Background:This study aimed to illustrate the prevalence of CHD by screening children in extremely high-altitudeareas(over 4000 m to even 5000 m above sea level)and explore an aid model for early diagnosis and treatme...Background:This study aimed to illustrate the prevalence of CHD by screening children in extremely high-altitudeareas(over 4000 m to even 5000 m above sea level)and explore an aid model for early diagnosis and treatmentfor the Tibetan population.Methods:A total of 2242 students from different schools in Ngamring County,Xigaze City,Tibet from September 2019 to September 2020 were selected for screening.The students were examinedthrough the inquiry of their current medical history and family history,cardiac auscultation and a physicalexamination,in order to screen out the suspected cases of CHD,and then the suspected cases were confirmed bycardiac color ultrasound examinations.After that,positive patients were be transferred to Shandong Province forfree treatment.Results:The prevalence of CHD among children in Ngamring County was 3.70%(83 cases),which is the highest incidence rate ever reported.The most common type of CHD was patent ductus arteriosus(PDA),accounting for 55.42%of the total number of cases screened,followed by atrial septal defect(ASD)andventricular septal defect(VSD),accounting for 28.92%and 12.05%,respectively.The prevalence of CHD in childrenat high altitude was significantly higher than that in children at low altitude.The children with CHD weretransferred to Shandong Province for surgery,the operations were successful and their recoveries went well.Conclusions:The results show that high altitude is closely related to the prevalence of CHD,and the incidencein Ngamring County is much higher than that in previous reports.展开更多
Background:Proprotein convertase subtilisin/kexin 9(PSCK9)inhibitors have been beneficial for many patients with hyperlipidemia.The objective of this study was to investigate the benefit of PSCK9 inhibitors in patient...Background:Proprotein convertase subtilisin/kexin 9(PSCK9)inhibitors have been beneficial for many patients with hyperlipidemia.The objective of this study was to investigate the benefit of PSCK9 inhibitors in patients with acute coronary syndrome(ACS).Methods:We systematically searched PubMed,EMBASE,and Cochrane Clinical Trials(published before January 2023;no language restriction)to compare the treatment of patients with ACS using PCSK9 inhibitors and placebo.The primary end points were major adverse cardiovascular events,nonfatal myocardial infarction,cardiogenic death,stroke,hospitalization for recurrent ACS,and coronary revascularization.Fixed-or random-effects models were used to assess the aggregated data.Results:Of the 1686 identified studies,5 were eligible and included in our analysis(of a total of 38,005 participants,18,609 cases were placed in the PCSK9 inhibitor treatment group and 19,396 cases in the placebo group).Compared with the placebo group,PCSK9 inhibitors significantly reduced the major adverse cardiovascular events(odds ratio[OR]:0.83;95%confidence interval[CI]:0.77–0.88;P<0.00001)for patients following ACS.The incidence of nonfatal myocardial infarction(relative risk:0.80;95%CI:0.74–0.87;P<0.00001),cardiovascular death(OR:0.96;95%CI:0.83–1.10;P=0.56),stroke(OR:0.74;95%CI:0.63–0.88;P=0.0007),hospitalization for recurrent ACS(OR:0.57;95%CI:0.40–0.83;P=0.003),or coronary revascularization(OR:0.82;95%CI:0.76–0.88;P<0.00001)all demonstrated a significant decrease in the comparison between the 2 groups.Conclusion:This meta-analysis demonstrated that treatment with PCSK9 inhibitors in patients with ACS reduced the probability of multiple cardiovascular events and improved patient prognosis.展开更多
Background:Drug-coated balloons(DCBs)are an up-and-coming tactic in treating in-stent restenosis and coronary artery small vessel disease,but their efficacy in treating acute myocardial infarction needs to be further ...Background:Drug-coated balloons(DCBs)are an up-and-coming tactic in treating in-stent restenosis and coronary artery small vessel disease,but their efficacy in treating acute myocardial infarction needs to be further explored.Methods:A meta-analysis of 7 studies was conducted to make a comparison with the results of DCB and drug-eluting stent implantation after a median follow-up of 15 months.Results:A total of 922 patients were included in this analysis in total,including 375 patients in the DCB group and 547 patients in the stent group.A total of 962 vascular diseases were manifested in the 2 groups.After 6 to 24 months of follow-up,there was no statistically significant difference with respect to major adverse cardiovascular events(odds ratio[OR]:0.82;95%confidence interval[CI]:0.52–1.29;Z=0.85;P=0.39),cardiac death(OR:0.92;95%CI:0.39–2.12;Z=0.21;P=0.84),target lesion revascularization(OR:1.09;95%CI:0.53–2.25;Z=0.24;P=0.81),late lumen loss(MD:−0.05;95%CI:−0.15 to 0.06;Z=0.85;P=0.40),or dual antiplatelet therapy(DAPT)(OR:1.04;95%CI:0.53–2.05;Z=0.11;P=0.91)between the 2 groups.In the DCB group,persistent residual stenosis or C-F dissection occurrence necessitated that a total of 30 patients receive extra bailout implantations.The rate of bailout stenting was 11.8%(95%CI:7.1–16).Moreover,the DCB group had a shorter DAPT duration compared with the stent group.Conclusion:Drug-coated balloons with shorter DAPT durations may be as effective and safe as stent therapy in treating acute myocardial infarction.展开更多
文摘Background:This study aimed to illustrate the prevalence of CHD by screening children in extremely high-altitudeareas(over 4000 m to even 5000 m above sea level)and explore an aid model for early diagnosis and treatmentfor the Tibetan population.Methods:A total of 2242 students from different schools in Ngamring County,Xigaze City,Tibet from September 2019 to September 2020 were selected for screening.The students were examinedthrough the inquiry of their current medical history and family history,cardiac auscultation and a physicalexamination,in order to screen out the suspected cases of CHD,and then the suspected cases were confirmed bycardiac color ultrasound examinations.After that,positive patients were be transferred to Shandong Province forfree treatment.Results:The prevalence of CHD among children in Ngamring County was 3.70%(83 cases),which is the highest incidence rate ever reported.The most common type of CHD was patent ductus arteriosus(PDA),accounting for 55.42%of the total number of cases screened,followed by atrial septal defect(ASD)andventricular septal defect(VSD),accounting for 28.92%and 12.05%,respectively.The prevalence of CHD in childrenat high altitude was significantly higher than that in children at low altitude.The children with CHD weretransferred to Shandong Province for surgery,the operations were successful and their recoveries went well.Conclusions:The results show that high altitude is closely related to the prevalence of CHD,and the incidencein Ngamring County is much higher than that in previous reports.
基金the Natural Science Foundation of China(no.81700321).
文摘Background:Proprotein convertase subtilisin/kexin 9(PSCK9)inhibitors have been beneficial for many patients with hyperlipidemia.The objective of this study was to investigate the benefit of PSCK9 inhibitors in patients with acute coronary syndrome(ACS).Methods:We systematically searched PubMed,EMBASE,and Cochrane Clinical Trials(published before January 2023;no language restriction)to compare the treatment of patients with ACS using PCSK9 inhibitors and placebo.The primary end points were major adverse cardiovascular events,nonfatal myocardial infarction,cardiogenic death,stroke,hospitalization for recurrent ACS,and coronary revascularization.Fixed-or random-effects models were used to assess the aggregated data.Results:Of the 1686 identified studies,5 were eligible and included in our analysis(of a total of 38,005 participants,18,609 cases were placed in the PCSK9 inhibitor treatment group and 19,396 cases in the placebo group).Compared with the placebo group,PCSK9 inhibitors significantly reduced the major adverse cardiovascular events(odds ratio[OR]:0.83;95%confidence interval[CI]:0.77–0.88;P<0.00001)for patients following ACS.The incidence of nonfatal myocardial infarction(relative risk:0.80;95%CI:0.74–0.87;P<0.00001),cardiovascular death(OR:0.96;95%CI:0.83–1.10;P=0.56),stroke(OR:0.74;95%CI:0.63–0.88;P=0.0007),hospitalization for recurrent ACS(OR:0.57;95%CI:0.40–0.83;P=0.003),or coronary revascularization(OR:0.82;95%CI:0.76–0.88;P<0.00001)all demonstrated a significant decrease in the comparison between the 2 groups.Conclusion:This meta-analysis demonstrated that treatment with PCSK9 inhibitors in patients with ACS reduced the probability of multiple cardiovascular events and improved patient prognosis.
基金the Natural Science Foundation of China(no.81700321).
文摘Background:Drug-coated balloons(DCBs)are an up-and-coming tactic in treating in-stent restenosis and coronary artery small vessel disease,but their efficacy in treating acute myocardial infarction needs to be further explored.Methods:A meta-analysis of 7 studies was conducted to make a comparison with the results of DCB and drug-eluting stent implantation after a median follow-up of 15 months.Results:A total of 922 patients were included in this analysis in total,including 375 patients in the DCB group and 547 patients in the stent group.A total of 962 vascular diseases were manifested in the 2 groups.After 6 to 24 months of follow-up,there was no statistically significant difference with respect to major adverse cardiovascular events(odds ratio[OR]:0.82;95%confidence interval[CI]:0.52–1.29;Z=0.85;P=0.39),cardiac death(OR:0.92;95%CI:0.39–2.12;Z=0.21;P=0.84),target lesion revascularization(OR:1.09;95%CI:0.53–2.25;Z=0.24;P=0.81),late lumen loss(MD:−0.05;95%CI:−0.15 to 0.06;Z=0.85;P=0.40),or dual antiplatelet therapy(DAPT)(OR:1.04;95%CI:0.53–2.05;Z=0.11;P=0.91)between the 2 groups.In the DCB group,persistent residual stenosis or C-F dissection occurrence necessitated that a total of 30 patients receive extra bailout implantations.The rate of bailout stenting was 11.8%(95%CI:7.1–16).Moreover,the DCB group had a shorter DAPT duration compared with the stent group.Conclusion:Drug-coated balloons with shorter DAPT durations may be as effective and safe as stent therapy in treating acute myocardial infarction.
