Pub Date : 2024-10-01DOI: 10.1016/j.rccl.2024.06.002
David Vivas , Carlos Escobar , Alberto Cordero , Rosa Fernández-Olmo , Armando Oterino , Agustín Blanco-Echevarría , Manuel Botana , Daniel Escribano , María del Mar Freijo , Pedro Martínez-Losas , Vicente Pascual , Borja Quiroga , Carmen Sánchez-Peinador , Mónica Torres-Fonseca , Román Freixa-Pamias , Vivencio Barrios , Gonzalo Barón-Esquivias
Although in the last years a better control of vascular risk factors has been achieved, «real-world» data showed that only a few percentage of patients reach low-density lipoprotein-cholesterol goal levels. Recently, new therapies for the management of dyslipidaemias have emerged, and they could help to achieve the goal targets recommended by currents practical clinical guidelines so as to reduce vascular outcomes. Nevertheless, it is still uncertain in daily clinical practice the ideal timing of prescribing these new drugs, and what are the patients more benefited, compared to «classical» therapies such as statins and/or ezetimibe. In this complex scenario, this consensus document is proposed. It is certified by most of the scientific societies of clinical specialties that may play a role in the patient-healthcare process of atherosclerotic disease (SEC/SEA/SEEN/SEMFYC/SEMERGEN/SEMG/SEN/SEACV/S.E.N.), and its aim is to recommend some practical and simple guidelines, based on current scientific evidence, for the management of new therapies for dyslipidaemias in different scenarios of daily clinical practice.
{"title":"Uso de nuevas terapias hipolipemiantes en la práctica clínica. Consenso SEC/SEA/SEEN/SEMFYC/SEMERGEN/SEMG/SEN/SEACV/S.E.N.","authors":"David Vivas , Carlos Escobar , Alberto Cordero , Rosa Fernández-Olmo , Armando Oterino , Agustín Blanco-Echevarría , Manuel Botana , Daniel Escribano , María del Mar Freijo , Pedro Martínez-Losas , Vicente Pascual , Borja Quiroga , Carmen Sánchez-Peinador , Mónica Torres-Fonseca , Román Freixa-Pamias , Vivencio Barrios , Gonzalo Barón-Esquivias","doi":"10.1016/j.rccl.2024.06.002","DOIUrl":"10.1016/j.rccl.2024.06.002","url":null,"abstract":"<div><div>Although in the last years a better control of vascular risk factors has been achieved, «real-world» data showed that only a few percentage of patients reach low-density lipoprotein-cholesterol goal levels. Recently, new therapies for the management of dyslipidaemias have emerged, and they could help to achieve the goal targets recommended by currents practical clinical guidelines so as to reduce vascular outcomes. Nevertheless, it is still uncertain in daily clinical practice the ideal timing of prescribing these new drugs, and what are the patients more benefited, compared to «classical» therapies such as statins and/or ezetimibe. In this complex scenario, this consensus document is proposed. It is certified by most of the scientific societies of clinical specialties that may play a role in the patient-healthcare process of atherosclerotic disease (SEC/SEA/SEEN/SEMFYC/SEMERGEN/SEMG/SEN/SEACV/S.E.N.), and its aim is to recommend some practical and simple guidelines, based on current scientific evidence, for the management of new therapies for dyslipidaemias in different scenarios of daily clinical practice.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 310-321"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.rccl.2024.02.006
Introduction and objectives
The aim was to describe the burden of disease of valvular heart disease (VHD) in-hospital interventions in Spain.
Methods
The analysis involved all cases between 2016 and 2019 in the Spanish Ministry of Health database under the International Classification of Diseases 10th Revision. Procedure rates by region and year (×106), patient risk profile (comorbidities), health outcomes (death), length of stay (LoS), and costs were examined.
Results
A total of 57 878 procedures were analyzed, representing a national rate from 292 in 2016 to 321 in 2019 (×106 inhabitants). Comorbidities measured by the age-adjusted Charlson Comorbidity Index ranged between 3.47 and 3.77 and increased over the period. The in-hospital complications have remained constant over the years with some exceptions. Death rate (×106 inhabitants) was 18.0, and the in-hospital mortality per year range was statistically constant and between 5.23% and 6.20%. The unadjusted LoS ranged from 14.68 to 15.34 days (standard deviations [SD], 16.03 and 15.79) including 2.68 to 3.27 days (SD, 6.57–7.82) in the intensive care unit. VHD procedures costs amounted to €1403.13 million in the period, representing an annual cost of €350.8 million. These costs decreased by 3.17% over the period. Per-procedure mean cost also decreased from €24 801.81 (SD, €10 231.91) to €24 015.50 (SD, €9825.39).
Conclusions
VHD entails a large and increasing volume of procedures in Spain. While a decline in the per-procedure mean cost was noted, the overall annual cost increased. This underscores the substantial burden on the national health system, even when considering solely in-hospital procedures.
{"title":"Characterizing the “iceberg peak” in valvular heart disease: Outcomes and costs of in-hospital procedures in Spain","authors":"","doi":"10.1016/j.rccl.2024.02.006","DOIUrl":"10.1016/j.rccl.2024.02.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The aim was to describe the burden of disease of valvular heart disease (VHD) in-hospital interventions in Spain.</div></div><div><h3>Methods</h3><div>The analysis involved all cases between 2016 and 2019 in the Spanish Ministry of Health database under the International Classification of Diseases 10th Revision. Procedure rates by region and year (×10<sup>6</sup>), patient risk profile (comorbidities), health outcomes (death), length of stay (LoS), and costs were examined.</div></div><div><h3>Results</h3><div>A total of 57<!--> <!-->878 procedures were analyzed, representing a national rate from 292 in 2016 to 321 in 2019 (×10<sup>6</sup> inhabitants). Comorbidities measured by the age-adjusted Charlson Comorbidity Index ranged between 3.47 and 3.77 and increased over the period. The in-hospital complications have remained constant over the years with some exceptions. Death rate (×10<sup>6</sup> inhabitants) was 18.0, and the in-hospital mortality per year range was statistically constant and between 5.23% and 6.20%. The unadjusted LoS ranged from 14.68 to 15.34 days (standard deviations [SD], 16.03 and 15.79) including 2.68 to 3.27 days (SD, 6.57–7.82) in the intensive care unit. VHD procedures costs amounted to €1403.13 million in the period, representing an annual cost of €350.8 million. These costs decreased by 3.17% over the period. Per-procedure mean cost also decreased from €24<!--> <!-->801.81 (SD, €10<!--> <!-->231.91) to €24<!--> <!-->015.50 (SD, €9825.39).</div></div><div><h3>Conclusions</h3><div>VHD entails a large and increasing volume of procedures in Spain. While a decline in the per-procedure mean cost was noted, the overall annual cost increased. This underscores the substantial burden on the national health system, even when considering solely in-hospital procedures.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 285-294"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.rccl.2024.06.001
Rosa Fernández Olmo , Armando Oterino , Miriam Martín Toro , Javier Mora , Mario Baquero , Alberto Cordero
{"title":"Determinación de la lipoproteína (a) y prevalencia de valores elevados entre los asistentes a una reunión científica","authors":"Rosa Fernández Olmo , Armando Oterino , Miriam Martín Toro , Javier Mora , Mario Baquero , Alberto Cordero","doi":"10.1016/j.rccl.2024.06.001","DOIUrl":"10.1016/j.rccl.2024.06.001","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 338-340"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.rccl.2024.02.002
{"title":"Origen anómalo de la arteria pulmonar derecha en un adulto","authors":"","doi":"10.1016/j.rccl.2024.02.002","DOIUrl":"10.1016/j.rccl.2024.02.002","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 345-346"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.rccl.2024.02.001
{"title":"Fibroelastoma papilar aórtico e ictus: un caso ilustrativo","authors":"","doi":"10.1016/j.rccl.2024.02.001","DOIUrl":"10.1016/j.rccl.2024.02.001","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 343-344"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.rccl.2024.03.004
Marisol Bravo Amaro , Francisco Marín , Joaquín Ruíz de Castroviejo , Elizabet Méndez Eirín , Lourdes García Bueno , Raquel Marzoa Rivas , Leopoldo Pérez de Isla , en representación de los investigadores del Grupo PANDORA
Introduction and objectives
The polypill from the Spanish National Centre for Cardiovascular Diseases (CNIC) contains drugs (acetylsalicylic acid/atorvastatin/ramipril) for adequate secondary prevention after acute coronary syndrome (ACS). The aim was to describe the 6-month management of drugs with an effect on cardiovascular prognosis in patients treated with CNIC polypill as a baseline treatment at discharge after a first ACS.
Methods
Observational, ambispective, multicenter, national study, according to standard clinical practice. Changes in baseline and adjuvant treatment were evaluated, as well as cardiovascular risk factors.
Results
In total, 288 patients were included and 285 were valid for analysis. Among them, 17.9% were women and the mean age was 62.2 (12.4) years. The most prescribed formulation of the CNIC polypill was 100 mg/40 mg/2.5 mg (55.8%). Of the participants, 76.5% maintained the baseline treatment prescribed at discharge. Also, in 8.8% of patients the dose was increased to optimize the treatment and in 3.5% decreased due to the need of therapeutic optimization or the appearance of side effects. All participants reported some adjuvant treatment, mainly antihypertensives (34.9%) and lipid-lowering agents (28.2%). A significant decrease in mean low-density lipoprotein cholesterol was observed between discharge and the following 2 visits (P < .0001).
Conclusions
After a first ACS, the treatment with CNIC polypill at discharge is effective and safe. CNIC polypill therapy remained unchanged as baseline treatment in most patients. Dose was increased or, at least, an adjuvant treatment was added according to standard clinical practices when it was required.
{"title":"Gestión terapéutica con policomprimido CNIC al alta de un primer síndrome coronario agudo en España: el estudio PANDORA","authors":"Marisol Bravo Amaro , Francisco Marín , Joaquín Ruíz de Castroviejo , Elizabet Méndez Eirín , Lourdes García Bueno , Raquel Marzoa Rivas , Leopoldo Pérez de Isla , en representación de los investigadores del Grupo PANDORA","doi":"10.1016/j.rccl.2024.03.004","DOIUrl":"10.1016/j.rccl.2024.03.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The polypill from the Spanish National Centre for Cardiovascular Diseases (CNIC) contains drugs (acetylsalicylic acid/atorvastatin/ramipril) for adequate secondary prevention after acute coronary syndrome (ACS). The aim was to describe the 6-month management of drugs with an effect on cardiovascular prognosis in patients treated with CNIC polypill as a baseline treatment at discharge after a first ACS.</div></div><div><h3>Methods</h3><div>Observational, ambispective, multicenter, national study, according to standard clinical practice. Changes in baseline and adjuvant treatment were evaluated, as well as cardiovascular risk factors.</div></div><div><h3>Results</h3><div>In total, 288 patients were included and 285 were valid for analysis. Among them, 17.9% were women and the mean age was 62.2 (12.4) years. The most prescribed formulation of the CNIC polypill was 100<!--> <!-->mg/40<!--> <!-->mg/2.5<!--> <!-->mg (55.8%). Of the participants, 76.5% maintained the baseline treatment prescribed at discharge. Also, in 8.8% of patients the dose was increased to optimize the treatment and in 3.5% decreased due to the need of therapeutic optimization or the appearance of side effects. All participants reported some adjuvant treatment, mainly antihypertensives (34.9%) and lipid-lowering agents (28.2%). A significant decrease in mean low-density lipoprotein cholesterol was observed between discharge and the following 2 visits (<em>P</em> <!--><<!--> <!-->.0001).</div></div><div><h3>Conclusions</h3><div>After a first ACS, the treatment with CNIC polypill at discharge is effective and safe. CNIC polypill therapy remained unchanged as baseline treatment in most patients. Dose was increased or, at least, an adjuvant treatment was added according to standard clinical practices when it was required.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 266-277"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.rccl.2024.05.004
Hakan Gökalp Uzun , Selim Ekinci , Muhammed Ali Şahin , Nazlıhan Ezgi Kavuk , Demet Funda Baş , Barış Kiliçaslan
Introduction and objectives
Recurrent strokes persist despite the use of guideline-recommended direct oral anticoagulants (DOACs). There is a scarcity of data concerning the current and optimal practices following a recurrent stroke while on DOACs. Consequently, our aim was to identify factors associated with this residual risk and to discern the current practice patterns among cardiologists and neurologists.
Methods
All consecutive patients with an acute cerebrovascular accident of any type and a diagnosis of atrial fibrillation (AF) were retrospectively screened at our stroke center. We gathered demographic information, clinical risk scores (CHA2DS2-VASc and HAS-BLED), echocardiographic and laboratory findings, risk factors, the modified Rankin score, and information about the treatment modality. DOAC usage was classified as either inappropriate (due to self-reported non-adherence and/or incorrect DOAC dosage) or appropriate.
Results
A total of 77 patients with stroke despite treatment with DOACs were included in the analysis. Of these, 28 (36%) had received inappropriate treatment (20 of them due to inadequate dosing). These patients tended to be older (P = .06) and had lower creatinine levels than the group receiving appropriate DOACs (0.9 vs 1; P = .01). At hospital discharge following the index stroke, various anticoagulants were administered to 75 patients (enoxaparin, n = 5; warfarin, n = 10; DOAC, n = 60). Two patients died and 20 patients were given antiplatelet therapy in addition to anticoagulants. The preferred DOACs after stroke were apixaban (n = 27), followed by rivaroxaban (n = 16), dabigatran (n = 14) and edoxaban (n = 3).
Conclusions
There is no standardized model or consensus among physicians regarding anticoagulant management. Despite the intended use of the drugs, strokes continue to occur in some patients. The 25% of strokes are related to inadequate dosage.
{"title":"Recurrent stroke despite correct anticoagulation therapy with DOACs: Analysis of the real-life therapeutic approach","authors":"Hakan Gökalp Uzun , Selim Ekinci , Muhammed Ali Şahin , Nazlıhan Ezgi Kavuk , Demet Funda Baş , Barış Kiliçaslan","doi":"10.1016/j.rccl.2024.05.004","DOIUrl":"10.1016/j.rccl.2024.05.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Recurrent strokes persist despite the use of guideline-recommended direct oral anticoagulants (DOACs). There is a scarcity of data concerning the current and optimal practices following a recurrent stroke while on DOACs. Consequently, our aim was to identify factors associated with this residual risk and to discern the current practice patterns among cardiologists and neurologists.</div></div><div><h3>Methods</h3><div>All consecutive patients with an acute cerebrovascular accident of any type and a diagnosis of atrial fibrillation (AF) were retrospectively screened at our stroke center. We gathered demographic information, clinical risk scores (CHA<sub>2</sub>DS<sub>2</sub>-VASc and HAS-BLED), echocardiographic and laboratory findings, risk factors, the modified Rankin score, and information about the treatment modality. DOAC usage was classified as either inappropriate (due to self-reported non-adherence and/or incorrect DOAC dosage) or appropriate.</div></div><div><h3>Results</h3><div>A total of 77 patients with stroke despite treatment with DOACs were included in the analysis. Of these, 28 (36%) had received inappropriate treatment (20 of them due to inadequate dosing). These patients tended to be older (<em>P</em> <!-->=<!--> <!-->.06) and had lower creatinine levels than the group receiving appropriate DOACs (0.9 vs 1; <em>P</em> <!-->=<!--> <!-->.01). At hospital discharge following the index stroke, various anticoagulants were administered to 75 patients (enoxaparin, n<!--> <!-->=<!--> <!-->5; warfarin, n<!--> <!-->=<!--> <!-->10; DOAC, n<!--> <!-->=<!--> <!-->60). Two patients died and 20 patients were given antiplatelet therapy in addition to anticoagulants. The preferred DOACs after stroke were apixaban (<em>n</em> <!-->=<!--> <!-->27), followed by rivaroxaban (<em>n</em> <!-->=<!--> <!-->16), dabigatran (<em>n</em> <!-->=<!--> <!-->14) and edoxaban (<em>n</em> <!-->=<!--> <!-->3).</div></div><div><h3>Conclusions</h3><div>There is no standardized model or consensus among physicians regarding anticoagulant management. Despite the intended use of the drugs, strokes continue to occur in some patients. The 25% of strokes are related to inadequate dosage.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 303-309"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.rccl.2024.05.003
Patients with multivessel coronary disease or left main coronary artery disease represent a highly complex minority within ischemic heart disease. However, there is ongoing controversy over the best treatment approach in these cases: whether to opt for coronary artery bypass grafting or percutaneous coronary intervention. Current recommendations from the latest 2018 clinical practice guidelines are based on studies from the past decade, and since then, technological advancements in percutaneous coronary intervention have achieved significant improvements, offering a better clinical prognosis today. This has led to an increase in the annual number of procedures performed and has even opened the door to treating patients who in the past were clear candidates for coronary artery bypass grafting.
{"title":"Intervencionismo coronario percutáneo en pacientes con enfermedad del tronco coronario izquierdo o enfermedad multivaso","authors":"","doi":"10.1016/j.rccl.2024.05.003","DOIUrl":"10.1016/j.rccl.2024.05.003","url":null,"abstract":"<div><div>Patients with multivessel coronary disease or left main coronary artery disease represent a highly complex minority within ischemic heart disease. However, there is ongoing controversy over the best treatment approach in these cases: whether to opt for coronary artery bypass grafting or percutaneous coronary intervention. Current recommendations from the latest 2018 clinical practice guidelines are based on studies from the past decade, and since then, technological advancements in percutaneous coronary intervention have achieved significant improvements, offering a better clinical prognosis today. This has led to an increase in the annual number of procedures performed and has even opened the door to treating patients who in the past were clear candidates for coronary artery bypass grafting.</div></div>","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 322-333"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141399974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.rccl.2024.05.002
{"title":"Impact of education on aortic stenosis awareness in the general population","authors":"","doi":"10.1016/j.rccl.2024.05.002","DOIUrl":"10.1016/j.rccl.2024.05.002","url":null,"abstract":"","PeriodicalId":36870,"journal":{"name":"REC: CardioClinics","volume":"59 4","pages":"Pages 334-338"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141389742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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