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}
Pub Date : 2022-07-01DOI: 10.1097/CP9.0000000000000023
Xiangeng Hou, Ying-Ying Zheng, Tingting Wu, You Chen, Yi Yang, Yi-tong Ma, Xiang Xie
Background and purpose: The association between platelet counts (PC) with clinical outcomes after percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD) has been reported by some but not all previous studies. The present study aims to investigate the association of PC with the outcomes of CAD patients who underwent PCI. Methods: We conducted a retrospective cohort study to examine the potential impact of baseline PC with long-term outcomes in patients receiving at least one stent. The final analysis included a total of 6,046 patients. The median follow-up was 32 (1–120) months Results: All-cause mortality did not differ significantly among the four groups based on baseline PC (lowest 25%, Quartile 1 [Q1], PC < 173, n = 1,473; 25%–50%, Quartile 2 [Q2], 173 ≤ PC < 208, n = 1,529; 50%–75%, Quartile 3 [Q3], 208 ≤ PC < 250, n = 1,507; and 75%–100%, Quartile 4 [Q4], PC ≥ 250, n = 1,537). The rate of major adverse cardiovascular and cerebrovascular events was 12.8% (188/1,473) in the Q1 group, 12.8% (196/1,529) in the Q2 group, 15.1% (228/1,507) in the Q3 group, and 16.3% (150/1,537) in the Q4 group (P = 0.010). The rate of major adverse cardiovascular events was 11.3% (167/1,473) in the Q1 group, 11.6% (177/1,529) in the Q2 group, 13.9% (210/1,507) in the Q3 group, and 15.0% (231/1,537) in the Q4 group (P = 0.004). Using Q1 as reference, the adjusted hazard ratio (aHR) for major adverse cardiovascular and cerebrovascular events in multivariate Cox regression was 1.212 (95% confidence interval [CI]: 1.004–1.455, P < 0.001) in Q2, 1.455 (95% CI: 1.200–1.766, P < 0.001) in Q3, and 1.754 (95% CI: 1.426–2.118, P < 0.001) in Q4. Using Q1 as reference, the aHR for major adverse cardiovascular events was 1.201(95% CI: 0.968–1.492, P = 0.096) in Q2, 1.489 (95% CI: 1.206–1.837, P < 0.001) in Q3, and 1.847 (95% CI: 1.500–2.275, P < 0.001) in Q4. Conclusion: A higher baseline PC was independently associated with an increased risk of major adverse cardiovascular and cerebrovascular events and major adverse cardiovascular events, but not all-cause-mortality in CAD patients after PCI.
背景和目的:血小板计数(PC)与冠状动脉疾病(CAD)患者经皮冠状动脉介入治疗(PCI)后的临床结果之间的关系已被一些但不是全部的先前研究报道。本研究旨在探讨PC与冠心病患者行PCI后预后的关系。方法:我们进行了一项回顾性队列研究，以检查基线PC对接受至少一个支架的患者的长期预后的潜在影响。最终的分析包括总共6046名患者。结果:基于基线PC的四组全因死亡率无显著差异(最低25%，四分位数1 [Q1]， PC < 173, n = 1473;25%-50%，四分位数2 [Q2]， 173≤PC < 208, n = 1529;50%-75%，四分位数3 [Q3]， 208≤PC < 250, n = 1,507;75%-100%，四分位数4 [Q4]， PC≥250,n = 1537)。Q1组主要心脑血管不良事件发生率为12.8% (188/ 1473)，Q2组为12.8% (196/ 1529)，Q3组为15.1% (228/ 1507)，Q4组为16.3% (150/ 1537)(P = 0.010)。主要心血管不良事件发生率Q1组为11.3% (167/ 1473)，Q2组为11.6% (177/ 1529)，Q3组为13.9% (210/ 1507)，Q4组为15.0% (231/ 1537)(P = 0.004)。以Q1为参照，多因素Cox回归分析中，第二季度主要心脑血管不良事件的校正危险比(aHR)为1.212(95%可信区间[CI]: 1.004 ~ 1.455, P < 0.001)，第三季度为1.455 (95% CI: 1.200 ~ 1.766, P < 0.001)，第四季度为1.754 (95% CI: 1.426 ~ 2.118, P < 0.001)。以Q1为参照，第二季度主要不良心血管事件的aHR为1.201(95% CI: 0.968 ~ 1.492, P = 0.096)，第三季度为1.489 (95% CI: 1.206 ~ 1.837, P < 0.001)，第四季度为1.847 (95% CI: 1.500 ~ 2.275, P < 0.001)。结论:较高的基线PC与PCI后CAD患者主要不良心脑血管事件和主要不良心血管事件的风险增加独立相关，但与全因死亡率无关。
{"title":"Baseline platelet count independently predicts long-term adverse outcomes in patients undergoing percutaneous coronary intervention: a single-center retrospective cohort study","authors":"Xiangeng Hou, Ying-Ying Zheng, Tingting Wu, You Chen, Yi Yang, Yi-tong Ma, Xiang Xie","doi":"10.1097/CP9.0000000000000023","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000023","url":null,"abstract":"Background and purpose: The association between platelet counts (PC) with clinical outcomes after percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD) has been reported by some but not all previous studies. The present study aims to investigate the association of PC with the outcomes of CAD patients who underwent PCI. Methods: We conducted a retrospective cohort study to examine the potential impact of baseline PC with long-term outcomes in patients receiving at least one stent. The final analysis included a total of 6,046 patients. The median follow-up was 32 (1–120) months Results: All-cause mortality did not differ significantly among the four groups based on baseline PC (lowest 25%, Quartile 1 [Q1], PC < 173, n = 1,473; 25%–50%, Quartile 2 [Q2], 173 ≤ PC < 208, n = 1,529; 50%–75%, Quartile 3 [Q3], 208 ≤ PC < 250, n = 1,507; and 75%–100%, Quartile 4 [Q4], PC ≥ 250, n = 1,537). The rate of major adverse cardiovascular and cerebrovascular events was 12.8% (188/1,473) in the Q1 group, 12.8% (196/1,529) in the Q2 group, 15.1% (228/1,507) in the Q3 group, and 16.3% (150/1,537) in the Q4 group (P = 0.010). The rate of major adverse cardiovascular events was 11.3% (167/1,473) in the Q1 group, 11.6% (177/1,529) in the Q2 group, 13.9% (210/1,507) in the Q3 group, and 15.0% (231/1,537) in the Q4 group (P = 0.004). Using Q1 as reference, the adjusted hazard ratio (aHR) for major adverse cardiovascular and cerebrovascular events in multivariate Cox regression was 1.212 (95% confidence interval [CI]: 1.004–1.455, P < 0.001) in Q2, 1.455 (95% CI: 1.200–1.766, P < 0.001) in Q3, and 1.754 (95% CI: 1.426–2.118, P < 0.001) in Q4. Using Q1 as reference, the aHR for major adverse cardiovascular events was 1.201(95% CI: 0.968–1.492, P = 0.096) in Q2, 1.489 (95% CI: 1.206–1.837, P < 0.001) in Q3, and 1.847 (95% CI: 1.500–2.275, P < 0.001) in Q4. Conclusion: A higher baseline PC was independently associated with an increased risk of major adverse cardiovascular and cerebrovascular events and major adverse cardiovascular events, but not all-cause-mortality in CAD patients after PCI.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"138 - 143"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61654755","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/CP9.0000000000000019
Z. Long, Yangyang Xu, Wei Liu, Lijun Wang, Maigeng Zhou, P. Yin, Y. Huo
Background and purpose: Heart diseases are the leading cause of death in China. Understanding of the secular trend of different subcategories of heart disease is important for policy making. The purpose of this study is to analyze the mortality trend of heart diseases in China from 2013 to 2020. Methods: A population-based longitudinal analysis was conducted using the China National Mortality Surveillance System to examine heart disease mortality change during a period from 2013 to 2020. The causes of death were coded using the International Classification of Diseases-10th Revision. The number of deaths and mortality rate were calculated based on sex, subcategories of heart disease, urban versus rural setting, and across different geographic locations. Data from the sixth census in China in 2010 was used as the standard population, and the mortality rates were adjusted based on the under-reporting rate. Results: Ischemic heart disease (IHD), hypertensive heart disease (HHD), and rheumatic heart disease (RHD) are the three leading causes of heart disease deaths during 2013–2020. There was a trend for increased age-standardized mortality rate (ASMR) of cardiac arrest, aortic aneurysm (AA), and nonrheumatic valvular heart diseases (NRVHDs) during the study period. In comparison to men, women had higher ASMR of RHD, and lower ASMR of IHD, HHD, cardiac arrest, AA, and NRVHDs. In comparison to rural areas, urban areas had lower ASMR of IHD, HHD, and RHD, and higher ASMR of cardiac arrest, AA, and NRVHDs. The spectrum of heart diseases differed significantly across age groups. In 2020, the percentages of IHD and HHD in the ≥65-year age group were higher than in other age groups. Significant differences in ASMR were noted across different geographic locations, with the highest in Xinjiang (198.14/100,000) and the lowest in Shanghai (62.19/100,000) in 2020. Conclusions: The mortality rate decreased for IHD, HHD, and RHD during the study period, but remained the leading causes of heart disease death in China. There was a trend for increasing mortality of cardiac arrest, AA, and NRVHDs, and significant difference across different geographic locations.
{"title":"Mortality trend of heart diseases in China, 2013–2020","authors":"Z. Long, Yangyang Xu, Wei Liu, Lijun Wang, Maigeng Zhou, P. Yin, Y. Huo","doi":"10.1097/CP9.0000000000000019","DOIUrl":"https://doi.org/10.1097/CP9.0000000000000019","url":null,"abstract":"Background and purpose: Heart diseases are the leading cause of death in China. Understanding of the secular trend of different subcategories of heart disease is important for policy making. The purpose of this study is to analyze the mortality trend of heart diseases in China from 2013 to 2020. Methods: A population-based longitudinal analysis was conducted using the China National Mortality Surveillance System to examine heart disease mortality change during a period from 2013 to 2020. The causes of death were coded using the International Classification of Diseases-10th Revision. The number of deaths and mortality rate were calculated based on sex, subcategories of heart disease, urban versus rural setting, and across different geographic locations. Data from the sixth census in China in 2010 was used as the standard population, and the mortality rates were adjusted based on the under-reporting rate. Results: Ischemic heart disease (IHD), hypertensive heart disease (HHD), and rheumatic heart disease (RHD) are the three leading causes of heart disease deaths during 2013–2020. There was a trend for increased age-standardized mortality rate (ASMR) of cardiac arrest, aortic aneurysm (AA), and nonrheumatic valvular heart diseases (NRVHDs) during the study period. In comparison to men, women had higher ASMR of RHD, and lower ASMR of IHD, HHD, cardiac arrest, AA, and NRVHDs. In comparison to rural areas, urban areas had lower ASMR of IHD, HHD, and RHD, and higher ASMR of cardiac arrest, AA, and NRVHDs. The spectrum of heart diseases differed significantly across age groups. In 2020, the percentages of IHD and HHD in the ≥65-year age group were higher than in other age groups. Significant differences in ASMR were noted across different geographic locations, with the highest in Xinjiang (198.14/100,000) and the lowest in Shanghai (62.19/100,000) in 2020. Conclusions: The mortality rate decreased for IHD, HHD, and RHD during the study period, but remained the leading causes of heart disease death in China. There was a trend for increasing mortality of cardiac arrest, AA, and NRVHDs, and significant difference across different geographic locations.","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":"7 1","pages":"111 - 117"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47043933","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 : 2022-06-23DOI: 10.1097/cp9.0000000000000010
P. Sookaromdee, V. Wiwanitkit
{"title":"Letter to the Editor: C-reactive protein and cardiovascular events in obstructive and nonobstructive coronary artery disease","authors":"P. Sookaromdee, V. Wiwanitkit","doi":"10.1097/cp9.0000000000000010","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000010","url":null,"abstract":"","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49489727","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 : 2022-06-23DOI: 10.1097/cp9.0000000000000014
Jian‐Jun Li
{"title":"Reply to Letter to the Editor: C-reactive protein and cardiovascular events in obstructive and nonobstructive coronary artery disease","authors":"Jian‐Jun Li","doi":"10.1097/cp9.0000000000000014","DOIUrl":"https://doi.org/10.1097/cp9.0000000000000014","url":null,"abstract":"","PeriodicalId":52908,"journal":{"name":"Cardiology Plus","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44436834","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：