Pub Date : 2022-10-01DOI: 10.1097/CP9.0000000000000033
Jing Li, H. Pei, Xianglin Ye, Jing Tian, Haixiang Yang, Qing Liu, Xiong Wang, Peng Wang
Background and purpose: Previous studies showed urate crystals in atherosclerotic plaques, suggesting that uric acid is involved in plaque formation, but whether it affects the formation of coronary collateral circulation (CCC) is unknown. This single-center retrospective study was conducted to investigate whether serum uric acid (SUA) level has an association with the CCC in patients with coronary chronic total occlusion (CTO). Methods: The final analysis included a total of 94 patients with CTO (defined as 100% stenosis in at least one of the left anterior descending artery, circumflex artery and right coronary artery with thrombolysis in myocardial infarction [TIMI] grade 0 of forward flow) for more than 3 months (66.03 ± 10.10 years of age; 54 men and 40 women). In the analysis, patients were divided into four groups of equal size based on the SUA level on admission (n = 32, 31, 31 for low, mid, and high SUA groups). Multivariate logistic regression was conducted to identify risk factors that were associated with poor CCC (as defined by Rentrop level ≤ 1). Results: The rate of poor CCC was 44.5% in the low SUA group, 54.8% in the mid-SUA group, and 77.4% in the high SUA group, respectively (P < 0.05 for all three pairwise comparisons). In multivariate regression analysis that treated SUA as a continuous variable, poorer CCC was associated with higher SUA (adjusted odds ratio [OR] = 1.011, 95% confidence interval [CI]: 1.005–1.017, P < 0.05). In comparison to the patients with lowest SUA in the regression analysis that treated SUA as a categorical variable, there was a statistically non-significant trend for increased risk of poor CCC (OR 2.277, 95% CI: 0.753–6.884) in the patient with mid-level SUA. The risk of poor CCC was significantly elevated in the patients with high SUA (OR 6.243, 95% CI: 1.872–20.828). Conclusions: Elevated SUA level was associated with poor CCC in patients with CTO.
{"title":"Correlation between serum uric acid and coronary collateral circulation in patients with coronary chronic total occlusion","authors":"Jing Li, H. Pei, Xianglin Ye, Jing Tian, Haixiang Yang, Qing Liu, Xiong Wang, Peng Wang","doi":"10.1097/CP9.0000000000000033","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000033","url":null,"abstract":"Background and purpose: Previous studies showed urate crystals in atherosclerotic plaques, suggesting that uric acid is involved in plaque formation, but whether it affects the formation of coronary collateral circulation (CCC) is unknown. This single-center retrospective study was conducted to investigate whether serum uric acid (SUA) level has an association with the CCC in patients with coronary chronic total occlusion (CTO). Methods: The final analysis included a total of 94 patients with CTO (defined as 100% stenosis in at least one of the left anterior descending artery, circumflex artery and right coronary artery with thrombolysis in myocardial infarction [TIMI] grade 0 of forward flow) for more than 3 months (66.03 ± 10.10 years of age; 54 men and 40 women). In the analysis, patients were divided into four groups of equal size based on the SUA level on admission (n = 32, 31, 31 for low, mid, and high SUA groups). Multivariate logistic regression was conducted to identify risk factors that were associated with poor CCC (as defined by Rentrop level ≤ 1). Results: The rate of poor CCC was 44.5% in the low SUA group, 54.8% in the mid-SUA group, and 77.4% in the high SUA group, respectively (P < 0.05 for all three pairwise comparisons). In multivariate regression analysis that treated SUA as a continuous variable, poorer CCC was associated with higher SUA (adjusted odds ratio [OR] = 1.011, 95% confidence interval [CI]: 1.005–1.017, P < 0.05). In comparison to the patients with lowest SUA in the regression analysis that treated SUA as a categorical variable, there was a statistically non-significant trend for increased risk of poor CCC (OR 2.277, 95% CI: 0.753–6.884) in the patient with mid-level SUA. The risk of poor CCC was significantly elevated in the patients with high SUA (OR 6.243, 95% CI: 1.872–20.828). Conclusions: Elevated SUA level was associated with poor CCC in patients with CTO.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"200 - 204"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49109390","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 : 2022-10-01DOI: 10.1097/CP9.0000000000000027
Ming Wang, Shuyi Zhang, Wenzheng Han
An 81-year-old man presented with progressive symptoms of heart failure. Echocardiography showed a mass in the right atrium (approximately 31 × 55 mm) that extended to the tricuspid valves as well as the superior vena cava. Positron emission tomography-computed tomography (PET-CT) showed elevated 18F-fluorodeoxyglucose (18F-FDG) uptake throughout the space-occupying lesions. The patient received surgery based on a preliminary diagnosis of myxoma. Pathological examination of the resected specimen revealed large B-cell lymphoma. The patient received three cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone regimen but no subsequent anti-tumor therapy. At the last follow-up 3.5 years later, he was still alive. In summary, primary cardiac lymphoma should be considered in differential diagnosis in isolated space-occupying lesions in the heart.
{"title":"18F-FDG PET/CT features and management of primary cardiac lymphoma: a case report","authors":"Ming Wang, Shuyi Zhang, Wenzheng Han","doi":"10.1097/CP9.0000000000000027","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000027","url":null,"abstract":"An 81-year-old man presented with progressive symptoms of heart failure. Echocardiography showed a mass in the right atrium (approximately 31 × 55 mm) that extended to the tricuspid valves as well as the superior vena cava. Positron emission tomography-computed tomography (PET-CT) showed elevated 18F-fluorodeoxyglucose (18F-FDG) uptake throughout the space-occupying lesions. The patient received surgery based on a preliminary diagnosis of myxoma. Pathological examination of the resected specimen revealed large B-cell lymphoma. The patient received three cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone regimen but no subsequent anti-tumor therapy. At the last follow-up 3.5 years later, he was still alive. In summary, primary cardiac lymphoma should be considered in differential diagnosis in isolated space-occupying lesions in the heart.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"205 - 209"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46209345","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 : 2022-10-01DOI: 10.1097/CP9.0000000000000034
Mingqiang Fu, Shufu Chang, Jianying Ma, Junbo Ge
A 60-year-old man presented with exertional chest pain and was hospitalized on a diagnosis of unstable angina. Coronary angiography revealed left main true bifurcation lesions and percutaneous coronary intervention (PCI) was conducted using the culotte-stenting technique. Post-dilatational angiography revealed an irregular protrusion of the stent strut in mid left anterior descending (LAD) coronary artery. Intravascular ultrasound (IVUS) showed a discontinuation of the middle stent strut with calcified nodules. An additional everolimus-eluting stent (EES) was placed across the discontinued lesions. Post-procedural IVUS revealed good expansion of the stents and final angiography showed optimal angiographic results with thromboly sis in myocardial infarction (TIMI) 3 flow. The patient was discharged the next day after the operation and maintained asymptomatic for chest pain at the 6-month follow-up point.
{"title":"Immediate stent fracture after everolimus-eluting stent implantation: a case report","authors":"Mingqiang Fu, Shufu Chang, Jianying Ma, Junbo Ge","doi":"10.1097/CP9.0000000000000034","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000034","url":null,"abstract":"A 60-year-old man presented with exertional chest pain and was hospitalized on a diagnosis of unstable angina. Coronary angiography revealed left main true bifurcation lesions and percutaneous coronary intervention (PCI) was conducted using the culotte-stenting technique. Post-dilatational angiography revealed an irregular protrusion of the stent strut in mid left anterior descending (LAD) coronary artery. Intravascular ultrasound (IVUS) showed a discontinuation of the middle stent strut with calcified nodules. An additional everolimus-eluting stent (EES) was placed across the discontinued lesions. Post-procedural IVUS revealed good expansion of the stents and final angiography showed optimal angiographic results with thromboly sis in myocardial infarction (TIMI) 3 flow. The patient was discharged the next day after the operation and maintained asymptomatic for chest pain at the 6-month follow-up point.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"210 - 213"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42774435","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 : 2022-10-01DOI: 10.1097/CP9.0000000000000032
Linjie Li, Xin Zhou, Z. Jin, G. A, Pengfei Sun, Zhuoqun Wang, Yong-le Li, Chengyi Xu, X. Su, Qing Yang, Y. Huo
Background and purpose: The Chest Pain Center accreditation project was launched in 2011 in China as a nationwide effort to improve clinical management of acute chest pain patients. In this study, we summarize the clinical characteristics and in-hospital outcomes of patients undergoing treatment for acute coronary syndrome (ACS) in Chest Pain Centers in China. Methods: Data were based on the Chinese Cardiovascular Association (CCA) Database-Chest Pain Center of 1,745,118 ACS patients admitted at 2,096 accredited Chest Pain Center between January 1, 2016, and December 31, 2021. Patient characteristics, time delays, treatment, and outcomes were analyzed using descriptive analysis. Results: The final analysis included a total of 1,745,118 patients, 699,476 patients (40.1%) with ST segment elevation myocardial infarction (STEMI), 349,572 (20.0%) with non-ST segment elevation myocardial infarction (NSTEMI), and 696,070 (39.9%) with unstable angina (UA). Electrocardiogram (ECG) was conducted in 89.4% of the patients within 10 min after first medical contact. For STEMI patients, the median door-to-wire crossing time was 72.1 (53.1 to 91.9) min and the median first medical contact-to-needle time was 32.3 (23.8 to 58.6) min. In-hospital mortality was 2.0% in the overall analysis, 3.6% for STEMI, 2.1% for NSTEMI, and 0.3% for UA. Primary percutaneous coronary intervention (PCI) was conducted in 62.8% of STEMI patients, with increasing rate in grade I and II hospitals over the 6-year study period. Patients treated with thrombolysis had significantly higher mortality than those treated with PCI and thrombolysis combined with PCI. The development of Chest Pain Centers varied substantially across geographic regions. Conclusions: Based on CCA Database-Chest Pain Center, the current study provided an overall description of the clinical characteristics of ACS patients in China. The results on management pattern and in-hospital outcomes of STEMI patients identified important areas for further improvement in ACS patient management in China.
{"title":"Clinical characteristics and in-hospital management strategies in patients with acute coronary syndrome: results from 2,096 accredited Chest Pain Centers in China from 2016 to 2021","authors":"Linjie Li, Xin Zhou, Z. Jin, G. A, Pengfei Sun, Zhuoqun Wang, Yong-le Li, Chengyi Xu, X. Su, Qing Yang, Y. Huo","doi":"10.1097/CP9.0000000000000032","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000032","url":null,"abstract":"Background and purpose: The Chest Pain Center accreditation project was launched in 2011 in China as a nationwide effort to improve clinical management of acute chest pain patients. In this study, we summarize the clinical characteristics and in-hospital outcomes of patients undergoing treatment for acute coronary syndrome (ACS) in Chest Pain Centers in China. Methods: Data were based on the Chinese Cardiovascular Association (CCA) Database-Chest Pain Center of 1,745,118 ACS patients admitted at 2,096 accredited Chest Pain Center between January 1, 2016, and December 31, 2021. Patient characteristics, time delays, treatment, and outcomes were analyzed using descriptive analysis. Results: The final analysis included a total of 1,745,118 patients, 699,476 patients (40.1%) with ST segment elevation myocardial infarction (STEMI), 349,572 (20.0%) with non-ST segment elevation myocardial infarction (NSTEMI), and 696,070 (39.9%) with unstable angina (UA). Electrocardiogram (ECG) was conducted in 89.4% of the patients within 10 min after first medical contact. For STEMI patients, the median door-to-wire crossing time was 72.1 (53.1 to 91.9) min and the median first medical contact-to-needle time was 32.3 (23.8 to 58.6) min. In-hospital mortality was 2.0% in the overall analysis, 3.6% for STEMI, 2.1% for NSTEMI, and 0.3% for UA. Primary percutaneous coronary intervention (PCI) was conducted in 62.8% of STEMI patients, with increasing rate in grade I and II hospitals over the 6-year study period. Patients treated with thrombolysis had significantly higher mortality than those treated with PCI and thrombolysis combined with PCI. The development of Chest Pain Centers varied substantially across geographic regions. Conclusions: Based on CCA Database-Chest Pain Center, the current study provided an overall description of the clinical characteristics of ACS patients in China. The results on management pattern and in-hospital outcomes of STEMI patients identified important areas for further improvement in ACS patient management in China.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"192 - 199"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47550587","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 : 2022-10-01DOI: 10.1097/CP9.0000000000000031
Jianyuan Pan, Ming Liu, H. Su, Likun Ma
Background and purpose: Hypertrophic obstructive cardiomyopathy (HOCM) is a global genetic myocardial disease. In clinical practice, an indicator that could be used to identify suitable patients for percutaneous transluminal septal myocardial ablation (PTSMA) and assess their long-term prognosis is important for cardiologists. HOCM patients undergoing PTSMA, poor long-term prognosis has been associated with higher left ventricular outflow tract gradient (LVOTG) and interventricular septal thickness (IVST). In this retrospective, multicenter study, we aimed to investigate the association between TG (TG = IVS thickness × LVOT gradient) index and acute- or long-term outcomes of HOCM patients after PTSMA and further investigate the interaction effects of LVOTG and IVST. Methods: The study design is based on four tertiary centers from Mid-China, and a total of 284 HOCM patients (132 males, average age 54.80 ± 11.98 years) were treated with PTSMA. A new clinic index (TG = IVS thickness × LVOT gradient) was designed. Both 30-day major cardiovascular adverse events and all-cause mortality of the HOCM patients were analyzed. Cox proportional hazards regression model adjusting for potential risk factors was applied to explore the hazard ratio (HR) for all-cause mortality. Results: Total alcohol injection volume was 2.201 ± 1.025 mL. LVOTG and IVST were reduced to 40.11 ± 24.44 mmHg and 17.68 ± 4.07 mm at the last clinical check-up, respectively. Patients with low IVST (≤20 mm) or low TG index (≤1,683) had a higher rate of PTSMA-contributable complications and a higher need for a permanent pacemaker. Within the 903 patient-years follow-up, a total of 21 (9.8%) deaths occurred. The number of deaths per 100 patient-years was 0.65 and 4.06 in the high versus low TG index groups. The 8-year OS rate was 48.95% (95% CI = 39.07%–57.75%) versus 82.63% (95% CI = 74.99%–86.66%) in the high versus low TG groups, respectively (log-rank P < 0.001). The patients with both high LVOTG (>82 mmHg) and high IVST had the highest risk of all-cause mortality (HR: 18.63 vs low LVOTG, 95% CI = 1.09–319.15). Conclusions: The 8-year OS rate was markedly higher in patients with a low TG index (≤1,683) (48.95%) versus in patients with a high TG index (>1,683 group) (82.63%). The TG index could be a useful tool in the evaluation of HOCM patients for suitability for PTSMA.
{"title":"A novel risk model to predict all-cause mortality in patients undergoing percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy","authors":"Jianyuan Pan, Ming Liu, H. Su, Likun Ma","doi":"10.1097/CP9.0000000000000031","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000031","url":null,"abstract":"Background and purpose: Hypertrophic obstructive cardiomyopathy (HOCM) is a global genetic myocardial disease. In clinical practice, an indicator that could be used to identify suitable patients for percutaneous transluminal septal myocardial ablation (PTSMA) and assess their long-term prognosis is important for cardiologists. HOCM patients undergoing PTSMA, poor long-term prognosis has been associated with higher left ventricular outflow tract gradient (LVOTG) and interventricular septal thickness (IVST). In this retrospective, multicenter study, we aimed to investigate the association between TG (TG = IVS thickness × LVOT gradient) index and acute- or long-term outcomes of HOCM patients after PTSMA and further investigate the interaction effects of LVOTG and IVST. Methods: The study design is based on four tertiary centers from Mid-China, and a total of 284 HOCM patients (132 males, average age 54.80 ± 11.98 years) were treated with PTSMA. A new clinic index (TG = IVS thickness × LVOT gradient) was designed. Both 30-day major cardiovascular adverse events and all-cause mortality of the HOCM patients were analyzed. Cox proportional hazards regression model adjusting for potential risk factors was applied to explore the hazard ratio (HR) for all-cause mortality. Results: Total alcohol injection volume was 2.201 ± 1.025 mL. LVOTG and IVST were reduced to 40.11 ± 24.44 mmHg and 17.68 ± 4.07 mm at the last clinical check-up, respectively. Patients with low IVST (≤20 mm) or low TG index (≤1,683) had a higher rate of PTSMA-contributable complications and a higher need for a permanent pacemaker. Within the 903 patient-years follow-up, a total of 21 (9.8%) deaths occurred. The number of deaths per 100 patient-years was 0.65 and 4.06 in the high versus low TG index groups. The 8-year OS rate was 48.95% (95% CI = 39.07%–57.75%) versus 82.63% (95% CI = 74.99%–86.66%) in the high versus low TG groups, respectively (log-rank P < 0.001). The patients with both high LVOTG (>82 mmHg) and high IVST had the highest risk of all-cause mortality (HR: 18.63 vs low LVOTG, 95% CI = 1.09–319.15). Conclusions: The 8-year OS rate was markedly higher in patients with a low TG index (≤1,683) (48.95%) versus in patients with a high TG index (>1,683 group) (82.63%). The TG index could be a useful tool in the evaluation of HOCM patients for suitability for PTSMA.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"186 - 191"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45307166","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 : 2022-07-01DOI: 10.1097/CP9.0000000000000020
Y. Oh, Weiliang Huang, J. Tan
We present a case (57-year-old man) of infective endocarditis caused by Streptococcus gallolyticus in a patient with incident early-stage colon cancer. Benzylpenicillin treatment was immediately initiated to control bacteremia, and curative cancer resection was conducted 1 week later. The patient was discharged and placed on a 6-week outpatient parenteral anti-biotic therapy program for infective endocarditis but was rehospitalized 2 months later for heart failure. Transesophageal echocardiography revealed multiple large vegetations and perforation of the aortic valve. Valve replacement was conducted successfully, and heart failure was alleviated. This case highlights the dilemma of prioritizing the management of two competing interests, one for heart failure caused by valve regurgitation and the other for early-stage colon cancer with a curative intent. In this case, curative resection of the colon cancer was conducted after reasonable control of the endocarditis. Perforation of the aortic valve and heart failure could have been avoided if valve replacement was conducted first, but at the risk of cancer progression.
{"title":"Stretococcus gallolyticus infective endocarditis, a different presentation-a case report","authors":"Y. Oh, Weiliang Huang, J. Tan","doi":"10.1097/CP9.0000000000000020","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000020","url":null,"abstract":"We present a case (57-year-old man) of infective endocarditis caused by Streptococcus gallolyticus in a patient with incident early-stage colon cancer. Benzylpenicillin treatment was immediately initiated to control bacteremia, and curative cancer resection was conducted 1 week later. The patient was discharged and placed on a 6-week outpatient parenteral anti-biotic therapy program for infective endocarditis but was rehospitalized 2 months later for heart failure. Transesophageal echocardiography revealed multiple large vegetations and perforation of the aortic valve. Valve replacement was conducted successfully, and heart failure was alleviated. This case highlights the dilemma of prioritizing the management of two competing interests, one for heart failure caused by valve regurgitation and the other for early-stage colon cancer with a curative intent. In this case, curative resection of the colon cancer was conducted after reasonable control of the endocarditis. Perforation of the aortic valve and heart failure could have been avoided if valve replacement was conducted first, but at the risk of cancer progression.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"144 - 147"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42011361","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 : 2022-07-01DOI: 10.1097/CP9.0000000000000021
Zhao-ping Liu, Jianping Li, Yan Zhang, B. Yu, Yitong Ma, G. Ma, Jian'an Wang, Bin Liu, Xin-Yan Su, Bao Li, Zheng-Chang Zhang, Yuguo Chen, Jiyan Chen, Lianglong Chen, Yundai Chen, Zuyi Yuan, S. Jia, Chuanyu Gao, Yida Tang, Xianghua Fu, Yaling Han, Junbo Ge, Xudong Ma, Y. Huo
Background and purpose: In the past 30 to 40 years, percutaneous coronary intervention (PCI) in China has greatly improved. The State Ministry of Health established a quality control (QC) system in 2009, and all medical centers were required to report their PCI cases. We analyzed the data from the QC system to describe the current status and development of PCI in China. Methods: PCI case data during a period from 2010 to 2018 were extracted from the online QC system. Data quality was audited by QC centers at the provincial level. Statistical analysis was mainly descriptive. Trend analysis was conducted by recoding the year as a continuous variable in linear regression or logistic regression. Results: The number of medical centers reporting PCI cases was 941 in 2010, and increased to 1,788 in 2018. Total number of PCI cases reported online to the QC system was 236,717 in 2010, and increased to 705,970 in 2018. Estimate of the actual case number that included those reported offline only (based on offline audit by provincial QC centers) was 284,936 in 2010, and increased to 915,256 in 2018. The most common indication for PCI was unstable angina (52.9%–59.1%), followed by ST elevation myocardial infarction (STEMI; 25.0%–27.4%). Majority of the PCI procedures were performed via the radial artery (65.4% in 2010 and 90.7% in 2018). Angiography detected a left main lesion in 5%, single-vessel disease in 38.7% to 44.4%, two-vessel disease in 22.3% to 27.5%, and three-vessel disease in 27.0% to 28.7% of the patients. The rate of primary PCI for STEMI in all STEMI cases was 28.0% in 2010, and increased to 45.9% in 2018. The average number of stents implanted per case was 1.63 in 2010, and decreased to 1.46 in 2018. There was a trend for decreasing mortality (0.31% in 2010; 0.26% in 2018). Conclusions: The number of PCI cases in China increased steadily during a period from 2010 to 2018, with stable mortality rate. Transradial access is the dominant PCI route. The rate of primary PCI for STEMI increased substantially, but remained relatively low.
{"title":"Trends in percutaneous coronary intervention in China: analysis of China PCI Registry Data from 2010 to 2018","authors":"Zhao-ping Liu, Jianping Li, Yan Zhang, B. Yu, Yitong Ma, G. Ma, Jian'an Wang, Bin Liu, Xin-Yan Su, Bao Li, Zheng-Chang Zhang, Yuguo Chen, Jiyan Chen, Lianglong Chen, Yundai Chen, Zuyi Yuan, S. Jia, Chuanyu Gao, Yida Tang, Xianghua Fu, Yaling Han, Junbo Ge, Xudong Ma, Y. Huo","doi":"10.1097/CP9.0000000000000021","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000021","url":null,"abstract":"Background and purpose: In the past 30 to 40 years, percutaneous coronary intervention (PCI) in China has greatly improved. The State Ministry of Health established a quality control (QC) system in 2009, and all medical centers were required to report their PCI cases. We analyzed the data from the QC system to describe the current status and development of PCI in China. Methods: PCI case data during a period from 2010 to 2018 were extracted from the online QC system. Data quality was audited by QC centers at the provincial level. Statistical analysis was mainly descriptive. Trend analysis was conducted by recoding the year as a continuous variable in linear regression or logistic regression. Results: The number of medical centers reporting PCI cases was 941 in 2010, and increased to 1,788 in 2018. Total number of PCI cases reported online to the QC system was 236,717 in 2010, and increased to 705,970 in 2018. Estimate of the actual case number that included those reported offline only (based on offline audit by provincial QC centers) was 284,936 in 2010, and increased to 915,256 in 2018. The most common indication for PCI was unstable angina (52.9%–59.1%), followed by ST elevation myocardial infarction (STEMI; 25.0%–27.4%). Majority of the PCI procedures were performed via the radial artery (65.4% in 2010 and 90.7% in 2018). Angiography detected a left main lesion in 5%, single-vessel disease in 38.7% to 44.4%, two-vessel disease in 22.3% to 27.5%, and three-vessel disease in 27.0% to 28.7% of the patients. The rate of primary PCI for STEMI in all STEMI cases was 28.0% in 2010, and increased to 45.9% in 2018. The average number of stents implanted per case was 1.63 in 2010, and decreased to 1.46 in 2018. There was a trend for decreasing mortality (0.31% in 2010; 0.26% in 2018). Conclusions: The number of PCI cases in China increased steadily during a period from 2010 to 2018, with stable mortality rate. Transradial access is the dominant PCI route. The rate of primary PCI for STEMI increased substantially, but remained relatively low.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"118 - 124"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45165012","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 : 2022-07-01DOI: 10.1097/CP9.0000000000000022
Shikai Yu, Yi Zhang, W. Peng, Dong Zhao, Hong Shi, Shuning Zhang, Y. Huo, Yawei Xu, J. Ge
Background and purpose: Cardiologists represent a subset of the population with the highest degree of awareness to cardiovascular diseases (CVD), and thus should have low exposure to modifiable risks and low CVD prevalence. However, the status of cardiovascular health in Chinese cardiologists remains unknown. Methods: China Cardiologist Heart Survey II is a nation-wide cross-sectional survey on licensed cardiologists in Chinese mainland. It was conducted between August 2020 and November 2021. An online questionnaire was used to acquire demographic and lifestyle information, cardiovascular risk factors, CVD status, and medications. Crude prevalence of cardiovascular risk factors, organ damage, and CVD were calculated and compared between sexes and between sub-specialties. Age-weighted prevalence of cardiovascular risk factors were compared to that in the general Chinese population in the literature. Results: The final analysis included a total of 15,827 cardiologists at the age of 25 to 60 years from 31 provinces. The median age was 38 years and 8650 (54.7%) were men. The most common cardiovascular risk factor was family history of premature CVD (20.4%), followed by hypertension (12.4%), hyperlipidemia (10.6%), overweight/obesity (8.3%), smoking (7.3%), and diabetes (2.4%). The most common sub-clinical organ damages included carotid plaque (3.4%) and microalbuminuria (1.2%). The rate of confirmed coronary artery disease was 0.4%. The rate of arrhythmia was 3.1%. The rate of obstructive sleep apnea syndrome was 2.2%. The rate of cardiovascular risk factors and organ damage was higher in men versus in women, and higher in interventional versus non-interventional cardiologists. In comparison to the data reported for the general population in China, cardiologists had lower age-weighted prevalence of hypertension (15.2% vs. 23.2%), diabetes (3.1% vs. 10.9%), hyperlipidemia (12.3% vs. 40.4%), obesity (2.1% vs. 11.9%), and smoking (7.7% vs. 27.7%). Conclusions: In comparison to the general public, cardiologists in Chinese mainland had much lower age-weighted prevalence of cardiovascular risk factors, but there is substantial room for further improvement, particularly in male and interventional cardiologists.
背景和目的:心脏病专家代表了对心血管疾病(CVD)认识程度最高的人群的一个子集，因此应该具有低暴露于可改变风险和低CVD患病率。然而，中国心脏病专家的心血管健康状况尚不清楚。方法:中国心脏病专家心脏调查II是一项针对中国大陆执业心脏病专家的全国性横断面调查。该调查于2020年8月至2021年11月进行。使用在线问卷获取人口统计和生活方式信息、心血管危险因素、心血管疾病状况和药物。计算并比较了不同性别和不同亚专科的心血管危险因素、器官损伤和心血管疾病的粗患病率。将心血管危险因素的年龄加权患病率与文献中中国普通人群的年龄加权患病率进行比较。结果:最终的分析包括来自31个省份的15,827名年龄在25至60岁之间的心脏病专家。中位年龄为38岁，男性8650例(54.7%)。最常见的心血管危险因素是早发性心血管疾病家族史(20.4%)，其次是高血压(12.4%)、高脂血症(10.6%)、超重/肥胖(8.3%)、吸烟(7.3%)和糖尿病(2.4%)。最常见的亚临床器官损害包括颈动脉斑块(3.4%)和微量白蛋白尿(1.2%)。冠状动脉疾病确诊率为0.4%。心律失常发生率为3.1%。阻塞性睡眠呼吸暂停综合征发生率为2.2%。心血管危险因素和器官损害的比率在男性中高于女性，在介入心脏病专家中高于非介入心脏病专家。与中国普通人群报告的数据相比，心脏病专家的高血压(15.2% vs. 23.2%)、糖尿病(3.1% vs. 10.9%)、高脂血症(12.3% vs. 40.4%)、肥胖(2.1% vs. 11.9%)和吸烟(7.7% vs. 27.7%)的年龄加权患病率较低。结论:与普通大众相比，中国大陆心脏病专家的心血管危险因素年龄加权患病率要低得多，但仍有很大的改善空间，尤其是男性和介入性心脏病专家。
{"title":"Cardiovascular health status in Chinese Cardiologists: China Cardiologist Heart Survey II","authors":"Shikai Yu, Yi Zhang, W. Peng, Dong Zhao, Hong Shi, Shuning Zhang, Y. Huo, Yawei Xu, J. Ge","doi":"10.1097/CP9.0000000000000022","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000022","url":null,"abstract":"Background and purpose: Cardiologists represent a subset of the population with the highest degree of awareness to cardiovascular diseases (CVD), and thus should have low exposure to modifiable risks and low CVD prevalence. However, the status of cardiovascular health in Chinese cardiologists remains unknown. Methods: China Cardiologist Heart Survey II is a nation-wide cross-sectional survey on licensed cardiologists in Chinese mainland. It was conducted between August 2020 and November 2021. An online questionnaire was used to acquire demographic and lifestyle information, cardiovascular risk factors, CVD status, and medications. Crude prevalence of cardiovascular risk factors, organ damage, and CVD were calculated and compared between sexes and between sub-specialties. Age-weighted prevalence of cardiovascular risk factors were compared to that in the general Chinese population in the literature. Results: The final analysis included a total of 15,827 cardiologists at the age of 25 to 60 years from 31 provinces. The median age was 38 years and 8650 (54.7%) were men. The most common cardiovascular risk factor was family history of premature CVD (20.4%), followed by hypertension (12.4%), hyperlipidemia (10.6%), overweight/obesity (8.3%), smoking (7.3%), and diabetes (2.4%). The most common sub-clinical organ damages included carotid plaque (3.4%) and microalbuminuria (1.2%). The rate of confirmed coronary artery disease was 0.4%. The rate of arrhythmia was 3.1%. The rate of obstructive sleep apnea syndrome was 2.2%. The rate of cardiovascular risk factors and organ damage was higher in men versus in women, and higher in interventional versus non-interventional cardiologists. In comparison to the data reported for the general population in China, cardiologists had lower age-weighted prevalence of hypertension (15.2% vs. 23.2%), diabetes (3.1% vs. 10.9%), hyperlipidemia (12.3% vs. 40.4%), obesity (2.1% vs. 11.9%), and smoking (7.7% vs. 27.7%). Conclusions: In comparison to the general public, cardiologists in Chinese mainland had much lower age-weighted prevalence of cardiovascular risk factors, but there is substantial room for further improvement, particularly in male and interventional cardiologists.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"125 - 131"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45832136","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 : 2022-07-01DOI: 10.1097/CP9.0000000000000018
Zhiyong Qi, Xin Liu, Gang Zhao, Junbo Ge
Background and purpose: Nucleotide-binding domain leucine-rich repeat containing protein (NLRP3) inflammasome contributes to the development and progression of atherosclerosis and cardiovascular diseases. Enhanced expression of NLRP3 in monocytes has been reported in patients with coronary artery disease (CAD). However, NLRP3 expression in platelets, an important link between inflammation and atherosclerosis/thrombosis in CAD patients has not been evaluated. The purpose of this study was to explore the expression of NLRP3 in platelets with acute coronary syndrome (ACS) and stable CAD. Methods: This prospective observational study included 60 treatment-naïve patients with newly diagnosed ACS, 60 patients with stable CAD, and 60 age- and sex-matched healthy individuals with normal coronary arteries (NCA). Platelet NLRP3 expression was evaluated by flow cytometry in venous blood samples, and compared among the 3 groups. Multivariate regression analysis was conducted to identify the risk of ACS. Results: Platelet NLRP3 expression was highest in the ACS group, followed by the stable CAD, and lowest in the NCA group (P < 0.001 for ACS vs. stable CAD, 44.7 ± 21.3 vs. 25.9 ± 15.9, as well as for stable CAD, vs. NCA, 25.9 ± 15.9 vs. 12.4 ± 7.2). Higher platelet NLRP3 correlated with higher plasma interleukin-1β and interleukin-18 (r = 0.662 and 0.324, respectively; P < 0.001 for both). In multivariate regression analysis, higher platelet NLRP3 was independently associated with ACS (odds ratio 1.06, 95% CI: 1.02–1.10 vs. stable CAD; odds ratio 1.23, 95% CI: 1.06–1.42 vs. NCA). Conclusion: Platelet NLRP3 expression was highest in the ACS group, followed by the stable CAD group, and lowest in the NCA group. Also, higher platelet NLRP3 expression was independently associated the ACS.
{"title":"Enhanced platelet NLRP3 inflammasome expression in patients with acute coronary syndrome and stable coronary artery disease: A prospective observational study","authors":"Zhiyong Qi, Xin Liu, Gang Zhao, Junbo Ge","doi":"10.1097/CP9.0000000000000018","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000018","url":null,"abstract":"Background and purpose: Nucleotide-binding domain leucine-rich repeat containing protein (NLRP3) inflammasome contributes to the development and progression of atherosclerosis and cardiovascular diseases. Enhanced expression of NLRP3 in monocytes has been reported in patients with coronary artery disease (CAD). However, NLRP3 expression in platelets, an important link between inflammation and atherosclerosis/thrombosis in CAD patients has not been evaluated. The purpose of this study was to explore the expression of NLRP3 in platelets with acute coronary syndrome (ACS) and stable CAD. Methods: This prospective observational study included 60 treatment-naïve patients with newly diagnosed ACS, 60 patients with stable CAD, and 60 age- and sex-matched healthy individuals with normal coronary arteries (NCA). Platelet NLRP3 expression was evaluated by flow cytometry in venous blood samples, and compared among the 3 groups. Multivariate regression analysis was conducted to identify the risk of ACS. Results: Platelet NLRP3 expression was highest in the ACS group, followed by the stable CAD, and lowest in the NCA group (P < 0.001 for ACS vs. stable CAD, 44.7 ± 21.3 vs. 25.9 ± 15.9, as well as for stable CAD, vs. NCA, 25.9 ± 15.9 vs. 12.4 ± 7.2). Higher platelet NLRP3 correlated with higher plasma interleukin-1β and interleukin-18 (r = 0.662 and 0.324, respectively; P < 0.001 for both). In multivariate regression analysis, higher platelet NLRP3 was independently associated with ACS (odds ratio 1.06, 95% CI: 1.02–1.10 vs. stable CAD; odds ratio 1.23, 95% CI: 1.06–1.42 vs. NCA). Conclusion: Platelet NLRP3 expression was highest in the ACS group, followed by the stable CAD group, and lowest in the NCA group. Also, higher platelet NLRP3 expression was independently associated the ACS.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"132 - 137"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49525575","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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