Pub Date : 2022-10-10eCollection Date: 2022-01-01DOI: 10.1155/2022/7619669
Xiuping Zhuo, Meinv Huang
Background: Atrial fibrillation (AF) is a significant stroke risk factor. Further research is needed to clarify whether higher atrial fibrillation burden (AFB) link to the elevated risk of ischemic embolism, and how AF burden could combine with CHA2DS2-VASc score to improve the anticoagulation strategy. We aim to evaluate if the AF burden characterized using 24-hours Holter ECG monitoring is associated with the risk of ischemic stroke.
Methods: This cohort study enrolled 210 Holter ECG monitoring detected atrial fibrillation patients. The burden of atrial fibrillation was defined as the percentage of time in atrial fibrillation during the monitoring period, and the AF burden and CHA2DS2-VASc score were compared between patients with and without thromboembolic outcomes. Multivariate regressions were conducted to estimate the predictors of thromboembolic outcomes.
Results: Eighteen thromboembolic events occurred within a median follow-up of 11.39 months. Patients with ischemic stroke had higher CHA2DS2-VASc scores but not higher AF burden. After adjusting for age, hypertension, diabetes, anticoagulation, antithrombotic therapy, AF burden, and AF with higher CHA2DS2-VASc score was associated with increased risk for ischemic stroke (hazard ratio (HR), 15.17). CHA2DS2-VASc score > 4.5 was a predictor of significantly higher risk of future stroke (AUC 0.92).
Conclusions: In Holter ECG monitoring detected AF, AF burden does not significantly impact the subsequent risk of stroke; whereas, CHA2DS2-VASc scoring is still a robust predictor of stroke risk. This may illustrate that once AF is detected from Holter ECG monitoring, underlying risk factors appear to be more predictive of subsequent stroke risk than atrial fibrillation burden.
{"title":"How is Ambulatory Electrocardiogram Predictive of Stroke in Atrial Fibrillation Patients?","authors":"Xiuping Zhuo, Meinv Huang","doi":"10.1155/2022/7619669","DOIUrl":"10.1155/2022/7619669","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a significant stroke risk factor. Further research is needed to clarify whether higher atrial fibrillation burden (AFB) link to the elevated risk of ischemic embolism, and how AF burden could combine with CHA<sub>2</sub>DS<sub>2</sub>-VASc score to improve the anticoagulation strategy. We aim to evaluate if the AF burden characterized using 24-hours Holter ECG monitoring is associated with the risk of ischemic stroke.</p><p><strong>Methods: </strong>This cohort study enrolled 210 Holter ECG monitoring detected atrial fibrillation patients. The burden of atrial fibrillation was defined as the percentage of time in atrial fibrillation during the monitoring period, and the AF burden and CHA<sub>2</sub>DS<sub>2</sub>-VASc score were compared between patients with and without thromboembolic outcomes. Multivariate regressions were conducted to estimate the predictors of thromboembolic outcomes.</p><p><strong>Results: </strong>Eighteen thromboembolic events occurred within a median follow-up of 11.39 months. Patients with ischemic stroke had higher CHA<sub>2</sub>DS<sub>2</sub>-VASc scores but not higher AF burden. After adjusting for age, hypertension, diabetes, anticoagulation, antithrombotic therapy, AF burden, and AF with higher CHA<sub>2</sub>DS<sub>2</sub>-VASc score was associated with increased risk for ischemic stroke (hazard ratio (HR), 15.17). CHA<sub>2</sub>DS<sub>2</sub>-VASc score > 4.5 was a predictor of significantly higher risk of future stroke (AUC 0.92).</p><p><strong>Conclusions: </strong>In Holter ECG monitoring detected AF, AF burden does not significantly impact the subsequent risk of stroke; whereas, CHA<sub>2</sub>DS<sub>2</sub>-VASc scoring is still a robust predictor of stroke risk. This may illustrate that once AF is detected from Holter ECG monitoring, underlying risk factors appear to be more predictive of subsequent stroke risk than atrial fibrillation burden.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9576441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40644345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: Coronary heart disease is a major cause of mortality in developed and developing countries. Changes in the trace element concentration in the human body are one of the main reasons for the transition of the human body from a healthy to a diseased state. In this meta-analysis, we have studied the relationship between the reduction in serum zinc ion concentration and coronary heart disease.
Methods: We used PubMed and Cochrane (as of June 30, 2021) databases for the literature search. Per the requirements of this systematic review, case-control studies involving serum zinc ion concentration and coronary heart disease were searched, and the quality of the included studies was evaluated before the meta-analysis.
Results: A total of 3,981 cases were found across seven articles. The standard mean deviation (SMD) of serum zinc ion concentration was -0.22 [-0.28, -0.15], z = 6.52, and P < 0.05 indicated that the difference was statistically significant. The forest plot results show that I2 = 34% < 50%, and the Q test showed P=0.17 > 0.1. These results suggest a lack of heterogeneity among the selected articles. Results from the funnel chart indicated that this study was free from publication bias.
Conclusion: The results of this meta-analysis reveal that a decrease in serum zinc ion concentration is related to the occurrence of coronary heart disease. Clinically, monitoring the serum zinc ion levels is proven to be of great significance for patients with coronary heart disease.
{"title":"Serum Zinc Ion Concentration Associated with Coronary Heart Disease: A Systematic Review and Meta-Analysis.","authors":"Heyu Meng, Jianjun Ruan, Yanqiu Chen, Zhaohan Yan, Xin Meng, Xiangdong Li, Jinsha Liu, Cuiying Mao, Ping Yang","doi":"10.1155/2022/4352484","DOIUrl":"https://doi.org/10.1155/2022/4352484","url":null,"abstract":"<p><strong>Aim: </strong>Coronary heart disease is a major cause of mortality in developed and developing countries. Changes in the trace element concentration in the human body are one of the main reasons for the transition of the human body from a healthy to a diseased state. In this meta-analysis, we have studied the relationship between the reduction in serum zinc ion concentration and coronary heart disease.</p><p><strong>Methods: </strong>We used PubMed and Cochrane (as of June 30, 2021) databases for the literature search. Per the requirements of this systematic review, case-control studies involving serum zinc ion concentration and coronary heart disease were searched, and the quality of the included studies was evaluated before the meta-analysis.</p><p><strong>Results: </strong>A total of 3,981 cases were found across seven articles. The standard mean deviation (SMD) of serum zinc ion concentration was -0.22 [-0.28, -0.15], <i>z</i> = 6.52, and <i>P</i> < 0.05 indicated that the difference was statistically significant. The forest plot results show that <i>I</i> <sup>2</sup> = 34% < 50%, and the <i>Q</i> test showed <i>P</i>=0.17 > 0.1. These results suggest a lack of heterogeneity among the selected articles. Results from the funnel chart indicated that this study was free from publication bias.</p><p><strong>Conclusion: </strong>The results of this meta-analysis reveal that a decrease in serum zinc ion concentration is related to the occurrence of coronary heart disease. Clinically, monitoring the serum zinc ion levels is proven to be of great significance for patients with coronary heart disease.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9560831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33516550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-29eCollection Date: 2022-01-01DOI: 10.1155/2022/5287566
Lei Liu, Xiaosong Ding, Hui Chen, Weiping Li, Hongwei Li
Background: The effects of β-blockers in patients with unstable angina pectoris (UAP) are unclear. We tried to evaluate associations between β-blockers in UAP and long-term outcomes.
Methods: We enrolled 5591 UAP patients and divided them into 2 groups based on β-blockers at discharge: 3790 did β-blockers and 1801 did not used them. Propensity score matching at 1 : 1 was performed to select 1786 patients from each group. The primary endpoint was major adverse cardiac and cerebral events (MACCE) during the long-term follow-up period.
Results: 67.8% of patients were on β-blockers at discharge; these patients were more likely to have CHD risk factors, lower ejection fraction, and severity of the coronary artery lesions. Over a median of 25.0 years, the incidence of MACCE was 25.5%. The risk was not significantly different between those on and those not on β-blocker treatment. The multivariate Cox regression analysis showed that no β-blocker use at discharge was not an independent risk factor for MACCE and sequence secondary endpoints. After propensity score matching, the results were similar.
Conclusions: β-blocker use was not associated with lower MACCE and other secondary composite endpoints in long-term outcomes. This result adds to the increasing body of evidence that the routine prescription of β-blockers might not be indicated in patients with UAP. Trial registration had retrospectively registered.
{"title":"Associations between <i>β</i>-Blocker Therapy at Discharge and Long-Term Follow-Up Outcomes in Patients with Unstable Angina Pectoris.","authors":"Lei Liu, Xiaosong Ding, Hui Chen, Weiping Li, Hongwei Li","doi":"10.1155/2022/5287566","DOIUrl":"https://doi.org/10.1155/2022/5287566","url":null,"abstract":"<p><strong>Background: </strong>The effects of <i>β</i>-blockers in patients with unstable angina pectoris (UAP) are unclear. We tried to evaluate associations between <i>β</i>-blockers in UAP and long-term outcomes.</p><p><strong>Methods: </strong>We enrolled 5591 UAP patients and divided them into 2 groups based on <i>β</i>-blockers at discharge: 3790 did <i>β</i>-blockers and 1801 did not used them. Propensity score matching at 1 : 1 was performed to select 1786 patients from each group. The primary endpoint was major adverse cardiac and cerebral events (MACCE) during the long-term follow-up period.</p><p><strong>Results: </strong>67.8% of patients were on <i>β</i>-blockers at discharge; these patients were more likely to have CHD risk factors, lower ejection fraction, and severity of the coronary artery lesions. Over a median of 25.0 years, the incidence of MACCE was 25.5%. The risk was not significantly different between those on and those not on <i>β</i>-blocker treatment. The multivariate Cox regression analysis showed that no <i>β</i>-blocker use at discharge was not an independent risk factor for MACCE and sequence secondary endpoints. After propensity score matching, the results were similar.</p><p><strong>Conclusions: </strong><i>β</i>-blocker use was not associated with lower MACCE and other secondary composite endpoints in long-term outcomes. This result adds to the increasing body of evidence that the routine prescription of <i>β</i>-blockers might not be indicated in patients with UAP. Trial registration had retrospectively registered.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9537036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33498194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-29eCollection Date: 2022-01-01DOI: 10.1155/2022/2090309
Qiankun Fan, Yinge Zhan, Mingqi Zheng, Fangfang Ma, Lishuang Ji, Lei Zhang, Gang Liu
Background: Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice. Although fat is currently considered to be a risk factor for AF and a pathogenic link between epicardial fat tissue (EFT) and AF has been speculated, there are currently few clinical studies and literature data domestically or abroad.
Objective: This study conducted a meta-analysis of observational case series studies to verify the relationship between atrial fibrillation and EFT and to strengthen the predictive value of EFT in the occurrence, development, and postablative recurrence of AF.
Methods: We conducted a systematic search of the literature in electronic databases until December 2021 and supplemented this through manual searches of individual studies, reviewed articles, and reference lists in conference proceedings. This study conducted a meta-analysis to compare the differences between different populations, such as healthy participants and AF patients, healthy subjects and AF subtype cases, and paroxysmal and persistent AF with AF recurrence and without AF recurrence after ablation.
Results: Following the retrieval of 828 articles, only 22 articles were selected as research results. Accordingly, the meta-analysis results show that the volume of EFT in AF is greater than that in healthy subjects (MD = 39.34 ml, 95% CI = 27.11, 51.58); persistent AF is greater than paroxysmal AF (MD = 14.37 ml, 95% CI = 7.46, 21.27); and recurrence after ablation is greater than without recurrence (MD = 14.37 ml, 95% CI = 7.46, 21.27).
Conclusion: The results of this study further confirm the connection between EFT and AF and that EFT has a certain predictive value for the occurrence and development of AF.
背景:心房颤动(AF)是临床上最常见的心律失常之一。虽然目前认为脂肪是房颤的危险因素,并推测心外膜脂肪组织(EFT)与房颤之间存在致病联系,但目前国内外的临床研究和文献资料较少。目的:本研究对观察性病例系列研究进行了荟萃分析,以验证房颤和EFT之间的关系,并加强EFT对房颤发生、发展和术后复发的预测价值。方法:我们在电子数据库中进行了系统的文献检索,直到2021年12月,并通过人工检索个别研究、综述文章和会议论文集中的参考文献列表进行了补充。本研究通过荟萃分析比较不同人群之间的差异,如健康受试者和房颤患者、健康受试者和房颤亚型病例、阵发性和持续性房颤合并房颤复发和房颤消融后不复发。结果:在检索828篇文献后,仅选择22篇文献作为研究成果。因此,meta分析结果显示,AF患者EFT体积大于健康受试者(MD = 39.34 ml, 95% CI = 27.11, 51.58);持续性房颤大于阵发性房颤(MD = 14.37 ml, 95% CI = 7.46, 21.27);消融后复发率大于未复发(MD = 14.37 ml, 95% CI = 7.46, 21.27)。结论:本研究结果进一步证实了EFT与房颤之间的联系,EFT对房颤的发生发展具有一定的预测价值。
{"title":"The Predictive Value of Epicardial Fat Tissue Volume in the Occurrence and Development of Atrial Fibrillation: A Systematic Review and Meta-Analysis.","authors":"Qiankun Fan, Yinge Zhan, Mingqi Zheng, Fangfang Ma, Lishuang Ji, Lei Zhang, Gang Liu","doi":"10.1155/2022/2090309","DOIUrl":"https://doi.org/10.1155/2022/2090309","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice. Although fat is currently considered to be a risk factor for AF and a pathogenic link between epicardial fat tissue (EFT) and AF has been speculated, there are currently few clinical studies and literature data domestically or abroad.</p><p><strong>Objective: </strong>This study conducted a meta-analysis of observational case series studies to verify the relationship between atrial fibrillation and EFT and to strengthen the predictive value of EFT in the occurrence, development, and postablative recurrence of AF.</p><p><strong>Methods: </strong>We conducted a systematic search of the literature in electronic databases until December 2021 and supplemented this through manual searches of individual studies, reviewed articles, and reference lists in conference proceedings. This study conducted a meta-analysis to compare the differences between different populations, such as healthy participants and AF patients, healthy subjects and AF subtype cases, and paroxysmal and persistent AF with AF recurrence and without AF recurrence after ablation.</p><p><strong>Results: </strong>Following the retrieval of 828 articles, only 22 articles were selected as research results. Accordingly, the meta-analysis results show that the volume of EFT in AF is greater than that in healthy subjects (MD = 39.34 ml, 95% CI = 27.11, 51.58); persistent AF is greater than paroxysmal AF (MD = 14.37 ml, 95% CI = 7.46, 21.27); and recurrence after ablation is greater than without recurrence (MD = 14.37 ml, 95% CI = 7.46, 21.27).</p><p><strong>Conclusion: </strong>The results of this study further confirm the connection between EFT and AF and that EFT has a certain predictive value for the occurrence and development of AF.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9537030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33498195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endothelial dysfunction may contribute to the increased morbidity and mortality associated with coronary heart disease (CHD). Flow-mediated dilatation (FMD) is the most popular noninvasive method for vascular endothelial function evaluation. This meta-analysis aimed to investigate the association between FMD and CHD. We searched the publications listed in the PubMed, Web of Science, Scopus, and Embase databases. Stata 14 software was used to analyze the data. Standardized mean difference (SMD) was used to calculate FMD levels, and the effect sizes were expressed with a 95% confidence interval (CI). I2 statistics were used to evaluate statistical heterogeneity. In this meta-analysis, 9 studies enrolled a total number of 943 participants, including 534 (56.63%) patients with CHD and 409 controls (43.37%). We found that patients with CHD showed a significantly lower FMD than the controls (SMD -0.706%; 95% CI: -0.985, -0.427; P=0.001) with high heterogeneity. In addition, funnel plot analysis suggested asymmetry that could be evidence of publication bias. But sensitivity analyses show that there were no influential studies. This meta-analysis provides evidence that patients with CHD show a significantly lower FMD than controls and highlights the literature on FMD as a hallmark in CHD diseases.
内皮功能障碍可能与冠心病(CHD)相关的发病率和死亡率增加有关。血流介导扩张(FMD)是血管内皮功能评估中最常用的无创方法。本荟萃分析旨在调查口蹄疫与冠心病之间的关系。我们检索了PubMed、Web of Science、Scopus和Embase数据库中列出的出版物。采用Stata 14软件对数据进行分析。采用标准化平均差(SMD)计算口蹄疫水平,效应量用95%置信区间(CI)表示。采用I2统计量评价统计异质性。在本荟萃分析中,9项研究共纳入943名参与者,其中534名(56.63%)冠心病患者和409名对照组(43.37%)。我们发现冠心病患者的FMD明显低于对照组(SMD -0.706%;95% ci: -0.985, -0.427;P=0.001),异质性高。此外,漏斗图分析表明,不对称可能是发表偏倚的证据。但敏感性分析表明,没有有影响力的研究。这项荟萃分析提供了证据,表明冠心病患者的FMD明显低于对照组,并强调了FMD作为冠心病疾病标志的文献。
{"title":"Flow-Mediated Dilatation in the Assessment of Coronary Heart Disease: A Meta-Analysis.","authors":"Xiaoyong Xiao, Xian Li, Xiaohua Xiao, Jingjing Wang, Dehong Liu, Zhe Deng","doi":"10.1155/2022/7967324","DOIUrl":"https://doi.org/10.1155/2022/7967324","url":null,"abstract":"<p><p>Endothelial dysfunction may contribute to the increased morbidity and mortality associated with coronary heart disease (CHD). Flow-mediated dilatation (FMD) is the most popular noninvasive method for vascular endothelial function evaluation. This meta-analysis aimed to investigate the association between FMD and CHD. We searched the publications listed in the PubMed, Web of Science, Scopus, and Embase databases. Stata 14 software was used to analyze the data. Standardized mean difference (SMD) was used to calculate FMD levels, and the effect sizes were expressed with a 95% confidence interval (CI). I<sup>2</sup> statistics were used to evaluate statistical heterogeneity. In this meta-analysis, 9 studies enrolled a total number of 943 participants, including 534 (56.63%) patients with CHD and 409 controls (43.37%). We found that patients with CHD showed a significantly lower FMD than the controls (SMD -0.706%; 95% CI: -0.985, -0.427; <i>P</i>=0.001) with high heterogeneity. In addition, funnel plot analysis suggested asymmetry that could be evidence of publication bias. But sensitivity analyses show that there were no influential studies. This meta-analysis provides evidence that patients with CHD show a significantly lower FMD than controls and highlights the literature on FMD as a hallmark in CHD diseases.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33498197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-28eCollection Date: 2022-01-01DOI: 10.1155/2022/2914385
Yong-Hoon Yoon, Gyung-Min Park, Jae-Hyung Roh, Sung-Ho Her, Seong-Hoon Lim, Tae Soo Kang, Seung Jin Lee, Jang-Whan Bae, WoongGil Choi, Yong-Mo Yang, Junghee Kim, Yu Jeong Choi, Si Wan Choi, Jae-Hwan Lee
Background: The optimal duration of dual antiplatelet therapy (DAPT) after biodegradable-polymer (BP) everolimus-eluting stent (EES) implantation remains uncertain.
Methods: This study analyzed 793 patients who underwent percutaneous coronary intervention (PCI) with BP-EES in 10 cardiovascular centers in Korea between July 2016 and January 2018. Using the prescription data at 6 months post-PCI, we divided these patients into two groups, namely, short-DAPT and prolonged-DAPT groups, which underwent DAPT for 6 and > 6 months of PCI, respectively. The primary endpoint, which included mortality, myocardial infarction, or target-vessel revascularization at 2 years, was compared by propensity score (PS) matching between the two groups.
Results: Out of the 793 patients, 283 matched pairs were identified by PS matching. Out of this matched population, 405 (71.6%) patients had an acute coronary syndrome. The primary endpoint did not differ in 2 years between the short-DAPT and prolonged-DAPT groups (7.5% vs. 8.3%; hazard ratio, 0.87; 95% confidential interval, 0.47-1.60; P = 0.648). Likewise, no difference was found regarding mortality, cardiac mortality, myocardial infarction, target-lesion failure, target-vessel failure, and bleeding events defined by the Bleeding Academic Research Consortium and Thrombolysis In the Myocardial Infarction classification. Meanwhile, one patient in the short-DAPT group had definite stent thrombosis at 364 days post-PCI. Subgroup analysis showed that several anatomical and procedural factors were not significantly related to DAPT duration. Most patients (77.4%) in both groups were prescribed clopidogrel at discharge.
Conclusions: In real-world patients undergoing PCI with BP-EES, the ischemic and bleeding endpoints demonstrated no difference between 6-month and prolonged (>6 months) DAPT.
{"title":"Comparison of 6-Month and Prolonged Dual Antiplatelet Therapy after Percutaneous Coronary Intervention with Biodegradable Polymer Everolimus-Eluting Stent.","authors":"Yong-Hoon Yoon, Gyung-Min Park, Jae-Hyung Roh, Sung-Ho Her, Seong-Hoon Lim, Tae Soo Kang, Seung Jin Lee, Jang-Whan Bae, WoongGil Choi, Yong-Mo Yang, Junghee Kim, Yu Jeong Choi, Si Wan Choi, Jae-Hwan Lee","doi":"10.1155/2022/2914385","DOIUrl":"10.1155/2022/2914385","url":null,"abstract":"<p><strong>Background: </strong>The optimal duration of dual antiplatelet therapy (DAPT) after biodegradable-polymer (BP) everolimus-eluting stent (EES) implantation remains uncertain.</p><p><strong>Methods: </strong>This study analyzed 793 patients who underwent percutaneous coronary intervention (PCI) with BP-EES in 10 cardiovascular centers in Korea between July 2016 and January 2018. Using the prescription data at 6 months post-PCI, we divided these patients into two groups, namely, short-DAPT and prolonged-DAPT groups, which underwent DAPT for 6 and > 6 months of PCI, respectively. The primary endpoint, which included mortality, myocardial infarction, or target-vessel revascularization at 2 years, was compared by propensity score (PS) matching between the two groups.</p><p><strong>Results: </strong>Out of the 793 patients, 283 matched pairs were identified by PS matching. Out of this matched population, 405 (71.6%) patients had an acute coronary syndrome. The primary endpoint did not differ in 2 years between the short-DAPT and prolonged-DAPT groups (7.5% vs. 8.3%; hazard ratio, 0.87; 95% confidential interval, 0.47-1.60; <i>P</i> = 0.648). Likewise, no difference was found regarding mortality, cardiac mortality, myocardial infarction, target-lesion failure, target-vessel failure, and bleeding events defined by the Bleeding Academic Research Consortium and Thrombolysis In the Myocardial Infarction classification. Meanwhile, one patient in the short-DAPT group had definite stent thrombosis at 364 days post-PCI. Subgroup analysis showed that several anatomical and procedural factors were not significantly related to DAPT duration. Most patients (77.4%) in both groups were prescribed clopidogrel at discharge.</p><p><strong>Conclusions: </strong>In real-world patients undergoing PCI with BP-EES, the ischemic and bleeding endpoints demonstrated no difference between 6-month and prolonged (>6 months) DAPT.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33498196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-27eCollection Date: 2022-01-01DOI: 10.1155/2022/2746304
Jan Alatic, David Suran, Damijan Vokac, Franjo Husam Naji
Introduction: Catheter ablation (CA) with pulmonary vein isolation (PVI) has become widely used in the past years for the treatment of atrial fibrillation (AF). Mitral annular plane systolic excursion (MAPSE) is the parameter that measures left ventricular longitudinal function, and it appears to be a good early marker of LV dysfunction. It is practically independent of poor image quality. The aim of our study was to analyse the role of echocardiographic variables, especially MAPSE in predicting the outcome of CA in patients with AF.
Materials and methods: We prospectively included 40 patients with paroxysmal and persistent AF that were referred for CA. All patients underwent radiofrequency CA with PVI. Standard transthoracic two-dimensional echocardiography was conducted one day after CA. Demographic data and the patients' characteristics were noted. The endpoint of our study was to estimate the AF recurrence rate diagnosed by ECG within 6 months of the follow-up period.
Results: 40 patients, mainly male (67.5%) with an average age of 61.43 ± 8.96 years were included in our study. The majority of patients had paroxysmal AF prior to ablation (77.5%). The AF recurrence rate was 20% after 6 months of follow-up. Lateral MAPSE in the AF-free group was greater than those who relapsed (1.57 ± 0.24 vs. 1.31 ± 0.25; p = 0.012). Patients who remained AF-free after a 6-month follow-up period had a significantly smaller left ventricular volume index (LAVI) than those who relapsed (34.29 ± 6.91 ml/m2 vs. 42.90 ± 8.43 ml/m2; p = 0.05). We found a significant reverse relationship between LAVI and MAPSE (p = 0.020).
Conclusion: MAPSE and LAVI present risk factors for AF recurrence, specifically reduced MAPSE and larger LAVI, are related to AF recurrence after CA. In the future, MAPSE could play a significant role when predicting the CA outcome in patients with AF.
{"title":"Mitral Annular Plane Systolic Excursion (MAPSE) as a Predictor of Atrial Fibrillation Recurrence in Patients after Pulmonary Vein Isolation.","authors":"Jan Alatic, David Suran, Damijan Vokac, Franjo Husam Naji","doi":"10.1155/2022/2746304","DOIUrl":"https://doi.org/10.1155/2022/2746304","url":null,"abstract":"<p><strong>Introduction: </strong>Catheter ablation (CA) with pulmonary vein isolation (PVI) has become widely used in the past years for the treatment of atrial fibrillation (AF). Mitral annular plane systolic excursion (MAPSE) is the parameter that measures left ventricular longitudinal function, and it appears to be a good early marker of LV dysfunction. It is practically independent of poor image quality. The aim of our study was to analyse the role of echocardiographic variables, especially MAPSE in predicting the outcome of CA in patients with AF.</p><p><strong>Materials and methods: </strong>We prospectively included 40 patients with paroxysmal and persistent AF that were referred for CA. All patients underwent radiofrequency CA with PVI. Standard transthoracic two-dimensional echocardiography was conducted one day after CA. Demographic data and the patients' characteristics were noted. The endpoint of our study was to estimate the AF recurrence rate diagnosed by ECG within 6 months of the follow-up period.</p><p><strong>Results: </strong>40 patients, mainly male (67.5%) with an average age of 61.43 ± 8.96 years were included in our study. The majority of patients had paroxysmal AF prior to ablation (77.5%). The AF recurrence rate was 20% after 6 months of follow-up. Lateral MAPSE in the AF-free group was greater than those who relapsed (1.57 ± 0.24 vs. 1.31 ± 0.25; <i>p</i> = 0.012). Patients who remained AF-free after a 6-month follow-up period had a significantly smaller left ventricular volume index (LAVI) than those who relapsed (34.29 ± 6.91 ml/m<sup>2</sup> vs. 42.90 ± 8.43 ml/m<sup>2</sup>; <i>p</i> = 0.05). We found a significant reverse relationship between LAVI and MAPSE (<i>p</i> = 0.020).</p><p><strong>Conclusion: </strong>MAPSE and LAVI present risk factors for AF recurrence, specifically reduced MAPSE and larger LAVI, are related to AF recurrence after CA. In the future, MAPSE could play a significant role when predicting the CA outcome in patients with AF.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9532161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33509495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-19eCollection Date: 2022-01-01DOI: 10.1155/2022/8372707
Ming Fang, Jun Luo, Xi Zhu, Yingbiao Wu, Xinming Li
Background: Heart failure is a critical health problem worldwide, and cardiac hypertrophy is an important characteristic of heart failure. Bromodomain-containing protein 4 (BRD4) is involved in various cellular processes, including cardiac hypertrophy. This study aimed to investigate the mechanism underlying the effects of BRD4 on cardiac hypertrophy.
Methods: Rat myoblast H9c2 cells were treated with angiotensin II (Ang II) to increase the mRNA and protein expressions of BRD4. BRD4 was silenced by small interfering RNA (siRNA) in H9c2 cells. Proteins involved in Nrf2-HO-1 pathway were determined by Western blot.
Results: Our data suggest that BRD4 silencing attenuated Ang II, increased the percentage of TUNEL + cells and caspase-3 activity, increased oxidative stress, and increased the expression and content of pro-inflammatory cytokines. Mechanistically, we found that BRD4 silencing enhanced the protein expressions of Nrf2 and HO-1 and inhibited the TLR4 and phosphorylation of NF-kappa B in Ang II-stimulated H9c2 cells. TLR4 overexpression attenuated cardioprotection against Ang II by BRD4 silencing, including cardiac hypertrophy, oxidative stress, and inflammatory cytokine production. Additionally, TLR4 overexpression attenuated an increase in Nrf2 and HO-1 proteins and decreased phosphorylated NF-kappa B in H9c2 cells.
Conclusion: Our results speculate that the BRD4/TLR4 axis might be a promising strategy for treating cardiovascular diseases with cardiac hypertrophy, including HF.
{"title":"BRD4 Silencing Protects Angiotensin II-Induced Cardiac Hypertrophy by Inhibiting TLR4/NF-<i>κ</i>B and Activating Nrf2-HO-1 Pathways.","authors":"Ming Fang, Jun Luo, Xi Zhu, Yingbiao Wu, Xinming Li","doi":"10.1155/2022/8372707","DOIUrl":"https://doi.org/10.1155/2022/8372707","url":null,"abstract":"<p><strong>Background: </strong>Heart failure is a critical health problem worldwide, and cardiac hypertrophy is an important characteristic of heart failure. Bromodomain-containing protein 4 (BRD4) is involved in various cellular processes, including cardiac hypertrophy. This study aimed to investigate the mechanism underlying the effects of BRD4 on cardiac hypertrophy.</p><p><strong>Methods: </strong>Rat myoblast H9c2 cells were treated with angiotensin II (Ang II) to increase the mRNA and protein expressions of BRD4. BRD4 was silenced by small interfering RNA (siRNA) in H9c2 cells. Proteins involved in Nrf2-HO-1 pathway were determined by Western blot.</p><p><strong>Results: </strong>Our data suggest that BRD4 silencing attenuated Ang II, increased the percentage of TUNEL + cells and caspase-3 activity, increased oxidative stress, and increased the expression and content of pro-inflammatory cytokines. Mechanistically, we found that BRD4 silencing enhanced the protein expressions of Nrf2 and HO-1 and inhibited the TLR4 and phosphorylation of NF-kappa B in Ang II-stimulated H9c2 cells. TLR4 overexpression attenuated cardioprotection against Ang II by BRD4 silencing, including cardiac hypertrophy, oxidative stress, and inflammatory cytokine production. Additionally, TLR4 overexpression attenuated an increase in Nrf2 and HO-1 proteins and decreased phosphorylated NF-kappa B in H9c2 cells.</p><p><strong>Conclusion: </strong>Our results speculate that the BRD4/TLR4 axis might be a promising strategy for treating cardiovascular diseases with cardiac hypertrophy, including HF.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33515113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-10eCollection Date: 2022-01-01DOI: 10.1155/2022/5509364
Jiamiao Gong, Kang An, Hongyuan Lin, Jianfeng Hou
Objective: To describe the natural history of the ascending aorta in elderly patients after aortic valve replacement (AVR) for aortic valve stenosis and to clarify the risk factors associated with the progression of the ascending aorta.
Methods: This retrospective review included a total of 87 elderly patients who had undergone aortic valve replacement for severe aortic valve stenosis in Fuwai Hospital. The patients were categorized into two groups based on the height-based aortic height index (AHI) before AVR, as determined by echocardiography and computed tomography: Group A (n = 28) was defined as an AHI > 2.44 cm/m, and Group B (n = 59) was defined as an AHI ≤ 2.44 cm/m. The perioperative and follow-up data were collected, and a linear mixed-effect model was used to analyze and compare the change rate of the ascending aorta after AVR.
Results: The mean follow-up period was 4.0 ± 1.3 years. The diameter of ascending aorta in group A increased from 37.2 ± 5.0 mm at discharge to 40.7 ± 4.7 mm at the last follow-up (P=0.001), while that of group B increased only from 33.3 ± 4.4 mm to 33.7 ± 4.1 mm (P > 0.05).The ascending aorta diameter expansive rate was 0.81 mm/year in group A and 0.14 mm/year in group B. The expansive rate was significantly greater in patients with an AHI>2.44 cm/m than in those with anything else (P = 0.009). A univariable linear mixed model analysis revealed that the AHI>2.44 cm/m was the only significant risk factor for ascending aortic dilatation rate after AVR. There were 4 patients who died in hospital and 11 late follow-up deaths. Particularly, there was no aortic event that occurred during follow-up.
Conclusion: For elderly patients with aortic stenosis, the possibility of progressive ascending aortic dilatation after AVR demands regular follow-up, and AHI may be an important risk factor for the change rate of the diameter of the ascending aorta.
{"title":"Ascending Aorta Diameter Changes after Aortic Valve Replacement in Elderly Patients with Aortic Valve Stenosis.","authors":"Jiamiao Gong, Kang An, Hongyuan Lin, Jianfeng Hou","doi":"10.1155/2022/5509364","DOIUrl":"https://doi.org/10.1155/2022/5509364","url":null,"abstract":"<p><strong>Objective: </strong>To describe the natural history of the ascending aorta in elderly patients after aortic valve replacement (AVR) for aortic valve stenosis and to clarify the risk factors associated with the progression of the ascending aorta.</p><p><strong>Methods: </strong>This retrospective review included a total of 87 elderly patients who had undergone aortic valve replacement for severe aortic valve stenosis in Fuwai Hospital. The patients were categorized into two groups based on the height-based aortic height index (AHI) before AVR, as determined by echocardiography and computed tomography: Group <i>A</i> (<i>n</i> = 28) was defined as an AHI > 2.44 cm/m, and Group <i>B</i> (<i>n</i> = 59) was defined as an AHI ≤ 2.44 cm/m. The perioperative and follow-up data were collected, and a linear mixed-effect model was used to analyze and compare the change rate of the ascending aorta after AVR.</p><p><strong>Results: </strong>The mean follow-up period was 4.0 ± 1.3 years. The diameter of ascending aorta in group <i>A</i> increased from 37.2 ± 5.0 mm at discharge to 40.7 ± 4.7 mm at the last follow-up (<i>P</i>=0.001), while that of group <i>B</i> increased only from 33.3 ± 4.4 mm to 33.7 ± 4.1 mm (<i>P</i> > 0.05).The ascending aorta diameter expansive rate was 0.81 mm/year in group <i>A</i> and 0.14 mm/year in group <i>B</i>. The expansive rate was significantly greater in patients with an AHI>2.44 cm/m than in those with anything else (<i>P</i> = 0.009). A univariable linear mixed model analysis revealed that the AHI>2.44 cm/m was the only significant risk factor for ascending aortic dilatation rate after AVR. There were 4 patients who died in hospital and 11 late follow-up deaths. Particularly, there was no aortic event that occurred during follow-up.</p><p><strong>Conclusion: </strong>For elderly patients with aortic stenosis, the possibility of progressive ascending aortic dilatation after AVR demands regular follow-up, and AHI may be an important risk factor for the change rate of the diameter of the ascending aorta.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40371491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-10eCollection Date: 2022-01-01DOI: 10.1155/2022/9464733
Joel Rodríguez-Saldaña, Francisco Padilla-Padilla, Ernesto G Cardona-Muñoz, Yulia Romero-Antonio, María Marcela Arguedas-Núñez, José G Sander-Padilla, Alberto Martínez-Muñoz, Laura A Lugo-Sánchez, Ileana C Rodríguez-Vazquez, Jorge González-Canudas
Introduction: Cardiovascular diseases are the leading cause of death worldwide. The combination of statins and cholesterol-absorption inhibitors promotes the decrease in risk factors, such as high concentrations of LDL (low-density lipoproteins). The aim of the study was to evaluate changes in the lipid profile and the effect on therapeutic goals, as well as the safety of dyslipidemia patients treated with Rosuvastatin/Ezetimibe (Trezete®).
Materials and methods: A real-world evidence study was conducted with retrospective data collection through a review of clinical records from dyslipidemia patients treated with Trezete® in routine medical practice. Clinical records included results of biochemical markers before treatment and at least one follow up between weeks 8 and 16.
Results: The study included 103 patients' clinical records (55.4% men) with a mean age of 56.0 ± 13.0 years. More than 57% of the patients had mixed dyslipidemia and a median disease progression of 3.1 (IQR, 1.5; 9.1) years. Regarding LDL concentrations, 72.8% of the patients achieved therapeutic goals according to cardiovascular risk (CVR), which was statistically significant. Similarly, 94.1% achieved goals for total cholesterol (<200 mg/dL) and 56.0% for triglycerides (<150 mg/dL), a p value <0.001. No cardiovascular events were observed.
Conclusion: Trezete® shows an important clinical impact on CVR-related target markers during the treatment of dyslipidemia patients. It is relevant to mention that a significant percentage of patients achieved therapeutic goals during the first months of treatment. Fixed-dose combination therapy has shown to be as safe as monotherapy treatment. ClinicalTrials.gov Identifier: NCT04862962.
{"title":"Real-World Evidence Evaluation on the Lipid Profile, Therapeutic Goals, and Safety of the Fixed-Dose Combination of Rosuvastatin/Ezetimibe (Trezete®) in Dyslipidemia Patients.","authors":"Joel Rodríguez-Saldaña, Francisco Padilla-Padilla, Ernesto G Cardona-Muñoz, Yulia Romero-Antonio, María Marcela Arguedas-Núñez, José G Sander-Padilla, Alberto Martínez-Muñoz, Laura A Lugo-Sánchez, Ileana C Rodríguez-Vazquez, Jorge González-Canudas","doi":"10.1155/2022/9464733","DOIUrl":"https://doi.org/10.1155/2022/9464733","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular diseases are the leading cause of death worldwide. The combination of statins and cholesterol-absorption inhibitors promotes the decrease in risk factors, such as high concentrations of LDL (low-density lipoproteins). The aim of the study was to evaluate changes in the lipid profile and the effect on therapeutic goals, as well as the safety of dyslipidemia patients treated with Rosuvastatin/Ezetimibe (Trezete®).</p><p><strong>Materials and methods: </strong>A real-world evidence study was conducted with retrospective data collection through a review of clinical records from dyslipidemia patients treated with Trezete® in routine medical practice. Clinical records included results of biochemical markers before treatment and at least one follow up between weeks 8 and 16.</p><p><strong>Results: </strong>The study included 103 patients' clinical records (55.4% men) with a mean age of 56.0 ± 13.0 years. More than 57% of the patients had mixed dyslipidemia and a median disease progression of 3.1 (IQR, 1.5; 9.1) years. Regarding LDL concentrations, 72.8% of the patients achieved therapeutic goals according to cardiovascular risk (CVR), which was statistically significant. Similarly, 94.1% achieved goals for total cholesterol (<200 mg/dL) and 56.0% for triglycerides (<150 mg/dL), a <i>p</i> value <0.001. No cardiovascular events were observed.</p><p><strong>Conclusion: </strong>Trezete® shows an important clinical impact on CVR-related target markers during the treatment of dyslipidemia patients. It is relevant to mention that a significant percentage of patients achieved therapeutic goals during the first months of treatment. Fixed-dose combination therapy has shown to be as safe as monotherapy treatment. ClinicalTrials.gov Identifier: NCT04862962.</p>","PeriodicalId":9494,"journal":{"name":"Cardiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40371492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}