furthermore, the results also uncovered that depression was an independent predictor of cumulative MACE (P < 0.01). The risk of MACE in patients with depression was 3.087 times higher than that in patients without depression (P < 0.01). Cox hazard regression showed that the risk of MACE in patients with anxiety and depression was significantly higher than that in patients without anxiety and depression (HR 4.642, P < 0.01). After screening, it was found that anxiety with depression could predict the occurrence of MACE (P < 0.01). The risk of MACE in patients with anxiety and depression was 3.702 times higher than that in patients without anxiety and depression (P < 0.01). Cox regression analysis showed that the risk of MACE with only anxiety and depression was 2.793 times higher than that without anxiety and depression (95% CI 0.914 8.526), with no statistical significance (P > 0.05), and the risk of MACE with depression without anxiety was significantly higher than that without anxiety and depression (P < 0.01). The risk of MACE in patients with anxiety and depression was 7.303 times higher than that in patients without anxiety and depression (P < 0.01). CONCLUSION Negative emotions such as anxiety and depression can increase the risk of poor prognosis of patients with CHD. Therefore, in clinical work, in addition to routine treatment and nursing during hospitalization, it is recommended to screen patients with depression in CHD patients. Medical staff should use simple and effective assessment tools in time and take active measures to improve the depression of patients. This trial is registered with ChiCTR2200055645.
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Affiliation(s)
- Guoxing Li
- Weifang Medical University, Weifang, Shandong 261053, China
| | - Yuhuan Tian
- Weifang Medical University, Weifang, Shandong 261053, China
| | - Qiumin Zhang
- Weifang Medical University, Weifang, Shandong 261053, China
| | - Zhaofeng Jin
- Weifang Medical University, Weifang, Shandong 261053, China
| | - Yuping Song
- Weifang Medical University, Weifang, Shandong 261053, China
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Zhang P, Fu H, Liu J, Liu X, Yang S, Guo Z, Fu N. Preoperative Fasting Blood Glucose Levels and the Risk of Contrast-Induced Nephropathy in Patients With Diabetes and Pre-diabetes Undergoing Coronary Arteriography or Percutaneous Coronary Intervention: A Cross-Sectional Study. Angiology 2022; 73:660-667. [PMID: 35084237 DOI: 10.1177/00033197211061916] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Diabetes mellitus is an independent risk factor for contrast-induced nephropathy (CIN) in patients undergoing coronary arteriography/percutaneous coronary intervention (CAG/PCI). We evaluated whether preoperative fasting blood glucose (FBG) levels in diabetic and pre-diabetic patients who underwent CAG/PCI influenced the occurrence of CIN. From June 1, 2020, to February 28, 2021, 687 patients were divided into five groups based on their preoperative FBG levels. Blood samples were collected at admission and at 48 hours and 72 hours after the procedure to determine serum creatinine levels. The P value for trend was used to analyze the trend between preoperative FBG levels and the increased risk of CIN. Univariable and multivariable logistic regression analysis were used to exclude the influence of confounding factors, and some high-risk confounders were selected for subgroup analysis. The results of our cross-sectional study show that elevated preoperative FBG levels are independently associated with the risk of CIN in diabetic and pre-diabetic patients undergoing CAG/PCI. Furthermore, the incidence of CIN gradually increases with the rise in preoperative FBG levels. Patients with elevated preoperative FBG at admission should be carefully monitored and more active measures should be taken to prevent CIN.
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Affiliation(s)
- Peng Zhang
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China.,Clinical College of Chest, 12610Tianjin Medical University, Tianjin, China.,12610Graduate School of Tianjin Medical University, Tianjin, China
| | - Han Fu
- 12610Graduate School of Tianjin Medical University, Tianjin, China
| | - Jie Liu
- 12610Graduate School of Tianjin Medical University, Tianjin, China
| | - Xiaogang Liu
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China.,Clinical College of Chest, 12610Tianjin Medical University, Tianjin, China.,12610Graduate School of Tianjin Medical University, Tianjin, China
| | - Shicheng Yang
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China.,Clinical College of Chest, 12610Tianjin Medical University, Tianjin, China.,12610Graduate School of Tianjin Medical University, Tianjin, China
| | - Zhigang Guo
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China.,Clinical College of Chest, 12610Tianjin Medical University, Tianjin, China.,12610Graduate School of Tianjin Medical University, Tianjin, China
| | - Naikuan Fu
- Department of Cardiology, 499773Tianjin Chest Hospital, Tianjin, China.,Clinical College of Chest, 12610Tianjin Medical University, Tianjin, China.,12610Graduate School of Tianjin Medical University, Tianjin, China
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Li M, Hou J, Gu X, Weng R, Zhong Z, Liu S. Incidence and risk factors of in-stent restenosis after percutaneous coronary intervention in patients from southern China. Eur J Med Res 2022; 27:12. [PMID: 35065663 PMCID: PMC8783476 DOI: 10.1186/s40001-022-00640-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/11/2022] [Indexed: 12/29/2022] Open
Abstract
Background In-stent restenosis (ISR) remains a challenge for coronary artery disease (CAD) patients who undergo percutaneous coronary intervention (PCI) with stents, and risk factors for ISR are controversial. This study aimed to investigate the incidence and risk factors of ISR in patients from southern China. Methods In this retrospective study, patients diagnosed as acute coronary syndromes (ACS) and underwent successful PCI with drug-eluting stent (DES) and conducted a follow-up coronary angiography in Center for Cardiovascular Diseases of Meizhou People’s Hospital at the period of January 1st, 2016 to January 1st, 2021 were included for analysis. The clinical and angiographic factors were compared between patients in ISR ( +) and ISR (−) groups. The association between variables and ISR was evaluated by multivariate logistic regression model. Result A total of 341 ACS patients who had been installed at least 1 stent were included in this study. The follow-up time was 34.2 ± 17.2 months. During the follow-up period, 62 (18.2%) patients experienced ISR, and the average time for ISR was 32.8 months; the incidence of ISR for left main coronary artery, left anterior descending coronary artery, left circumflex artery coronary artery and right coronary artery were 6.7%, 20.9%, 19.4% and 14.4%, respectively; left ventricular ejection fraction (LVEF), stent number, stent type, statin therapy, antiplatelet therapy were significantly different between patients in ISR ( +) and ISR (−) group. Multivariate logistic analysis suggested that LVEF and stent number were significantly correlated with ISR. Conclusion Our study revealed the incidence and risk factors of ISR in patients from southern China. Our data suggested that LVEF and stent number were independent risk factors associated with ISR.
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Qin X, Qin H, Li Z, Xue S, Huang B, Liu X, Wang D. Luteolin alleviates ischemia/reperfusion injury-induced no-reflow by regulating Wnt/β-catenin signaling in rats. Microvasc Res 2022; 139:104266. [PMID: 34688627 DOI: 10.1016/j.mvr.2021.104266] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 12/21/2022]
Abstract
The no-reflow phenomenon induced by ischemia-reperfusion (I/R) injury seriously limits the therapeutic value of coronary recanalization and leads to a poor prognosis. Previous studies have shown that luteolin (LUT) is a vasoprotective factor. However, whether LUT can be used to prevent the no-reflow phenomenon remains unknown. Positron emission tomography perfusion imaging, performed to detect the effects of LUT on the no-reflow phenomenon in vivo, revealed that LUT treatment was able to reduce the no-reflow area in rat I/R models. In vitro, LUT was shown to reduce the hypoxia-reoxygenation injury-induced endothelial permeability and apoptosis. The levels of malondialdehyde, reactive oxygen species and NADPH were also measured and the results indicated that LUT could inhibit the oxidative stress. Western blot analysis revealed that LUT protected endothelial cells from I/R injury by regulating the Wnt/β-catenin pathway. Overall, we concluded that the use of LUT to minimize I/R induced microvascular damage is a feasible strategy to prevent the no-reflow phenomenon.
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Affiliation(s)
- Xichun Qin
- Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China; Department of Thoracic Surgery, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Hao Qin
- Department of Thoracic Surgery, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Zhimin Li
- Xuzhou Central Hospital, 99 West Huaihai Road, Xuzhou 221006, Jiangsu, China
| | - Song Xue
- Department of Cardiology, Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou 221002, China
| | - Bing Huang
- Department of Cardiology, Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou 221002, China
| | - Xiucheng Liu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Dongjin Wang
- Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China; Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China.
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Zhang P. A Novel Robotic Control System Mimics Doctor’s Operation to Assist Percutaneous Coronary Intervention. CARDIOVASCULAR INNOVATIONS AND APPLICATIONS 2022. [DOI: 10.15212/cvia.2022.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives: The use of current robotic systems to assist in percutaneous coronary intervention (PCI) fundamentallydiffers from performing conventional PCI. To overcome this problem, we developed a novel master-slave roboticcontrol system to assist in PCI, and evaluated its safety and feasibility in the delivery and manipulation of coronaryguidewires in vitro and in vivo.Methods: The novel robotic assist PCI system is composed of three parts: 1) a master actuator, which imitates thetraditional torque used by surgeons in conventional PCI, 2) a slave actuator, including a guidewire delivery system andforce monitoring equipment, and 3) a local area network based communication system.Results: The experiment was performed in six pigs. Both robotic and manual control completed the operation with no device- or procedure-associated complications. An experienced interventional cardiologist who was a first-time userof the novel robotic PCI system was able to advance the guidewire into a distal branch of a coronary artery within asimilar time to that required with the manual procedure.Conclusion: This early in vivo experiment with the novel robotic assisted PCI control system demonstrated that its feasibility, safety, and procedural effectiveness are comparable to those of manual operation. The novel robotic-assisted PCI control system required significantly less time to learn than other currently available systems.
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Khaled S, Shalaby G. Myocardial recovery after percutaneous coronary intervention in coronary artery disease patients with impaired systolic function- predictive utility of global longitudinal strain. Indian Heart J 2022; 74:488-493. [PMID: 36372350 PMCID: PMC9773278 DOI: 10.1016/j.ihj.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/19/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Coronary revascularization is associated with better outcomes in coronary artery disease patients. We aim to investigate the prevalence, and factors associated with left ventricular (LV) improvement following successful percutaneous coronary intervention (PCI) of patients with impaired systolic function with specific reference to the value of baseline GLS. METHODS This retrospective study reviewed the records of coronary artery disease patients with impaired systolic function who were admitted and treated with PCI. RESULT Out of 420 consecutive acute coronary syndrome patients with an impaired systolic function who were admitted and treated with PCI during the period from January 2021 to December 2021, 147 patients (35%) showed no improvement in the Left ventricular ejection fraction (LVEF) post PCI and 273 patients (65%) showed improvement of the LVEF post PCI in their follow up echocardiogram. Larger myocardial injury dilated LV dimension at the acute phase showed a strong impact on further improving LV systolic function. Baseline GLS showed a higher statistical difference between the Non-improving LVEF and improving LVEF groups. Moreover, the early GLS and further LV systolic function improvement were strongly correlated (P < 0.001) with higher sensitivity and specificity. A receiver operating characteristic curve (ROC) analysis demonstrated that GLS values greater than 9% are a predictor of significant LVEF improvement in the follow-up stage. CONCLUSION Sizable proportion of patients with impaired systolic function following successful PCI show further LV systolic recovery. We demonstrated that the baseline GLS values of more than 9% are an accurate predictor of significant LVEF improvement.
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Affiliation(s)
- Sheeren Khaled
- Banha University, Egypt,King Abdullah Medical City, Muzdallfa Road, Makkah, Saudi Arabia,Corresponding author. King Abdullah Medical City, Muzdallfa Road, Makkah, Saudi Arabia.
| | - Ghada Shalaby
- King Abdullah Medical City, Muzdallfa Road, Makkah, Saudi Arabia,Zagazig University, Egypt
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Gan L, Sun D, Cheng Y, Wang D, Wang F, Wang L, Li W, Shen D, Guo D, Zhang Z, Wang H, Li J, Yang Y, Liang T. Post-operative blood pressure and 3-year major adverse cardiac events in Chinese patients undergoing PCI. BMC Cardiovasc Disord 2021; 21:623. [PMID: 34969370 PMCID: PMC8717657 DOI: 10.1186/s12872-021-02435-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is no clear evidence for the target value of blood pressure control after Percutaneous coronary intervention (PCI). Therefore, our study was designed to explore the relationship between blood pressure after PCI and major adverse cardiac events (MACE) during 3-year follow-up. METHODS This study is a prospective study. We included the patients who were diagnosed with acute coronary syndrome and underwent PCI stent implantation operation. The study initially collected information of 552 patients. The start and end times of the study are from January 1, 2017 to December 31, 2020. The independent variables of this study are the average systolic blood pressure and the average diastolic blood pressure after PCI. The dependent variable is the occurrence of MACE events in patients within 3 years after PCI. MACE is defined as acute myocardial infarction, recurring chest pain, heart failure, stroke, revascularization and cardiac death. RESULTS A total of 514 subjects met the inclusion criteria. The average age of the study subjects is 61.92 ± 9.49 years old, of which 67.12% are male. 94 subjects had a MACE event within 3 years, and the occurrence rate was 18.29%. There is no significant non-linear or linear relationship between diastolic blood pressure and MACE events. There is a curvilinear relationship between the average systolic blood pressure of patients after PCI and MACE events within 3 years and the inflection point is 121. On the left side of the inflection point, the effect size and 95% CI are 1.09 and 1.01-1.18, respectively (P = 0.029). The impact size and 95% CI at the right inflection point were 1.00 and 0.98-1.02(P = 0.604), respectively. CONCLUSION There is a curvilinear relationship between systolic blood pressure and prognosis of patients after PCI. Under the premise of ensuring the safety of patients, maintaining lower blood pressure after surgery is beneficial to improve the prognosis of patients.
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Affiliation(s)
- Lijun Gan
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Dandan Sun
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Yuntao Cheng
- Cardiac Emergency Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Deyang Wang
- Cardiac Emergency Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Fen Wang
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Lin Wang
- Catheterization Room, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Wei Li
- Department of Nursing, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Dandan Shen
- Cardiac Emergency Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Daotong Guo
- Cardiac Emergency Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Zonglei Zhang
- Cardiac Emergency Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Haiyan Wang
- Cardiac Emergency Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Jinli Li
- Cardiac Emergency Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Yong Yang
- Cardiac Emergency Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Tao Liang
- School of Nursing, Peking Union Medical College, Beijing, China.
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