BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction(STEMI)and multivessel coronary...BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction(STEMI)and multivessel coronary artery disease.However,only a few single-center retrospective studies were performed on small Chinese cohorts.Our study aims to demonstrate the advantage of multivessel percutaneous intervention(PCI)strategy on 30-day in-hospital outcomes to patients with STEMI and multivessel disease in larger Chinese population.METHODS From the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)project,5935 patients with STEMI and multivessel disease undergoing PCI and hospitalized for fewer than 30 days were analyzed.After 5:1 propensity score matching,3577 patients with culprit-only PCI and 877 with in-hospital multivessel PCI were included.The primary outcome was major adverse cardiovascular and cerebrovascular event(MACCE),defined as a composite of myocardial infarction,all-cause death,stent thrombosis,heart failure,and stroke.RESULTS Multivariable logistic regression analysis revealed that in-hospital multivessel PCI was associated with lower risk of 30-day MACCE(adjusted OR=0.75,95%CI:0.57-0.98,P=0.032)than culprit-only PCI and conferred no increased risk of allcause death,myocardial infarction,stent thrombosis,stroke,or bleeding.Subgroup analysis showed that MACCE reduction was observed more often from patients with trans-femoral access(OR=0.34,95%CI:0.15-0.74)than with trans-radial access(OR=0.87,95%CI:0.66-1.16,P for interaction=0.017).CONCLUSIONS The in-hospital multivessel PCI strategy was associated with a lower risk of 30-day MACCE than culprit-only PCI in patients with STEMI and multivessel coronary artery disease.展开更多
AIM:To investigate whether serum adiponectin protects against cardiometabolic risk in a population sample with prevailing metabolic syndrome.METHODS:Middle-aged adults representative of a general population with basel...AIM:To investigate whether serum adiponectin protects against cardiometabolic risk in a population sample with prevailing metabolic syndrome.METHODS:Middle-aged adults representative of a general population with baseline circulating adiponectin measurements(n=1224)were analyzed prospectively at a mean of 3.8 years’follow-up,using continuous values or sex-specific tertiles.Total adiponectin was assayed by an ELISA kit.Type-2 diabetes was identified by criteria of the American Diabetes Association.Hypertension was defined as a blood pressure≥140 mmHg and/or≥90 mmHg and/or use of antihypertensive medication.Outcomes were predicted using Cox proportional hazards regression analysis in models that were controlled for potential confounders.RESULTS:In models of multiple linear regression,sex hormone-binding globulin,fasting insulin(inverse)and,in men,age were significant independent covariates of serum adiponectin which further tended in women to be positively associated with serum creatinine.Cox regression analyses for incident coronary heart disease(CHD),adjusted for sex,age,non-HDL cholesterol,waist circumference and C-reactive protein,revealed significant inverse association with adiponectin tertiles in men but not women(HR=0.66;95%CI:0.32-1.38 for highest tertile).Cox regression for type-2 diabetes in a similar model(wherein glucose replaced non-HDL cholesterol),adiponectin tertiles appeared to protect in each gender.HR for incident hypertension roughly displayed unity in each of the adiponectin tertiles(P-trend=0.67).CONCLUSION:High adiponectin levels failed to protect against the development of hypertension and,in women,against CHD,presumably paralleling impairment in renal function as well.Involvement of adiponectin in autoimmune complex with loss of antioxidative-antiatherogenic properties may be underlying.展开更多
Uremic cardiomyopathy is chronic ischemic left ventricular dysfunction characterized by heart failure, myocardial ischemia, hypotension in dialysis and arrhythmia. This nosologic entity represents a leading cause of m...Uremic cardiomyopathy is chronic ischemic left ventricular dysfunction characterized by heart failure, myocardial ischemia, hypotension in dialysis and arrhythmia. This nosologic entity represents a leading cause of morbidity and mortality among patients with endstage renal disease receiving long-term hemodialysis. It is intuitive that revascularization in the presence of coronary artery disease in these patients represents an effective option for improving their prognosis. Although the surgical option seems to be followed by the best clinical outcome, some patients refuse this option and others are not good candidates for surgery. The present report describes the case of a patient affected by uremic cardiomyopathy and severe coronary artery disease in whom revascularization with percutaneous coronary angioplasty was followed by a significant improvement in quality of life.展开更多
Background and objective The value of D-dimer in the risk stratification of patients with coronary artery disease(CAD) and the relationship between D-dimer and the diseased coronary arteries remains controversial or u...Background and objective The value of D-dimer in the risk stratification of patients with coronary artery disease(CAD) and the relationship between D-dimer and the diseased coronary arteries remains controversial or unclear,especially in the elderly.This study was to evaluate the usefulness of D-dimer as a biomarker in assessing the vulnerable blood in the elderly patients with coronary disease.Methods Sixty elderly (≥60 years old) male patients with suspected CAD were enrolled in this prospective study. Patients were divided into CAD group (n=41,10 with stable angina and 31 with unstable angina) and control group (n=19) according to their coronary angiography Results Clinical information including age,body mass index (BMI),smoking index,and the complications of primary hypertension or diabetes,and CAD family history was collected.Venous blood was sampled serially for the determination of total cholesterol,HDL cholesterol,LDL cholesterol,triglycerides,apoA1,apoB,glucose,uric acid,homocysteine (Hcy),hs-CRP,soluble thrombomodulin (sTM),and markers of fibrinolytic system and hypercoagulability,such as D-dimer,fibrinogen, etc.The extent of coronary atherosclerosis was assessed,using the Gensini scoring system on the basis of coronary angiography. Results Compared with the controls,the patients with CAD had significantly higher levels of D-dimer.D-dimer level was significantly correlated to age,hs-CRP,Hcy,and PAI-1.Patients with D-dimer levels in the top triplicate of D-dimer level had significantly higher prevalence of unstable angina compared with patients in the lowest triplicate (OR=4.8,Z=3.28,P=0.001).In an ordinal logistic regression,the OR value of developing more serious CAD augmented 3.1-fold with each increasing triplicate of D-dimer. Patients with unstable angina had a significantly higher level of D-dimer than the controls (P=0.005),and an increasing trend compared with patients with stable angina (P=0.059),whereas there was no difference between the patients with stable angina and the controls (P=0.885).D-dimer was significantly correlated with Gensini scores (r=0.3930,P=0.0019).Ordinal logistic regression showed that the OR value of increasing one or two triplicates of Genslni’s scores augmented 1.44-fold with each increasing triplicate of D-dimer (OR=2. 44,Z=2.87,P=0.004).Conclusions D-dimer may be a helpful biomarker in identifying the severity of vulnerable blood in elderly patients with CAD.展开更多
Objective The aim of this study is to establish whether cyclin-dependent kinase inhibitor 2B antisense RNA 1(CDKN2 B-AS1) gene polymorphisms are associated with premature triple-vessel disease(PTVD). Methods Nine sing...Objective The aim of this study is to establish whether cyclin-dependent kinase inhibitor 2B antisense RNA 1(CDKN2 B-AS1) gene polymorphisms are associated with premature triple-vessel disease(PTVD). Methods Nine single-nucleotide polymorphisms(rs1063192, rs10757274, rs1333042, rs1333049, rs2285327, rs3217986, rs3217992, rs4977574, and rs9632884) were genotyped in 884 PTVD patients and 907 control subjects(males ≤ 50 years old and females ≤ 60 years old) using the improved multiplex ligase detection reaction method. Results The allele frequencies of rs10757274 G, rs1333049 C, rs4977574 G(all P < 0.001), and rs3217986 G(P = 0.040) were significantly higher in the PTVD group than in the control group, but those of rs1063192 A, rs1333042 G, and rs9632884 C(all P < 0.001) were significantly lower in the former than in the latter. Logistic regression analysis revealed that homozygote AA of rs1333042 is associated with decreased risk for PTVD(OR = 0.42, 95% CI: 0.22-0.82, P = 0.011). In addition, the allele frequencies observed differed between genders. The G allele of rs3217986 was associated with increased risk for PTVD in male patients only(OR = 2.94, 95% CI: 1.27-6.80, P = 0.012) in the dominant model, and no positively mutated allele was found in female patients. Conclusion Polymorphisms of the CDKN2 B-AS1 gene are associated with the incidence of PTVD in the Chinese population. Furthermore, the frequencies of mutated alleles differed between genders.展开更多
Background For patients with cardiovascular disease (CVD), co-existence of peripheral artery disease (PAD) predicts increased mortality, and such patients are also more likely to benefit from aggressive therapy. Surve...Background For patients with cardiovascular disease (CVD), co-existence of peripheral artery disease (PAD) predicts increased mortality, and such patients are also more likely to benefit from aggressive therapy. Surveillance of PAD is often neglected at health clinics. Our aim is to highlight the importance and ease of surveillance of PAD in patients with CVD. Objective To determine the prevalence of symptomatic and asymptomatic PAD in a Malaysian patient population with documented CVD. Methods and Results A total of 393 subjects with established CVD were recruited from three centres (85 women and 308 men), as part of a larger international (AGATHA) survey. PAD, determined by presence of claudicant symptoms on interview and/or abnormal ankle-brachial index (ABI) score of less than 0.9, was present in 21.4% of patients-of whom 64% were asymptomatic. Abnormal ABI is associated with higher systolic blood pressure and number of arterial beds affected. Conclusions Concomitant PAD is prevalent among CVD patients in Malaysia. ABI screening is simple and yields a high proportion of patients with extensive atherosclerosis who may require more aggressive atherosclerotic risk management.(J Geriatr Cardiol 2007;4:195-199.)展开更多
Objective To investigate the correlation between serum resistin level, cardiovascular risk factors and severity of coronary disease in acute coronary syndrome (ACS). Methods After evaluated by clinical history, electr...Objective To investigate the correlation between serum resistin level, cardiovascular risk factors and severity of coronary disease in acute coronary syndrome (ACS). Methods After evaluated by clinical history, electrocardiography, exercise tolerance tests, laboratory tests, and coronary angiography, 220 consecutive patients with suspected chest pain were divided into normal control group, stable angina pectoris (SAP) group, and ACS group, respectively. Baseline clinical characteristics, including height, weight, waist circumference, hip circumference, white blood cell count, high-sensitive C-reactive protein (hsCRP), total cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, were compared among three groups. ELISA was used to detect serum resistin levels. Pearson's correlation coefficient analysis was used to assess association between resistin and other traditional cardiovascular risk factors. Multinomial logistic regression analyses were used to define the relationship between serum resistin level and SAP or ACS. Results Serum resistin level in ACS group (1.18±0.48 μg/L) was significantly higher than that in normal control and SAP groups (0.49±0.40 and 0.66±0.40 μg/L; P<0.01). Only in ACS group, increased serum resistin level was significantly correlated with hsCRP (r=0.262, P=0.004) and white blood cell count (r=0.347, P=0.001). Furthermore, serum resistin levels showed a stepwise increase with the number increase of > 50% stenosed coronary vessels. Multinomial logistic regression test demonstrated that serum resistin was a strong risk factor for ACS (OR=29.132, 95%CI: 10.939-77.581, P<0.001). Conclusion These findings suggested the potential role of resistin in atherosclerosis and especially its involvement in ACS.展开更多
BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly co...BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly commonplace for patients to experience the simultaneous occurrence of cancer and CHD,a trend that is steadily rising.AIM To determine the impacts of continuing care on lung cancer patients with CHD following percutaneous coronary intervention(PCI).METHODS There were 94 lung cancer patients with CHD following PCI who were randomly assigned to the intervention group(n=38)and the control group(n=41).In the intervention group,continuing care was provided,while in the control group,routine care was provided.An evaluation of cardiac and pulmonary function,medication compliance,a 6-min walk test,and patient quality of life was performed.RESULTS Differences between the two groups were significant in left ventricular ejection fraction,6-min walk test,oxygen uptake,quality of life and medication compliance(P<0.05).In comparison with the control group,the enhancement in the intervention group was more significant.The intervention group had more patients with high medication compliance than the control group,with a statistically significant difference(P<0.05).CONCLUSION After undergoing PCI,lung patients with CHD could benefit from continued care in terms of cardiac and pulmonary function,medications compliance,and quality of life.展开更多
This editorial refers to the article“Comparative analysis of Nε-carboxymethyllysine and inflammatory markers in diabetic and non-diabetic coronary artery disease patients”,published in the recent issue of the World...This editorial refers to the article“Comparative analysis of Nε-carboxymethyllysine and inflammatory markers in diabetic and non-diabetic coronary artery disease patients”,published in the recent issue of the World Journal of Diabetes 2023 is based on glucose metabolism,advanced glycation end products(AGEs),inflammation and adiposity on diabetes and coronary artery disease(CAD).This study has included CAD patients who were stratified according to glycosylated hemoglobin higher than 6.5 and sex-matched.A higher prevalence of hypertension,dyslipidemia,and non-vegetarian diet were found in the diabetic group.These risk factors might influence body weight and adiposity and explain the increment of the left atrium.Although this data was not supported by the study.The diet can also explain the non-enzymatic reactions on lipids,proteins,or nucleic acids and consequently an increment of AGEs.These molecules can emit fluorescence.However,one of the non-fluorescent and most abundant AGEs is Nε-carboxymethyl-lysine(CML).Its association with coronary artery stenosis and severity in the diabetic group might suggest its role as a player in CAD progression.Thus,CML,after binding with its receptor(RAGE),can induce calcification cascade through reactive oxygen species and mitogen-activated protein kinase.Moreover,this interaction AGE-RAGE can cause activation of the transcription nuclear factor-kb and induce inflammatory cytokines.It might explain the relationship between CML and pro-inflammatory cytokines in diabetic and CAD patients.Although this is a population from one center,the determination of CML and inflammatory cytokines might improve the diagnosis of severe and progressive CAD.Future and comparative studies among glycosylated hemoglobin,CML,and other AGE levels according to diagnosis and prognosis value might modify the clinical practice.Although these molecules are irreversible,they can act through a specific receptor inducing a signal transduction that might be modulated by inhibitors,antibodies,or siRNA.Further mechanistic studies might improve the development of future preventive therapies for diabetic patients.展开更多
Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospec...Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospective and observational study,we recruited 500 patients with ACS.For all the eligible patients,demographic details were collected,and laboratory parameters were evaluated.The CAD severity was evaluated in terms of the number of involved vessels.The NLR was calculated based on neutrophils and lymphocytes and the correlation of various risk factors and severity and outcome of CAD was performed.Results:77.2%of Patients was male,and 52%of the patients aged between 55-70 years.Based on the type of ACS,396 out of 500 patients had ST-elevation myocardial infarction.An ascending trend in the white blood cell levels and NLR value was noted as the severity of the ACS increased and the highest white blood cell levels and NLR was noted among classⅣpatients.The mean NLR value among the non-survivors were higher compared to the survivors(9.52±5.72 vs.4.76±2.36;P<0.01).Receiver operating curve showed that the cut-off NLR value was 5.76 with a sensitivity of 75.0%and a specificity of 77.3%.Conclusions:The NLR can be used as an independent prognostic marker in ACS.An elevated NLR value serves as a reliable predictor for short-term complications,notably in-hospital mortality.展开更多
[Objectives]This study was conducted to explore the relationship between neutrophil percentage-to-albumin ratio(NPAR)and coronary heart disease complicated with diabetes.[Methods]A total of 603 patients with coronary ...[Objectives]This study was conducted to explore the relationship between neutrophil percentage-to-albumin ratio(NPAR)and coronary heart disease complicated with diabetes.[Methods]A total of 603 patients with coronary heart disease who underwent coronary angiography in Pingquan County Hospital from January,2023 to December,2023 and met the inclusion criteria were included as the research object.All the patients were divided into a coronary heart disease complicated with diabetes group(CAD+T2DM group)(n=298 cases)and a control group(CAD group)(n=305 cases),according to patients medical history,heart color ultrasound and biochemical test results.The clinical data,biochemical test results and coronary artery imaging data of patients were recorded,and the Gensini score was calculated.The neutrophil percentage(NEUT%)and albumin count were determined to calculate NPAR.[Results]The NPAR value of the coronary heart disease complicated with diabetes mellitus group was(1.6±0.42),which was significantly higher than that of the control group(1.47±0.49),and the difference was statistically significant(P<0.05).The area under the ROC curve was 0.619(95%CI:0.591-0.675,P<0.05),and the prediction of coronary heart disease complicated with diabetes using NPAR showed a Youden index of 0.31,a sensitivity of 60.4%,a specificity of 40.3%,and a best cut-off score of 1.4506.[Conclusions]The neutrophil percentage-to-albumin ratio(NPAR)is closely related to coronary heart disease complicated with diabetes mellitus,and NPAR has clinical application value in the diagnosis of coronary heart disease complicated with diabetes mellitus.展开更多
Coronary atherosclerotic heart disease(CHD)is the main type of cardiovascular disease.The efficacy of Uyghur drug compound Saffron formula in CHD has been clinically proven.However,the underlying mechanism remains unc...Coronary atherosclerotic heart disease(CHD)is the main type of cardiovascular disease.The efficacy of Uyghur drug compound Saffron formula in CHD has been clinically proven.However,the underlying mechanism remains unclear.In this study,researchers investigated the active ingredients and mechanism of action of Crocus sativus and Rosa rugosa in the treatment of CHD by network pharmacology and molecular docking techniques,collected target information with the help of TCMSP,GEO,GeneCards,and other databases,constructed protein-protein interaction(PPI)network diagrams by STRING database,performed GO and KEGG pathway enrichment analysis on common targets,and finally molecularly docked the active ingredients with core targets.C.sativus-R.rugosa have a variety of polyphenol compounds,a total of 12 active ingredients,including quercetin and kaempferol,were screened.The first three targets intersected with the core targets of CHD as AKT1,TNF,and IL-1B.Enrichment results of KEGG pathway showed that C.sativus-R.rugosa against CHD involved atherosclerosis pathways.The molecular docking results showed that quercetin and kaempferol were well bound to the core targets,and it was speculated that these components might be the main active ingredients for the treatment of CHD.The potential mechanism of action of C.sativus-R.rugosa for the treatment of coronary heart disease was initially revealed.展开更多
Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly p...Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.展开更多
Objective:To analyze the effects of providing extended rehabilitation nursing services at home to patients with coronary heart disease(CHD)combined with heart failure(CHF)on psychological improvement and adherence to ...Objective:To analyze the effects of providing extended rehabilitation nursing services at home to patients with coronary heart disease(CHD)combined with heart failure(CHF)on psychological improvement and adherence to medical compliance behavior.Methods:79 patients with CHD with CHF admitted to Sijia Town Central Health Hospital,Haimen District,Nantong City,Jiangsu Province,between June 2021 and June 2023 were selected and grouped according to the randomized numerical table method.The control group(39 cases)was provided with conventional nursing care and extended rehabilitation nursing care at home was provided to the observation group(40 cases).The psychological status,adherence to medical behaviors,cardiac function,and complications between both groups were compared.Results:The scores of anxieties and depression self-assessment scales(SAS,SDS)of patients in the observation group were lower than those of the control group(t=2.954,3.212;P<0.05);the compliance of patients in the observation group was higher than that of the control group(P<0.05).The levels of left ventricular ejection fraction,end-systolic and end-diastolic internal diameters(LVEF,LVESD,LVEDD)of patients in the observation group at 58.02±5.34%,44.49±5.16 mm,and 49.16±5.76 mm respectively were better than those of the control group after nursing care(t=3.205,3.288,2.633;P<0.05);the complication rate of the observation group was lower than that of the control group(P<0.05).Conclusion:Extended rehabilitation nursing at home exhibited a psychological regulation effect on CHD with CHF patients,improved their medical compliance,improved cardiac function,reduced the incidence of complications,and had significant application value.展开更多
Objective:To explore the application effect of the blended education strategy based on the Learning Pass platform in the phase III cardiac rehabilitation of patients with coronary artery disease.Methods:90 patients di...Objective:To explore the application effect of the blended education strategy based on the Learning Pass platform in the phase III cardiac rehabilitation of patients with coronary artery disease.Methods:90 patients diagnosed with coronary artery disease in the Department of Cardiology of our hospital from January 2019 to January 2021 were selected and divided into the control group and the experimental group according to the method of randomized numerical table,with 45 cases in each group.Both the experimental group and the control group received pre-discharge cardiac rehabilitation education by conventional means.The control group received education and supervision information via WeChat after discharge,while the experimental group joined the Learning Pass platform to receive online and offline hybrid education and supervision,with online as the mainstay and offline as a supplement.The disease cognitive level,self-management skills,quality of life,medication adherence,and emotional status of the two groups were compared.Results:The disease cognitive levels in the experimental group were significantly higher than those of the control group(P<0.05);the scores of the experimental group in terms of quality of life,self-management skills,and medication adherence were significantly higher than those of the control group(P<0.05);and the scores of anxiety and depression in the experimental group were significantly lower than those of the control group(P<0.05).Conclusion:The blended education strategy based on the Learning Pass platform has a significant application effect in phase III cardiac rehabilitation of patients with coronary artery disease.It can improve patients’disease cognitive level,self-management skills,and quality of life,and provide a basis for improving patients’prognosis.展开更多
Objective:To analyze the combined therapeutic effect of clopidogrel(CLO)and aspirin(ASP)on coronary heart disease(CHD)in community-dwelling elderly.Methods:Thirty elderly patients with CHD who were admitted to the Xin...Objective:To analyze the combined therapeutic effect of clopidogrel(CLO)and aspirin(ASP)on coronary heart disease(CHD)in community-dwelling elderly.Methods:Thirty elderly patients with CHD who were admitted to the Xinxin Community Health Service Station,Pangzhuang Street,Quanshan District,Xuzhou City,from November 2020 to November 2022 were selected and randomly grouped into an observation group and a control group,with 15 cases in each group.The observation group was given the combination of CLO and ASP and the reference group was given only ASP.The total effective rate and other treatment indicators between the two groups were compared.Results:The total effective rate of the observation group(93.33%)was higher than that of the reference group(60.00%)(P<0.05).The adverse drug reaction rate(13.33%)and long-term cardiovascular adverse event rate(6.67%)of the observation group were lower than those of the reference group at 46.67%and 40.00%respectively,(P<0.05).Before treatment,the two groups had no difference in the quality-of-life scores(P>0.05).After treatment,the quality-of-life scores of the observation group were higher than those of the reference group(P<0.05).Conclusion:CLO combined with ASP improved the therapeutic effect of community-dwelling elderly patients with CHD,reduced adverse reactions during medication,prevented adverse cardiovascular events,and comprehensively improved the patient’s quality of life.展开更多
Coronary angiography has long been the standard for coronary imaging,but it has limitations in assessing vessel wall anatomy and guiding percutaneous coronary intervention(PCI).Intracoronary imaging techniques like in...Coronary angiography has long been the standard for coronary imaging,but it has limitations in assessing vessel wall anatomy and guiding percutaneous coronary intervention(PCI).Intracoronary imaging techniques like intravascular ultrasound(IVUS)and optical coherence tomography(OCT)can overcome these limitations.IVUS uses ultrasound and OCT uses near-infrared light to visualize coronary pathology in unique ways due to differences in temporal and spatial resolution.These techniques have evolved to offer clinical utility in plaque characterization and vessel assessment during PCI.Meta-analyses and adjusted observational studies suggest that both IVUS and OCT-guided PCI correlate with reduced cardiovascular risks compared to angiographic guidance alone.While IVUS demonstrates consistent clinical outcome benefits,OCT evidence is less robust.IVUS has progressed from early motion detection to high-resolution systems,with smaller compatible catheters.OCT utilizes near infrared light to achieve unparalleled resolutions,but requires temporary blood clearance for optimal imaging.Enhanced visualization and guidance make IVUS and OCT well-suited for higher risk PCI in patients with diabetes and chronic kidney disease by allowing detailed visualization of complex lesions and ensuring optimal stent deployment and positioning in PCI for patients with type 2 diabetes and chronic kidney disease,improving outcomes.IVUS and recent advancements in zero-and low-contrast OCT techniques can reduce nephrotoxic contrast exposure,thus helping to minimize PCI complications in these high-risk patient groups.IVUS and OCT provide valuable insights into coronary pathophysiology and guide interventions precisely compared to angiography alone.Both have comparable clinical outcomes,emphasizing the need for tailored imaging choices based on clinical scenarios.Continued refinement and integration of intravascular imaging will likely play a pivotal role in optimizing coronary interventions and outcomes.This systematic review aims to delve into the nuances of IVUS and OCT,highlighting their strengths and limitations as PCI adjuncts.展开更多
基金We thank all hospitals and staff participating in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)project.The CCC-ACS Project is a collaborative project of the American Heart Association and the Chinese Society of Cardiology.The American Heart Association received funding from Pfizer through an independent grant for learning and change and AstraZeneca as a quality improvement initiative.
文摘BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction(STEMI)and multivessel coronary artery disease.However,only a few single-center retrospective studies were performed on small Chinese cohorts.Our study aims to demonstrate the advantage of multivessel percutaneous intervention(PCI)strategy on 30-day in-hospital outcomes to patients with STEMI and multivessel disease in larger Chinese population.METHODS From the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)project,5935 patients with STEMI and multivessel disease undergoing PCI and hospitalized for fewer than 30 days were analyzed.After 5:1 propensity score matching,3577 patients with culprit-only PCI and 877 with in-hospital multivessel PCI were included.The primary outcome was major adverse cardiovascular and cerebrovascular event(MACCE),defined as a composite of myocardial infarction,all-cause death,stent thrombosis,heart failure,and stroke.RESULTS Multivariable logistic regression analysis revealed that in-hospital multivessel PCI was associated with lower risk of 30-day MACCE(adjusted OR=0.75,95%CI:0.57-0.98,P=0.032)than culprit-only PCI and conferred no increased risk of allcause death,myocardial infarction,stent thrombosis,stroke,or bleeding.Subgroup analysis showed that MACCE reduction was observed more often from patients with trans-femoral access(OR=0.34,95%CI:0.15-0.74)than with trans-radial access(OR=0.87,95%CI:0.66-1.16,P for interaction=0.017).CONCLUSIONS The in-hospital multivessel PCI strategy was associated with a lower risk of 30-day MACCE than culprit-only PCI in patients with STEMI and multivessel coronary artery disease.
文摘AIM:To investigate whether serum adiponectin protects against cardiometabolic risk in a population sample with prevailing metabolic syndrome.METHODS:Middle-aged adults representative of a general population with baseline circulating adiponectin measurements(n=1224)were analyzed prospectively at a mean of 3.8 years’follow-up,using continuous values or sex-specific tertiles.Total adiponectin was assayed by an ELISA kit.Type-2 diabetes was identified by criteria of the American Diabetes Association.Hypertension was defined as a blood pressure≥140 mmHg and/or≥90 mmHg and/or use of antihypertensive medication.Outcomes were predicted using Cox proportional hazards regression analysis in models that were controlled for potential confounders.RESULTS:In models of multiple linear regression,sex hormone-binding globulin,fasting insulin(inverse)and,in men,age were significant independent covariates of serum adiponectin which further tended in women to be positively associated with serum creatinine.Cox regression analyses for incident coronary heart disease(CHD),adjusted for sex,age,non-HDL cholesterol,waist circumference and C-reactive protein,revealed significant inverse association with adiponectin tertiles in men but not women(HR=0.66;95%CI:0.32-1.38 for highest tertile).Cox regression for type-2 diabetes in a similar model(wherein glucose replaced non-HDL cholesterol),adiponectin tertiles appeared to protect in each gender.HR for incident hypertension roughly displayed unity in each of the adiponectin tertiles(P-trend=0.67).CONCLUSION:High adiponectin levels failed to protect against the development of hypertension and,in women,against CHD,presumably paralleling impairment in renal function as well.Involvement of adiponectin in autoimmune complex with loss of antioxidative-antiatherogenic properties may be underlying.
文摘Uremic cardiomyopathy is chronic ischemic left ventricular dysfunction characterized by heart failure, myocardial ischemia, hypotension in dialysis and arrhythmia. This nosologic entity represents a leading cause of morbidity and mortality among patients with endstage renal disease receiving long-term hemodialysis. It is intuitive that revascularization in the presence of coronary artery disease in these patients represents an effective option for improving their prognosis. Although the surgical option seems to be followed by the best clinical outcome, some patients refuse this option and others are not good candidates for surgery. The present report describes the case of a patient affected by uremic cardiomyopathy and severe coronary artery disease in whom revascularization with percutaneous coronary angioplasty was followed by a significant improvement in quality of life.
文摘Background and objective The value of D-dimer in the risk stratification of patients with coronary artery disease(CAD) and the relationship between D-dimer and the diseased coronary arteries remains controversial or unclear,especially in the elderly.This study was to evaluate the usefulness of D-dimer as a biomarker in assessing the vulnerable blood in the elderly patients with coronary disease.Methods Sixty elderly (≥60 years old) male patients with suspected CAD were enrolled in this prospective study. Patients were divided into CAD group (n=41,10 with stable angina and 31 with unstable angina) and control group (n=19) according to their coronary angiography Results Clinical information including age,body mass index (BMI),smoking index,and the complications of primary hypertension or diabetes,and CAD family history was collected.Venous blood was sampled serially for the determination of total cholesterol,HDL cholesterol,LDL cholesterol,triglycerides,apoA1,apoB,glucose,uric acid,homocysteine (Hcy),hs-CRP,soluble thrombomodulin (sTM),and markers of fibrinolytic system and hypercoagulability,such as D-dimer,fibrinogen, etc.The extent of coronary atherosclerosis was assessed,using the Gensini scoring system on the basis of coronary angiography. Results Compared with the controls,the patients with CAD had significantly higher levels of D-dimer.D-dimer level was significantly correlated to age,hs-CRP,Hcy,and PAI-1.Patients with D-dimer levels in the top triplicate of D-dimer level had significantly higher prevalence of unstable angina compared with patients in the lowest triplicate (OR=4.8,Z=3.28,P=0.001).In an ordinal logistic regression,the OR value of developing more serious CAD augmented 3.1-fold with each increasing triplicate of D-dimer. Patients with unstable angina had a significantly higher level of D-dimer than the controls (P=0.005),and an increasing trend compared with patients with stable angina (P=0.059),whereas there was no difference between the patients with stable angina and the controls (P=0.885).D-dimer was significantly correlated with Gensini scores (r=0.3930,P=0.0019).Ordinal logistic regression showed that the OR value of increasing one or two triplicates of Genslni’s scores augmented 1.44-fold with each increasing triplicate of D-dimer (OR=2. 44,Z=2.87,P=0.004).Conclusions D-dimer may be a helpful biomarker in identifying the severity of vulnerable blood in elderly patients with CAD.
基金supported by funding from the CAMS Innovation Fund for Medical Sciences(CIFMS)[2016-I2M-1-002]National Basic Research Program of China [2010CB732601]+1 种基金National High Technology Research and Development Program of China [2015AA020407]National Natural Science Foundation of China [81470380]
文摘Objective The aim of this study is to establish whether cyclin-dependent kinase inhibitor 2B antisense RNA 1(CDKN2 B-AS1) gene polymorphisms are associated with premature triple-vessel disease(PTVD). Methods Nine single-nucleotide polymorphisms(rs1063192, rs10757274, rs1333042, rs1333049, rs2285327, rs3217986, rs3217992, rs4977574, and rs9632884) were genotyped in 884 PTVD patients and 907 control subjects(males ≤ 50 years old and females ≤ 60 years old) using the improved multiplex ligase detection reaction method. Results The allele frequencies of rs10757274 G, rs1333049 C, rs4977574 G(all P < 0.001), and rs3217986 G(P = 0.040) were significantly higher in the PTVD group than in the control group, but those of rs1063192 A, rs1333042 G, and rs9632884 C(all P < 0.001) were significantly lower in the former than in the latter. Logistic regression analysis revealed that homozygote AA of rs1333042 is associated with decreased risk for PTVD(OR = 0.42, 95% CI: 0.22-0.82, P = 0.011). In addition, the allele frequencies observed differed between genders. The G allele of rs3217986 was associated with increased risk for PTVD in male patients only(OR = 2.94, 95% CI: 1.27-6.80, P = 0.012) in the dominant model, and no positively mutated allele was found in female patients. Conclusion Polymorphisms of the CDKN2 B-AS1 gene are associated with the incidence of PTVD in the Chinese population. Furthermore, the frequencies of mutated alleles differed between genders.
文摘Background For patients with cardiovascular disease (CVD), co-existence of peripheral artery disease (PAD) predicts increased mortality, and such patients are also more likely to benefit from aggressive therapy. Surveillance of PAD is often neglected at health clinics. Our aim is to highlight the importance and ease of surveillance of PAD in patients with CVD. Objective To determine the prevalence of symptomatic and asymptomatic PAD in a Malaysian patient population with documented CVD. Methods and Results A total of 393 subjects with established CVD were recruited from three centres (85 women and 308 men), as part of a larger international (AGATHA) survey. PAD, determined by presence of claudicant symptoms on interview and/or abnormal ankle-brachial index (ABI) score of less than 0.9, was present in 21.4% of patients-of whom 64% were asymptomatic. Abnormal ABI is associated with higher systolic blood pressure and number of arterial beds affected. Conclusions Concomitant PAD is prevalent among CVD patients in Malaysia. ABI screening is simple and yields a high proportion of patients with extensive atherosclerosis who may require more aggressive atherosclerotic risk management.(J Geriatr Cardiol 2007;4:195-199.)
基金This study was supported by the grant from the National Natural Science Foundation of China （No. 81100160, 81470504）. The authors declare no conflicts of interest.
文摘Objective To investigate the correlation between serum resistin level, cardiovascular risk factors and severity of coronary disease in acute coronary syndrome (ACS). Methods After evaluated by clinical history, electrocardiography, exercise tolerance tests, laboratory tests, and coronary angiography, 220 consecutive patients with suspected chest pain were divided into normal control group, stable angina pectoris (SAP) group, and ACS group, respectively. Baseline clinical characteristics, including height, weight, waist circumference, hip circumference, white blood cell count, high-sensitive C-reactive protein (hsCRP), total cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, were compared among three groups. ELISA was used to detect serum resistin levels. Pearson's correlation coefficient analysis was used to assess association between resistin and other traditional cardiovascular risk factors. Multinomial logistic regression analyses were used to define the relationship between serum resistin level and SAP or ACS. Results Serum resistin level in ACS group (1.18±0.48 μg/L) was significantly higher than that in normal control and SAP groups (0.49±0.40 and 0.66±0.40 μg/L; P<0.01). Only in ACS group, increased serum resistin level was significantly correlated with hsCRP (r=0.262, P=0.004) and white blood cell count (r=0.347, P=0.001). Furthermore, serum resistin levels showed a stepwise increase with the number increase of > 50% stenosed coronary vessels. Multinomial logistic regression test demonstrated that serum resistin was a strong risk factor for ACS (OR=29.132, 95%CI: 10.939-77.581, P<0.001). Conclusion These findings suggested the potential role of resistin in atherosclerosis and especially its involvement in ACS.
文摘BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly commonplace for patients to experience the simultaneous occurrence of cancer and CHD,a trend that is steadily rising.AIM To determine the impacts of continuing care on lung cancer patients with CHD following percutaneous coronary intervention(PCI).METHODS There were 94 lung cancer patients with CHD following PCI who were randomly assigned to the intervention group(n=38)and the control group(n=41).In the intervention group,continuing care was provided,while in the control group,routine care was provided.An evaluation of cardiac and pulmonary function,medication compliance,a 6-min walk test,and patient quality of life was performed.RESULTS Differences between the two groups were significant in left ventricular ejection fraction,6-min walk test,oxygen uptake,quality of life and medication compliance(P<0.05).In comparison with the control group,the enhancement in the intervention group was more significant.The intervention group had more patients with high medication compliance than the control group,with a statistically significant difference(P<0.05).CONCLUSION After undergoing PCI,lung patients with CHD could benefit from continued care in terms of cardiac and pulmonary function,medications compliance,and quality of life.
文摘This editorial refers to the article“Comparative analysis of Nε-carboxymethyllysine and inflammatory markers in diabetic and non-diabetic coronary artery disease patients”,published in the recent issue of the World Journal of Diabetes 2023 is based on glucose metabolism,advanced glycation end products(AGEs),inflammation and adiposity on diabetes and coronary artery disease(CAD).This study has included CAD patients who were stratified according to glycosylated hemoglobin higher than 6.5 and sex-matched.A higher prevalence of hypertension,dyslipidemia,and non-vegetarian diet were found in the diabetic group.These risk factors might influence body weight and adiposity and explain the increment of the left atrium.Although this data was not supported by the study.The diet can also explain the non-enzymatic reactions on lipids,proteins,or nucleic acids and consequently an increment of AGEs.These molecules can emit fluorescence.However,one of the non-fluorescent and most abundant AGEs is Nε-carboxymethyl-lysine(CML).Its association with coronary artery stenosis and severity in the diabetic group might suggest its role as a player in CAD progression.Thus,CML,after binding with its receptor(RAGE),can induce calcification cascade through reactive oxygen species and mitogen-activated protein kinase.Moreover,this interaction AGE-RAGE can cause activation of the transcription nuclear factor-kb and induce inflammatory cytokines.It might explain the relationship between CML and pro-inflammatory cytokines in diabetic and CAD patients.Although this is a population from one center,the determination of CML and inflammatory cytokines might improve the diagnosis of severe and progressive CAD.Future and comparative studies among glycosylated hemoglobin,CML,and other AGE levels according to diagnosis and prognosis value might modify the clinical practice.Although these molecules are irreversible,they can act through a specific receptor inducing a signal transduction that might be modulated by inhibitors,antibodies,or siRNA.Further mechanistic studies might improve the development of future preventive therapies for diabetic patients.
文摘Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospective and observational study,we recruited 500 patients with ACS.For all the eligible patients,demographic details were collected,and laboratory parameters were evaluated.The CAD severity was evaluated in terms of the number of involved vessels.The NLR was calculated based on neutrophils and lymphocytes and the correlation of various risk factors and severity and outcome of CAD was performed.Results:77.2%of Patients was male,and 52%of the patients aged between 55-70 years.Based on the type of ACS,396 out of 500 patients had ST-elevation myocardial infarction.An ascending trend in the white blood cell levels and NLR value was noted as the severity of the ACS increased and the highest white blood cell levels and NLR was noted among classⅣpatients.The mean NLR value among the non-survivors were higher compared to the survivors(9.52±5.72 vs.4.76±2.36;P<0.01).Receiver operating curve showed that the cut-off NLR value was 5.76 with a sensitivity of 75.0%and a specificity of 77.3%.Conclusions:The NLR can be used as an independent prognostic marker in ACS.An elevated NLR value serves as a reliable predictor for short-term complications,notably in-hospital mortality.
基金Supported by Self-financing Project of Chengde Science and Technology Program in 2023(202303A079).
文摘[Objectives]This study was conducted to explore the relationship between neutrophil percentage-to-albumin ratio(NPAR)and coronary heart disease complicated with diabetes.[Methods]A total of 603 patients with coronary heart disease who underwent coronary angiography in Pingquan County Hospital from January,2023 to December,2023 and met the inclusion criteria were included as the research object.All the patients were divided into a coronary heart disease complicated with diabetes group(CAD+T2DM group)(n=298 cases)and a control group(CAD group)(n=305 cases),according to patients medical history,heart color ultrasound and biochemical test results.The clinical data,biochemical test results and coronary artery imaging data of patients were recorded,and the Gensini score was calculated.The neutrophil percentage(NEUT%)and albumin count were determined to calculate NPAR.[Results]The NPAR value of the coronary heart disease complicated with diabetes mellitus group was(1.6±0.42),which was significantly higher than that of the control group(1.47±0.49),and the difference was statistically significant(P<0.05).The area under the ROC curve was 0.619(95%CI:0.591-0.675,P<0.05),and the prediction of coronary heart disease complicated with diabetes using NPAR showed a Youden index of 0.31,a sensitivity of 60.4%,a specificity of 40.3%,and a best cut-off score of 1.4506.[Conclusions]The neutrophil percentage-to-albumin ratio(NPAR)is closely related to coronary heart disease complicated with diabetes mellitus,and NPAR has clinical application value in the diagnosis of coronary heart disease complicated with diabetes mellitus.
基金supported by Young and Middle Aged Teachers’Career Development Support Project of Shenyang Pharmaceutical University(ZQN2019005).
文摘Coronary atherosclerotic heart disease(CHD)is the main type of cardiovascular disease.The efficacy of Uyghur drug compound Saffron formula in CHD has been clinically proven.However,the underlying mechanism remains unclear.In this study,researchers investigated the active ingredients and mechanism of action of Crocus sativus and Rosa rugosa in the treatment of CHD by network pharmacology and molecular docking techniques,collected target information with the help of TCMSP,GEO,GeneCards,and other databases,constructed protein-protein interaction(PPI)network diagrams by STRING database,performed GO and KEGG pathway enrichment analysis on common targets,and finally molecularly docked the active ingredients with core targets.C.sativus-R.rugosa have a variety of polyphenol compounds,a total of 12 active ingredients,including quercetin and kaempferol,were screened.The first three targets intersected with the core targets of CHD as AKT1,TNF,and IL-1B.Enrichment results of KEGG pathway showed that C.sativus-R.rugosa against CHD involved atherosclerosis pathways.The molecular docking results showed that quercetin and kaempferol were well bound to the core targets,and it was speculated that these components might be the main active ingredients for the treatment of CHD.The potential mechanism of action of C.sativus-R.rugosa for the treatment of coronary heart disease was initially revealed.
文摘Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.
文摘Objective:To analyze the effects of providing extended rehabilitation nursing services at home to patients with coronary heart disease(CHD)combined with heart failure(CHF)on psychological improvement and adherence to medical compliance behavior.Methods:79 patients with CHD with CHF admitted to Sijia Town Central Health Hospital,Haimen District,Nantong City,Jiangsu Province,between June 2021 and June 2023 were selected and grouped according to the randomized numerical table method.The control group(39 cases)was provided with conventional nursing care and extended rehabilitation nursing care at home was provided to the observation group(40 cases).The psychological status,adherence to medical behaviors,cardiac function,and complications between both groups were compared.Results:The scores of anxieties and depression self-assessment scales(SAS,SDS)of patients in the observation group were lower than those of the control group(t=2.954,3.212;P<0.05);the compliance of patients in the observation group was higher than that of the control group(P<0.05).The levels of left ventricular ejection fraction,end-systolic and end-diastolic internal diameters(LVEF,LVESD,LVEDD)of patients in the observation group at 58.02±5.34%,44.49±5.16 mm,and 49.16±5.76 mm respectively were better than those of the control group after nursing care(t=3.205,3.288,2.633;P<0.05);the complication rate of the observation group was lower than that of the control group(P<0.05).Conclusion:Extended rehabilitation nursing at home exhibited a psychological regulation effect on CHD with CHF patients,improved their medical compliance,improved cardiac function,reduced the incidence of complications,and had significant application value.
文摘Objective:To explore the application effect of the blended education strategy based on the Learning Pass platform in the phase III cardiac rehabilitation of patients with coronary artery disease.Methods:90 patients diagnosed with coronary artery disease in the Department of Cardiology of our hospital from January 2019 to January 2021 were selected and divided into the control group and the experimental group according to the method of randomized numerical table,with 45 cases in each group.Both the experimental group and the control group received pre-discharge cardiac rehabilitation education by conventional means.The control group received education and supervision information via WeChat after discharge,while the experimental group joined the Learning Pass platform to receive online and offline hybrid education and supervision,with online as the mainstay and offline as a supplement.The disease cognitive level,self-management skills,quality of life,medication adherence,and emotional status of the two groups were compared.Results:The disease cognitive levels in the experimental group were significantly higher than those of the control group(P<0.05);the scores of the experimental group in terms of quality of life,self-management skills,and medication adherence were significantly higher than those of the control group(P<0.05);and the scores of anxiety and depression in the experimental group were significantly lower than those of the control group(P<0.05).Conclusion:The blended education strategy based on the Learning Pass platform has a significant application effect in phase III cardiac rehabilitation of patients with coronary artery disease.It can improve patients’disease cognitive level,self-management skills,and quality of life,and provide a basis for improving patients’prognosis.
文摘Objective:To analyze the combined therapeutic effect of clopidogrel(CLO)and aspirin(ASP)on coronary heart disease(CHD)in community-dwelling elderly.Methods:Thirty elderly patients with CHD who were admitted to the Xinxin Community Health Service Station,Pangzhuang Street,Quanshan District,Xuzhou City,from November 2020 to November 2022 were selected and randomly grouped into an observation group and a control group,with 15 cases in each group.The observation group was given the combination of CLO and ASP and the reference group was given only ASP.The total effective rate and other treatment indicators between the two groups were compared.Results:The total effective rate of the observation group(93.33%)was higher than that of the reference group(60.00%)(P<0.05).The adverse drug reaction rate(13.33%)and long-term cardiovascular adverse event rate(6.67%)of the observation group were lower than those of the reference group at 46.67%and 40.00%respectively,(P<0.05).Before treatment,the two groups had no difference in the quality-of-life scores(P>0.05).After treatment,the quality-of-life scores of the observation group were higher than those of the reference group(P<0.05).Conclusion:CLO combined with ASP improved the therapeutic effect of community-dwelling elderly patients with CHD,reduced adverse reactions during medication,prevented adverse cardiovascular events,and comprehensively improved the patient’s quality of life.
文摘Coronary angiography has long been the standard for coronary imaging,but it has limitations in assessing vessel wall anatomy and guiding percutaneous coronary intervention(PCI).Intracoronary imaging techniques like intravascular ultrasound(IVUS)and optical coherence tomography(OCT)can overcome these limitations.IVUS uses ultrasound and OCT uses near-infrared light to visualize coronary pathology in unique ways due to differences in temporal and spatial resolution.These techniques have evolved to offer clinical utility in plaque characterization and vessel assessment during PCI.Meta-analyses and adjusted observational studies suggest that both IVUS and OCT-guided PCI correlate with reduced cardiovascular risks compared to angiographic guidance alone.While IVUS demonstrates consistent clinical outcome benefits,OCT evidence is less robust.IVUS has progressed from early motion detection to high-resolution systems,with smaller compatible catheters.OCT utilizes near infrared light to achieve unparalleled resolutions,but requires temporary blood clearance for optimal imaging.Enhanced visualization and guidance make IVUS and OCT well-suited for higher risk PCI in patients with diabetes and chronic kidney disease by allowing detailed visualization of complex lesions and ensuring optimal stent deployment and positioning in PCI for patients with type 2 diabetes and chronic kidney disease,improving outcomes.IVUS and recent advancements in zero-and low-contrast OCT techniques can reduce nephrotoxic contrast exposure,thus helping to minimize PCI complications in these high-risk patient groups.IVUS and OCT provide valuable insights into coronary pathophysiology and guide interventions precisely compared to angiography alone.Both have comparable clinical outcomes,emphasizing the need for tailored imaging choices based on clinical scenarios.Continued refinement and integration of intravascular imaging will likely play a pivotal role in optimizing coronary interventions and outcomes.This systematic review aims to delve into the nuances of IVUS and OCT,highlighting their strengths and limitations as PCI adjuncts.
