Coronary artery disease and heart failure:Late-breaking trials presented at American Heart Association scientific session 2023

The late-breaking science presented at the 2023 scientific session of the American Heart Association paves the way for future pragmatic trials and provides meaningful information to guide management strategies in coronary artery disease and heart failure(HF).The dapagliflozin in patient with acute myocardial infarction(DAPA-MI)trial showed that dapagliflozin use among patients with acute MI without a history of diabetes mellitus or chronic HF has better cardiometabolic outcomes compared with placebo,with no difference in cardiovascular outcomes.The MINT trial showed that in patients with acute MI and anemia(Hgb<10 g/dL),a liberal transfusion goal(Hgb≥10 g/dL)was not superior to a restrictive strategy(Hgb 7-8 g/dL)with respect to 30-day all-cause death and recurrent MI.The ORBITA-2 trial showed that among patients with stable angina and coronary stenoses causing ischemia on little or no antianginal therapy,percutaneous coronary intervention results in greater improvements in anginal frequency and exercise times compared with a sham procedure.The ARIES-HM3 trial showed that in patients with advanced HF who received a HeartMate 3 levitated left ventricular assist device and were anticoagulated with a vitamin K antagonist,placebo was noninferior to daily aspirin with respect to the composite endpoint of bleeding and thrombotic events at 1 year.The TEAMMATE trial showed that everolimus with low-dose tacrolimus is safe in children and young adults when given≥6 months after cardiac transplantation.Providing patients being treated for HF with reduced ejection fraction(HFrEF)with specific out-of-pocket(OOP)costs for multiple medication options at the time of the clinical encounter may reduce‘contingency planning’and increase the extent to which patients are taking the medications decided upon.The primary outcome,which was cost-informed decisionmaking,defined as the clinician or patient mentioning costs of HFrEF medication,occurred in 49%of encounters with the checklist only control group compared with 68%of encounters in the OOP cost group.

Clinical efficacy of angina pectoris after pci in patients with coronary heart disease complicated with type 2 diabetes by Yiqi Yangyin and Huatan Tongluo recipe

Objective:To evaluate the clinical efficacy of Yiqi Yangyin and Huatan Tongluo Recipe in improving the symptoms of angina pectoris and cardiac function in patients with coronary heart disease complicated with type 2 diabetes after PCI.Methods Sixty-two patients with coronary heart disease complicated with type 2 diabetes after PCI were randomly divided into treatment group and control group,with 31 patients in each group.Both groups were treated with western medicine.The treatment group added Yiqi Yangyin and Huayu Tongluo Recipe granules.The changes of metabolic equivalent(METs),angina symptoms,TCM symptoms,BNP,hypersensitive C-reactive protein(hs-CRP),Interleukin-6(IL-6),Tumor necrosis factor-(TNF-α)and left ventricular ejection fraction(LVEF)were analyzed after 1 course of treatment and Corrected TIMI Frame Count(CTFC)after six month.Results The improvement of METS and LVEF in the treatment group was better than that in the control group(P<0.05);the improvement of BNP,hs-CRP,IL-6,TNF-αand CTFC in the treatment group was better than that in the control group;the curative effect of angina pectoris in the treatment group was better than that in the control group;the effective rate of TCM syndrome improvement in the treatment group was better than that in the control group.Conclusion Yiqi Yangyin and Huatan Tongluo Recipe can effectively alleviate angina pectoris symptoms in patients with coronary heart disease complicated with type 2 diabetes after PCI,suggesting cardiac function,inhibiting inflammatory response,and improving microcirculation disturbance.

Clinical Non-inferiority Trial on Treatment of Coronary Heart Disease Angina Pectoris of Xin-blood Stasis Syndrome Type with Lyophilized Salvia Salt of Lithospermic Acid Powder for Injection

Objective： To evaluate the effectiveness and safety of lyophilized Salvia salt of lithospermic acid powder for injection （SSLA） in treating coronary heart diseases angina pectoris （CHD-AP） of Xin-blood stasis syndrome type, and to conduct the non-inferiority trial with Danshen injection （丹参注射液, DSI） as positive control. Methods： An non-inferiority clinical layered, segmented, randomized, and blinded trial on three parallel and multiple centered groups was conducted in 480 patients with stable effort angina grade Ⅰ , Ⅱand Ⅲ, who had two or more times of attack every week. The 240 patients in test group A were treated with SSLA 200 mg added in 250 ml of 5% glucose solution for intravenous dripping every day; the 120 patients in test group B were treated with SSLA but the dosage doubled; and the 120 patients in the control group were treated with DSI 20 ml daily in the same method as SSLA was given. The clinical effectiveness and safety were evaluated after the patients were treated for 14 days. Results： The results showed that the markedly effective rate in test groups A, B and control group was 37.45 %, 36.75 % and 30.09 % respectively, while the total effective rate in them was 88.09%, 89.74% and 67.26% respectively. Statistical significance was shown in comparisons of the therapeutic effect between control group with test group A and test group B, with that in the two test groups superior to that in the control group, and non-inferiority trial showed eligibility （P〈0.01）. Adverse reaction appeared in 8 patients in the test groups and 2 in the control group. Conclusion： SSLA has definite therapeutic effect in treating patients with CHD-AP, with its effect not inferior to that of DSI, and no evident toxic-adverse reaction.

Efficacy of Danlou Tablet in the Treatment of Coronary Heart Disease with Phlegm and Blood Stasis Syndrome and Its Effects on Serum Inflammatory Factors

[Objectives] To explore the efficacy of Danlou Tablet( DLT) in the treatment of coronary heart disease( CHD) with phlegm and blood stasis syndrome and its effects on serum inflammatory factors. [Methods]One hundred and ninety-seven patients with CHD and phlegm and blood stasis syndrome in our hospital from January 2016 to January 2018 were selected and randomly divided into two groups: control group( n =98) treated with aspirin plus atorvastatin,and research group( n =99) treated with DLT and aspirin plus atorvastatin for one month. The clinical efficacy and incidence of adverse reactions were observed. Serum secretory phospholipase A2( s PLA2),lipoprotein-associated phospholipase A2( LP-PLA2),oxidized low-density lipoprotein( ox-LDL),monocyte chemoattractant protein-1( MCP-1) and World Health Organization Quality of Life( WHOQOL-100) scores were compared before and after one month of treatment. [Results] The total effective rate was93. 94% in the research group,which was higher than that in the control group( 79. 59%,P < 0. 05);the levels of serum s PLA2,LP-PLA2,ox-LDL and MCP-1 in the research group were lower than those in the control group after one month of treatment( P < 0. 05). There was no statistical significance of the difference in the total incidence of adverse reactions between the research group and the control group( P > 0. 05).After one month of treatment,WHOQOL-100 scores were higher in two groups,which were higher in the research group than that in the control group( P < 0. 05). [Conclusions]DLT can significantly reduce the level of serum inflammatory factors,improve the quality of life in patients with CHD and phlegm and blood stasis syndrome.

Clinical perspective on C-reactive protein in prognostication of major adverse cardiac events in the elderly with established coronary heart disease

The systemic response to tissue injury, regardless of cause is characterized by a cytokine-mediated alteration in the hepatic synthesis of a number of different plasma proteins,known collectively as 'acute phase reactants'. These proteins include C-reactive protein, serum amyloid A protein, alphal glycoprotein, ceruloplasmin, alpha macroglobulins, complement components (C1-C4, factor B, C9, C11), alpha1antitrypsin, alpha1 antichymotrypsin, fibrinogen, prothrombin,factor Ⅷ, plasminogen, haptoglobin, ferritin, immunoglobulins and lipoproteins. The initiation of the acute phase response is linked to the production of hormone-like polypeptide mediators now called cytokines, namedly, interleukin 1(IL-1),tumor necrosis factor, interferon gamma, interleukin 6 (IL-6),leukemia inhibitory factor, ciliary neurotropic factor, oncostatin M, and interleukin 11 (IL- 11).……

Clinical observation of Huatan Huoxue Formula in treating coronary heart disease with hyperlipidemia

OBJECTIVE: To explore the effect of the Huatan Huoxue Formula combined with atorvastatin calcium in the treatment of coronary heart disease with hyperlipidemia. METHODS: 50 patients with coronary heart disease and hyperlipidemia were randomly divided into the experimental group and the control group, with 25 cases in each group, who were treated in the East Hospital of Beijing University of Chinese Medicine. From March 2015 to April 2016. Patients in the experimental group were given the Huatan Huoxue Formula combined with atorvastatin with 8 weeks; while the control group was just treated with atorvastatin. Blood Lipid changes were compared between the two groups. RESULTS: Blood Lipid levels were significantly improved in the two groups after treatment. Compared with the control group, the levels of TG, TC and LDL-C in the experimental group were decreased, while the HDL-C was increased more significantly. The difference was statistically significant(P<0.05).CONCLUSIONS: The effect of the Huatan Huoxue Formula combined with atorvastatin on coronary heart disease and hyperlipidemia patients is more significant.

Systematic Evaluation and Meta-analysis on the Efficacy and Safety of Qidongyixin Oral Liquid(芪冬颐心口服液)in the Treatment of Coronary Heart Disease

Objective:To systematically evaluate the efficacy and safety of Qidongyixin Oral Liquid(芪冬颐心口服液)in the treatment of coronary heart disease.Methods:Randomized controlled trials(RCTs)on the treatment of coronary heart disease(CHD)with Qidongyixin Oral Liquid(芪冬颐心口服液)were screened out by systematically searching in CNKI,Wanfang Data,VIP,Sinomed,Cochrane Library,PubMed,Embase,Web of Science,Clinical-Trials.gov.Meta-analysis of the final included studies was performed according to RevMan 5.3 software.Results:A total of 9 studies were included,with a total sample size of 1224 cases,including 612 in the experimental group and 612 in the control group.Metaanalysis results showed that:Conventional treatment,combined with Qidongyixin Oral Liquid(芪冬颐心口服液)on the treatment of CHD had a significant efficiency,which was better than conventional treatment only(RR=1.18,95%CI[1.07-1.29],P=0.0005),and could better improve patients’electrocardiogram(RR=1.21,95%CI[1.08,1.35],P=0.001),increase left ventricle ejection fraction(MD=3.84,95%CI[3.34,4.33],P<0.00001),and reduce left ventricular end-diastolic diameter(MD=-2.81,95%CI[-3.84,-2.41],P<0.00001)and left ventricular end-systolic diameter(MD=-2.43,95%CI[-3.42,-1.43],P<0.00001).Conclusion:Qidongyixin Oral Liquid(芪冬颐心口服液)can improve the effective rate of the treatment of coronary heart disease,better improve patients’electrocardiogram,reduce the left ventricular end-diastolic and end-systolic diameter,and reduce the onset time of angina pectoris.However,the quality of the cases included in the study is relatively small,and the level of evidence is low.Therefore,RCT with large samples and rigorous design is still needed to prove the reliability of the results.

Grid Search for Predicting Coronary Heart Disease by Tuning Hyper-Parameters

Diagnosing the cardiovascular disease is one of the biggest medical difficulties in recent years.Coronary cardiovascular(CHD)is a kind of heart and blood vascular disease.Predicting this sort of cardiac illness leads to more precise decisions for cardiac disorders.Implementing Grid Search Optimization(GSO)machine training models is therefore a useful way to forecast the sickness as soon as possible.The state-of-the-art work is the tuning of the hyperparameter together with the selection of the feature by utilizing the model search to minimize the false-negative rate.Three models with a cross-validation approach do the required task.Feature Selection based on the use of statistical and correlation matrices for multivariate analysis.For Random Search and Grid Search models,extensive comparison findings are produced utilizing retrieval,F1 score,and precision measurements.The models are evaluated using the metrics and kappa statistics that illustrate the three models’comparability.The study effort focuses on optimizing function selection,tweaking hyperparameters to improve model accuracy and the prediction of heart disease by examining Framingham datasets using random forestry classification.Tuning the hyperparameter in the model of grid search thus decreases the erroneous rate achieves global optimization.

Risk Assessment and Risk Perception of Coronary Heart Disease in Gaza Strip, Palastine

Aim: The aim of the present study was to estimate the prevalence of coronary heart diseases (CHD) risk factors among Ghaza (Palastine) university students, to assess the CHD risk among them using a suitable scoring system and to identify how they perceive their risk of CHD. Methods: During the period from May 2008 to May 2009, 501 students were involved. Participants were subjected to the following activities;self administered questionnaire: including socio-demographic data, medical history of chronic diseases, family history about CHD, knowledge and perception of risk factors, anthropometric measurements in addition to laboratory testing. Results: The mean age was 20.8 ± 2.07 years;54% were females. The prevalence of hypertension and DM was 3.6% and 0.4% while it was 2.6% for hypercholesterolemia. The mean levels of LDL-C (88 mg/dl vs 85.5 mg/dl) and HDL-C (52.4 mg/dl vs 42.6 mg/dl) were higher among females than among males. Smoking was more prevalent among males than among females (33.1% vs 1.7%) with a total prevalence of 19%. Overweight and obesity were more prevalent among males (30.7% vs 22.5% and 9.6% vs 5.6%). In contrast to risk perception female students tend to be more knowledgeable than males with regards to different aspects of CHD. The overall level of perceived risk was moderate. Logistic regression analysis revealed that age and sex were associated significantly by higher level of total perception (p < 0.05). Conclusion: Health education and health promotion programs should be implemented and integrated within the primary health care sectors and directed to university students before admission. Further research needed to be implemented on larger sample to test knowledge and perception of the public in regard to their risk for heart disease including school children and community so that education could be provided in a more focused manner.

Lipid Profile of Coronary Heart Disease Patients: A Prospective Observational Study

Background: Coronary heart disease (CHD) remains the major cause of mortality and morbidity in the entire world population despite therapeutic advances that control many risk factors. Lipid profile is regarded as an important factor in the development of coronary heart disease. There have been numerous studies confirming the association of hyperlipidemias with coronary heart disease in most of the Western as well as Asian countries of the world. But we have very little data on the relation between CHD and lipid profile. Aim of the Study: The aim of this study was to assess abnormal lipid levels and their association with coronary heart disease. Methods: This comparative observational study was conducted at the Department of Cardiology in M. Abdur Rahim Medical College, Dinajpur, Bangladesh from January 2019 to December 2019. Properly written consent was taken from all the participants before starting the main part of the investigation. Obeying inclusion and exclusion criteria of the study, a total of 131 participants were finalized as the study population. Among them, the Case Group was formed with 90 patients who had CHD, and with 41 healthy people, the Control Group was formed. All necessary data were collected, analyzed, and disseminated by several programs of MS-Office and SPSS version 23. Result: The study was conducted with 90 case group participants and 41 control group participants. Among the case group, 78% were male and 22% were female. Among the male case group participants, 44.29% were from 51 - 60 years of age, 35.71% were from 41 - 50 years of age and the rest 20% were above 60 years of age. On the other hand, among the female participants of Case Group, 45% were from 51 - 60 years of age, 30% from 41 - 50 years of age, and 25% were over 60 years of age. Regression analysis between the male and the female showed the P-value of 0.242. Serum cholesterol concentration and HDL concentration were significant between the Case and Control groups in all age groups and the P-value was <0.0001 in every age group. Triglyceride concentration was significant between the Case and Control groups in 41 - 50 and 51 - 60 years age groups with a P-value of <0.0001. But in the >60 years age group, we did not find any significant correlation and there the P-value was 0.478. LDL concentration between the groups showed significant correlations between the Case and Control groups in 41 - 50 and 51 - 60-years’ age groups where the P values were found, <0.0001 and 0.0002 respectively. But in the >60 years’ age group, we did not find any significant correlation and there the P- value was 0.515. Conclusion: In this study, it was found that the total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol concentrations were significantly higher in coronary heart disease (CHD) patients.

Pulse Wave Analysis in Patients with Coronary Heart Disease Based on Hilbert-Huang Transformation and Time-domain

Objective: To study the characteristics of pulse tracings in CHD, and objectively evaluate the significance of pulse signal in diagnosis and appreciation of therapeutic effect in patients with coronary heart disease(CHD), and accordingly provide with theoretic proofs for developing non-invasive technique of pulse diagnosis. Methods: By using the pulse detection system, pulse graphs in CHD patients, patients without CHD and "health" adults were collected and compared. Then characters of the pulse signal were analyzed with Hilbert-Huang transformation routine (HHT) and time-domain method respectively. Results: There existed characteristic change in pulse graph in CHD. ① h1,h3,h4,h3/h1,t,t5/t4 in time domain parameters of pulse graph increased and w1 was widened. ② 44% of C2 wave in HHT display showed chaotic and disorderly wave and irregularly wave amplitude in CHD. And 72% of C5 Wave exhibited in irregular wave with average wave amplitude over 10 gram-forces. These changes were significantly different from health adults. Conclusion: Characteristic wave of pulse graph extracted with methods of time domain or HHT routine might be considered as proofs for diagnosis and differentiation in CHD. Our researches prognosticate that pulse diagnosis can be used as an ancillary determination in occurrence of CHD for reasons of the advantage of convenient operation and non-invasion.

Coronary heart disease-related fatigue:risk factors,assessment and treatments

Coronary atherosclerotic heart disease is a disease of myocardial ischemia and hypoxia,which often presents as chest pain,dyspnea,cold sweat and fatigue.Fatigue is the subjective experience of patients,which is easy to be ignored,and will lead to the decline of patients’quality of life and physical activity level,etc.,with a high incidence and great harm.The purpose of this paper was to review the concept,risk factors,assessment tools and intervention measures of coronary atherosclerotic heart disease fatigue in order to provide a reference for identifying and improving the fatigue of coronary atherosclerotic heart disease.

Effect of Psychological Education Combined with Progressive Muscle Relaxation Training on the Symptom Cluster and Rehospitalization Rate of Elderly Patients with Coronary Heart Disease

Objective:To investigate the effect of psychological education combined with progressive muscle relaxation training on the symptom cluster and rehospitalization of elderly patients with coronary heart disease.Methods:This study is a longitudinal randomized controlled study involving 140 elderly patients with coronary heart disease.The patients were divided into two groups:an intervention group and a control group,with 70 cases in each group,via random number table.The patients in the control group received routine nursing,whereas those in the intervention group received psychological education combined with progressive muscle relaxation training for 4 weeks on the basis of routine nursing.The effect of the intervention was evaluated before intervention,at the end of 1 month,3 months,and 6 months after intervention.Results:At the end of 1 month,3 months,and 6 months,the sleep,fatigue,anxiety,and functional status of the patients in the intervention group were significantly better than those of the control group,with statistical significance difference(P<0.05).The rehospitalization rate of the intervention group was lower than that of the control group,and the difference was statistically significant(X2=10.685,P=0.001).Conclusion:Psychological education combined with progressive muscle relaxation training is effective in alleviating the symptom cluster of elderly patients with coronary heart disease and reducing their rehospitalization rate;thus,it should be popularized.

A Readmission Risk Prediction Model for Elderly Patients with Coronary Heart Disease

Objective:To analyze the independent risk factors and establish a risk prediction model by investigating the readmission of elderly patients with coronary heart disease(CHD)within 1 year after discharge.Methods:A total of 480 CHD patients,who were hospitalized in the Affiliated Hospital of Hebei University from October 2019 to December 2020,were included in this study.A general data scale,mental health status scale,the Clinical Frailty Scale,Pittsburgh Sleep Quality Index,as well as the Family Adaptability and Cohesion Evaluation Scale were used to collect data.According to the number of readmissions due to CHD within 1 year after discharge,the patients were divided into two groups:the readmission group(n=212)and the no readmission group(n=268).General data,laboratory examination indicators,frailty,mental health status,sleep status,as well as family intimacy and adaptability were compared between the two groups.Logistic regression was used to analyze the independent risk factors for the readmission of these patients,and R software was used to construct a line diagram model for predicting readmission of elderly patients with CHD.Results:Five factors including body mass index(OR=1.045),low density lipoprotein(OR=1.123),frailty(OR=1.946),mental health(OR=1.099),as well as family intimacy and adaptability(OR=0.928)were included to construct the risk prediction model for the readmission of elderly patients with CHD within 1 year after discharge.The ROC curve showed that the area under the curve for predicting readmission of elderly patients with CHD was 0.816;Hosmer-Lemeshow goodness of fit test showed X2=1.456 and P=0.989;the maximum Youden index corresponding to the predicted value of risk was 0.526.The results showed that the model could accurately predict the risk of readmission in elderly patients with CHD within 1 year after discharge.Conclusion:This study constructed a line diagram model based on five independent risk factors of the readmission of elderly patients with CHD:body mass index,low density lipoprotein,frailty,mental health status,as well as family intimacy and adaptability.This model has good discrimination,accuracy,and predictive efficiency,providing reference for the early prevention and intervention of readmission in elderly patients with CHD recurrence.

Combined effects of hypertension and angiotensin Ⅱ on the risk of coronary heart disease:a population-based prospective cohort study among Inner Mongolians in China

Objective To investigate the combined effects of hypertension and angiotensinⅡon the risk of coronary heart disease(CHD)on the basis of a 10-year prospective study in an Inner Mongolian population of China.Methods Based on a cross-sectional survey,a prospective cohort study was conducted from June 2003 to July 2012 among 2,530 Mongolian people.

Reducing cholesterol to prevent coronary heart disease

Coronary heart disease (CHD) remains the number one killer of men and women in the United States of America despite major advances in interventional technologies for the treatment of coronary artery disease. CHD is rapidly becoming a major cause of morbidity and mortality in developing nations as well and is now recognized as the leading cause of death worldwide.

Depression as a risk factor for coronary heart disease—How strong is the evidence?

A critical appraisal is made of the evidence that depression is a causal risk factor for coronary heart disease. PubMed and Science Citation Index were searched for relevant papers. Forty eight papers satisfying inclusion criteria and reporting an association between a measure of depression and a coronary disease outcome were compared in terms of baseline assessment, exposure and endpoint definition, covariates measured and whether changes in, or treatment of, depression was assessed during follow-up. There was considerable variation in the definition of depression and coronary heart disease and contradictory findings are reported. Conventional risk factors for coronary heart disease were not assessed consistently or adequately. Only three of the forty-eight papers gave consideration to the time course of depression during follow-up and prior to study entry. Potentially confounding variables such as anxiety, personality traits and other psychiatric disorders were not taken into consideration in the majority of papers. Treatment of depression during the follow-up period was not mentioned in any of the papers. In light of identified methodological shortcomings and the inconsistent findings reported we suggest that there is as yet no convincing evidence that depression is an independent causal risk factor for coronary heart disease.

Hyperhomoysteinemia as a risk factor for coronary heart diseases in chronic hepatitis C patients

Hepatitis C virus is one of the major health problems worldwide. It affects mainly the liver but several extrahepatic manifestations are also accounted. Chronic hepatitis C patients are at an increased risk of developing hepatic steatosis, which share many clinical features with the metabolic syndrome. Hepatic steatosis has also been associated with elevated levels of markers of inflammation such as homocysteine, identified as hyperhomocysteinemia (HHC). HHC due to Methylenetetrahydrofolate Reductase (MTHFR) gene, in particular the C677T polymorphism, was recently associated with coronary heart diseases (CHD) in chronic hepatitis C (CHC) patients. Homocysteine is an intermediate in methionine metabolism, which takes place mainly in the liver metabolism. Deficiencies of micronutrients (folate, vitamin B 6 and possibly vitamin B 12) along with mild hyperhomocysteinemia, perhaps, act synergistically with other classical risk factors to further increase the risk of CHD. Clinical data indicate that HHC is associated with an increased incidence of CHD as well as with the severity of the disease in CHC patients. In conclusion, HHC might be a potential aetiological factor of CHD in CHC patients. The aim of this review is to investigate the progression of coronary heart diseases in chronic hepatitis C patients and correlate with levels of homocysteine in concurrence to genetic defects and nutrient deficiencies. However, future studies need to clarify the mechanistic role of HHC in CHD and CHC as a useful paradigm with most interesting therapeutic implications.

Study on the relationship between Lp-PLA2, D- dimer and Galectin-3 and atherosclerotic vulnerable plaque in patients with coronary heart disease

Objective: To explore the relationship and clinical value of serum phospholipase A2 (Lp-PLA2), d-dimers, and serum galectin-3 (galectin-3) with atherosclerotic vulnerable plaques in coronary artery patients with coronary heart disease. Methods: A total of 248 patients who underwent coronary angiography (CAG) and intravascular ultrasound (IVUS) in our hospital from June 2017 to September 2018 were selected and divided into vulnerable plaque group (89), stable plaque group (89) and control group (70) according to the examination results. The serum levels of Lp-PLA2, d-dimer and galectin-3 in three groups were compared, as well as their correlation with the detection parameters. To evaluate the clinical value of Lp-PLA2, d-dimer and galectin-3 in patients with coronary heart disease (CHD) with atherosclerotic vulnerable plaque. Results: Serum Lp-PLA2, d-dimer and galectin-3 levels were significantly different from the three groups (P<0.05), and the control group < stable plaque group <vulnerable plaque group (P<0.05). Correlation analysis showed that Lp-PLA2, d-dimer and galectin-3 were significantly positively correlated with plaque area, plaque load, necrotic core and calcified tissue (P<0.01), and negatively correlated with fibrous lipid and fibrous tissue (P<0.01). ROC curve showed that Lp-PLA2, d-dimer and galectin-3 had certain predictive value for vulnerable coronary atherosclerotic plaques (AUC=0.939, 0.977, 0.920, P<0.01), and the three combinations (AUC=0.986, P<0.01) had higher predictive value. Conclusion: Serum Lp-PLA2, d-dimer and galectin-3 are significantly correlated with coronary atherosclerotic vulnerable plaques in patients with coronary heart disease, with high sensitivity and specificity, which can be used for the diagnosis and treatment of early atherosclerotic vulnerable plaques.

Research progress on the correlation between TCM syndromes of coronary heart disease and blood biochemical indexes

The researches on the correlation between TCM syndromes of coronary heart disease and blood biochemical indexes from Jan.2011 to Jul.2020 were reviewed,in order to explore the association of different TCM syndromes of coronary heart disease with blood biochemical indexes,such as blood lipid metabolism,inflammatory factors,coagulation-fibrinolysis system,blood rheology and vascular endothelial function,which was hoped to provide a guidance on the clinical combined application of TCM syndrome differentiation and biochemical indexes of coronary heart disease,so as to promote the objectification and standardization of TCM syndrome differentiation.