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Cao Q, Li H, Pan X, Wang Y, Zhang P, He L, Wang J, Huang M, Xu F. A Systematic Review and Meta-Analysis of the Predictive Power of China-PAR Against Cardiovascular Disease. Clin Med Res 2024; 22:28-36. [PMID: 38609143 DOI: 10.3121/cmr.2024.1846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 04/14/2024]
Abstract
Background and Purpose: To evaluate the predictive power of the China-PAR model for cardiovascular disease (CVD).Methods: Dominate databases, including PubMed, Web of Science, CNKI, Wanfang Data Knowledge Service Platform, Chinese Biomedical Literature Service System, and VIP self-built database, were searched from January 1, 2016 to February 22, 2022. The primary outcome included observed events and predicted events by China-PAR. Meta-analysis was performed using RevMan 5.3 software. Stroke, arteriosclerotic cardiovascular disease (ASCVD), male, and female were divided into subgroup analyses. Funnel plots were used to assess publication bias.Results: A total of nine studies, which included 221,918 participants, were analyzed. Meta-analysis showed the combined observed incidence of CVD was 3.97%, and the combined predicted incidence was 9.59% by China-PAR. There was no significant difference between the observed and the predicted events. Subgroup analysis showed there was no statistical significance between the observed and the predicted events for stroke or for ASCVD. The difference between the observed and the predicted events by China-PAR was not statistically significant in either males or females.Conclusions: China-PAR model has important public health significance to further improve the primary prevention strategy of CVD.
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Affiliation(s)
- Qiongfang Cao
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China
| | - Huan Li
- Department of Pharmacy, Chengdu Medical College, Sichuan, 610500, China
| | - Xinyu Pan
- Department of Pharmacy, Chengdu Medical College, Sichuan, 610500, China
| | - Yuhan Wang
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China
| | - Peng Zhang
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China
| | - Lanying He
- Department of Neurology, Chengdu Second People's Hospital, Sichuan, 610041, China
| | - Jian Wang
- Department of Neurology, Chengdu Second People's Hospital, Sichuan, 610041, China
| | - Min Huang
- Department of Physiology, Chengdu Medical College, Chengdu, Sichuan, 610500, China; Tel: +86 28 6273 9793;
| | - Fan Xu
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China,
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Lai X, Cui Z, Zhang H, Zhang YM, Wang F, Wang X, Meng LQ, Cheng XY, Liu G, Zhao MH. Long-term visit-to-visit variability in low-density lipoprotein cholesterol is associated with poor cardiovascular and kidney outcomes in patients with primary nephrotic syndrome. Int Urol Nephrol 2023; 55:1565-1574. [PMID: 36648742 DOI: 10.1007/s11255-023-03467-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023]
Abstract
PURPOSE It is unclear whether long-term variability in low-density lipoprotein cholesterol (LDL-C) is associated with clinical outcomes in patients with nephrotic syndrome (NS). METHODS A large cohort of 1100 patients with primary NS underwent treatment and regular follow-up. Long-term variability in LDL-C was assessed by calculating its weighted standard deviation (w-SD). The primary endpoints of this study were the occurrence of arteriosclerotic cardiovascular disease (ASCVD) or kidney dysfunction. Factors associated with the w-SD of LDL-C were evaluated by linear regression. Associations of the w-SD of LDL-C with clinical outcomes were evaluated by Cox proportional hazards regression. RESULTS Over a median follow-up of 44.8 (interquartile range, 26.8, 70.1) months, 198 patients developed ASCVD (45.9 cases per 1,000 patient-years), and 84 patients developed kidney dysfunction (17.6 cases per 1,000 patient-years). The incidence rates of the primary outcomes increased across the quartiles of the w-SD of LDL-C (log-rank, P < 0.001). Multivariate Cox regression analysis showed that higher LDL-C variability was associated with an increased risk of ASCVD [hazard ratio (HR), 2.236; 95% confidence interval (CI), 1.684-2.969, P < 0.001] and an increased risk of kidney dysfunction (HR, 3.047; 95% CI 2.240-4.144, P < 0.001). The results were similar after adjusting the w-SD of LDL-C by its related parameters (baseline and mean LDL-C as well as mean total cholesterol), although the mean LDL-C was also an independent risk factor for ASCVD and kidney dysfunction. CONCLUSION Long-term variability in LDL-C was independently associated with the risk of ASCVD and kidney dysfunction in NS patients.
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Affiliation(s)
- Xuan Lai
- Renal Division, Institute of Nephrology, Key Laboratory of Renal Disease, Key Laboratory of CKD Prevention and Treatment, Peking University First Hospital, Peking University, Ministry of Health of China, Ministry of Education of China, Beijing, China.,Geriatrics Department, Peking University Third Hospital, Beijing, China
| | - Zhao Cui
- Renal Division, Institute of Nephrology, Key Laboratory of Renal Disease, Key Laboratory of CKD Prevention and Treatment, Peking University First Hospital, Peking University, Ministry of Health of China, Ministry of Education of China, Beijing, China.
| | - Hua Zhang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Yi-Miao Zhang
- Renal Division, Institute of Nephrology, Key Laboratory of Renal Disease, Key Laboratory of CKD Prevention and Treatment, Peking University First Hospital, Peking University, Ministry of Health of China, Ministry of Education of China, Beijing, China
| | - Fang Wang
- Renal Division, Institute of Nephrology, Key Laboratory of Renal Disease, Key Laboratory of CKD Prevention and Treatment, Peking University First Hospital, Peking University, Ministry of Health of China, Ministry of Education of China, Beijing, China
| | - Xin Wang
- Renal Division, Institute of Nephrology, Key Laboratory of Renal Disease, Key Laboratory of CKD Prevention and Treatment, Peking University First Hospital, Peking University, Ministry of Health of China, Ministry of Education of China, Beijing, China
| | - Li-Qiang Meng
- Renal Division, Institute of Nephrology, Key Laboratory of Renal Disease, Key Laboratory of CKD Prevention and Treatment, Peking University First Hospital, Peking University, Ministry of Health of China, Ministry of Education of China, Beijing, China
| | - Xu-Yang Cheng
- Renal Division, Institute of Nephrology, Key Laboratory of Renal Disease, Key Laboratory of CKD Prevention and Treatment, Peking University First Hospital, Peking University, Ministry of Health of China, Ministry of Education of China, Beijing, China
| | - Gang Liu
- Renal Division, Institute of Nephrology, Key Laboratory of Renal Disease, Key Laboratory of CKD Prevention and Treatment, Peking University First Hospital, Peking University, Ministry of Health of China, Ministry of Education of China, Beijing, China
| | - Ming-Hui Zhao
- Renal Division, Institute of Nephrology, Key Laboratory of Renal Disease, Key Laboratory of CKD Prevention and Treatment, Peking University First Hospital, Peking University, Ministry of Health of China, Ministry of Education of China, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China
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Schultes B, Ernst B, Schmid SM. Treating hypercholesterinemia in a patient with maternally inherited diabetes and deafness (MIDD) by the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab. Acta Diabetol 2021; 58:1575-1577. [PMID: 34370095 DOI: 10.1007/s00592-021-01776-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Bernd Schultes
- Metabolic Center St. Gallen, friendlyDocs Ltd, Lerchentalstreet 21, CH-9016, St. Gallen, Switzerland.
- Institute for Endocrinology and Diabetes, University of Lübeck, Lübeck, Germany.
| | - Barbara Ernst
- Metabolic Center St. Gallen, friendlyDocs Ltd, Lerchentalstreet 21, CH-9016, St. Gallen, Switzerland
| | - Sebastian M Schmid
- Institute for Endocrinology and Diabetes, University of Lübeck, Lübeck, Germany
- German Center for Diabetes Research, Neuherberg, Germany
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Chen PY, Liu YH, Duan CY, Fan HL, Zeng LH, Guo W, Jiang L, Wei XB, He WF, Tao S, Guo ZQ, Chen JY, Tan N, He PC. Association of in-hospital intensive statins dosage and death in arteriosclerotic cardiovascular disease with percutaneous coronary intervention: insights of multicentre cohort from China. Eur J Clin Pharmacol 2020; 76:1755-1763. [PMID: 32700000 DOI: 10.1007/s00228-020-02966-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/16/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE In-hospital statin dosage-related effect remains unknown for patients with arteriosclerotic cardiovascular disease (ASCVD). This study aimed to determine the associations of different in-hospital intensive statins dosages with the prognosis for patients in the era of percutaneous coronary intervention (PCI). METHODS From January 2010 to December 2014, consecutive ASCVD patients receiving PCI were enrolled from five centres in China. All the enrolled patients were classified into high-dose (40 mg atorvastatin or 20 mg rosuvastatin) or low-dose (20 mg atorvastatin or 10 mg rosuvastatin) intensive statin group. In-hospital all-cause death was the primary outcome. RESULTS Of the 7008 patients included in this study, 5248 received low-dose intensive statins (mean age, 64.28 ± 10.39; female, 25.2%), whereas 1760 received high-dose intensive statins (mean age, 63.68 ± 10.59; female, 23.1%). There was no significant difference in the in-hospital all-cause death between the two groups (adjusted OR, 1.27; 95% CI, 0.43-3.72; P = 0.665). All-cause death was similar between the two groups during the 30-day follow-up period (adjusted HR, 1.28; 95% CI, 0.55-2.97; P = 0.571). However, the high-dose intensive statins were tightly associated with the reduction in in-hospital dialysis (adjusted OR, 0.11; 95% CI, 0.01-0.81; P = 0.030). Besides, primary analyses were confirmed by subgroup analyses. CONCLUSIONS The in-hospital high-dose intensive statins are not associated with the lower risk of in-hospital or 30-day all-cause death among ASCVD patients undergoing PCI. Given the robust beneficial effect of high-dose intensive statins with in-hospital dialysis, an individualized high-dose intensive statin therapy can be rational in specified populations.
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Affiliation(s)
- Peng-Yuan Chen
- Department of Cardiology, Guangdong Provincial People's Hospital's Nanhai Hospital, the Second Hospital of Nanhai District Foshan City, Foshan, 528000, China
| | - Yuan-Hui Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100, China.,School of Medicine, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510100, China
| | - Chong-Yang Duan
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Hua-Lin Fan
- School of Medicine, Guangdong Provincial People's Hospital, South China University of Technology, Guangzhou, 510100, China
| | - Li-Huan Zeng
- School of Medicine, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510100, China
| | - Wei Guo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100, China
| | - Lei Jiang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100, China.,School of Medicine, Guangdong Provincial People's Hospital, South China University of Technology, Guangzhou, 510100, China
| | - Xue-Biao Wei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100, China
| | - Wen-Fei He
- Department of Cardiology, Guangdong Provincial People's Hospital's Nanhai Hospital, the Second Hospital of Nanhai District Foshan City, Foshan, 528000, China
| | - Sha Tao
- Department of Cardiology, Guangdong Provincial People's Hospital's Nanhai Hospital, the Second Hospital of Nanhai District Foshan City, Foshan, 528000, China
| | - Zhi-Qiang Guo
- Department of Cardiology, Guangdong Provincial People's Hospital's Nanhai Hospital, the Second Hospital of Nanhai District Foshan City, Foshan, 528000, China
| | - Ji-Yan Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100, China.,School of Medicine, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510100, China.,School of Medicine, Guangdong Provincial People's Hospital, South China University of Technology, Guangzhou, 510100, China
| | - Ning Tan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100, China.,School of Medicine, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510100, China.,School of Medicine, Guangdong Provincial People's Hospital, South China University of Technology, Guangzhou, 510100, China
| | - Peng-Cheng He
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100, China. .,School of Medicine, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510100, China. .,School of Medicine, Guangdong Provincial People's Hospital, South China University of Technology, Guangzhou, 510100, China.
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Masana L, López Miranda J, Civeira F, Reinares L, Guijarro C, Plana N, Cuenca R, Sánchez D, Hernández JL, Andrés R, Blanco A, Villamayor S. Clinical profile of patients treated with evolocumab in lipid/internal medicine units of Spain. Observational study (RETOSS-IMU). Clin Investig Arterioscler 2020; 32:183-192. [PMID: 32317124 DOI: 10.1016/j.arteri.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe the clinical characteristics, the reasons for initiating therapy, and the effects of treatment in the initial phase of evolocumab availability in lipid/internal medicine units in Spain. METHODS Retrospective, observational study, based on the medical records of consecutive patients initiating treatment with evolocumab (from February 2016 to July 2017) in 20 internal medicine units in Spain. A review was made of the demographic and clinical characteristics of the patients, the lipid lowering treatment, and the evolution of the lipid profiles between 12weeks pre-initiation and 12±4weeks post-initiation of evolocumab. RESULTS A total of 136 patients were analysed, of whom 64.0% were men, and the mean age (standard deviation, SD) was 56.6 (11.5) years. The large majority (75%) had familial hypercholesterolaemia (4 homozygous), and 51.0% of them had suffered at least one cardiovascular event. Atherosclerotic cardiovascular disease (ASCVD) was present in 61% of all patients. At initiation of evolocumab, 61.0% of the patients were taking high-intensity statins, and 60.3% were receiving ezetimibe. The mean (and SD) of LDL-C levels at initiation of evolocumab was 169.1 (56.6) mg/dL. The LDL-C was greater than 160mg/dL in 46.4% of patients, and ≥190mg/dL in 26.5%. During the observation period, evolocumab produced significant reductions in LDL-C of 55.7% (P<.0001), achieving mean values of 74.3mg/dL. At week12, more than half (53.8%) of patients achieved LDL-C levels <70mg/dL, and 26.9% <50mg/dL. CONCLUSIONS In the lipid/internal medicine units, evolocumab was mainly prescribed in patients with familial hypercholesterolaemia, with or without ASCVD. The initial use of evolocumab was in accordance with the guidelines of the Spanish Society of Arteriosclerosis (SEA) of 2016, with LDL-C levels being well above the recommended thresholds for treatment initiation. Evolocumab treatment in clinical practice reduced LDL-C levels by about 55%, a similar reduction to that reported in clinical trials. Most patients achieved LDL-C goals.
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Affiliation(s)
- Lluís Masana
- Servicio de Medicina Interna, Hospital Universitario Sant Joan, IISPV, CIBERDEM, Reus, Tarragona, España.
| | - José López Miranda
- Servicio de Medicina Interna, Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, CIBEROBN, Córdoba, España
| | - Fernando Civeira
- Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, CIBERCV, Universidad de Zaragoza, Zaragoza, España
| | - Leonardo Reinares
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, España
| | - Carlos Guijarro
- Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| | - Núria Plana
- Servicio de Medicina Interna, Hospital Universitario Sant Joan, IISPV, CIBERDEM, Reus, Tarragona, España
| | - Rafael Cuenca
- Servicio de Medicina Interna, Hospital Alto Guadalquivir, Andújar, Jaén, España
| | - Demetrio Sánchez
- Servicio de Medicina Interna, Hospital Nuestra Señora de Sonsoles, Ávila, España
| | - José Luis Hernández
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, España
| | - Raimundo Andrés
- Servicio de Medicina Interna, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - Agustín Blanco
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España
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