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Diagnostic Model of In-Hospital Mortality in Patients with Acute ST-Segment Elevation Myocardial Infarction Used Artificial Intelligence Methods 基于人工智能方法的急性st段抬高型心肌梗死住院死亡率诊断模型
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-05-25 DOI: 10.1155/2022/8758617
Yong Li
Background Preventing in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) is a crucial step. Objectives The objective of our research was to develop and externally validate the diagnostic model of in-hospital mortality in acute STEMI patients used artificial intelligence methods. Methods We divided nonrandomly the American population with acute STEMI into a training set, a test set, and a validation set. We converted the unbalanced data into balanced data. We used artificial intelligence methods to develop and externally validate several diagnostic models. We used confusion matrix combined with the area under the receiver operating characteristic curve (AUC) to evaluate the pros and cons of the above models. Results The strongest predictors of in-hospital mortality were age, gender, cardiogenic shock, atrial fibrillation (AF), ventricular fibrillation (VF), third degree atrioventricular block, in-hospital bleeding, underwent percutaneous coronary intervention (PCI) during hospitalization, underwent coronary artery bypass grafting (CABG) during hospitalization, hypertension history, diabetes history, and myocardial infarction history. The F2 score of logistic regression in the training set, the test set, and the validation dataset was 0.81, 0.6, and 0.59, respectively. The AUC of logistic regression in the training set, the test set, and the validation data set was 0.77, 0.78, and 0.8, respectively. The diagnostic model built by logistic regression was the best. Conclusion The strongest predictors of in-hospital mortality were age, gender, cardiogenic shock, AF, VF, third degree atrioventricular block, in-hospital bleeding, underwent PCI during hospitalization, underwent CABG during hospitalization, hypertension history, diabetes history, and myocardial infarction history. We had used artificial intelligence methods developed and externally validated several diagnostic models of in-hospital mortality in acute STEMI patients. The diagnostic model built by logistic regression was the best. We registered this study with the registration number ChiCTR1900027129 (the WHO International Clinical Trials Registry Platform (ICTRP) on 1 November 2019).
预防st段抬高型心肌梗死(STEMI)患者的住院死亡率是至关重要的一步。本研究的目的是利用人工智能方法开发并外部验证急性STEMI患者住院死亡率的诊断模型。方法:我们将美国急性STEMI患者非随机分为训练组、测试组和验证组。我们将不平衡数据转换为平衡数据。我们使用人工智能方法开发和外部验证了几个诊断模型。我们使用混淆矩阵结合受者工作特征曲线下面积(AUC)来评价上述模型的优缺点。结果院内死亡率最强预测因子为年龄、性别、心源性休克、房颤(AF)、室颤(VF)、房室传导阻滞、院内出血、住院期间行经皮冠状动脉介入治疗(PCI)、住院期间行冠状动脉旁路移植术(CABG)、高血压史、糖尿病史、心肌梗死史。logistic回归在训练集、测试集和验证集上的F2得分分别为0.81、0.6和0.59。训练集、测试集和验证数据集的logistic回归AUC分别为0.77、0.78和0.8。采用logistic回归建立的诊断模型效果最好。结论年龄、性别、心源性休克、房颤、室颤、三度房室传导阻滞、院内出血、住院期间行PCI、住院期间行冠脉搭桥、高血压史、糖尿病史、心梗史是院内死亡率的最强预测因子。我们使用人工智能方法开发并外部验证了急性STEMI患者住院死亡率的几种诊断模型。采用logistic回归建立的诊断模型效果最好。我们于2019年11月1日在世卫组织国际临床试验注册平台(ictr1900027129)注册了该研究。
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引用次数: 0
The Beneficial Role of Nrf2 in the Endothelial Dysfunction of Atherosclerosis Nrf2在动脉粥样硬化内皮功能障碍中的有益作用
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-05-12 DOI: 10.1155/2022/4287711
Zixia Huang, Mingyue Wu, Lijin Zeng, Deming Wang
Cardiovascular disease (CVD) is a serious public health issue in China, accounting for more than 40% of all mortality, and it is the leading cause of death worldwide. Atherosclerosis is the pathological basis for much CVD, including coronary heart disease, acute myocardial infarction, and stroke. Endothelial dysfunction is an initiating and exacerbating factor in atherosclerosis. Recent research has linked oxidative stress and mitochondrial damage to endothelial dysfunction. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a transcription factor with antioxidant effects that is strongly connected to several CVDs. However, the mechanism by which Nrf2 reduces CVD is unknown. Research indicates that Nrf2 improves endothelial function by resisting oxidative stress and mitochondrial damage, thereby delaying atherosclerosis. This article examines the mechanisms and potential targets of Nrf2 affecting endothelial cell function to improve atherosclerosis and to provide ideas for the development of new CVD treatments.
心血管疾病(CVD)在中国是一个严重的公共卫生问题,占所有死亡人数的40%以上,是世界范围内死亡的主要原因。动脉粥样硬化是许多心血管疾病的病理基础,包括冠心病、急性心肌梗死和中风。内皮功能障碍是动脉粥样硬化的起始和加重因素。最近的研究将氧化应激和线粒体损伤与内皮功能障碍联系起来。核因子红系2相关因子2 (Nrf2)是一种具有抗氧化作用的转录因子,与多种心血管疾病密切相关。然而,Nrf2降低CVD的机制尚不清楚。研究表明Nrf2通过抵抗氧化应激和线粒体损伤改善内皮功能,从而延缓动脉粥样硬化。本文探讨了Nrf2影响内皮细胞功能的机制和潜在靶点,以改善动脉粥样硬化,并为开发新的心血管疾病治疗方法提供思路。
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引用次数: 5
Efficacy of Dialectical Comprehensive Treatment of Traditional Chinese Medicine in Patients with Chronic Stable Heart Failure: A Randomized Controlled Trial 中医辨证综合疗法治疗慢性稳定型心力衰竭的疗效:随机对照试验
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-05-12 DOI: 10.1155/2022/5408063
Lixiang Yang, Yuanyuan Chen, Fei Lou, Xiaoxia Zhao, Jia Zhou
The treatment of chronic stable heart failure (CSHF) with integrated traditional Chinese and Western medicine has been of wide concern. We mainly discuss the clinical efficacy of TCM decoction combined with acupuncture and moxibustion (A&M) in CSHF treatment on the basis of syndrome differentiation and treatment (SDT). The control group was given conventional cardiac rehabilitation (CCR), and the treatment group was given TCM decoction combined with A&M treatment based on SDT on the basis of conventional cardiac rehabilitation. The clinical efficacy and cardiopulmonary exercise testing (CPET) indicators were evaluated. Left ventricular ejection fraction (LVEF), NT-proBNP, myocardial ischemia threshold (MIT), and 6-minute walking distance (6MWD) were measured by ultrasound, ELISA, electrocardiogram, and 6MWD test. After treatment, the clinical efficacy, LVEF, and 6MWD of the treatment group were better than in the control group. The NT-proBNP plasma level and MIT in the treatment group were lower than in the control group. The treatment group had enhanced AT, VO2 Peak, VO2 Peak/HR, and Peak power and decreased resting systolic pressure and peak systolic pressure, and the difference was statistically significant. Dialectical comprehensive treatment of TCM could effectively improve cardiac function and clinical treatment effect, which was worthy of clinical application.
中西医结合治疗慢性稳定型心力衰竭(CSHF)已受到广泛关注。我们在辨证论治(SDT)的基础上,主要探讨中药汤剂结合针灸(A&M)治疗CSHF的临床疗效。对照组给予常规心脏康复治疗(CCR),治疗组在常规心脏康复治疗的基础上给予中药汤剂联合A&M治疗,以SDT为基础。评价两组临床疗效及心肺运动试验(CPET)指标。采用超声、ELISA、心电图、6MWD检测左室射血分数(LVEF)、NT-proBNP、心肌缺血阈值(MIT)、6分钟步行距离(6MWD)。治疗后,治疗组临床疗效、LVEF、6MWD均优于对照组。治疗组NT-proBNP血浆水平和MIT均低于对照组。治疗组AT、VO2 Peak、VO2 Peak/HR、Peak power均升高,静息收缩压和峰值收缩压均降低,差异有统计学意义。中医辨证综合治疗能有效改善心功能,提高临床治疗效果,值得临床推广应用。
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引用次数: 0
Programmed Cell Death of Endothelial Cells in Myocardial Infarction and Its Potential Therapeutic Strategy 心肌梗死中内皮细胞的程序性死亡及其潜在的治疗策略
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-05-11 DOI: 10.1155/2022/6558060
Mingyue Wu, Zixia Huang, Lijin Zeng, Chunfei Wang, Deming Wang
Cardiovascular disease, especially coronary artery disease and stroke, kills around one-third of the world's population, and myocardial infarction, a primary symptom of coronary heart disease, is a major worldwide health problem. Cardiovascular disease research has historically focused on promoting angiogenesis following myocardial damage. Myocardial vascular repair is crucial for improving myocardial infarction prognosis. Endothelial cells, the largest population of nonmyocytes within myocardial tissue, play an important role in angiogenesis. In recent years, different types of programmed cell death such as apoptosis, necroptosis, pyroptosis, ferroptosis, and autophagy have been described and found to be linked with cardiovascular diseases such as myocardial infarction, heart failure, and myocarditis. This will have important implications for reforming the treatment strategy of cardiovascular diseases. Different types of cell death of endothelial cells in myocardial infarction have been proposed, the roles and mechanisms of endothelial cell death in myocardial infarction are summarized in this review, and endothelial cell death inhibition as a therapeutic technique for treating myocardial infarction might be advantageous to human health.
心血管疾病,特别是冠状动脉疾病和中风,导致世界上约三分之一的人口死亡,而心肌梗死是冠心病的主要症状,是一个全球性的主要健康问题。心血管疾病的研究历来侧重于促进心肌损伤后的血管生成。心肌血管修复是改善心肌梗死预后的关键。内皮细胞是心肌组织中最大的非肌细胞群,在血管生成中起着重要作用。近年来,不同类型的程序性细胞死亡,如凋亡、坏死坏死、焦亡、铁亡和自噬,已被描述并发现与心血管疾病如心肌梗死、心力衰竭和心肌炎有关。这将对改革心血管疾病的治疗策略具有重要意义。本文综述了心肌梗死中内皮细胞死亡的不同类型,并对其在心肌梗死中的作用和机制进行了综述,认为内皮细胞死亡抑制作为一种治疗心肌梗死的治疗技术可能有利于人类健康。
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引用次数: 2
Pattern Changes in the Heart Rate Variability of Patients Undergoing Coronary Artery Bypass Grafting Surgery 冠状动脉搭桥术患者心率变异性的模式变化
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-04-30 DOI: 10.1155/2022/1455025
Ngo Van Thanh, Nguyen Sinh Hien, P. N. Son, Pham Truong Son
Introduction Coronary artery bypass grafting (CABG) with extracorporeal circulation is a key therapy for coronary artery disease (CAD). However, cardiovascular events and cardiac arrhythmias may still occur in these patients following surgery. Many studies have demonstrated a correlation between cardiac arrhythmias and heart rate variability (HRV). This study aimed to establish the temporal change pattern of HRV observed following CABG. Methods A prospective method was used to study 119 consecutive patients with stable CAD who were assessed using 24-hour Holter recordings 2 days before CABG and 1 week, 3 months, and 6 months after the surgery at Hanoi Heart Hospital from June 2016 to August 2018. Main results: All the time-domain and frequency-domain parameters of HRV decreased precipitately after CABG and were mostly recovered 3 months postoperatively. The percentage of decreased HRV before surgery was 28.6% and 51.8% after 7 days, 19.6% after 3 months, and 12.7% after 6 months. ASDNN and SDNN before and after surgery had the highest rates of change. Conclusion The early decrease in HRV observed 7 days after CABG may be related to the acute effects of the surgery. The recovery of HRV at 3 months after surgery, regardless of the preoperative state of the patients, implies that the autonomic nervous system (ANS) disorder may be improved at this time. At 6 months after surgery, the autonomic nervous injury was recovered in combination with improvement of reperfusion, resulting in improvement in almost all HRV indices compared with those indices preoperatively.
体外循环冠状动脉旁路移植术(CABG)是治疗冠状动脉疾病(CAD)的重要手段。然而,这些患者在手术后仍可能发生心血管事件和心律失常。许多研究表明心律失常与心率变异性(HRV)之间存在相关性。本研究旨在建立冠脉搭桥后HRV的时间变化规律。方法采用前瞻性方法,对2016年6月至2018年8月在河内心脏医院连续就诊的119例稳定期冠心病患者在冠脉搭桥前2天、术后1周、3个月和6个月的24小时动态心电图进行评估。主要结果:冠脉搭桥后HRV各时域、频域参数均急剧下降,术后3个月基本恢复。术前HRV下降比例分别为28.6%、51.8%,术后7天、3个月、6个月分别为19.6%、12.7%。手术前后ASDNN和SDNN的变化率最高。结论冠脉搭桥术后7天HRV早期下降可能与手术的急性效应有关。无论患者术前状态如何,术后3个月HRV的恢复表明此时自主神经系统(ANS)紊乱可能得到改善。术后6个月自主神经损伤恢复,再灌注改善,几乎所有HRV指标均较术前改善。
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引用次数: 1
Analysis of a Family with Brugada Syndrome and Sudden Cardiac Death Caused by a Novel Mutation of SCN5A SCN5A基因突变致Brugada综合征和心源性猝死1家系分析
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-04-28 DOI: 10.1155/2022/9716045
Yao-Bin Zhu, Jian-Hui Zhang, Yuanling Ji, Ya-Nan Hu, Han-Lu Wang, Dan-dan Ruan, Xiao-Rong Meng, Xin-fu Lin, Jie-wei Luo, W. Chen
Background Brugada syndrome is a hereditary cardiac disease associated with mutations in ion channel genes. The clinical features include ventricular fibrillation, syncope, and sudden cardiac death. A family with Brugada syndrome with sudden cardiac death was analyzed to locate the associated mutation in the SCN5A gene. Methods and Results Three generations of a Han Chinese family with Brugada syndrome were recruited in the study; their clinical phenotype data were collected and DNA samples extracted from the peripheral blood. Next-generation sequencing was carried out in the proband, and candidate genes and mutations were screened using the full exon capture technique. The family members who participated in the survey were tested for possible mutations using Sanger sequencing. Six family members were diagnosed with Brugada syndrome, including four asymptomatic patients. A newly discovered heterozygous mutation in the proband was located in exon 25 of SCN5A (NM_000335.5) at c.4313dup(p.Trp1439ValfsTer32). Among the surviving family members, only those with a Brugada wave on their electrocardiogram carried the c.4313dup(p.Trp1439ValfsTer32) variant. Bioinformatics prediction revealed that the frameshift of the c.4313dup (p.Trp1439ValfsTer32) mutant led to a coding change of 32 amino acids, followed by a stop codon, resulting in a truncated protein product. Conclusion The newly discovered mutation site c.4313dup(p.Trp1439ValfsTer32) in exon 25 of SCN5A may be the molecular genetic basis of the family with Brugada syndrome.
Brugada综合征是一种与离子通道基因突变相关的遗传性心脏病。临床特征包括心室颤动、晕厥和心源性猝死。我们分析了一例Brugada综合征合并心源性猝死的家族,以定位SCN5A基因的相关突变。方法与结果选取一个汉族Brugada综合征家族三代为研究对象;收集他们的临床表型数据并从外周血中提取DNA样本。先证者进行下一代测序,利用全外显子捕获技术筛选候选基因和突变。参与调查的家庭成员使用桑格测序检测可能的突变。6名家庭成员被诊断为Brugada综合征,包括4名无症状患者。新发现的先证者杂合突变位于SCN5A (NM_000335.5)的第25外显子c.4313dup(p.Trp1439ValfsTer32)。在幸存的家庭成员中,只有那些心电图上有Brugada波的人携带c.4313dup(p.Trp1439ValfsTer32)变体。生物信息学预测表明,c.4313dup (p.Trp1439ValfsTer32)突变体的移码导致32个氨基酸的编码改变,随后是一个终止密码子,导致蛋白产物的截断。结论新发现的SCN5A外显子25突变位点c.4313dup(p.Trp1439ValfsTer32)可能是Brugada综合征家族的分子遗传基础。
{"title":"Analysis of a Family with Brugada Syndrome and Sudden Cardiac Death Caused by a Novel Mutation of SCN5A","authors":"Yao-Bin Zhu, Jian-Hui Zhang, Yuanling Ji, Ya-Nan Hu, Han-Lu Wang, Dan-dan Ruan, Xiao-Rong Meng, Xin-fu Lin, Jie-wei Luo, W. Chen","doi":"10.1155/2022/9716045","DOIUrl":"https://doi.org/10.1155/2022/9716045","url":null,"abstract":"Background Brugada syndrome is a hereditary cardiac disease associated with mutations in ion channel genes. The clinical features include ventricular fibrillation, syncope, and sudden cardiac death. A family with Brugada syndrome with sudden cardiac death was analyzed to locate the associated mutation in the SCN5A gene. Methods and Results Three generations of a Han Chinese family with Brugada syndrome were recruited in the study; their clinical phenotype data were collected and DNA samples extracted from the peripheral blood. Next-generation sequencing was carried out in the proband, and candidate genes and mutations were screened using the full exon capture technique. The family members who participated in the survey were tested for possible mutations using Sanger sequencing. Six family members were diagnosed with Brugada syndrome, including four asymptomatic patients. A newly discovered heterozygous mutation in the proband was located in exon 25 of SCN5A (NM_000335.5) at c.4313dup(p.Trp1439ValfsTer32). Among the surviving family members, only those with a Brugada wave on their electrocardiogram carried the c.4313dup(p.Trp1439ValfsTer32) variant. Bioinformatics prediction revealed that the frameshift of the c.4313dup (p.Trp1439ValfsTer32) mutant led to a coding change of 32 amino acids, followed by a stop codon, resulting in a truncated protein product. Conclusion The newly discovered mutation site c.4313dup(p.Trp1439ValfsTer32) in exon 25 of SCN5A may be the molecular genetic basis of the family with Brugada syndrome.","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"17 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85388775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Association of Low Expression of NUMB in Peripheral Blood with Acute Myocardial Infarction 外周血NUMB低表达与急性心肌梗死的关系
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-04-26 DOI: 10.1155/2022/7981637
Heyu Meng, Lihong Li, Jianjun Ruan, Yanqiu Chen, Zhaohan Yan, Jinsha Liu, Xiangdong Li, Cuiying Mao, Ping Yang
Objective Our study's goal was to find out acute myocardial infarction (AMI) patients' NUMB gene expression patterns and to evaluate its role as a diagnostic marker for AMI detection. Methods Peripheral blood was drawn from 124 individuals who had an AMI and 115 patients who had stable coronary artery disease (SCAD). The real-time quantitative polymerase chain reaction was used to measure the mRNA expression level of the NUMB gene in peripheral blood. Results The AMI group's NUMB gene expression was 0.906 (0.181–0.954), whereas the SCAD group's expression was 1.024 (0.207–1.127). However, the AMI group had 0.885 times lower NUMB mRNA expression than the SCAD group (P < 0.05). Conclusion Multivariate logistic regression evaluation found that lower NUMB expression was correlated with an increased risk of coronary artery disease. However, age and fasting plasma glucose levels were not associated with decreased NUMB expression.
目的了解急性心肌梗死(AMI)患者的NUMB基因表达模式,并评价其作为AMI诊断标志物的作用。方法选取124例急性心肌梗死患者和115例稳定型冠状动脉疾病(SCAD)患者的外周血。采用实时定量聚合酶链反应法检测小鼠外周血NUMB基因mRNA表达水平。结果AMI组NUMB基因表达量为0.906 (0.181 ~ 0.954),SCAD组NUMB基因表达量为1.024(0.207 ~ 1.127)。AMI组的NUMB mRNA表达量比SCAD组低0.885倍(P < 0.05)。结论多因素logistic回归评价发现,低NUMB表达与冠状动脉疾病风险增加相关。然而,年龄和空腹血糖水平与NUMB表达降低无关。
{"title":"Association of Low Expression of NUMB in Peripheral Blood with Acute Myocardial Infarction","authors":"Heyu Meng, Lihong Li, Jianjun Ruan, Yanqiu Chen, Zhaohan Yan, Jinsha Liu, Xiangdong Li, Cuiying Mao, Ping Yang","doi":"10.1155/2022/7981637","DOIUrl":"https://doi.org/10.1155/2022/7981637","url":null,"abstract":"Objective Our study's goal was to find out acute myocardial infarction (AMI) patients' NUMB gene expression patterns and to evaluate its role as a diagnostic marker for AMI detection. Methods Peripheral blood was drawn from 124 individuals who had an AMI and 115 patients who had stable coronary artery disease (SCAD). The real-time quantitative polymerase chain reaction was used to measure the mRNA expression level of the NUMB gene in peripheral blood. Results The AMI group's NUMB gene expression was 0.906 (0.181–0.954), whereas the SCAD group's expression was 1.024 (0.207–1.127). However, the AMI group had 0.885 times lower NUMB mRNA expression than the SCAD group (P < 0.05). Conclusion Multivariate logistic regression evaluation found that lower NUMB expression was correlated with an increased risk of coronary artery disease. However, age and fasting plasma glucose levels were not associated with decreased NUMB expression.","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"13 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79528600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Effect of PCSK9 Inhibitor on Blood Lipid Levels in Patients with High and Very-High CVD Risk: A Systematic Review and Meta-Analysis PCSK9抑制剂对心血管疾病高风险和极高风险患者血脂水平的影响:一项系统综述和荟萃分析
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-04-26 DOI: 10.1155/2022/8729003
Yue Zhang, Yanrong Suo, Lin-Po Yang, Xiaolu Zhang, Qun Yu, M. Zeng, Wenlan Zhang, Xijuan Jiang, Yijing Wang
Objectives We aimed to investigate the effects of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor on blood lipid levels in patients with high and very-high cardiovascular risk. Design 14 trials (n = 52,586 patients) comparing treatment with or without PCSK9 inhibitors were retrieved from PubMed and Embase updated to 1st Jun 2021. The data quality of included studies was assessed by two independent researchers using the Cochrane systematic review method. All-cause mortality, cardiovascular mortality, and changes in serum low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), apolipoprotein B (ApoB), lipoprotein (a) (LP (a)), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein A1 (ApoA1) from baseline were analyzed using Rev Man 5.1.0 software. Results Compared with treatments without PCSK9 inhibitor, addition of PCSK9 inhibitors (evolocumab and alirocumab) had obvious decreasing effects on the levels of LDL-C [MD = −46.86, 95% CI (−54.99 to −38.72), P < 0.00001], TC [MD = −31.92, 95% CI (−39.47 to −24.38), P < 0.00001], TG [MD = −8.13, 95% CI (−10.48 to −5.79), P < 0.00001], LP(a) [MD = −26.69, 95% CI (-27.93 to −25.44), P < 0.00001], non-HDL-C [MD = −42.86, 95% CI (−45.81 to −39.92), P < 0.00001], and ApoB [MD = −38.44, 95% CI (−42.23 to -34.65), P < 0.00001] in high CVD risk patients. Conversely, changes of HDL-C [MD = 6.27, CI (5.17 to 7.36), P < 0.00001] and ApoA1 [MD = 4.33, 95% CI (3.53 to 5.13), P < 0.00001] from baseline were significantly more in high cardiovascular disease risk patients who received PCSK9 inhibitors treatment. Conclusion Addition of PCSK9 inhibitors to standard therapy resulted in definite improvement in blood lipid levels compared with therapies that did not include them.
目的:探讨枯草杆菌蛋白转化酶(protein conversion ase subtilisin/ keexin type 9, PCSK9)抑制剂对心血管高危和极高危患者血脂水平的影响。设计从PubMed和Embase检索到更新至2021年6月1日的14项试验(n = 52,586例患者),比较使用或不使用PCSK9抑制剂的治疗。纳入研究的数据质量由两名独立研究人员使用Cochrane系统评价方法进行评估。采用Rev Man 5.1.0软件分析全因死亡率、心血管死亡率以及基线时血清低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、载脂蛋白B (ApoB)、脂蛋白(a) (LP (a))、非高密度脂蛋白胆固醇(non-HDL-C)、高密度脂蛋白胆固醇(HDL-C)和载脂蛋白A1 (ApoA1)的变化。结果与治疗没有PCSK9抑制剂相比,添加PCSK9抑制剂(evolocumab和alirocumab)有明显的减少影响低密度脂蛋白的水平(MD =−46.86,95%可信区间(54.99−−38.72),P < 0.00001), TC (MD =−31.92,95%可信区间(39.47−−24.38),P < 0.00001), TG (MD =−8.13,95%可信区间(10.48−−5.79),P < 0.00001), LP (a) (MD =−26.69,95%可信区间(-27.93−25.44),P < 0.00001), non-HDL-C (MD =−42.86,95%可信区间(45.81−−39.92),P < 0.00001),和飞机观测(MD =−38.44,CVD高危患者95% CI (- 42.23 ~ -34.65), P < 0.00001。相反,在接受PCSK9抑制剂治疗的心血管疾病高危患者中,HDL-C [MD = 6.27, CI (5.17 ~ 7.36), P < 0.00001]和ApoA1 [MD = 4.33, 95% CI (3.53 ~ 5.13), P < 0.00001]较基线的变化更为显著。结论:与不含PCSK9抑制剂的治疗相比,在标准治疗中添加PCSK9抑制剂可明显改善血脂水平。
{"title":"Effect of PCSK9 Inhibitor on Blood Lipid Levels in Patients with High and Very-High CVD Risk: A Systematic Review and Meta-Analysis","authors":"Yue Zhang, Yanrong Suo, Lin-Po Yang, Xiaolu Zhang, Qun Yu, M. Zeng, Wenlan Zhang, Xijuan Jiang, Yijing Wang","doi":"10.1155/2022/8729003","DOIUrl":"https://doi.org/10.1155/2022/8729003","url":null,"abstract":"Objectives We aimed to investigate the effects of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor on blood lipid levels in patients with high and very-high cardiovascular risk. Design 14 trials (n = 52,586 patients) comparing treatment with or without PCSK9 inhibitors were retrieved from PubMed and Embase updated to 1st Jun 2021. The data quality of included studies was assessed by two independent researchers using the Cochrane systematic review method. All-cause mortality, cardiovascular mortality, and changes in serum low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), apolipoprotein B (ApoB), lipoprotein (a) (LP (a)), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein A1 (ApoA1) from baseline were analyzed using Rev Man 5.1.0 software. Results Compared with treatments without PCSK9 inhibitor, addition of PCSK9 inhibitors (evolocumab and alirocumab) had obvious decreasing effects on the levels of LDL-C [MD = −46.86, 95% CI (−54.99 to −38.72), P < 0.00001], TC [MD = −31.92, 95% CI (−39.47 to −24.38), P < 0.00001], TG [MD = −8.13, 95% CI (−10.48 to −5.79), P < 0.00001], LP(a) [MD = −26.69, 95% CI (-27.93 to −25.44), P < 0.00001], non-HDL-C [MD = −42.86, 95% CI (−45.81 to −39.92), P < 0.00001], and ApoB [MD = −38.44, 95% CI (−42.23 to -34.65), P < 0.00001] in high CVD risk patients. Conversely, changes of HDL-C [MD = 6.27, CI (5.17 to 7.36), P < 0.00001] and ApoA1 [MD = 4.33, 95% CI (3.53 to 5.13), P < 0.00001] from baseline were significantly more in high cardiovascular disease risk patients who received PCSK9 inhibitors treatment. Conclusion Addition of PCSK9 inhibitors to standard therapy resulted in definite improvement in blood lipid levels compared with therapies that did not include them.","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"34 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88784484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Impact of MMP-9 Genetic Polymorphism and Concentration on the Development of Coronary Artery Disease in Ukrainian Population MMP-9基因多态性和浓度对乌克兰人群冠状动脉疾病发展的影响
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-04-11 DOI: 10.1155/2022/2067632
O. Pogorielova, V. Korniienko, Yaroslav D Chumachenko, O. Obukhova, I. Martsovenko, V. Harbuzova
Coronary artery disease (CAD) is one of the leading causes of death in Europe. It is known that atherosclerosis is the primary risk factor of CAD development. MMP-9 is involved in all stages of atherosclerosis and thus may contribute to CAD emergence. To investigate the influence of MMP-9 on the (CAD) development 25 patients with intact coronary arteries (CA), 40 patients with acute coronary syndrome (ACS), and 63 patients with chronic coronary syndrome (CCS) were enrolled in the study. Real-time PCR was carried out for genotyping on the rs17567-polymorphic locus, and ELISA study was performed to measure the MMP-9 plasma concentration. It was found the lower risk of MI occurrence for AG-carriers (Pa=0.023; ORa = 0.299, 95% CI = 0.106–0.848) in Ukrainian population.
冠状动脉疾病(CAD)是欧洲主要的死亡原因之一。众所周知,动脉粥样硬化是冠心病发生的主要危险因素。MMP-9参与动脉粥样硬化的所有阶段,因此可能有助于CAD的出现。为探讨MMP-9对冠心病发展的影响,本研究纳入25例完整冠状动脉(CA)患者、40例急性冠状动脉综合征(ACS)患者和63例慢性冠状动脉综合征(CCS)患者。采用Real-time PCR对rs17567多态性位点进行基因分型,ELISA检测MMP-9血药浓度。ag -携带者发生心肌梗死的风险较低(Pa=0.023;ORa = 0.299, 95% CI = 0.106-0.848)。
{"title":"Impact of MMP-9 Genetic Polymorphism and Concentration on the Development of Coronary Artery Disease in Ukrainian Population","authors":"O. Pogorielova, V. Korniienko, Yaroslav D Chumachenko, O. Obukhova, I. Martsovenko, V. Harbuzova","doi":"10.1155/2022/2067632","DOIUrl":"https://doi.org/10.1155/2022/2067632","url":null,"abstract":"Coronary artery disease (CAD) is one of the leading causes of death in Europe. It is known that atherosclerosis is the primary risk factor of CAD development. MMP-9 is involved in all stages of atherosclerosis and thus may contribute to CAD emergence. To investigate the influence of MMP-9 on the (CAD) development 25 patients with intact coronary arteries (CA), 40 patients with acute coronary syndrome (ACS), and 63 patients with chronic coronary syndrome (CCS) were enrolled in the study. Real-time PCR was carried out for genotyping on the rs17567-polymorphic locus, and ELISA study was performed to measure the MMP-9 plasma concentration. It was found the lower risk of MI occurrence for AG-carriers (Pa=0.023; ORa = 0.299, 95% CI = 0.106–0.848) in Ukrainian population.","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"14 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88594117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Characteristics of Patent Foramen Ovale: Analysis from a Single Center 卵圆孔未闭的特征:单中心分析
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2022-04-06 DOI: 10.1155/2022/5430598
Bin Zhang, Dong Li, Anjian Song, Q. Ren, Shangan Cai, Peng Wang, Wenfeng Tan, Gaoxing Zhang, Jun Guo
Objective To collect and analyze data of patent foramen ovale (PFO). Methods This study included a total of 260 patients diagnosed with PFO. We analyzed basic clinical data such as sex, age, transesophageal echocardiography as well as other symptoms. Results Our data showed that females accounted for the highest proportion of PFO (166 females, 64%), with the highest number of patients (65 patients) having between 45 and 55 years. Transesophageal echocardiography examination demonstrated frequent occurrence of tunnel-like anatomical structures. In addition, PFO was associated with symptoms such as migraine, stroke or TIA, syncope, chest tightness, and palpitations, with dizziness being the most common symptom in the patients with PFO. Conclusion Our data demonstrated that females accounted for the highest proportion of PFO patients, with those aged between 45 and 55 years being most affected. The most frequently encountered clinical symptom was dizziness. Taken together, these findings may help doctors to better understand and screen for PFO patients.
目的收集和分析卵圆孔未闭(PFO)的临床资料。方法本研究共纳入260例诊断为PFO的患者。我们分析了基本的临床资料,如性别、年龄、经食管超声心动图以及其他症状。结果我们的数据显示,PFO患者中女性所占比例最高(166例,占64%),年龄在45 ~ 55岁之间的患者最多(65例)。经食管超声心动图检查显示常出现隧道样解剖结构。此外,PFO还伴有偏头痛、中风或TIA、晕厥、胸闷和心悸等症状,其中头晕是PFO患者最常见的症状。结论我们的数据表明,女性在PFO患者中所占比例最高,年龄在45 - 55岁之间的患者受影响最大。最常见的临床症状是头晕。综上所述,这些发现可能有助于医生更好地了解和筛查PFO患者。
{"title":"Characteristics of Patent Foramen Ovale: Analysis from a Single Center","authors":"Bin Zhang, Dong Li, Anjian Song, Q. Ren, Shangan Cai, Peng Wang, Wenfeng Tan, Gaoxing Zhang, Jun Guo","doi":"10.1155/2022/5430598","DOIUrl":"https://doi.org/10.1155/2022/5430598","url":null,"abstract":"Objective To collect and analyze data of patent foramen ovale (PFO). Methods This study included a total of 260 patients diagnosed with PFO. We analyzed basic clinical data such as sex, age, transesophageal echocardiography as well as other symptoms. Results Our data showed that females accounted for the highest proportion of PFO (166 females, 64%), with the highest number of patients (65 patients) having between 45 and 55 years. Transesophageal echocardiography examination demonstrated frequent occurrence of tunnel-like anatomical structures. In addition, PFO was associated with symptoms such as migraine, stroke or TIA, syncope, chest tightness, and palpitations, with dizziness being the most common symptom in the patients with PFO. Conclusion Our data demonstrated that females accounted for the highest proportion of PFO patients, with those aged between 45 and 55 years being most affected. The most frequently encountered clinical symptom was dizziness. Taken together, these findings may help doctors to better understand and screen for PFO patients.","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":"34 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87160669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
期刊
Cardiology Research and Practice
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