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Real world effectiveness of PCSK-9 inhibitors combined with statins versus statins-based therapy among patients with very high risk of atherosclerotic cardiovascular disease in China(RWE-PCSK study) 被引量:7
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作者 Yu-Qi LIU Dan-Dan LI +32 位作者 Meng CHAI Hong-Liang CONG Xiao-Qiang CONG Jun DAI Rong-Pin DU Ming GAO Jin-Cheng GUO Yan-Qing GUO Xiao-Jian HONG Rong-Chong HUANG Feng-Shun JIA Jia-Yu LI Qing LI Jia-Mei LIU Xin-Ping LIU Yu-Guo LIU Hong-Gang NIE Bing SHAO Xiao-Yu SHEN Hai-Qing SONG Yi-Jun SONG Li-Jun WANG Shuo WANG Dong-Mei WU Jing XIA Zhi-Yong YANG Hong-Ying YU Hui ZHANG Tie-Mei ZHANG Ji-Yi ZHAO Liang-Chen ZHAO Ming-Qi ZHENG Yun-Dai CHEN 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2021年第4期261-270,共10页
BACKGROUND The efficacy and safety of proprotein convertase subtilisin/kexin type 9(PCSK-9) inhibitors were confirmed by several clinical trials, but its effectiveness in routine clinical practice in China has not bee... BACKGROUND The efficacy and safety of proprotein convertase subtilisin/kexin type 9(PCSK-9) inhibitors were confirmed by several clinical trials, but its effectiveness in routine clinical practice in China has not been evaluated. This study aims to describe the real world effectiveness of PCSK-9 inhibitors combined with statins compared with statins-based therapy among patients with very high risk of atherosclerotic cardiovascular disease(ASCVD).METHODS This is a multi-center observational study, enrolled patients from 32 hospitals who underwent percutaneous coronary intervention(PCI) from January to June in 2019. There are 453 patients treated with PCSK-9 inhibitors combined with statins in PCSK-9 inhibitor group and 2,610 patients treated with statins-based lipid lowering therapies in statins-based group. The lipid control rate and incidence of major adverse cardiovascular events(MACE) over six months were compared between two groups.A propensity score-matched(PSM) analysis was used to balance two groups on confounding factors. Survival analysis using Kaplan-Meier methods was applied for MACE.RESULTS In a total of 3,063 patients, 89.91% of patients had received moderate or high-intensity statins-based therapy before PCI, but only 9.47% of patients had low-density lipoprotein cholesterol(LDL-C) levels below 1.4 mmol/L at baseline. In the PSM selected patients, LDL-C level was reduced by 42.57% in PCSK-9 inhibitor group and 30.81%(P < 0.001) in statins-based group after six months. The proportion of LDL-C ≤ 1.0 mmol/L increased from 5.29% to 29.26% in PCSK-9 inhibitor group and 0.23% to 6.11% in statins-based group, and the proportion of LDL-C ≤ 1.4 mmol/L increased from 10.36% to 47.69% in PCSK-9 inhibitor group and 2.99% to 18.43% in statins-based group(P < 0.001 for both). There was no significant difference between PCSK-9 inhibitor and statins-based treatment in reducing the risk of MACE(hazard ratio = 2.52, 95% CI: 0.49-12.97, P = 0.250).CONCLUSIONS In the real world, PCSK-9 inhibitors combined with statins could significantly reduce LDL-C levels among patients with very high risk of ASCVD in China. The long-term clinical benefits for patients received PCSK-9 inhibitor to reduce the risk of MACE is still unclear and requires further study. 展开更多
关键词 LDL RWE-PCSK study Real world effectiveness of PCSK-9 inhibitors combined with statins versus statins-based therapy among patients with very high r
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Application of a rapid exchange extension catheter technique in type
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作者 Hong-Chao Wang Wei Lu +3 位作者 Zi-Han Gao Ya-Nan Xie Jie Hao Jin-Ming Liu 《World Journal of Clinical Cases》 SCIE 2021年第12期2751-2762,共12页
BACKGROUND In transradial intervention procedures,poor back-up support and noncoaxial alignment of the guide catheter(GC)may result in failure of the balloon or stent to reach the targeted lesion.Methods to provide ex... BACKGROUND In transradial intervention procedures,poor back-up support and noncoaxial alignment of the guide catheter(GC)may result in failure of the balloon or stent to reach the targeted lesion.Methods to provide extra back-up support using the original GC and wire can improve procedural success with reduced complications.A rapid exchange guide extension catheter provides convenient and efficient back-up support while preserving the initial GC and inserted wire.AIM To evaluate the efficacy and safety of rapid exchange extension catheter in the treatment of type B2/C nonocclusive coronary lesions via the radial access.METHODS A total of 135 patients with type B2/C nonocclusive lesions who were treated via the transradial approach were enrolled in the study.The clinical characteristics,indications for use of the rapid exchange extension catheter,and procedural details and results were reviewed and analyzed.All procedure-related complications and major adverse cardiovascular events were recorded during the in-hospital stay and follow-up period.RESULTS The most common indication for the use of a rapid exchange extension catheter was vascular tortuosity(37.8%),followed by heavy calcification(28.9%),long lesions(20.0%),proximal stent(6.7%),in-stent restenosis(5.2%),and coronary origin anomalies(1.5%).The following technologies failed in passing targeted lesions before delivering the rapid exchange catheter:Multiple predilatation technique(57%),buddy wire technique(33.4%),balloon anchoring technique (5.9%), and cutting balloon modification (3.7%). The mean depth of the extensioncatheter intubation was 20.56 ± 13.05 mm, and the mean rapid exchange catheterservice time was 18.9 ± 9.7 min. The mean length and diameter of stents were 33.5± 14.4 mm and 2.75 ± 0.45 mm, respectively. The total rate of technique success(balloon or stent successful crossing of the target lesion with this technique) was94.8%.CONCLUSIONThe rapid exchange extension catheter technique showed acceptable safety andefficacy in the transradial coronary interventions of type B2/C nonocclusivecoronary lesions. We recommend this technique to assist in complex lesionintervention via radial access. 展开更多
关键词 Transradial intervention Mother-child extension catheter Percutaneous coronary intervention Exchange extension catheter Backup support Type B2/C nonocclusive coronary lesions
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Correlation analysis of carotid intima media thickness and function in patients with H-type hypertension and acute cerebral infarction
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作者 Yue Wang Zhi-Feng Zhou 《Journal of Hainan Medical University》 2017年第17期126-129,共4页
Objective:To explore the correlation of carotid intima media thickness with function in patients with H-type hypertension and acute cerebral infarction.Methods:A total of 150 patients with acute cerebral infarction wh... Objective:To explore the correlation of carotid intima media thickness with function in patients with H-type hypertension and acute cerebral infarction.Methods:A total of 150 patients with acute cerebral infarction who were admitted in our hospital from June, 2016 to June, 2017 were included in the study and divided into H-type hypertension group (H-type hypertension merged with acute cerebral infarction, Hcy≥10 μmol/L), non-H-type hypertension group (non- H-type hypertension merged with acute cerebral infarction, Hcy≥10 μmol/L), and the control group (no hypertension but with acute cerebral infarction) according to Hcy level and whether being suffered from hypertension or not with 50 cases in each group. Moreover, 50 healthy individuals who came for physical examinations were served as the healthy group. The morning fasting peripheral venous blood was collected at physical examination time for patients in the healthy group and after admission for patients with acute cerebral infarction. Hcy, sICAM-1, MCP-1, and YKL-40 were detected. The color Doppler ultrasound diagnostic apparatus was used to detect IMT, distensibility, and stiffness. Results: Hcy, MCP-1, sICAM-1, and YKL-40 levels in H-type hypertension group, non-H-type hypertension group, and the control group were significantly higher than those in the healthy group. Hcy, MCP-1, sICAM-1, and YKL-40 levels in H-type hypertension group and non-H-type hypertension group were significantly higher than those in the control group. Hcy, MCP-1, sICAM-1, and YKL-40 levels in H-type hypertension group were significantly higher than those in non-H-type hypertension group. IMT and stiffness in H-type hypertension group, non-H-type hypertension group, and the control group were significantly greater than those in the healthy group, while distensibility was significantly less than that in the healthy group. IMT and stiffness in H-type hypertension group and non-H-type hypertension group were significantly greater than those in the control group, while distensibility was significantly less than that in the control group. IMT and stiffness in H-type hypertension group were significantly greater than those in non-H-type hypertension group, while distensibility was significantly less than that in non-H-type hypertension group.Conclusions: Hcy can directly affect carotid AS, increase carotid IMT, and promote the occurrence of hypertension merged with acute cerebral infarction;therefore, positive monitoring of serum Hcy level and IMT thickness in patients with hypertension and acute cerebral infarction and early intervention are of great significance in reducing the occurrence of carotid AS, delaying the progression of carotid AS, and preventing hypertension and acute cerebral infarction. 展开更多
关键词 H-type HYPERTENSION Acute cerebral INFARCTION CAROTID IMT FUNCTION
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Canagliflozin Regulates Ferroptosis, Potentially via Activating AMPK/PGC-1α/Nrf2 Signaling in HFpEF Rats
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作者 Sai Ma Lili He +2 位作者 Qingjuan Zuo Guorui Zhang Yifang Guo 《Cardiovascular Innovations and Applications》 2022年第3期92-101,共10页
Aims:Sodium-glucose cotransporter-2(SGLT2)inhibitors have been found to ameliorate major adverse cardiovascular events in patients with heart failure with preserved ejection fraction(HFpEF),but the exact mechanism is ... Aims:Sodium-glucose cotransporter-2(SGLT2)inhibitors have been found to ameliorate major adverse cardiovascular events in patients with heart failure with preserved ejection fraction(HFpEF),but the exact mechanism is unknown.Ferroptosis is a form of programmed necrosis.Herein,we verified that canagliflozin(CANA)ameliorates heart function in HFpEF rats,partly by regulating ferroptosis,which may be activated by AMPK/PGC-1α/Nrf2 signaling.Methods:An HFpEF model was established and subjected to CANA treatment.Blood pressure was monitored,and echocardiography was performed at the 12th week.Pathological examination was performed,and expression of ferroptosis-associated proteins and AMPK/PGC-1α/Nrf2 signaling related proteins was detected.Results:CANA had an antihypertensive effect and increased E/A ratios in HFpEF rats.Myocardial pathology was ameliorated,on the basis of decreased cross-sectional area and intercellular fibrosis.Acyl-CoA synthetase longchain family member 4(ACSL4)expression increased,whereas ferritin heavy chain 1(FTH1)expression decreased in HFpEF rats,which showed iron overload.CANA reversed changes in ACSL4 and FTH1,and decreased iron accumulation,but did not alter glutathione peroxidase 4(GPX4)expression.The expression of AMPK/PGC-1α/Nrf2 signaling related proteins and heme oxygenase 1(HO-1)in the HFpEF group decreased but was reverted after CANA treatment.Conclusions:CANA regulates ferroptosis,potentially via activating AMPK/PGC-1α/Nrf2 signaling in HFpEF rats. 展开更多
关键词 ferroptosis heart failure SGLT2 inhibitors AMPK
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Influence of Tirofiban maintenance duration on patients with acute myocardial infarction treated by percutaneous coronary intervention 被引量:6
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作者 Zhen-Guo Ji Hong-Bin Liu +4 位作者 Zhi-Hong Liu Guo-Ping Ma Li-Qiang Qin Wei Dong Li-Ya Wang 《Chronic Diseases and Translational Medicine》 2015年第2期-,共8页
Objective: To evaluate the efficacy and short term prognosis of Tirofiban in different treatment duration in patients with acute ST segment elevation myocardial infarction (STEMI) and percutaneous coronary interventio... Objective: To evaluate the efficacy and short term prognosis of Tirofiban in different treatment duration in patients with acute ST segment elevation myocardial infarction (STEMI) and percutaneous coronary intervention (PCI) combined with intracoronary injection. Methods: A total of 125 patients with acute STEMI were enrolled in this study. They were randomly divided into two groups: control group (n ? 61) and Tirofiban group (n ? 64). The Tirofiban was used by intracoronary and intravenous administration in Tirofiban group which was randomly divided into three sub-groups according to the duration of Tirofiban by persistent intravenous injection for 12 hours, 24 hours or 36 hours. Thrombolysis in myocardial infarction flow and myocardial perfusion grades were recorded immediately after PCI. The adverse cardiac events and cardiac death within 180 days of PCI, and the adverse effects (hemorrhage and thrombocytopenia) were compared between the two groups and within Tirofiban sub-groups. Results: Grade 3 in myocardial perfusion was significantly better in Tirofiban group than control group (85.94% vs. 72.13%, P ? 0.03) after PCI. There was one cardiac death in control group in 180 days after PCI. The adverse cardiac event rates between two groups was significant difference (16 patients in control group and only 8 in Tirofiban group, P ? 0.047). There was no significant difference in incidence of hemorrhage complications and platelet counts between two groups. Nevertheless, hemorrhage complications in the 12-and 24-hour subgroups were less than 36-hour subgroup (P ? 0.01). Conclusions: Intravenous Tirofiban treatment reduced the adverse cardiac events and improved short term prognosis without increasing the adverse reactions of the drugs in patients undergoing PCI. The less rate of hemorrhage complication can be achieved in short-duration of Tirofiban by intravenous injection after PCI. Copyright ? 2015, Chinese Medical Association Production. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). 展开更多
关键词 Platelet glycoprotein IIb/IIIa inhibitor Acute ST segment elevation myocardial infarction Coronary artery Percutaneous coronary intervention
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Effects of Shaolin Neigong on the strength and stability of the forearm Rou-Kneading manipulation
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作者 Yang Fei Song Xiao-dan +5 位作者 Bai Wei-jie Fan Yue-xian Chen Zi-long Zhang Yan Yang Li-yun Li Jin-long 《Journal of Acupuncture and Tuina Science》 CSCD 2021年第6期411-418,共8页
Objective To collect,compare and analyze the changes in the strength and stability of the forearm Rou-Kneading manipulation before and after the training in Shaolin Neigong(internal Qigong).Methods Ninety first-year u... Objective To collect,compare and analyze the changes in the strength and stability of the forearm Rou-Kneading manipulation before and after the training in Shaolin Neigong(internal Qigong).Methods Ninety first-year undergraduates were randomized into three groups using the random number table method,with 30 people in each group.The Gongfa(Qigong method)group received training in both Shaolin Neigong and forearm Rou-Kneading manipulation.The manipulation group only received training in forearm Rou-Kneading manipulation.The control group only received training in forearm Rou-Kneading manipulation for one week.The ZTC-1 intelligent Tuina(Chinese therapeutic massage)manipulation parameter detection system was used to collect the wave crest,wave trough,and crest-trough difference of the strength and frequency of the forearm Rou-Kneading manipulation on the Z-axis(up and down),X-axis(left and right)and Y-axis(backward and forward)at weeks one,five and ten from the three groups.The collected data were then processed and analyzed.Results The intra-group comparisons showed statistical significance in the Gongfa group and manipulation group(P<0.05).The strength and stability shown on the axes Z,X,and Y constantly grew with the increase of training time in the Gongfa group.The wave crest on the axes Z and Y steadily rose in the manipulation group,as well as the frequency on the axes Z,X and Y.The control group failed to show statistical significance in any of the three times of intra-group comparisons(P>0.05).The between-group comparisons showed statistical significance among the three groups at weeks five and ten(P<0.05).At week five,the wave crest on the axes Z,X,and Y,and the crest-trough difference on the axes X and Y were more prominent in the Gongfa group than in the manipulation group,showing statistical significance(P<0.05).At week ten,the wave crest,wave trough,and crest-trough differences on the axes Z,X,and Y were more prominent in the Gongfa group than in the manipulation group,presenting statistical significance(P<0.05).Conclusion Practicing Shaolin Neigong can help the trainees reach the level of strength and frequency of Tuina clinicians in a shorter time in the forearm Rou-Kneading manipulation training.It can advance the efficiency in studying the forearm Rou-Kneading manipulation and promote the quality of the manipulation. 展开更多
关键词 Tuina Massage Physical and Breathing Exercises QIGONG Exercise Shaolin Neigong Rou-Kneading Manipulation
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