Pub Date : 2022-06-01DOI: 10.1097/CD9.0000000000000044
Fajiu Li, Xijie Zhu, Ziyang Zhu, Yinjian Yang, Zhuang Tian, Duolao Wang, Shi Chen, Xiaoyan Gao, Yalin Xu, Bo Zhang, Wei Yu, Min Liu, Xiqi Xu, Chenghong Li, Shuyang Zhang
Objective: Cardiac damage is commonly reported in patients with coronavirus disease 2019 (COVID-19) but its prevalence and impact on the long-term survival of patients remain uncertain. This study aimed to explore the prevalence of myocardial injury and assess its prognostic value in patients with COVID-19.
Methods: A single-center, retrospective cohort study was performed at the Affiliated Hospital of Jianghan University. Data from 766 patients with confirmed COVID-19 who were hospitalized from December 27, 2019 to April 25, 2020 were collected. Demographic, clinical, laboratory, electrocardiogram, treatment data and all-cause mortality during follow-up were collected and analyzed.
Results: Of the 766 patients with moderate to critically ill COVID-19, 86 (11.2%) died after a mean follow-up of 72.8 days. Myocardial injury occurred in 94 (12.3%) patients. The mortality rate was 64.9% (61/94) and 3.7% (25/672) in patients with and without myocardial injury, respectively. Cox regression showed that myocardial injury was an independent risk factor for mortality (hazard ratio: 8.76, 95% confidence interval: 4.76-16.11, P< 0.001). Of the 90 patients with myocardial injury with electrocardiogram results, sinus tachycardia was present in 29, bundle branch block in 26, low voltage in 10, and abnormal T-wave in 53.
Conclusions: COVID-19 not only involves pneumonia but also cardiac damage. Myocardial injury is a common complication and an independent risk factor for mortality in COVID-19 patients.
{"title":"Non-Ischemic, Non-Hypoxic Myocardial Injury, and Long-Term Mortality in Patients with Coronavirus Disease 2019: A Retrospective Cohort Study.","authors":"Fajiu Li, Xijie Zhu, Ziyang Zhu, Yinjian Yang, Zhuang Tian, Duolao Wang, Shi Chen, Xiaoyan Gao, Yalin Xu, Bo Zhang, Wei Yu, Min Liu, Xiqi Xu, Chenghong Li, Shuyang Zhang","doi":"10.1097/CD9.0000000000000044","DOIUrl":"https://doi.org/10.1097/CD9.0000000000000044","url":null,"abstract":"<p><strong>Objective: </strong>Cardiac damage is commonly reported in patients with coronavirus disease 2019 (COVID-19) but its prevalence and impact on the long-term survival of patients remain uncertain. This study aimed to explore the prevalence of myocardial injury and assess its prognostic value in patients with COVID-19.</p><p><strong>Methods: </strong>A single-center, retrospective cohort study was performed at the Affiliated Hospital of Jianghan University. Data from 766 patients with confirmed COVID-19 who were hospitalized from December 27, 2019 to April 25, 2020 were collected. Demographic, clinical, laboratory, electrocardiogram, treatment data and all-cause mortality during follow-up were collected and analyzed.</p><p><strong>Results: </strong>Of the 766 patients with moderate to critically ill COVID-19, 86 (11.2%) died after a mean follow-up of 72.8 days. Myocardial injury occurred in 94 (12.3%) patients. The mortality rate was 64.9% (61/94) and 3.7% (25/672) in patients with and without myocardial injury, respectively. Cox regression showed that myocardial injury was an independent risk factor for mortality (hazard ratio: 8.76, 95% confidence interval: 4.76-16.11, <i>P</i> <i><</i> 0.001). Of the 90 patients with myocardial injury with electrocardiogram results, sinus tachycardia was present in 29, bundle branch block in 26, low voltage in 10, and abnormal T-wave in 53.</p><p><strong>Conclusions: </strong>COVID-19 not only involves pneumonia but also cardiac damage. Myocardial injury is a common complication and an independent risk factor for mortality in COVID-19 patients.</p>","PeriodicalId":72524,"journal":{"name":"Cardiology discovery","volume":"2 2","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/35/cd9-2-77.PMC9749942.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10780650","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 : 2022-04-24DOI: 10.1097/CD9.0000000000000074
The coronary left main (LM) artery is characterized by large caliber, length varying from <8 to >15 mm, and 2 large daughter vessels branching from it; it supplies blood to a large area (>75%) of the myocardium. LM bifurcation lesion is defined as the presence of atherosclerosis involving either or both of the 2 daughter vessels. Thus, the optimal strategy of revascularization for diseased LM has been an interesting research topic for a long time. With developments in percutaneous techniques, design, and materials of drug-eluting stents; intravascular imaging; new generation of antiplatelet medications; and particularly recent pooled evidence from randomized clinical trials comparing percutaneous coronary intervention with coronary artery bypass grafting, implantation of a drug-eluting stenting with or without other approved techniques is considered an important therapeutic approach for LM bifurcation lesions. Mirroring the anatomical complexity of the LM, stenting LM bifurcations is technically demanding, and intraprocedural complications can be catastrophic given the large amount of jeopardized myocardium. Therefore, the Chinese Society of Cardiology designed a writing committee with members from 3 working groups (ie, clinical research, intravascular imaging and physiology, and interventional cardiology) for the first time, to write a guideline on percutaneous treatment for LM bifurcation lesions, with view to improve the procedural quality and clinical outcomes. This guideline consists of introduction, anatomical description of the LM tree, risk stratification, strategies of revascularization, antiplatelet strategy, follow-up, and long-term management for patients with LM bifurcation lesions.
{"title":"Chinese Guideline for Percutaneous Coronary Intervention in Patients with Left Main Bifurcation Disease","authors":"","doi":"10.1097/CD9.0000000000000074","DOIUrl":"https://doi.org/10.1097/CD9.0000000000000074","url":null,"abstract":"The coronary left main (LM) artery is characterized by large caliber, length varying from <8 to >15 mm, and 2 large daughter vessels branching from it; it supplies blood to a large area (>75%) of the myocardium. LM bifurcation lesion is defined as the presence of atherosclerosis involving either or both of the 2 daughter vessels. Thus, the optimal strategy of revascularization for diseased LM has been an interesting research topic for a long time. With developments in percutaneous techniques, design, and materials of drug-eluting stents; intravascular imaging; new generation of antiplatelet medications; and particularly recent pooled evidence from randomized clinical trials comparing percutaneous coronary intervention with coronary artery bypass grafting, implantation of a drug-eluting stenting with or without other approved techniques is considered an important therapeutic approach for LM bifurcation lesions. Mirroring the anatomical complexity of the LM, stenting LM bifurcations is technically demanding, and intraprocedural complications can be catastrophic given the large amount of jeopardized myocardium. Therefore, the Chinese Society of Cardiology designed a writing committee with members from 3 working groups (ie, clinical research, intravascular imaging and physiology, and interventional cardiology) for the first time, to write a guideline on percutaneous treatment for LM bifurcation lesions, with view to improve the procedural quality and clinical outcomes. This guideline consists of introduction, anatomical description of the LM tree, risk stratification, strategies of revascularization, antiplatelet strategy, follow-up, and long-term management for patients with LM bifurcation lesions.","PeriodicalId":72524,"journal":{"name":"Cardiology discovery","volume":"2 1","pages":"134 - 144"},"PeriodicalIF":0.0,"publicationDate":"2022-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42146217","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 : 2022-03-01DOI: 10.1097/CD9.0000000000000048
S. Funakoshi, Miki Kawazoe, Kazuhiro Tada, Makiko Abe, H. Arima
Abstract Hypertension is one of the most important modifiable risk factors for stroke, and greater than 50% of all stroke events are estimated to be attributable to elevated blood pressure (BP). Randomized trials and meta-analyses have demonstrated that reducing BP is the most effective and generalizable strategy for preventing recurrent stroke. Based on currently available evidence, BP should be reduced to below 140/90 mmHg in all patients during the chronic post-stroke phase and to below 130/80 mmHg when well-tolerated.
{"title":"Blood Pressure Lowering for the Secondary Prevention of Stroke","authors":"S. Funakoshi, Miki Kawazoe, Kazuhiro Tada, Makiko Abe, H. Arima","doi":"10.1097/CD9.0000000000000048","DOIUrl":"https://doi.org/10.1097/CD9.0000000000000048","url":null,"abstract":"Abstract Hypertension is one of the most important modifiable risk factors for stroke, and greater than 50% of all stroke events are estimated to be attributable to elevated blood pressure (BP). Randomized trials and meta-analyses have demonstrated that reducing BP is the most effective and generalizable strategy for preventing recurrent stroke. Based on currently available evidence, BP should be reduced to below 140/90 mmHg in all patients during the chronic post-stroke phase and to below 130/80 mmHg when well-tolerated.","PeriodicalId":72524,"journal":{"name":"Cardiology discovery","volume":"2 1","pages":"51 - 57"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48551296","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 : 2022-02-11DOI: 10.1097/CD9.0000000000000043
Baotao Huang, Ran Zhang, Chen Li
Abstract Coronary artery involvement in cardiovascular syphilis is infrequent and often overlooked, especially in patients with latent syphilis. Herein, we present the case of myocardial infarction largely related to cardiovascular syphilis in a 63-year-old man. Invasive coronary angiography and contrast-enhanced computed tomography scan revealed a critical ostial narrowing of the left main trunk, an occlusive right coronary artery, and moderate-to-severe ostial stenosis of multiple major branches of the abdominal aorta. Syphilis screening and confirmatory tests were positive. Cardiovascular syphilis was considered. Percutaneous coronary intervention (PCI) was performed uneventfully, and a coronary stent was implanted in the ostium of the left main coronary artery. However, on day 3 after PCI, the patient died suddenly, likely because of stent thrombosis. In conclusion, severe coronary lesions confined to the ostia suggest rheumatologic large-vessel vasculitis or infectious aortitis.
{"title":"A Rare and Lethal Ostial Left Main Trunk Lesion: A Case Report","authors":"Baotao Huang, Ran Zhang, Chen Li","doi":"10.1097/CD9.0000000000000043","DOIUrl":"https://doi.org/10.1097/CD9.0000000000000043","url":null,"abstract":"Abstract Coronary artery involvement in cardiovascular syphilis is infrequent and often overlooked, especially in patients with latent syphilis. Herein, we present the case of myocardial infarction largely related to cardiovascular syphilis in a 63-year-old man. Invasive coronary angiography and contrast-enhanced computed tomography scan revealed a critical ostial narrowing of the left main trunk, an occlusive right coronary artery, and moderate-to-severe ostial stenosis of multiple major branches of the abdominal aorta. Syphilis screening and confirmatory tests were positive. Cardiovascular syphilis was considered. Percutaneous coronary intervention (PCI) was performed uneventfully, and a coronary stent was implanted in the ostium of the left main coronary artery. However, on day 3 after PCI, the patient died suddenly, likely because of stent thrombosis. In conclusion, severe coronary lesions confined to the ostia suggest rheumatologic large-vessel vasculitis or infectious aortitis.","PeriodicalId":72524,"journal":{"name":"Cardiology discovery","volume":"2 1","pages":"58 - 61"},"PeriodicalIF":0.0,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47036729","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 : 2022-02-08DOI: 10.1097/cd9.0000000000000041
Qin Jiang, J. Du, Tao Yu, Xiaobo Huang, Mingliang Zuo, Keli Huang
{"title":"Ascending Aortic Aneurysm and Dissection Secondary to Bicuspid Aortic Valve with Concomitant Coarctation of Descending Aorta Successfully Repaired with Extracorporeal Membrane Oxygenation Support","authors":"Qin Jiang, J. Du, Tao Yu, Xiaobo Huang, Mingliang Zuo, Keli Huang","doi":"10.1097/cd9.0000000000000041","DOIUrl":"https://doi.org/10.1097/cd9.0000000000000041","url":null,"abstract":"","PeriodicalId":72524,"journal":{"name":"Cardiology discovery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47146629","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 : 2022-01-27DOI: 10.1097/CD9.0000000000000045
Fei Xie, Yonggang Chen, Xinhua Chen, Zhihong Zhao
Abstract Pulsed electric field (PEF) is a novel energy source by which high-voltage electric pulses are used to create irreversible electroporation. PEF is non-thermal and highly tissue-dependent in which specific targeting of the atrial myocardium is achieved and sparing of adjacent tissues is feasible, theoretically increasing the safety of the procedure, which could potentially break the trade-off between effective lesions and collateral damage and substantially improve risk-benefit ratios in atrial fibrillation (AF) ablation. Although recently published trials have shown a clear effect of AF ablation, large-scale clinical trials are lacking. Current clinical evidence has demonstrated significant efficacy in achieving durable pulmonary vein isolation without ablation-related adverse events. However, their putative benefits regarding efficacy, efficiency, and safety remain to be proven in randomized controlled trials.
{"title":"Irreversible Electroporation Ablation for Atrial Fibrillation: Status and Challenges","authors":"Fei Xie, Yonggang Chen, Xinhua Chen, Zhihong Zhao","doi":"10.1097/CD9.0000000000000045","DOIUrl":"https://doi.org/10.1097/CD9.0000000000000045","url":null,"abstract":"Abstract Pulsed electric field (PEF) is a novel energy source by which high-voltage electric pulses are used to create irreversible electroporation. PEF is non-thermal and highly tissue-dependent in which specific targeting of the atrial myocardium is achieved and sparing of adjacent tissues is feasible, theoretically increasing the safety of the procedure, which could potentially break the trade-off between effective lesions and collateral damage and substantially improve risk-benefit ratios in atrial fibrillation (AF) ablation. Although recently published trials have shown a clear effect of AF ablation, large-scale clinical trials are lacking. Current clinical evidence has demonstrated significant efficacy in achieving durable pulmonary vein isolation without ablation-related adverse events. However, their putative benefits regarding efficacy, efficiency, and safety remain to be proven in randomized controlled trials.","PeriodicalId":72524,"journal":{"name":"Cardiology discovery","volume":"2 1","pages":"41 - 50"},"PeriodicalIF":0.0,"publicationDate":"2022-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48790769","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}
Objective: Coronavirus disease 2019 (COVID-19) is a global public health crisis. There are no specific antiviral agents for the treatment of SARS-CoV-2. Information regarding the effect of Abidol on in-hospital mortality is scarce. The present study aimed to evaluate the treatment effect of Abidol for patients with COVID-19 before and after propensity score matching (PSM).
Methods: This retrospective cohort study analyzed 1019 patients with confirmed COVID-19 in China from December 22, 2019 to March 13, 2020. Patients were divided to Abidol (200 mg, tid, 5-7 days, n = 788, 77.3%) and No-Abidol (n = 231, 22.7%) groups. The primary outcome was the mortality during hospitalization.
Results: Among 1019 COVID-19 patients, the age was (60.4 ± 14.5) years. Abidol-treated patients, compared with No-Abidol-treated patients, had a shorter duration from onset of symptoms to admission, less frequent renal dysfunction, lower white blood cell counts (lymphocytes <0.8) and erythrocyte sending rate, lower interleukin-6, higher platelet counts and plasma IgG and oxygen saturation, and less frequent myocardial injury. The mortality during hospitalization before PSM was 17.9% in Abidol group and 34.6% in No-Abidol (hazard ratio (HR) = 2.610, 95% confident interval (CI): 1.980-3.440), all seen in severe and critical patients. After PSM, the in-hospital death was 13.6% in Abidol and 28.6% in No-Abidol group (HR = 2.728, 95% CI: 1.598-4.659).
Conclusions: Abidol-treatment results in less in-hospital death for severe and critical patients with COVID-19. Further randomized study is warranted to confirm the findings from this study.
{"title":"Antiviral Abidol is Associated with the Reduction of In-Hospital Mortality in COVID-19 Patients.","authors":"Hesong Zeng, Xingwei He, Wanjun Liu, Jing Kan, Liqun He, Jinhe Zhao, Cynthia Chen, Junjie Zhang, Shaoliang Chen","doi":"10.1097/CD9.0000000000000014","DOIUrl":"https://doi.org/10.1097/CD9.0000000000000014","url":null,"abstract":"<p><strong>Objective: </strong>Coronavirus disease 2019 (COVID-19) is a global public health crisis. There are no specific antiviral agents for the treatment of SARS-CoV-2. Information regarding the effect of Abidol on in-hospital mortality is scarce. The present study aimed to evaluate the treatment effect of Abidol for patients with COVID-19 before and after propensity score matching (PSM).</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 1019 patients with confirmed COVID-19 in China from December 22, 2019 to March 13, 2020. Patients were divided to Abidol (200 mg, tid, 5-7 days, <i>n</i> = 788, 77.3%) and No-Abidol (<i>n</i> = 231, 22.7%) groups. The primary outcome was the mortality during hospitalization.</p><p><strong>Results: </strong>Among 1019 COVID-19 patients, the age was (60.4 ± 14.5) years. Abidol-treated patients, compared with No-Abidol-treated patients, had a shorter duration from onset of symptoms to admission, less frequent renal dysfunction, lower white blood cell counts (lymphocytes <0.8) and erythrocyte sending rate, lower interleukin-6, higher platelet counts and plasma IgG and oxygen saturation, and less frequent myocardial injury. The mortality during hospitalization before PSM was 17.9% in Abidol group and 34.6% in No-Abidol (hazard ratio (HR) = 2.610, 95% confident interval (CI): 1.980-3.440), all seen in severe and critical patients. After PSM, the in-hospital death was 13.6% in Abidol and 28.6% in No-Abidol group (HR = 2.728, 95% CI: 1.598-4.659).</p><p><strong>Conclusions: </strong>Abidol-treatment results in less in-hospital death for severe and critical patients with COVID-19. Further randomized study is warranted to confirm the findings from this study.</p>","PeriodicalId":72524,"journal":{"name":"Cardiology discovery","volume":"1 1","pages":"37-43"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/69/cd9-1-37.PMC8710295.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39641898","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 : 2021-12-01DOI: 10.1097/cd9.0000000000000042
{"title":"Correction to: Rationale and Design of a Randomized Controlled Trial on Intensive Management of Blood PRESSure and Cholesterol in Elderly Chinese with Hypertension and Atrial FibrillatION (IMPRESSION)","authors":"","doi":"10.1097/cd9.0000000000000042","DOIUrl":"https://doi.org/10.1097/cd9.0000000000000042","url":null,"abstract":"","PeriodicalId":72524,"journal":{"name":"Cardiology discovery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48858414","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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