Background Coronary artery disease （CAD） is a leading cause of death in elderly because aging is the important non-modifiable risk factors of atherosclerosis and also a predictor of poor outcomes. Underuse of guidel...Background Coronary artery disease （CAD） is a leading cause of death in elderly because aging is the important non-modifiable risk factors of atherosclerosis and also a predictor of poor outcomes. Underuse of guideline directed therapy may contribute to suboptimal risk factor control and worse outcomes in the elderly. We aimed to explore the management of CAD, risk factors control as well as goal attain- ment in elderly compared to nonelderly CAD patients. Methods The CORE-Thailand is an ongoing multicenter, prospective, observational registry of patients with high atherosclerotic risk in Thailand. The data of 4120 CAD patients enrolled in this cohort was analyzed comparing between the elderly （age ≥ 65 years） vs. nonelderly （age 〈 65 years）. Results There were 2172 elderly and 1948 nonelderly patients. The elderly CAD patients had higher prevalence of hypertension, dyslipidemia, atrial fibrillation and chronic kidney disease. The proportion of patients who received coronary revascularization was not different between the elderly and nonelderly CAD patients. Antiplatelets were prescribed less in the elderly while statin was prescribed in the similar proportion. Goal attainments of risk factor control of glycemic control, low density lipoprotein cholesterol, and smoking cessation except the blood pressure goal were higher in the elderly CAD patients. Conclusions The CORE-Thailand registry showed the equity in the treatment of CAD between elderly and non-elderly. Elderly CAD patients had higher rate of goal attainment in risk factor control except blood pressure goal. The effects of goal attainment on cardiovascular outcomes will be demonstrated from ongoing cohort.展开更多
文摘CT血管造影(computed tomography angiography,CTA)作为一种无创、检测精确较高的辅助诊断方法,尚急需能有效消除冠脉目标附近干扰噪声并寻求可全自动快速准确追踪目标的新算法以大幅减轻医生阅片压力、辅助其进行可靠诊断与治疗。提出了一种特征融合的误差最小平方和(minimum output sum of squared error,MOSSE)冠脉目标追踪新算法,通过提取冠脉血管多个特征,将其融合加入现有的MOSSE追踪方法,实现全自动准确快速追踪冠脉目标。使用河北大学附属医院9位患者(5男4女,均龄65岁,其中6位有冠心病史)的CTA数据进行了算法验证,并与文献已报道基于中心线提取和基于区域生长的现有冠脉目标提取算法进行了处理结果对比分析。结果表明,新算法处理追踪一例患者切片数据仅需耗时0.02 s,多个病例的平均准确度达94.30%,性能优于上述现有冠脉目标提取算法,能实现全自动准确高效追踪到形态变化剧烈的冠脉目标,可为冠心病的临床诊治起到更为高效的辅助作用。
文摘Background Coronary artery disease （CAD） is a leading cause of death in elderly because aging is the important non-modifiable risk factors of atherosclerosis and also a predictor of poor outcomes. Underuse of guideline directed therapy may contribute to suboptimal risk factor control and worse outcomes in the elderly. We aimed to explore the management of CAD, risk factors control as well as goal attain- ment in elderly compared to nonelderly CAD patients. Methods The CORE-Thailand is an ongoing multicenter, prospective, observational registry of patients with high atherosclerotic risk in Thailand. The data of 4120 CAD patients enrolled in this cohort was analyzed comparing between the elderly （age ≥ 65 years） vs. nonelderly （age 〈 65 years）. Results There were 2172 elderly and 1948 nonelderly patients. The elderly CAD patients had higher prevalence of hypertension, dyslipidemia, atrial fibrillation and chronic kidney disease. The proportion of patients who received coronary revascularization was not different between the elderly and nonelderly CAD patients. Antiplatelets were prescribed less in the elderly while statin was prescribed in the similar proportion. Goal attainments of risk factor control of glycemic control, low density lipoprotein cholesterol, and smoking cessation except the blood pressure goal were higher in the elderly CAD patients. Conclusions The CORE-Thailand registry showed the equity in the treatment of CAD between elderly and non-elderly. Elderly CAD patients had higher rate of goal attainment in risk factor control except blood pressure goal. The effects of goal attainment on cardiovascular outcomes will be demonstrated from ongoing cohort.
