2018 update of expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCI

East Asians are the most populous race in the world and their health status is an important global issue.Compared with Caucasian populations, East Asian patients have a different benefit/risk ratio when using antithrombotic treatment. Despite this observation, treatment strategies in East Asian patients are mostly based on the American and European guidelines. Despite a lower platelet inhibitory response to clopidogrel, East Asian patients show a similar or even a lower rate of ischemic event occurrence and higher bleeding risk compared with Caucasian patients. For potent P2Y_(12) inhibitors(ticagrelor and prasugrel),East Asian patients have shown less favorable net clinical benefits compared with Caucasian patients,which may be related to differences in pharmacokinetic/pharmacodynamic profiles and therapeutic zone of antiplatelet effect. This updated consensus mainly focuses on state-of-the-art and current controversies in the East Asian population. In addition, when East Asian patients are administered potent P2Y_(12) receptor inhibitors, the strategies and ongoing trials to overcome the related hurdles are discussed.

Non-obstructive Coronary Artery Disease in Chinese Patients with Angina Diagnosed by Coronary Angiography:A Retrospective Study

Objective:This study aimed to estimate the proportion of non-obstructive coronary artery disease(CAD)patients in large percutaneous coronary intervention(PCI)centers in China.Methods:The study was conducted at 6 large PCI centers in China from January 1,2013 to December 31,2015.Demographic and clinical data were collected from medical records,prescription records,and laboratory reports of patients with symptoms of angina who underwent coronary angiography(CAG).Results:A total of 1713 patients were consecutively screened,1600 of whom were included in the study.CAG showed that 300 patients had non-obstructive CAD while 1300 had obstructive CAD.Among the 300 patients with non-obstructive CAD,203 displayed mild coronary stenosis(20%-49%)and 91 had normal coronary status(ie,<20%stenosis).Of the 1300 patients with obstructive CAD,61.6%(801/1300)had typical symptoms of angina,compared with 49.3%(148/300)for patients with nonobstructive CAD.In addition,there were more women than men in the non-obstructive CAD group,whereas the reverse was observed among obstructive CAD patients.Conclusion:The prevalence of non-obstructive CAD in the Chinese population with coronary heart disease was estimated to be approximately 20%.Additionally,typical angina symptoms were correlated with obstructive CAD,whereas female gender was identified as a risk factor for non-obstructive CAD.

Integrative self-assembly of covalent organic frameworks and fluorescent molecules for ultrasensitive detection of a nerve agent simulant

Binding of fluorescent molecules to the porous matrix through noncovalent interactions will synergistically expand their application spectrum. In this regard, we report an integrative self-assembly of molecule 1 with benzothiadizole and 9,9-dihexyl fluorene units, and covalent organic frameworks(COFs) via an emulsion-modulated polymerization process, within which molecules of 1 are able to interact with the scaffolds of COFs through CH-π interactions. Thus the π-πinteractions between the fluorescent molecules are largely suppressed, giving rise to their remarkable monomer-like optical properties. Of particular interest is that, given by the specific interaction between COFs and a nerve agent simulant diethyl chlorophosphite(DCP), these assembled composites show the ability of ultrasensitive detection of DCP with a detection limit of ~40 ppb. Moreover, the present integrative assembly strategy can be extended to encapsulate multiple fluorescent molecules, enabling the assemblies with white light emission. Our results highlight opportunities for the development of highly emissive porous materials by molecular selfassembly of fluorophores and molecular units of COFs.