Objective To evaluate the effects of simvastatin combined with omega-3 fatty acids on high sensitive C-reactive protein(HsCRP), lipidemia, and fibrinolysis in coronary heart disease (CHD) and CHD risk equivalent patie...Objective To evaluate the effects of simvastatin combined with omega-3 fatty acids on high sensitive C-reactive protein(HsCRP), lipidemia, and fibrinolysis in coronary heart disease (CHD) and CHD risk equivalent patients with mixed dyslipi-demia. Methods A randomized, double-blind placebo controlled and parallel group trial was conducted. Patients with CHD and CHD risk equivalents with mixed dyslipidemia were treated with 10 or 20 mg simvastatin for 6-12 weeks. Following with the treatment of patients whose low-density lipoprotein cholesterol (LDL-ch) reaching goal level (< 100 mg/dL) or close to the goal (< 130 mg/dL), while triglyceride (TG) ≥200 mg/dL and < 500 mg/dL, was combined with omega-3 fatty acids (3 g/d) or a placebo for 2 months. The effects of the treatment on HsCRP, total cholesterol (TC), LDL-ch, high-density lipoprotein cholesterol (HDL-ch), TG, lipoprotein (a) [LP (a)], apolipoprotein A1 (apoA1), apolipoprotein B (apoB), plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (tPA) were investigated. Forty patients finished the study with each group consisting of twenty patients. Results (1) There were significant reductions of HsCRP, TG, TC, and TC/HDL-ch, which decreased by 2.16 ±2.77 mg/L (38.5%), 94.0 ±65.4 mg/dL (31.1%), 13.3 ±22.3 mg/dL (6.3%), 0.78 ±1.60 respectively in the omega-3 fatty acids group (P< 0.01, < 0.001, < 0.05, < 0.05) compared to the baseline. HsCRP and triglyceride reduction were more significant in omega-3 fatty acids group compared to the placebo group (P=0.021 and 0.011 respectively). (2) In the omega-3 fatty acids group, the values and percentage of TG reduction had a significantly positive relation with HsCRP reduction (r=0.51 and 0.45, P=0.021 and 0.047 respectively). Conclusion In CHD and CHD risk equivalent patients with mixed dyslipidemia, dyslipidemia’s therapeutic effect using simvastatin and omega-3 fatty acids may result from not only the combination of lipid adjustment, but also enhancement of their own nonlipid influences.展开更多
Transcatheter edge-to-edge repair(TEER)of the mitral valve has emerged as a standard treatment for patients with severe degenerative mitral regurgitation at high or prohibitive surgical risk.The devices approved by th...Transcatheter edge-to-edge repair(TEER)of the mitral valve has emerged as a standard treatment for patients with severe degenerative mitral regurgitation at high or prohibitive surgical risk.The devices approved by the Food and Drug Administration including MitraClip(Abbott Vascular,California,USA)and PASCAL(Edwards Lifesciences,California,USA)cost over$33,000 in western countries.[1]This pricing presents a significant economic burden especially in developing countries,where TEER devices are typically not covered by health insurance.展开更多
文摘Objective To evaluate the effects of simvastatin combined with omega-3 fatty acids on high sensitive C-reactive protein(HsCRP), lipidemia, and fibrinolysis in coronary heart disease (CHD) and CHD risk equivalent patients with mixed dyslipi-demia. Methods A randomized, double-blind placebo controlled and parallel group trial was conducted. Patients with CHD and CHD risk equivalents with mixed dyslipidemia were treated with 10 or 20 mg simvastatin for 6-12 weeks. Following with the treatment of patients whose low-density lipoprotein cholesterol (LDL-ch) reaching goal level (< 100 mg/dL) or close to the goal (< 130 mg/dL), while triglyceride (TG) ≥200 mg/dL and < 500 mg/dL, was combined with omega-3 fatty acids (3 g/d) or a placebo for 2 months. The effects of the treatment on HsCRP, total cholesterol (TC), LDL-ch, high-density lipoprotein cholesterol (HDL-ch), TG, lipoprotein (a) [LP (a)], apolipoprotein A1 (apoA1), apolipoprotein B (apoB), plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (tPA) were investigated. Forty patients finished the study with each group consisting of twenty patients. Results (1) There were significant reductions of HsCRP, TG, TC, and TC/HDL-ch, which decreased by 2.16 ±2.77 mg/L (38.5%), 94.0 ±65.4 mg/dL (31.1%), 13.3 ±22.3 mg/dL (6.3%), 0.78 ±1.60 respectively in the omega-3 fatty acids group (P< 0.01, < 0.001, < 0.05, < 0.05) compared to the baseline. HsCRP and triglyceride reduction were more significant in omega-3 fatty acids group compared to the placebo group (P=0.021 and 0.011 respectively). (2) In the omega-3 fatty acids group, the values and percentage of TG reduction had a significantly positive relation with HsCRP reduction (r=0.51 and 0.45, P=0.021 and 0.047 respectively). Conclusion In CHD and CHD risk equivalent patients with mixed dyslipidemia, dyslipidemia’s therapeutic effect using simvastatin and omega-3 fatty acids may result from not only the combination of lipid adjustment, but also enhancement of their own nonlipid influences.
基金supported by the National Key R&D Program of China(2022YFC2503400)Major science and technology special plan project of Yunnan Province(202302AA310045)Yunnan Provincial Clinical Research Center for Cardiovascular Diseases(202102AA310002).
文摘Transcatheter edge-to-edge repair(TEER)of the mitral valve has emerged as a standard treatment for patients with severe degenerative mitral regurgitation at high or prohibitive surgical risk.The devices approved by the Food and Drug Administration including MitraClip(Abbott Vascular,California,USA)and PASCAL(Edwards Lifesciences,California,USA)cost over$33,000 in western countries.[1]This pricing presents a significant economic burden especially in developing countries,where TEER devices are typically not covered by health insurance.
