Prevalence and clinical characteristics of atrial fibrillation in hospitalized patients with coronary artery disease and hypertension: a cross-sectional study from 2008 to 2018

Background: The clinical characteristics of patients with the comorbidities of hypertension and coronary artery disease (HT-CAD) and atrial fibrillation (AF) are largely unknown. This study aimed to investigate the prevalence of AF in patients with HT-CAD and clinical characteristics of patients with both HT-CAD and AF. Methods: This cross-sectional study was conducted in Chinese People’s Liberation Army General Hospital in Beijing, China, and included 20,747 inpatients with HT-CAD with or without AF from August 2008 to July 2018. We examined the overall prevalence, clinical characteristics, comorbidity profiles, treatment patterns, and blood pressure (BP) control of patients with both HT-CAD and AF. Multivariate logistic regression was used to investigate the associations of cardiovascular risk factors with AF in patients with HT-CAD. Results: The overall prevalence of AF in patients with HT-CAD was 4.87% (1011/20,747), and this increased with age;to be specific, the prevalence in women and men increased from 0.78% (2/255) and 1.02% (26/2561) at the age of <50 years to 8.73% (193/2210) and 10.28 % (298/2900) at the age of ≥70 years, respectively. HT-CAD patients who had AF had a higher prevalence of cardiovascular-related comorbidities than those without AF. Multivariate logistic regression showed that age, gender (male), body mass index, heart failure, and chronic kidney disease were independently associated with the risk of AF in patients with HT-CAD. For those with both HT-CAD and AF, 73.49% (743/1011) had a CHA 2 DS 2 -VASc score of ≥4, and only about half of them had the BP controlled at <140/90 mmHg, which indicated a high risk of thromboembolism and stroke. The use of oral anticoagulation increased during the study period (10.00% [20/200] in 2008 to 2011 vs. 30.06% [159/529] in 2015 to 2018, P < 0.01), but remained at a relatively low level. Conclusions: AF is highly prevalent among patients with HT-CAD. Patients with both HT-CAD and AF have a higher prevalence of cardiovascular-related comorbidities, lower BP control rate, and lower use of oral anticoagulation.

Paired box 5 increases the chemosensitivity of esophageal squamous cell cancer cells by promoting p53 signaling activity

Background:Gene promoter methylation is a major epigenetic change in cancers,which plays critical roles in carcinogenesis.As a crucial regulator in the early stages of B-cell differentiation and embryonic neurodevelopment,the paired box 5(PAX5)gene is downregulated by methylation in several kinds of tumors and the role of this downregulation in esophageal squamous cell carcinoma(ESCC)pathogenesis remains unclear.Methods:To elucidate the role of PAX5 in ESCC,eight ESCC cell lines,51 primary ESCC tissue samples,and eight normal esophageal mucosa samples were studied and The Cancer Genome Atlas(TCGA)was queried.PAX5 expression was examined by reverse transcription-polymerase chain reaction and western blotting.Cell apoptosis,proliferation,and chemosensitivity were detected by flow cytometry,colony formation assays,and 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide assays in ESCC cell lines with PAX5 overexpression or silencing.Tumor xenograft models were established for in vivo verification.Results:PAX5 methylation was found in 37.3%(19/51)of primary ESCC samples,which was significantly associated with age(P=0.007)and tumor-node-metastasis stage(P=0.014).TCGA data analysis indicated that PAX5 expression was inversely correlated with promoter region methylation(r=-0.189,P=0.011 for cg00464519 and r=-0.228,P=0.002 for cg02538199).Restoration of PAX5 expression suppressed cell proliferation,promoted apoptosis,and inhibited tumor growth of ESCC cell lines,which was verified in xenografted mice.Ectopic PAX5 expression significantly increased p53 reporter luciferase activity and increased p53 messenger RNA and protein levels.A direct interaction of PAX5 with the p53 promoter region was confirmed by chromatin immunoprecipitation assays.Re-expression of PAX5 sensitized ESCC cell lines KYSE150 and KYSE30 to fluorouracil and docetaxel.Silencing of PAX5 induced resistance of KYSE450 cells to these drugs.Conclusions:As a tumor suppressor gene regulated by promoter region methylation in human ESCC,PAX5 inhibits proliferation,promotes apoptosis,and induces activation of p53 signaling.PAX5 may serve as a chemosensitive marker of ESCC.