Influencing factors of fatigue in young and middle-aged patients with coronary heart disease:a cross-sectional study

Objective:To examine the present state of fatigue in young and middle-aged patients with coronary heart disease(CHD)and to identify the elements that may be affecting it.Methods:From December 2020 to June 2021,240 young and middle-aged patients with CHD who were being treated in the cardiology department of a tertiary care hospital in Suzhou were chosen using a convenience sampling method in order to gather data on the patients’sociodemographic status,fatigue,social support,and stress.Results:Of the 240 disseminated questionnaires,220 valid responses were returned,resulting in an effective recovery rate of 91.67%.The frequency of exhaustion was 51.8%,and the fatigue score was(5.27±2.77).The stress score was(11.15±3.36),while the overall social support score was(39.13±4.72).Binary logistic regression analysis indicated that age,exercise,staying up late,stress,social support,high-sensitivity troponin T,high-density lipoprotein,and ejection fraction were independent risk factors for fatigue in young and middle-aged patients with CHD(P<0.05).Conclusions:Fatigue is more prevalent in young and middle-aged patients with CHD.Clinical nurses can create a unique management plan for patients based on their lifestyle and behavioral patterns,stress levels,social support,and clinical signs to reduce fatigue.

Independent and combined effects of environmental factors and miR-126, miR-143, and miR-145 on the risk of coronary heart disease

Objective To evaluate the effects of environmental factors and microRNAs （miRNAs） （miR-126, miR-143, and miR-145） on the risk of coronary heart disease （CHD）. Methods A frequency-matched case-control study （450 patients, 450 controls） was conducted from April 2014 to December 2016 in Fuzhou City, China. Environmental factors were investigated using a self-administered questionnaire, and the expression levels of miR-126, rniR-143, and miR-145 were determined by quantitative real-time Polymerase Chain Reaction （PCR） in pe- ripheral blood mononuclear cells. Unconditional logistic regression models were used for statistical evaluation. Results Alcohol consumption, high-salt diets, high-intensity work, and lack of physical activity were significantly associated with increased CHD risk, whereas light diet was significantly associated with decreased risk. MiR-126, miR-143, and miR-145 were highly expressed in the CHD group compared with the control group. After adjustment for other environmental factors, unconditional logistic regression results revealed that miR-126, miR-143, and depression were the independent risk factors of CHD, and light diet was the independent protective factor of CHD. Conclusions Our data suggest that a family history of CHD, anxiety, and alcohol consumption was significantly associated with increased CHD risk, whereas light diet was significantly associated with decreased risk. Furthermore, miR-126 and miR-143 in combination with several risk factors, could play a joint role in the development of CHD. Therefore, it is necessary to manage patients with CHD in all directions and multiple level.

Risk factors for intracerebral hemorrhage and coronary heart diseases over a 3-year period in patients admitted to some hospitals of Tongliao city of Nei Monggol Autonomous Region Retrospective analysis on case data

BACKGROUND： Intracerebral hemorrhage（ICH） and coronary heart disease （CHD） have the same pathological base, atherosclerosis, and the similar risk factors,such as smoking ,drinking, hypertension, hyperlipemia, diabetes mellitus, etc; but the distributions of two diseases are very different in the populations. This may be related to the exposure of risk factors and different effects of risk factors on two diseases. OBJECTIVE： To analyze the distribution difference of risk factors for ICH and CHD in the populations of Tongliao city of Nei Monggol Autonomous Region. DESIGN： Retrospective analysis. SETTING： School of Radiation Medicine and Public Health, Soochow University; Tongliao Hospital, Nei Monggol Autonomous Region. PARTICIPANTS： Random sampling was used to select 6 hospitals from 10 hospitals affiliated to Tongliao City of Nei Monggol Autonomous Region. Totally 1 672 medical records of patients with ICH and 2 195 medical records of patients with CHD admitted to Department of Neurology and Department of Cardiovascular Internal Medicine of above-mentioned 6 hospitals between January 2003 and December 2005 were collected according to the investigation need. METHODS： The subjects, whose medical records were involved, were performed retrospective analysis with pre-prepared questionnaire ＂Stroke and Coronary Heart Disease Epidemiologic Questionnaire＂. The main contents included： ①Social demography condition： The distributions of gender, age, nationality, etc. ②Previous history of disease： hypertension, diabetes mellitus, etc. ③Related risk factors： systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, smoking, drinking and glucose （GLU）. The database of Epidata was transformed to SPSS database. Single-and multiple-factor non-conditional Logistic regression analysis were performed on the data, and OR value and 95% CI were calculated. The distribution differences of risk factors for two diseases were compared. MAIN OUTCOME MEASURES： Single- and multi-factor non-conditional Logistic regression analysis results of each factor of patients. RESULTS： Single-factor non-conditional Logistic regression analysis showed that statistical significance existed in gender, age, nationality, smoking, drinking, history of hypertension, history of diabetes mellitus, hypertension, triglyceride （TG）, and GLU ten factors（OR =0.199, OR 95% CI 0.142-0.280 to OR =7.484, OR 95% CI 6.186-9.054, P 〈 0.01）. ②The results of multiple-factor non-conditional Logistic regression analysis showed 8 factors including age, gender, smoking, hypertension, history of hypertension, history of diabetes mellitus, GLU and TG（OR =0.203, OR 95% CI 0.114-0.361 to OR =8.262,OR 95% CI 5.466- 12.491, P 〈 0.01）. CONCLUSION： ICH and CHD are the diseases induced by various risk factors. Significant difference exists in gender, age, smoking, hypertension, history of hypertension, GLU, history of diabetes mellitus and TG.

Risk Factors and Intervention Status of Cardiovascular Disease in Elderly Patients with Coronary Heart Disease

To analyze the correlation between coronary heart disease and the possible risk factors such as age, gender, hypertension, dyslipidemia, smoking, diabetes, uric acid and plasma fibrinogen, to screen the main risk factors of coronary heart disease in the elderly and evaluate the intervention status of coronary heart disease in the elderly. In the unchangeable risk factors, age is still the main risk factor of coronary heart disease;in terms of gender, the onset age of female coronary heart disease is later than that of male, but the complications and mortality rate are higher than that of male, and the risk factors are more than that of male. The first level prevention needs doctors and patients to establish a mutual trust relationship, and actively intervene to reduce the total risk of cardiovascular disease. Drug compliance management should be strengthened in secondary prevention.

Correlation of coronary CTA calcification score with serum inflammatory factors and plaque stability-related indexes in patients with coronary heart disease

Objective: To investigate the correlation of coronary CTA calcification score (CACS) with serum inflammatory factors and plaque stability-related indexes in patients with coronary heart disease. Methods: A total of 228 patients with possible coronary heart disease who were examined in this hospital between November 2014 and March 2017 were selected, and the CACS levels as well as the serum contents of inflammatory factors and plaque stability indexes in patients with different lesions were determined. Pearson test was used to assess the correlation between CACS level and disease severity in patients with coronary heart disease. Results: The CACS level of triple vessel disease group was higher than that of double vessel disease group and single vessel disease group, and the CACS level of double vessel disease group was higher than that of single vessel disease group;serum sICAM-1, IL-6, IL-18, CRP, PTX3, Lp-PLA2 and Cat K contents were higher than those of double vessel disease group and single vessel disease group;serum sICAM-1, IL-6, IL-18, CRP, PTX3, Lp-PLA2 and Cat K contents of double vessel disease group were higher than those of single vessel disease group;serum Cys C content of triple vessel disease group was lower than that of double vessel disease group and single vessel disease group, and serum Cys C content of double vessel disease group was lower than that of single vessel disease group. Pearson test showed that the CACS level in patients with coronary heart disease was directly correlated with serum contents of inflammatory factors and plaque stability indexes. Conclusion: The CACS levels in patients with coronary heart disease increase with the aggravation of disease, and the specific CACS level is directly correlated with the degree of inflammatory response and the stability of the plaques.

Changes and significance of serum inflammatory factors,UA,Hcy and small dense low-density lipoprotein levels in patients with coronary heart disease

Objective: To investigate the changes and significance of serum inflammatory factors, uric acid (UA), homocysteine (Hcy) and small dense low-density lipoprotein (sdLDL-C) levels in patients with coronary heart disease (CHD). Methods: A total of 152 patients with CHD were selected as the CHD group, including stable angina pectoris (SAP group, n=48), unstable angina pectoris (UAP group, n=55), and acute myocardial infarction (AMI group, n=49), according to the Gensinis score, it can be divided into mild group (n=88), moderate group (n=43) and severe group (n=21), at the same time 55 healthy people were selected as control group. The serum inflammatory factors [hypersensitivity C reactive protein (hs-CRP), tumor necrosis factor -α (TNF-α)], UA, Hcy and sdLDL-C levels were compared between patients with different CHD and different degree of coronary artery lesions. Results: The levels of hs-CRP, TNF-α, UA, Hcy and sdLDL-C in the CHD group were significantly higher than those in the control group;In the CHD group, the levels of hs-CRP, TNF-α, UA, Hcy and sdLDL-C in the UAP group and AMI group were significantly higher than those off the SAP group, and the level of AMI group [(7.96±1.49) mg/L, (92.87±14.50) ng/L, (417.75±43.88) mol/L, (23.25±7.33) and mol/L (1.31±0.53) mmol/L] was significantly higher than that of UAP group [(6.15±0.97) mg/L, (73.88±9.27) ng/L, (393.63±68.29) mol/L, (19.67±7.26) mol/L and (1.08±0.44) mmol/L];Compared with mild group hs-CRP, TNF-α, UA, Hcy and sdLDL-C levels, the levels of the moderate group and severe group were significantly increased, and the level of severe group was significantly higher than that of moderate group. Conclusion: The levels of serum inflammatory factors, UA, Hcy and sdLDL-C in patients with coronary heart disease are significantly increased, and the detection of the levels has a great significance for the diagnosis of coronary heart disease and the assessment of the severity of coronary heart disease.

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.

Correlation of serum ADAMTS-1 and ADAMTS-13 contents with plaque nature, inflammatory factors and adipocytokines in patients with coronary heart disease

Objective: To investigate the correlation of serum ADAMTS-1 and ADAMTS-13 contents with plaque nature, inflammatory factors and adipocytokines in patients with coronary heart disease. Methods: A total of 106 patients with coronary heart disease undergoing examination in the hospital between September 2014 and June 2017 were enrolled in coronary heart disease group, and 100 healthy volunteers were enrolled in normal control group. Differences in serum ADAMTS-1, ADAMTS-13, plaque nature-related index, inflammatory factor and adipocytokine contents were compared between the two groups. Pearson test was used to assess the correlation of ADAMTS-1 and ADAMTS-13 contents with plaque nature, inflammatory factor and adipocytokines in patients with coronary heart disease. Results: Serum ADAMTS-1 content of coronary heart disease group was higher than that of normal control group whereas ADAMTS-13 content was lower than that of normal control group;serum plaque nature-related indexes Hcy and UA contents were higher than those of normal control group;serum inflammatory factors HMGB1, IL-6, IL-8 and IL-18 contents were higher than those of normal control group;serum adipocytokines APN and Vaspin contents were lower than those of normal control group whereas Visfatin and RBP4 contents were higher than those of normal control group. Pearson test showed that serum ADAMTS-1 and ADAMTS-13 contents of patients with coronary heart disease were directly correlated with the contents of plaque nature-related indexes, inflammatory factors and adipocytokines. Conclusion: Serum ADAMTS-1 content abnormally increases and ADAMTS-13 content abnormally decreases in patients with coronary heart disease, and the specific contents are directly correlated with the condition of coronary heart disease.

Effect of atorvastatin combined with trimetazidine on heart function, oxidative stress and inflammatory factors in patients with coronary heart disease

Objective:To investigate the effects of atorvastatin combined with trimetazidine on heart function, oxidative stress and inflammatory factors in patients with coronary heart disease, Methods:110 patients with coronary heart disease from June 2015 to June 2016 in our hospital were selected as the research objects, randomly divided into observation group 55 cases and control group 55 cases, The patients in both groups received conventional treatment of coronary heart disease, and the control group was given orally atorvastatin calcium capsules at the same time. The observation group was added with trimetazidine hydrochloride tablets on the basis of the control group. The left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end-diastolic diameter (LVESD), C reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), superoxide dismutase (SOD) and MDA levels of two groups were compared respectively before and after treatment. Results: Before treatment, the LVESD, LVEDD and LVEF levels between observation group and the control group had no significant difference (P>0.05);Compared with before treatment, LVESD and LVEDD levels in the observation group and control group after treatment were significantly decreased, LVEF increased significantly, and there were significant differences (P<0.05);After treatment, the observation group LVESD and LVEDD were lower than the control group, LVEF in the observation group after treatment was higher than the control group, and the differences were statistically significant (P<0.05). Before treatment, SOD and MDA between the observation group and the control group had no significant difference (P>0.05);After treatment, SOD in the observation group and the control group were significantly increased, MDA decreased significantly, and the differences were statistically significant (P<0.05);After treatment, SOD in the observation group was higher than the control group, MDA in the observation group was lower than the control group, and the differences were statistically significant (P<0.05). Before treatment, CRP, TNF-α, and IL-6 between the observation group and the control group had no significant difference (P>0.05);compared with before treatment, the CRP, TNF-α, and IL-6 of observation group and control group after treatment were significantly decreased, and the differences were statistically significant (P<0.05);After treatment, CRP, TNF-α, and IL-6 of the observation group were lower than the control group, and the difference was statistically significant (P<0.05).Conclusions:Atorvastatin combined with trimetazidine can more significantly improve cardiac function in patients with coronary heart disease, reduce oxidative stress and inflammation.

Effect of Different Styles of Coronary Heart Disease and Its Risk Factors on Cardiac Remodeling and Dysfunction

Objectives To evaluate the effect of different styles of coronary heart disease （CHD）, different regions of acute myocardial infarction （AMI）, its risk factors and branches of coronary stenosis on left ventricular remodeling and dysfunction by applying echocardiography. Methods 251 patients with CHD and 96 patients without CHD （NoCHD） were verified by selective coronary angiography. CHD patients were divided into stable angina pectoris （SAP） 26, unstable angina pectoris（UAP） 53, acute myocardial infarction （AMI） 140 and old myocardial infarction （OMI） 30 based on clinical situation, cTnT, cardiac enzyme and ECG. AMI patients were further divided into subgroups including acute anterior myocardial infarct （Aa,n = 53）, acute inferior myocardial infarction （Ai, n=54） and Aa＋Ai （n=33） based on ECG. Cardiac parameters： end-diastolic interventricular septum thickness（IVSd）, end-diastolic left ventricular internal diameter （LVd）, left ventricular mass （LM）, end-diastolic left ventricular volume （EDV）, end-systolic left ventricular volume （ESV） and left ventricular ejection fraction（LVEF） were measured by ACUSON 128XP/10 echocardiography. Multiples linear regression analyses were performed to test statistical associations between LVEF and the involved branches of coronary stenosis, blood pressure, lipids, glucose and etc after onset of myocardial infarction. Results EDV and ESV were increased and LVEF decreased on patients with AMI,OMI and UAP （P〈0.05-0.0001）. LM was mainly increased in patients with OMI （P〈0.01） and LVd was mainly enlarged in patients with AMI. EF was significantly decreased and EDV, ESV, LM and LVd were remarkably increased in AMI patients with Aa and Aa＋Ai. With the multiple linear regression analyses by SPSS software, we found that LVEF was negatively correlated to the involved branches of coronary stenosis as well as to systolic blood pressure after onset of myocardial infarction while there was no significant correlation between LVEF and other factors. LVEF was significantly decreased, and LVd and LM increased in AMI patients with antecedent hypertension, compared to patients without hypertension （P〈0.001）. Conclusions Effects of different styles of CHD and different regions of AMI on left ventricular remodeling and cardiac function are different. Myocardial infarction, especially Aa and Aa＋Ai, is one of the most important causes of left ventricular remodeling and cardiac dysfunction. Multiple vessel stenosis and systolic blood pressure at the onset of myocardial infarction reduce LVEF in AMI patients. Antecedent hypertension may accelerate the effect of AMI on cardiac remodeling and dysfunction. Therefore primary and secondary preventions of CHD are critical for protecting heart from remodeling and dysfunction.

Effects of telmisartan combined with nifedipine controlled release tablet on inflammatory factors, vascular endothelial function and left ventricular function in patients with coronary heart disease with mild to moderate hypertension

Objective: To investigate the effect of telmisartan combined with Nifedipine Controlled Release Tablet on inflammatory factors, vascular endothelial function and left ventricular function in patients with coronary heart disease with mild to moderate hypertension. Methods:A total of 92 cases of patients with coronary heart disease with mild to moderate hypertension were selected as the object of observation, according to the random data table, they were divided into the control group (n=46) and observation group (n=46), and patients in the control group were treated with Nifedipine Controlled Release Table therapy, on this basis, the observation group patients were given telmisartan treatment, two groups were treated for 6 months. The levels of the blood pressure, inflammatory factors, vascular endothelial function and left ventricular function compared between the two groups before and after treatment. Results: There were no significant differences in the levels of SBP, DBP, hs-CRP, TNF-α, NO, ET-1, LVEF, LVEDD and LVESD in the two groups before treatment. After treatment, two groups of SBP, DBP, hs-CRP, TNF-α, ET-1, LVEDD and LVESD levels were significantly lower than those in the same group before treatment, and after treatment, the levels of SBP, DBP, hs-CRP, TNF-α, ET-1 and LVESD in the observation group were significantly lower than those in the control group, while there were no significant difference in the level of LVEDD between the two groups after treatment;Compared with level in the group before treatment, the levels of NO and LVEF in the two groups were significantly increased, and the observation group [(82.13±19.01) μmol/L, (52.83±7.45)%] was significantly higher than the control group ((67.37±13.08) μmol/L, (49.47±6.96)%)Conclusion: Telmisartan combined with Nifedipine Controlled Release Table in treating coronary heart disease with mild to moderate hypertension, can effectively control blood pressure, reduce the inflammatory stress, improve vascular endothelial function and left ventricular function of patients, has an important clinical value.

Myocardial bridge-related coronary heart disease:Independent influencing factors and their predicting value

BACKGROUND Myocardial bridge(MB)will compress the mural coronary artery(MCA)during the systole and cause myocardial ischemia.In the diagnosis of coronary heart disease(CHD),because the structure of MB is difficult to be observed by coronary angiography(CAG),the clinical study of the influence of MB on CHD is lacking.With the advancement of computed tomography coronary angiography technology,detailed observations of the MB anatomy have realized.AIM To explore the main influencing factors of MB-related CHD and to find potential indicators for predicting MB-related CHD.METHODS A total of 1718 patients with suspected CHD due to the symptoms of myocardial ischemia were enrolled as subjects.Patients diagnosed with CHD were included in a CHD group,and patients with no significant abnormalities were included in a control group.In the CHD group,patients were divided into an MB-CHD subgroup if MB-related CHD was found.In the control group,patients were divided into a simple MB subgroup if MB was found.The patient's clinical data and MB-related indicators,including the branch of MB,MB type(superficial/deep type),MB length,MB thickness,systolic and diastolic compression of the MCA,and MCA systolic stenosis rate were recorded and compared.Logistic regression analysis was used to explore the independent influencing factors of MD-related CHD.ROC curve was used to analyze the diagnostic efficacy of potential indicators for MB-related CHD.RESULTS There were 1060 cases in the CHD group and 658 cases in the control group,and there were 236 cases in the MB-CHD subgroup and 52 cases in the simple MB subgroup.Multivariate logistic regression analysis showed that the combined MB had a significant effect on the occurrence of CHD(P<0.05).MB thickness,systolic compression,diastolic compression,and MCA systolic stenosis rate had significant effects on the occurrence of MB-related CHD(P<0.05).The area under the curve(AUC)of the combination of these influencing factors for the diagnosis of MB-related CHD was 0.959,which was significantly higher than the AUCs of the four indicators separately(P<0.05).The sensitivity was 97.06%and the specificity was 87.63%.CONCLUSION MB thickness,systolic compression,diastolic compression,and MCA systolic stenosis are independent influencing factors for MB-related CHD.The combination of these factors has potential diagnostic value for MB-related CHD.

Cardiac rehabilitation knowledge in patients with coronary heart disease in Baoding city of China: A cross-sectional study

Objective: The purpose of this study is to assess the awareness on cardiac rehabilitation (CR) in patients with coronary heart disease (CHD).Methods: Inpatients diagnosed with coronary heart disease were recruited from 3 hospitals in this study.The study employed a cardiac structured questionnaire to assess respondents' level of awareness,and bivariate to analyze the sociodemographic factors that influence the awareness on CR.Results: Of all 500 participants,66.40% were male and the mean age was 62.51 ± 9.96 years.The mean score of knowledge was 44.00 ± 17.00 (score range: 0-93),and the mean level of awareness was 47.31%(awareness range: 0-100%).The highest mean level of awareness was in the reexamination subscale (98%) and the lower were in the basic information about CR program,SP optimized medication and heart rate subscale.Bivariate analysis showed that higher age was associated with less knowledge.Patients with higher education level and better income status had better knowledge.And patients who lived in rural and had no jobs had less knowledge.Conclusions: This study showed low levels of awareness on CR program in CHD patients in Baoding.Therefore,the need for health education is indicated in this study to improve the awareness on CR among CHD patients.

Characteristic analysis of clinical coronary heart disease and coronary artery disease concerning young and middle-aged male patients

BACKGROUND Coronary heart disease(CHD)is a type of coronary atherosclerotic heart disease.In recent years,the incidence of CHD has been increasing annually,with an increasing number of young patients.Severe CHD may cause severe myocardial ischemia or myocardial necrosis,which in turn may cause myocardial infarction and related complications that seriously affect the life and health of the patient.AIM To examine the coronary arteries and clinical features of young and middle-aged male patients with CHD.METHODS From February 2019 to January 2020,110 male CHD patients admitted to our hospital were selected as research subjects and were divided into two groups by age:middle-aged group(n=55)and young group(n=55).The coronary arteries and clinical features of the patients were compared.RESULTS There were no significant differences in dyslipidemia,stroke history,high-density lipoprotein cholesterol,or triacylglycerol(P>0.05)between the two groups.In the young group,age,diabetes,hypertension,smoking history,body mass index,family history of CHD,drinking history,fibrinogen,low-density lipoprotein cholesterol,total cholesterol,and single-vessel disease were higher than those in the middle-aged group.Correspondingly,serum uric acid,hyperuricemia,myocardial infarction,Gensini score>50,collateral circulation,multivessel disease,double vessel disease,involvement of the right coronary artery,and involvement of the left main coronary artery were lower in the young group than in the middle-aged group.The middle-aged group mainly suffered from a high Gensini score,implicating multiple arteries,whereas the young group was mainly affected by single-vessel disease.The between-group difference was significant(P<0.05).CONCLUSION In CHD attacks,multiple coronary arteries are implicated in middle-aged male patients and single-vessel disease in young male patients.

Effectiveness of cognitive behavioral therapy-based interventions on health outcomes in patients with coronary heart disease:A metaanalysis

BACKGROUND Recently,the efficacy of cognitive behavioral therapy(CBT)-based intervention on health outcomes in patients with coronary heart disease(CHD)has been recognized in randomized controlled trials(RCTs),but no comprehensive systematic review has been conducted.To address this research gap,our study aimed to evaluate whether comprehensive CBT-based interventions positively affect health outcomes in CHD patients.It was hypothesized that CBT-based interventions are effective in:(1)Reducing depression,anxiety,and stress symptoms;(2)Reducing body mass index,blood pressure,and lipid levels;and(3)Improving quality of life,and exercise endurance.AIM To verify the effectiveness of CBT-based interventions on CHD patients through a meta-analysis of previous publications.METHODS Relevant RCTs published in English were obtained by searching electronic databases,including PubMed,Embase,Cochrane Central Register of Controlled Trials,Scopus,and Proquest,with the retrieval time from inception to August 2020.The primary outcomes were psychological factors(depression,anxiety,and stress symptoms),physiological factors(body mass index,blood pressure,blood lipids).The secondary outcomes included quality of life and exercise endurance.We used Review Manager 5.3 to conduct the meta-analysis and used the Physiotherapy Evidence Database tool to evaluate the quality of studies.RESULTS A total of 22 RCTs comprising 4991 patients with CHD were included in the systematic review and meta-analysis.The main analysis revealed that CBT-based intervention can reduce depression symptoms:-2.00[95%confidence interval(CI):-2.83 to-1.16,P<0.001];anxiety symptoms:-2.07(95%CI:-3.39 to-0.75,P=0.002);stress symptoms:-3.33(95%CI:-4.23 to-2.44,P<0.001);body mass index:-0.47(95%CI:-0.81 to-0.13,P=0.006);and improve physical functioning:3.36(95%CI:1.63 to 5.10,P=0.000)and mental functioning:6.91(95%CI:4.10 to 9.73,P<0.001).Moreover,subgroup analysis results showed that CBT-based interventions were more effective for symptoms of depression and anxiety in CHD patients when individual,as opposed to group treatment,and psycho-education,behavioral and cognitive strategies were applied as the core treatment approaches.CONCLUSION CBT-based interventions are effective treatment strategies for CHD patients,significantly improving their symptoms of depression,anxiety and stress,body mass index,and health-related quality of life.

Effect of Trimetazidine Dihydrochloride Tablets adjuvant therapy on inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function in patients with coronary heart disease complicated with heart failure

Objective: To investigate the effects of Trimetazidine Dihydrochloride Tablets on inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function in patients with coronary heart disease complicated with heart failure. Methods: A total of 98 patients with coronary heart disease and heart failure who met the criteria of the study were selected as the subjects, based on the random data table they were divided into the control group (n=49) and observation group (n=49), the patients in the control group were treated with Metoprolol Tartrate Sustained-release Tablets treatment, and the patients in the observation group were treated with Metoprolol Tartrate Sustained-release Tablets combined with Trimetazidine Dihydrochloride Tablets, the levels of inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function indexes were compared between the two groups before and after treatment. Results: The difference of the CRP, TNF-α, MDA, SOD, NO, ET-1, LVEF, LVEDD and LVESD levels in the two groups before treatment were not statistically significant;Compared with the levels of the two groups before treatment, the two groups of CRP, TNF-α, MDA, ET-1, LVEDD and LVESD levels after treatment were significantly decreased, and the level of the observation group after treatment was significantly lower than those levels in the control group, the difference was statistically significant;The levels of SOD, NO and LVEF of the two groups after treatment were significantly higher than those in the same group before treatment, and the observation group levels [(88.09±7.51) U/ml, (72.58±14.64) mol/L, (48.34±5.09)% ] were significantly higher than the control group [(79.44±7.27) U/ml, (61.89±11.06) mol/L, (44.19±4.58)%], the difference was statistically significant. Conclusion: Trimetazidine Dihydrochloride Tablets in the treatment of coronary heart disease with heart failure can effectively inhibit the release of inflammatory factors, improve oxidative stress state, vascular endothelial function and myocardial function, has an important clinical value.

Conventional risk factors among newly diagnosed coronary heart disease patients in Delhi

AIM:To analyze the conventional risk factors among newly diagnosed cases of coronary heart disease(CHD) admitted to a hospital in Delhi,India.METHODS:This hospital-based prospective study in-cluded 276 consecutive newly diagnosed cases of CHD in the Coronary Care Unit of a tertiary care hospital in Delhi.RESULTS:The mean age of the cases was 49.7± 9.5 years,with the youngest case aged 27 years.The two risk factors present most frequently among the cases were inadequate physical activity and abnormal lipid profile.Just about 3.6%of cases in our study had a physical activity level(PAL)that could be termed as"active",with a large proportion(96.4%)having a PAL suggestive of a sedentary lifestyle.A majority of patients were found to be current tobacco smokers(53.3%)and 188(68.1%)subjects were lifetime ever smokers.There was not a single case who did not have one or more of the risk factors.More than one-quarter(n=76)had six or more of the studied risk factors.CONCLUSION:Indians have among the CHD highest mortality rates amongst all ethnic groups studied so far.It is important to study the regional epidemiology of the cardiovascular events to allow for location-specific prevention and control programs.

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.

Factors Influencing the Diferent Incidences between Coronary Heart Disease and Stroke

To search factors influencing morbidity between coronary heart disease(CHD) and stroke, a longitudinal prospective study was done in a cohort of 1 809 participants aged 3574 at entry of Jiangsu province, China. The average annual agedadjusted incidence of stroke was 142.3/\{100 000\}, being over 1315 years more than that of coronary event(CE)(49.1/100 000), the difference of the incidences between the two diseases was very significant(P<0.01). Multivariate regression analysis revealed that the main risk factors of CHD include increase of serum total cholecsterol, hypertension and mental stress, whereas the most important risk factors for stroke consist of elevation of systolic blood pressure(SBP) as well as smoking and alcohol drinking habit. It was noted that these participants in cohort usually had high salt intake, low animal protein diet, and low level of serum cholecsterol with high level of blood presure and smoking and alcohol habit. We suggest that rational dietary food, stopping smoking, limited alcohol and community control of hypertension are the preventive strategy against these diseases.

Effect of programmed cell death factor 4 on the severity of coronary heart disease and coronary artery disease with blood stasis and toxin

Objective:To explore the diagnostic value of PDCD4 on the degree of arterial stenosis in"blood stasis"coronary heart disease.Methods:Select 80 patients with coronary heart disease in the Second Cardiovascular Zone of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine in April 2020,and divide them into the"phlegm toxin"group(n=40)and the"phlegm stasis"group(n=40)based on the dialectics of traditional Chinese medicine.).Record the gender,age,smoking,and alcohol consumption of the subjects between the two groups,and detect their white blood cell count,neutrophil count,platelet count,platelet volume,platelet distribution width,blood creatinine,uric acid,cystatin,and fibrin The expression levels of original,high-sensitivity C-reactive protein,D-dimer,total cholesterol,triglycerides,high-density lipoprotein,low-density lipoprotein,apolipoprotein a,apolipoprotein b,and PDCD4.Multivariate logistic regression analysis was used to screen out the risk factors that affect coronary plaque formation,and the receiver operating characteristic(ROC)curve of each index was established to evaluate the severity of coronary stenosis in patients with stasis coronary heart disease by each index and combined index Diagnostic efficiency.Results:The two groups of patients were tested in terms of gender,age,smoking,drinking,triglycerides,cholesterol,high-density lipoprotein,low-density lipoprotein,apolipoprotein-a,apolipoprotein-b,white blood cell count,neutrophil The cell count,platelet count,platelet volume width and platelet distribution width were not statistically significant(P>0.05);the expression levels of hypersensitivity-C-reactive protein,serum creatinine,cystatin,uric acid and PDCD4 were statistically significant between the two groups Difference(P<0.05),and the corresponding hypersensitivity-C-reactive protein,creatinine,cystatin,uric acid and PDCD4 expression levels in the blood stasis group were higher than those in the phlegm blood stasis group.After multivariate logistic regression analysis,the level of PDCD4 in peripheral blood[OR=31.088,95%CI(2.498,3.869)]was an independent influencing factor of the"stagnation"type of coronary heart disease,and PDCD4 was diagnosed as the"stagnation"type of coronary heart disease The area under the ROC curve(AUC)is 88.6%,95%CI(1.894,2.532)(P=0.29);the level of PDCD4 in peripheral blood is positively correlated with the number and severity of coronary artery disease,the number of coronary artery disease and stenosis The greater the degree,the higher the detection value of PDCD4,(P<0.05).Conclusion:The expression level of PDCD4 in peripheral blood is closely related to the subtype of"stasis toxin"and the severity of coronary vascular stenosis.It can be used as a quantitative diagnostic index for the diagnosis of"stasis toxin"coronary heart disease and the severity of coronary vascular stenosis.