Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or o...Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or older with chronic angina in which 47 patients were assigned coronary angiography and revascularisation and 56 patients with optimised medical therapy. The primary endpoint was quality of life after 6 months, as assessed by questionnaire and the presence of major adverse cardiac events (death, non fatal myocardial infarction, or hospital admission for acute coronary syndrome with or without the need for revascularisation). Results After 6 months follow up, angina severity decreased and measures of quality of life increased in both treatment groups( P <0.05 ); however, these improvements were significantly greater after revascularisation( P <0.01 ). Major adverse cardiac events occurred in 30 ( 53.6% ) of patients in the medical group and 9 ( 19.1% ) in the invasive group ( P <0.01 ).Conclusions Patients aged 75 years or older with angina benefit more from revascularisation than from optimised medical therapy in terms of symptom relief and quality of life. Therefore, these patients should be offered invasive assessment despite their high risk profile followed by revascularisation if feasible.展开更多
Introduction
Chronic kidney disease (CKD) is a significant contributor to cardiovascular morbidity and mortality.Patients with CKD are known to have a greater prevalence of cardiovascular disease than the general popu...Introduction
Chronic kidney disease (CKD) is a significant contributor to cardiovascular morbidity and mortality.Patients with CKD are known to have a greater prevalence of cardiovascular disease than the general population,1 and patients with concurrent CKD and coronary artery disease (CAD) have greater mortality than patients without CKD.2-4 The rate of cardiovascular mortality is approximately 50%,five to 10 times higher than the general population.展开更多
Background Implementing the current guidelines for leisure-time physical activity(LTPA)provides significant health benefits,especially for middle-aged adults,but it is unclear whether LTPA also translates into cardiov...Background Implementing the current guidelines for leisure-time physical activity(LTPA)provides significant health benefits,especially for middle-aged adults,but it is unclear whether LTPA also translates into cardiovascular health benefits among elderly people.Therefore,we aimed to assess the association of LTPA with the risks of cardiovascular disease(CVD),including coronary heart disease(CHD)and stroke,and all-cause mortality in an elderly population.Methods In this prospective cohort study,32,942 participants aged 60 years or older who participated in a health check-up programme in China between 2010 and 2018 were included.We evaluated the morbidity and mortality risks through the Cox regression model,competing risk model and restricted cubic spline model.Results During a median of 6.84 years of follow-up,there were 6,857 elderly people with incident CVD;a total of 6,324 deaths occurred due to all causes and 2,060 deaths occurred due to CVD.Compared with the inactive group,reductions in CVD morbidity and mortality were observed,with hazard ratios(HRs)of 0.89(95%CI:0.83–0.96)and 0.81(95%CI:0.71–0.92)in the insufficiently active group,0.86(95%CI:0.80–0.92)and 0.79(95%CI:0.69–0.90)in the sufficiently active group,and 0.79(95%CI:0.70–0.89)and 0.58(95%CI:0.45–0.76)in the highly active group,respectively;but no significant reductions were observed in the very highly active group,with HRs of 0.87(95%CI:0.71–1.06)and 0.99(95%CI:0.70–1.40),respectively.Compared with the inactive group,reductions in all-cause mortality were also observed,with a HR of 0.90(95%CI:0.84–0.97)in the insufficiently active group,0.82(95%CI:0.77–0.89)in the sufficiently active group,0.77(95%CI:0.67–0.87)in the highly active group,and 0.80(95%CI:0.64–0.98)in the very highly active group.A restricted cubic spline diagram showed that there was an L-shaped association between LTPA and the risk of all-cause mortality but a U-shaped or reverse J-shaped relationship between LTPA and the risk of CVD morbidity and mortality,especially stroke.In addition,a subgroup analysis showed that elderly population who consistently performed LTPA for ten years or more had a lower risk of morbidity and mortality.Conclusions In an elderly population,even insufficient activity is associated with a decreased risk of all-cause mortality and CVD,and moderate levels of LTPA may be optimal for CVD prevention.In addition,elderly people who consistently perform LTPA over several years may experience greater health benefits.展开更多
文摘Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or older with chronic angina in which 47 patients were assigned coronary angiography and revascularisation and 56 patients with optimised medical therapy. The primary endpoint was quality of life after 6 months, as assessed by questionnaire and the presence of major adverse cardiac events (death, non fatal myocardial infarction, or hospital admission for acute coronary syndrome with or without the need for revascularisation). Results After 6 months follow up, angina severity decreased and measures of quality of life increased in both treatment groups( P <0.05 ); however, these improvements were significantly greater after revascularisation( P <0.01 ). Major adverse cardiac events occurred in 30 ( 53.6% ) of patients in the medical group and 9 ( 19.1% ) in the invasive group ( P <0.01 ).Conclusions Patients aged 75 years or older with angina benefit more from revascularisation than from optimised medical therapy in terms of symptom relief and quality of life. Therefore, these patients should be offered invasive assessment despite their high risk profile followed by revascularisation if feasible.
文摘Introduction
Chronic kidney disease (CKD) is a significant contributor to cardiovascular morbidity and mortality.Patients with CKD are known to have a greater prevalence of cardiovascular disease than the general population,1 and patients with concurrent CKD and coronary artery disease (CAD) have greater mortality than patients without CKD.2-4 The rate of cardiovascular mortality is approximately 50%,five to 10 times higher than the general population.
基金supported by National Key Research and Development Programme of China(2017YFC1307705&2016YFC0106907)the Science and Technology Development Programme of Henan(No.201403007)。
文摘Background Implementing the current guidelines for leisure-time physical activity(LTPA)provides significant health benefits,especially for middle-aged adults,but it is unclear whether LTPA also translates into cardiovascular health benefits among elderly people.Therefore,we aimed to assess the association of LTPA with the risks of cardiovascular disease(CVD),including coronary heart disease(CHD)and stroke,and all-cause mortality in an elderly population.Methods In this prospective cohort study,32,942 participants aged 60 years or older who participated in a health check-up programme in China between 2010 and 2018 were included.We evaluated the morbidity and mortality risks through the Cox regression model,competing risk model and restricted cubic spline model.Results During a median of 6.84 years of follow-up,there were 6,857 elderly people with incident CVD;a total of 6,324 deaths occurred due to all causes and 2,060 deaths occurred due to CVD.Compared with the inactive group,reductions in CVD morbidity and mortality were observed,with hazard ratios(HRs)of 0.89(95%CI:0.83–0.96)and 0.81(95%CI:0.71–0.92)in the insufficiently active group,0.86(95%CI:0.80–0.92)and 0.79(95%CI:0.69–0.90)in the sufficiently active group,and 0.79(95%CI:0.70–0.89)and 0.58(95%CI:0.45–0.76)in the highly active group,respectively;but no significant reductions were observed in the very highly active group,with HRs of 0.87(95%CI:0.71–1.06)and 0.99(95%CI:0.70–1.40),respectively.Compared with the inactive group,reductions in all-cause mortality were also observed,with a HR of 0.90(95%CI:0.84–0.97)in the insufficiently active group,0.82(95%CI:0.77–0.89)in the sufficiently active group,0.77(95%CI:0.67–0.87)in the highly active group,and 0.80(95%CI:0.64–0.98)in the very highly active group.A restricted cubic spline diagram showed that there was an L-shaped association between LTPA and the risk of all-cause mortality but a U-shaped or reverse J-shaped relationship between LTPA and the risk of CVD morbidity and mortality,especially stroke.In addition,a subgroup analysis showed that elderly population who consistently performed LTPA for ten years or more had a lower risk of morbidity and mortality.Conclusions In an elderly population,even insufficient activity is associated with a decreased risk of all-cause mortality and CVD,and moderate levels of LTPA may be optimal for CVD prevention.In addition,elderly people who consistently perform LTPA over several years may experience greater health benefits.
