Background Proton pump inhibitors(PPIs) are recommended by the latest guidelines to reduce the risk of bleeding in acute myocardial infarction(AMI) patients treated with dual antiplatelet therapy(DAPT). However, previ...Background Proton pump inhibitors(PPIs) are recommended by the latest guidelines to reduce the risk of bleeding in acute myocardial infarction(AMI) patients treated with dual antiplatelet therapy(DAPT). However, previous pharmacodynamic and clinical studies have reported controversial results on the interaction between PPI and the P2 Y12 inhibitor clopidogrel. We investigated the impact of PPIs use on in-hospital outcomes in AMI patients, aiming to provide a new insight on the value of PPIs. Methods A total of 23,380 consecutive AMI patients who received clopidogrel with or without PPIs in the China Acute Myocardial Infarction(CAMI) registry were analyzed. The primary endpoint was major adverse cardiovascular and cerebrovascular events(MACCE) defined as a composite of in-hospital cardiac death, re-infarction and stroke. Propensity score matching(PSM) was used to control potential baseline confounders. Multivariate logistic regression analysis was performed to evaluate the effect of PPIs use on MACCE and gastrointestinal bleeding(GIB). Results Among the whole AMI population, a large majority received DAPT and 67.5% were co-medicated with PPIs. PPIs use was associated with a decreased risk of MACCE(Before PSM OR: 0.857, 95% CI: 0.742-0.990, P = 0.0359;after PSM OR: 0.862, 95% CI: 0.768-0.949, P = 0.0245) after multivariate adjustment. Patients receiving PPIs also had a lower risk of cardiac death but a higher risk of complicating with stroke. When GIB occurred, an alleviating trend of GIB severity was observed in PPIs group. Conclusions Our study is the first nation-wide large-scale study to show evidence on PPIs use in AMI patients treated with DAPT. We found that PPIs in combination with clopidogrel was associated with decreased risk for MACCE in AMI patients, and it might have a trend to mitigate GIB severity. Therefore, PPIs could become an available choice for AMI patients during hospitalization.展开更多
Supercapacitors are one of the most promising energy storage devices in the fields of vehicle transportation,flexible electronic devices,aerospace,etc.However,the existed self-discharge that is the spontaneous voltage...Supercapacitors are one of the most promising energy storage devices in the fields of vehicle transportation,flexible electronic devices,aerospace,etc.However,the existed self-discharge that is the spontaneous voltage decay after supercapacitors are fully charged,brings about the wide gap between experimental studies and practical utilization of supercapacitors.Although eliminating the selfdischarge completely is not reachable,suppressing the self-discharge rate to the lowest point is possible and feasible.So far,the significant endeavors have been devoted to achieve this goal.Herein,we summary and discuss the possible mechanisms for the self-discharge and the underlying influence factors.Moreover,the strategies to suppress the self-discharge are systemically summed up by three independent but unified aspects:modifying the electrode,modulating the electrolyte and tuning the separator.Finally,the major challenges to suppress the self-discharge of supercapacitors are concluded and the promising strategies are also pointed out and discussed.This review is presented with the view of serving as a guideline to suppress the self-discharge of supercapacitors and to across-the-board facilitate their widespread application.展开更多
基金supported by the CAMS Innovation Fund for Medical Sciences (CIFMS, 2016-I2M-1-009)Twelfth Five-Year Planning Project of the Scientific and Technological Department of China (2011BAI11B02)National Natural Science Foundation of China (No 81670415)。
文摘Background Proton pump inhibitors(PPIs) are recommended by the latest guidelines to reduce the risk of bleeding in acute myocardial infarction(AMI) patients treated with dual antiplatelet therapy(DAPT). However, previous pharmacodynamic and clinical studies have reported controversial results on the interaction between PPI and the P2 Y12 inhibitor clopidogrel. We investigated the impact of PPIs use on in-hospital outcomes in AMI patients, aiming to provide a new insight on the value of PPIs. Methods A total of 23,380 consecutive AMI patients who received clopidogrel with or without PPIs in the China Acute Myocardial Infarction(CAMI) registry were analyzed. The primary endpoint was major adverse cardiovascular and cerebrovascular events(MACCE) defined as a composite of in-hospital cardiac death, re-infarction and stroke. Propensity score matching(PSM) was used to control potential baseline confounders. Multivariate logistic regression analysis was performed to evaluate the effect of PPIs use on MACCE and gastrointestinal bleeding(GIB). Results Among the whole AMI population, a large majority received DAPT and 67.5% were co-medicated with PPIs. PPIs use was associated with a decreased risk of MACCE(Before PSM OR: 0.857, 95% CI: 0.742-0.990, P = 0.0359;after PSM OR: 0.862, 95% CI: 0.768-0.949, P = 0.0245) after multivariate adjustment. Patients receiving PPIs also had a lower risk of cardiac death but a higher risk of complicating with stroke. When GIB occurred, an alleviating trend of GIB severity was observed in PPIs group. Conclusions Our study is the first nation-wide large-scale study to show evidence on PPIs use in AMI patients treated with DAPT. We found that PPIs in combination with clopidogrel was associated with decreased risk for MACCE in AMI patients, and it might have a trend to mitigate GIB severity. Therefore, PPIs could become an available choice for AMI patients during hospitalization.
基金partly supported by the National Natural Science Foundation of China(NSFC,No.51872035)the Talent Program of Rejuvenation of the Liaoning(No.XLYC1807002)+1 种基金the Fundamental Research Funds for the Central Universities(DUT19LAB20)the National Key Research Development Program of China(2016YFB0101201)。
文摘Supercapacitors are one of the most promising energy storage devices in the fields of vehicle transportation,flexible electronic devices,aerospace,etc.However,the existed self-discharge that is the spontaneous voltage decay after supercapacitors are fully charged,brings about the wide gap between experimental studies and practical utilization of supercapacitors.Although eliminating the selfdischarge completely is not reachable,suppressing the self-discharge rate to the lowest point is possible and feasible.So far,the significant endeavors have been devoted to achieve this goal.Herein,we summary and discuss the possible mechanisms for the self-discharge and the underlying influence factors.Moreover,the strategies to suppress the self-discharge are systemically summed up by three independent but unified aspects:modifying the electrode,modulating the electrolyte and tuning the separator.Finally,the major challenges to suppress the self-discharge of supercapacitors are concluded and the promising strategies are also pointed out and discussed.This review is presented with the view of serving as a guideline to suppress the self-discharge of supercapacitors and to across-the-board facilitate their widespread application.
