Is frailty associated with short-term outcomes for elderly patients with acute coronary syndrome？

BackgroundFrailty 由于老化并且逐渐地是在心血管的药的一个新预示的因素老病人的复杂自然。有希望地分析在哪个脆弱与 .MethodsPatients 变老的急性冠的症候群(交流) 为老病人预言短期的结果的方式有用、有意义 &#x02265；65 年，与从心病学的交流的诊断，部门和医学部门被包括从单个中心。包括医学症候群的临床的数据用全面医学评价被收集。脆弱根据临床的脆弱规模被定义，风险上的合作病态的影响被冠的动脉疾病(CAD ) 确定 &#x02014；特定的索引。病人们被跟随在上面由临床的访问或电话，咨询和中部的后续时间是 120 天。后面起来项目包括了所有原因死亡， unscheduled 回来访问，在里面医院和周期性的主要不利心血管的事件。Multivariable 回归幸存分析用考克斯 regression.ResultsOf 被执行 352 个病人，(43.18%) 152 根据学习仪器被认为脆弱(5 &#x02212； 7 在规模上) ，并且(26.42%) 93 中等或严重地被考虑脆弱(6 &#x02212； 7 在规模上) 。包括不能自制，秋天历史，视觉缺陷，听觉缺陷，便秘，长期的疼痛，睡觉混乱，牙齿的问题，焦虑或消沉的医学症候群，和谵妄比在非脆弱的病人更经常在脆弱的病人( P = 0.000 ， 0.031 ， 0.009 ， 0.014 ， 0.000 ， 0.003 ， 0.022 ， 0.000 ， 0.074 ，和 0.432 ，分别地)。为性别调整了，年龄，冠的动脉疾病的严厉(离开了主要冠的动脉损害) 并且由考克斯幸存分析的合作病态(CAD 特定的索引) ，脆弱被发现到强烈并且独立地为主要合成结果与风险被联系：所有原因死亡[危险比率(HR )= 5.393；95% CI：1.477 &#x02212； 19.692， P = 0.011 ] 并且 unscheduled 回来访问(HR = 2.832；95% CI：1.140 &#x02212； 7.037， P = 0.025 ).ConclusionsComprehensive 医学评价和临床的脆弱的规模在有交流的老病人的评估是有用的。脆弱强烈并且独立地与交流为老病人与短期的结果被联系。

Plasma levels of receptor interacting protein kinase-3 correlated with coronary artery disease

Background: Necroptosis plays an important role in human atherosclerosis and atheroma development. Since receptor interacting protein kinase-3 (RIP3) acts as a key mediator of necroptosis, this study aimed to explore its relationship between plasma RIP3 levels and coronary artery disease (CAD) and discover a potential new biomarker for screening CAD subtypes and severity. Methods: A total of 318 patients with CAD who had coronary angiography and 166 controls in Peking Union Medical College Hospital from September 2017 to January 2018 were enrolled in this study. Patients with CAD were divided into three subgroups: patients with stable coronary artery disease (SCAD), patients with unstable angina (UA), and patients with myocardial infarction (MI). The severity of atherosclerosis was determined by Gensini score (GSS). Logistic regression was used to determine the relationship between plasma RIP3 levels and CAD. The correlation between plasma RIP3 and GSS was calculated using multiple linear regression models. Results: Overall, plasma RIP3 levels were significantly higher than serum RIP3 levels. Plasma RIP3 levels in patients with CAD were significantly higher than those in controls. Plasma RIP3 levels were strongly associated with CAD (odds ratio: 6.00, 95% confidence interval 3.04–11.81;P < 0.001). Plasma RIP3 levels increased linearly from controls to patients with SCAD, then patients with UA, and finally to patients with MI. We found a significantly positive correlation between proportion of cases of acute coronary syndrome in subjects and their plasma RIP3 level quartile. Plasma RIP3 levels were also associated with GSS (B 0.027;standard error 0.012;P < 0.05). Conclusions: Plasma RIP3 levels were independently associated with CAD. Plasma RIP3 levels could potentially supplement clinical assessment to screen CAD and determine CAD severity.