Pub Date : 2023-07-01Epub Date: 2023-06-23DOI: 10.1097/CP9.0000000000000055
Ling Leng, Xiu-Wu Bian
Heart dysfunction is one of the most life-threatening organ dysfunctions caused by coronavirus disease 2019 (COVID-19). Myocardial or cardiovascular damage is the most common extrapulmonary organ complication in critically ill patients. Understanding the pathogenesis and pathological characteristics of myocardial and vascular injury is important for improving clinical diagnosis and treatment approach. Herein, the mechanism of direct damage caused by severe acute respiratory syndrome coronavirus 2 to the heart and secondary damage caused by virus-driven inflammation was reviewed. The pathological mechanism of ischemia and hypoxia due to microthrombosis and inflammatory injury as well as the injury mechanism of tissue inflammation and single myocardial cell necrosis triggered by the viral infection of pericytes or macrophages, hypoxia, and energy metabolism disorders were described. The latter can provide a novel diagnosis, treatment, and investigation strategy for heart dysfunctions caused by COVID-19 or the Omicron variant.
{"title":"Injury mechanism of COVID-19-induced cardiac complications.","authors":"Ling Leng, Xiu-Wu Bian","doi":"10.1097/CP9.0000000000000055","DOIUrl":"10.1097/CP9.0000000000000055","url":null,"abstract":"<p><p>Heart dysfunction is one of the most life-threatening organ dysfunctions caused by coronavirus disease 2019 (COVID-19). Myocardial or cardiovascular damage is the most common extrapulmonary organ complication in critically ill patients. Understanding the pathogenesis and pathological characteristics of myocardial and vascular injury is important for improving clinical diagnosis and treatment approach. Herein, the mechanism of direct damage caused by severe acute respiratory syndrome coronavirus 2 to the heart and secondary damage caused by virus-driven inflammation was reviewed. The pathological mechanism of ischemia and hypoxia due to microthrombosis and inflammatory injury as well as the injury mechanism of tissue inflammation and single myocardial cell necrosis triggered by the viral infection of pericytes or macrophages, hypoxia, and energy metabolism disorders were described. The latter can provide a novel diagnosis, treatment, and investigation strategy for heart dysfunctions caused by COVID-19 or the Omicron variant.</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":" ","pages":"159-166"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49100041","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 : 2023-07-01DOI: 10.1097/cp9.0000000000000062
Mirjana T. Macvanin, Esma R. Isenovic
Diabetes mellitus (DM) refers to a complex cluster of metabolic disorders characterized by hyperglycemia caused by inadequate insulin secretion, insulin resistance, or excessive glucagon secretion. If not correctly treated, the prolonged effects of DM-associated metabolic perturbations lead to systemic vascular complications and cardiovascular disease (CVD), the principal cause of mortality among patients with DM. Given the increase in the global prevalence of diabetes, novel diagnostic and therapeutic procedures are necessary for its effective identification and treatment. Recent findings point to an important role of microRNA (miRNAs) in DM initiation and progression, as well as the occurrence of associated cardiovascular complications. miRNAs are short, highly conserved, single-stranded, non-coding RNAs that contribute to the maintenance of physiological homeostasis through the regulation of crucial processes such as metabolism, cell proliferation, and apoptosis. The increased availability of high-throughput methodologies for identifying and characterizing non-coding RNAs has led to considerable interest in miRNAs as potential biomarkers and therapeutic agents for DM. In this review, we first comprehensively detail the regulatory miRNAs involved in the pathophysiology of DM and diabetic cardiomyopathy (DCMP). Subsequently, we summarize findings regarding the utility of several of these miRNAs as potential prognostic and diagnostic biomarkers for DM and DM-associated CVD. Finally, we evaluate the potential of miRNA-based therapeutic approaches for treating DM and DCMP in the clinical setting.
{"title":"Diabetes and associated cardiovascular complications: The role of microRNAs","authors":"Mirjana T. Macvanin, Esma R. Isenovic","doi":"10.1097/cp9.0000000000000062","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000062","url":null,"abstract":"Diabetes mellitus (DM) refers to a complex cluster of metabolic disorders characterized by hyperglycemia caused by inadequate insulin secretion, insulin resistance, or excessive glucagon secretion. If not correctly treated, the prolonged effects of DM-associated metabolic perturbations lead to systemic vascular complications and cardiovascular disease (CVD), the principal cause of mortality among patients with DM. Given the increase in the global prevalence of diabetes, novel diagnostic and therapeutic procedures are necessary for its effective identification and treatment. Recent findings point to an important role of microRNA (miRNAs) in DM initiation and progression, as well as the occurrence of associated cardiovascular complications. miRNAs are short, highly conserved, single-stranded, non-coding RNAs that contribute to the maintenance of physiological homeostasis through the regulation of crucial processes such as metabolism, cell proliferation, and apoptosis. The increased availability of high-throughput methodologies for identifying and characterizing non-coding RNAs has led to considerable interest in miRNAs as potential biomarkers and therapeutic agents for DM. In this review, we first comprehensively detail the regulatory miRNAs involved in the pathophysiology of DM and diabetic cardiomyopathy (DCMP). Subsequently, we summarize findings regarding the utility of several of these miRNAs as potential prognostic and diagnostic biomarkers for DM and DM-associated CVD. Finally, we evaluate the potential of miRNA-based therapeutic approaches for treating DM and DCMP in the clinical setting.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135851621","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 : 2023-07-01DOI: 10.1097/cp9.0000000000000058
Zejia Wu, Shuang Xia, Dunliang Ma, Liwen Li
99m Tc-pyrophosphate ( 99m Tc-PYP) scintigraphy is highly sensitive and specific for the diagnosis of transthyretin cardiac amyloidosis (ATTR-CA). Commonly used alternative tracers included 99m Tc-3,3-diphosphono-1,2-propanodicarboxylic acid ( 99m Tc-DPD) and 99m Tc-hydroxymethylene diphosphonate ( 99m Tc-HMDP). A 61-year-old Chinese man presented with signs indicative of left ventricular hypertrophy. Genetic testing revealed heterozygous transthyretin Ala117Ser mutation. Scintigraphy using 99m Tc-methylene diphosphonate failed to show myocardial uptake. Five months later, the patient underwent permanent pacemaker implantation. Tafamidis was used irregularly, and the patient died 2 years later. 99m Tc-methylene diphosphonate may not be appropriate for diagnostic use in ATTR-CA patient with transthyretin Ala117Ser mutation.
{"title":"Negative methylene diphosphonate scintigraphy in biopsy-confirmed hereditary transthyretin Ala117Ser cardiac amyloidosis: a case report","authors":"Zejia Wu, Shuang Xia, Dunliang Ma, Liwen Li","doi":"10.1097/cp9.0000000000000058","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000058","url":null,"abstract":"99m Tc-pyrophosphate ( 99m Tc-PYP) scintigraphy is highly sensitive and specific for the diagnosis of transthyretin cardiac amyloidosis (ATTR-CA). Commonly used alternative tracers included 99m Tc-3,3-diphosphono-1,2-propanodicarboxylic acid ( 99m Tc-DPD) and 99m Tc-hydroxymethylene diphosphonate ( 99m Tc-HMDP). A 61-year-old Chinese man presented with signs indicative of left ventricular hypertrophy. Genetic testing revealed heterozygous transthyretin Ala117Ser mutation. Scintigraphy using 99m Tc-methylene diphosphonate failed to show myocardial uptake. Five months later, the patient underwent permanent pacemaker implantation. Tafamidis was used irregularly, and the patient died 2 years later. 99m Tc-methylene diphosphonate may not be appropriate for diagnostic use in ATTR-CA patient with transthyretin Ala117Ser mutation.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135805123","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 : 2023-07-01DOI: 10.1097/cp9.0000000000000063
Mina W. Mohareb, Mohammed A. Kariem, Aly Tohamy, Noha M. Gamal, Rehab M. Mosaad, Nora N. Esmaiel, Alaaeldin G. Fayez
Background and purpose: Ischemic heart disease frequently leads to heart failure, often resulting in death. In this study, we aimed to identify common hub mRNAs and pathways involved in the pathological progression of ischemic cardiomyopathy (ICM). Methods: Validation quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was carried out on peripheral blood and left ventricle specimens from patients in three groups with stable coronary artery disease (CAD), myocardial infarction (MI), and ICM and compared with corresponding controls. qRT-PCR was preceded by computational analysis of eight high-throughput RNA sequencing and microarray datasets from 499 patients and 233 controls, to determine possible common biologically meaningful differentially expressed genes (DEGs). To determine the potential pathological pathways, we performed Gene Ontology functional annotation, pathway enrichment analysis, protein–protein interaction (PPI) analysis, and constructed transcriptional factor/miRNA regulatory networks. Finally, approved drugs were screened. Results: Fifteen common DEGs with P < 0.01 were identified. STAT3, CEBPD, GLUL , and CD163 were hub-enriched mRNAs with an interaction score ≥ 0.50. Our qRT-PCR analysis showed an increased expression of STAT3 in all three patient groups and CD163 , mainly in cardiac samples, in a remarkably ascending manner. Interaction modules showed co-regulators supporting high STAT3-CD163 connectivity, suggesting a potential role for STAT3-CD163 cross-talk-mediated inflammatory responses in ICM progression. Conclusions: Our results provided a novel perspective for understanding the underlying mechanisms of ICM progression and exploring new therapeutic agents. Clinical trial registration: URL: www.clinicaltrials.gov. Unique identifier: NCT05508269.
{"title":"STAT3-CD163 cross-talk exhibits promising biomarkers for a progressive ischemic cardiomyopathy: integrative computational and gene expression profiling based on Gene Expression Omnibus datasets","authors":"Mina W. Mohareb, Mohammed A. Kariem, Aly Tohamy, Noha M. Gamal, Rehab M. Mosaad, Nora N. Esmaiel, Alaaeldin G. Fayez","doi":"10.1097/cp9.0000000000000063","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000063","url":null,"abstract":"Background and purpose: Ischemic heart disease frequently leads to heart failure, often resulting in death. In this study, we aimed to identify common hub mRNAs and pathways involved in the pathological progression of ischemic cardiomyopathy (ICM). Methods: Validation quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was carried out on peripheral blood and left ventricle specimens from patients in three groups with stable coronary artery disease (CAD), myocardial infarction (MI), and ICM and compared with corresponding controls. qRT-PCR was preceded by computational analysis of eight high-throughput RNA sequencing and microarray datasets from 499 patients and 233 controls, to determine possible common biologically meaningful differentially expressed genes (DEGs). To determine the potential pathological pathways, we performed Gene Ontology functional annotation, pathway enrichment analysis, protein–protein interaction (PPI) analysis, and constructed transcriptional factor/miRNA regulatory networks. Finally, approved drugs were screened. Results: Fifteen common DEGs with P < 0.01 were identified. STAT3, CEBPD, GLUL , and CD163 were hub-enriched mRNAs with an interaction score ≥ 0.50. Our qRT-PCR analysis showed an increased expression of STAT3 in all three patient groups and CD163 , mainly in cardiac samples, in a remarkably ascending manner. Interaction modules showed co-regulators supporting high STAT3-CD163 connectivity, suggesting a potential role for STAT3-CD163 cross-talk-mediated inflammatory responses in ICM progression. Conclusions: Our results provided a novel perspective for understanding the underlying mechanisms of ICM progression and exploring new therapeutic agents. Clinical trial registration: URL: www.clinicaltrials.gov. Unique identifier: NCT05508269.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135856484","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 : 2023-07-01DOI: 10.1097/cp9.0000000000000060
Wenzheng Han, Ming Wang, Shaofeng Guan, Qian Gan, Weiyi Fang, Kun Xia, Xinkai Qu
Background and purpose: Robotic-assisted percutaneous coronary intervention (PCI) has been increasingly used for simple lesion. For complex lesions, extensive manual intervention is still required. This study aims to verify the stability and safety of this robot system in complex lesion under fifth-generation (5G) network before clinical trial. Methods: We developed a robotic system that allows simultaneous remote control of multiple devices using a 5G wireless network. The key feature of the system is a bionic thumb along with two-bionic forefingers. The system was tested in eight pigs (six over 18.3 km and two over 1,100 km). Two stents were placed in the left main bifurcation using the culotte technique. All procedures, barring device loading onto the robot system, including manipulation of the guiding catheter, wire adjustments, stent or balloon positioning, and notably the final kissing step, were conducted remotely. Results: The rate of procedure success was 100%, with no device-related complications. In comparison to short-distance remote control, the delay with long-distance remote control was minimal (90.9 ± 1.5 vs. 81.5 ± 2.7 ms for command data transmission; 163.2 ± 1.3 vs. 161.0 ± 1.4 ms for image transmission). The procedure time was shorter when using two pairs versus a single pair of bionic fingers (104.3 ± 10.2 vs. 126.0 ± 3.9 min), primarily due to less time needed for device loading and exchange (33.1 ± 4.2 vs. 56.1 ± 4.0 min). Conclusions: With the 5G network, long distance was not a significant barrier for robotic-assisted PCI for chronic total occlusion. A design of the independent bionic finger module enabled final kissing balloon inflation with reduced requirement for manual intervention. Whether the system could be used beyond left main bifurcation lesions requires further investigation.
背景与目的:机器人辅助经皮冠状动脉介入治疗(PCI)在单性病变中的应用越来越广泛。对于复杂的病变,仍然需要广泛的人工干预。本研究旨在临床试验前验证该机器人系统在第五代(5G)网络下复杂病变环境下的稳定性和安全性。方法:我们开发了一个机器人系统,可以使用5G无线网络同时远程控制多个设备。该系统的主要特点是一个仿生拇指和两个仿生食指。该系统在8头猪身上进行了测试(6头超过18.3公里,2头超过1100公里)。两个支架放置在左主分叉使用导管技术。所有程序,包括将设备装载到机器人系统上,包括导尿管的操作、导线调整、支架或球囊的定位,特别是最后的接吻步骤,都是远程进行的。结果:手术成功率100%,无器械相关并发症。与近距离遥控相比,远程遥控的指令数据传输延迟最小(90.9±1.5 ms vs 81.5±2.7 ms);163.2±1.3 vs. 161.0±1.4 ms图像传输)。与单对仿生手指相比,使用两对仿生手指的手术时间更短(104.3±10.2 vs 126.0±3.9 min),主要是由于设备加载和交换所需的时间更短(33.1±4.2 vs 56.1±4.0 min)。结论:在5G网络下,远距离不是机器人辅助PCI治疗慢性全闭塞的显著障碍。独立仿生手指模块的设计使最终的接吻气球膨胀减少了人工干预的要求。该系统是否可以用于左主干分叉病变以外的病变,需要进一步研究。
{"title":"A multi-device robotic-assisted PCI system: a proof-of concept study for left main bifurcation stenting with culotte technique in a porcine model","authors":"Wenzheng Han, Ming Wang, Shaofeng Guan, Qian Gan, Weiyi Fang, Kun Xia, Xinkai Qu","doi":"10.1097/cp9.0000000000000060","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000060","url":null,"abstract":"Background and purpose: Robotic-assisted percutaneous coronary intervention (PCI) has been increasingly used for simple lesion. For complex lesions, extensive manual intervention is still required. This study aims to verify the stability and safety of this robot system in complex lesion under fifth-generation (5G) network before clinical trial. Methods: We developed a robotic system that allows simultaneous remote control of multiple devices using a 5G wireless network. The key feature of the system is a bionic thumb along with two-bionic forefingers. The system was tested in eight pigs (six over 18.3 km and two over 1,100 km). Two stents were placed in the left main bifurcation using the culotte technique. All procedures, barring device loading onto the robot system, including manipulation of the guiding catheter, wire adjustments, stent or balloon positioning, and notably the final kissing step, were conducted remotely. Results: The rate of procedure success was 100%, with no device-related complications. In comparison to short-distance remote control, the delay with long-distance remote control was minimal (90.9 ± 1.5 vs. 81.5 ± 2.7 ms for command data transmission; 163.2 ± 1.3 vs. 161.0 ± 1.4 ms for image transmission). The procedure time was shorter when using two pairs versus a single pair of bionic fingers (104.3 ± 10.2 vs. 126.0 ± 3.9 min), primarily due to less time needed for device loading and exchange (33.1 ± 4.2 vs. 56.1 ± 4.0 min). Conclusions: With the 5G network, long distance was not a significant barrier for robotic-assisted PCI for chronic total occlusion. A design of the independent bionic finger module enabled final kissing balloon inflation with reduced requirement for manual intervention. Whether the system could be used beyond left main bifurcation lesions requires further investigation.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"133 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135804979","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 : 2023-04-05DOI: 10.1097/cp9.0000000000000040
Yuxiang Dai, Junbo Ge
{"title":"Artificial intelligence in medical practice: current status and future perspectives","authors":"Yuxiang Dai, Junbo Ge","doi":"10.1097/cp9.0000000000000040","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000040","url":null,"abstract":"","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44964547","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 : 2023-04-01Epub Date: 2023-05-31DOI: 10.1097/CP9.0000000000000049
Ru Chen, Yi Guo, Shan Deng, Jian Wang, Meng Gao, Hongli Han, Lin Wang, Hongwei Jiang, Kai Huang
Omicron is currently the dominant strain of severe acute respiratory syndrome coronavirus 2, but little is known about the characteristics and management of omicron related myocardial injury, particularly the potential benefit of the antiviral agent azvudine.
Methods: Patients with confirmed and suspected coronavirus disease 2019 (COVID-19) admitted to Wuhan Union Hospital from December 7, 2022, to December 30, 2022, were included in this study. Cox regression was conducted to identify risk factors for all-cause mortality. A propensity score-matched analysis was performed at a 1:1 ratio with a caliper of 0.1 pooled standard deviations of relevant confounders.
Results: The final analysis included a total of 332 patients (167 confirmed cases and 165 suspected cases), 42.77% (142/332) of the patients were 80 years of age or older and 68.67% (228/332) of them were men, 158 patients were treated with azvudine. In the matched cohort, the total mortality was 30.30% (60/198), 40 (20.20%, 40/198) patients received noninvasive ventilation and 22 (11.11%, 22/198) received invasive ventilation, 34 (17.17%, 34/198) patients were admitted to intensive care unit (ICU). The rate of shock, multiple organ damages and arrhythmia were 11.62% (23/198), 20.20% (40/198), and 12.12% (24/198), respectively. There was no significant difference on these clinical outcomes in patients treated with azvudine or not. Azvudine reduced early mortality (within 14 days from admission) (hazard ratio: 0.37, 95% confidence interval: 0.18-0.77) even after adjusting for other treatments including glucocorticoids, immunoglobin and anticoagulant therapy, but not the final in-hospital mortality of patients.
Conclusions: Patients with COVID-19-related myocardial injury had a high mortality of about 30.30% (60/198). Azvudine improved the early survival of the patients but not final mortality.
{"title":"All-cause mortality in moderate and severe COVID-19 patients with myocardial injury receiving versus not receiving azvudine: a propensity score-matched analysis.","authors":"Ru Chen, Yi Guo, Shan Deng, Jian Wang, Meng Gao, Hongli Han, Lin Wang, Hongwei Jiang, Kai Huang","doi":"10.1097/CP9.0000000000000049","DOIUrl":"10.1097/CP9.0000000000000049","url":null,"abstract":"<p><p>Omicron is currently the dominant strain of severe acute respiratory syndrome coronavirus 2, but little is known about the characteristics and management of omicron related myocardial injury, particularly the potential benefit of the antiviral agent azvudine.</p><p><strong>Methods: </strong>Patients with confirmed and suspected coronavirus disease 2019 (COVID-19) admitted to Wuhan Union Hospital from December 7, 2022, to December 30, 2022, were included in this study. Cox regression was conducted to identify risk factors for all-cause mortality. A propensity score-matched analysis was performed at a 1:1 ratio with a caliper of 0.1 pooled standard deviations of relevant confounders.</p><p><strong>Results: </strong>The final analysis included a total of 332 patients (167 confirmed cases and 165 suspected cases), 42.77% (142/332) of the patients were 80 years of age or older and 68.67% (228/332) of them were men, 158 patients were treated with azvudine. In the matched cohort, the total mortality was 30.30% (60/198), 40 (20.20%, 40/198) patients received noninvasive ventilation and 22 (11.11%, 22/198) received invasive ventilation, 34 (17.17%, 34/198) patients were admitted to intensive care unit (ICU). The rate of shock, multiple organ damages and arrhythmia were 11.62% (23/198), 20.20% (40/198), and 12.12% (24/198), respectively. There was no significant difference on these clinical outcomes in patients treated with azvudine or not. Azvudine reduced early mortality (within 14 days from admission) (hazard ratio: 0.37, 95% confidence interval: 0.18-0.77) even after adjusting for other treatments including glucocorticoids, immunoglobin and anticoagulant therapy, but not the final in-hospital mortality of patients.</p><p><strong>Conclusions: </strong>Patients with COVID-19-related myocardial injury had a high mortality of about 30.30% (60/198). Azvudine improved the early survival of the patients but not final mortality.</p>","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 2","pages":"103-110"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/df/cp9-8-103.PMC10364645.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939473","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}
Background and purpose: Associations between fine and coarse particulate matters (i.e., PM2.5 and PM2.5–10, respectively) and the onset of angina have rarely been investigated. We aimed to systematically explore the impacts of PM2.5 as well as PM2.5–10 on the onset of stable and unstable angina at the hourly timescale. Methods: We performed a time-stratified case-crossover study among 995,734 angina patients from 1,655 hospitals in 305 Chinese cities from January 2015 to December 2021. Concentrations of PM2.5 and PM2.5–10 were collected at the hourly timescale from nearby fixed-site monitoring stations. Hourly onset information of unstable and stable angina was obtained from the Chinese Cardiovascular Association Database-Chest Pain Center. We applied conditional logistic regressions combined with polynomial distributed lag models to explore the lagged exposure–response associations. Subgroup analyses were performed to explore potential effect modifiers including age, sex, season, and region. Results: Transient exposure to PM2.5 was significantly associated with elevated risk of unstable and stable angina onset. The associations occurred immediately in the concurrent hour of exposure, attenuated thereafter, and turned to null at approximately lag 12 h for unstable angina and 9 h for stable angina. Each interquartile range increase in the PM2.5 concentrations over 0 to 12 h was associated with 1.32% (95% confidence interval [95% CI]: 0.94%–1.70%) and 1.69% (95% CI: 0.99%–2.39%) increase in the onset risk of unstable and stable angina, respectively. The results remained similar after controlling for co-pollutants. Greater magnitudes of associations were found among females and during cold season. Null associations were observed between PM2.5–10 and any type of angina. Conclusion: Our study indicates that acute exposure to PM2.5, rather than PM2.5–10, was significantly associated with the onset of both unstable and stable angina, underscoring the need of continued efforts in controlling particulate matter air pollution.
{"title":"Differentiating the effects of fine and coarse particulate air pollution on the onset of stable and unstable angina: a case-crossover study in 305 Chinese cities","authors":"Yixuan Jiang, Qingli Zhang, Xinlei Zhu, Xiaowei Xue, Qinglin He, Ya Gao, Renjie Chen","doi":"10.1097/CP9.0000000000000052","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000052","url":null,"abstract":"Background and purpose: Associations between fine and coarse particulate matters (i.e., PM2.5 and PM2.5–10, respectively) and the onset of angina have rarely been investigated. We aimed to systematically explore the impacts of PM2.5 as well as PM2.5–10 on the onset of stable and unstable angina at the hourly timescale. Methods: We performed a time-stratified case-crossover study among 995,734 angina patients from 1,655 hospitals in 305 Chinese cities from January 2015 to December 2021. Concentrations of PM2.5 and PM2.5–10 were collected at the hourly timescale from nearby fixed-site monitoring stations. Hourly onset information of unstable and stable angina was obtained from the Chinese Cardiovascular Association Database-Chest Pain Center. We applied conditional logistic regressions combined with polynomial distributed lag models to explore the lagged exposure–response associations. Subgroup analyses were performed to explore potential effect modifiers including age, sex, season, and region. Results: Transient exposure to PM2.5 was significantly associated with elevated risk of unstable and stable angina onset. The associations occurred immediately in the concurrent hour of exposure, attenuated thereafter, and turned to null at approximately lag 12 h for unstable angina and 9 h for stable angina. Each interquartile range increase in the PM2.5 concentrations over 0 to 12 h was associated with 1.32% (95% confidence interval [95% CI]: 0.94%–1.70%) and 1.69% (95% CI: 0.99%–2.39%) increase in the onset risk of unstable and stable angina, respectively. The results remained similar after controlling for co-pollutants. Greater magnitudes of associations were found among females and during cold season. Null associations were observed between PM2.5–10 and any type of angina. Conclusion: Our study indicates that acute exposure to PM2.5, rather than PM2.5–10, was significantly associated with the onset of both unstable and stable angina, underscoring the need of continued efforts in controlling particulate matter air pollution.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"8 1","pages":"126 - 133"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45603153","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}