BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are...BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disease(CHD).Therefore,the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people.METHODS 19,194 participants aged≥60 years who had three AIP measurements between 2018 and 2020 were included in this study.AIP was defined as log10(triglyceride/high-density lipoprotein cholesterol).The group-based trajectory model was used to identify different trajectory patterns of AIP from 2018 to 2020.Cox proportional hazards models were used to estimate the hazard ratio(HR)with 95%CI of CHD events between different trajectory groups from 2020 to 2023.RESULTS Three different trajectory patterns were identified through group-based trajectory model:the low-level group(n=7410,mean AIP:-0.25 to-0.17),the medium-level group(n=9981,mean AIP:0.02-0.08),and the high-level group(n=1803,mean AIP:0.38-0.42).During a mean follow-up of 2.65 years,a total of 1391 participants developed CHD.After adjusting for potential confounders,compared with the participants in the low-level group,the HR with 95%CI of the medium-level group and the high-level group were estimated to be 1.24(1.10-1.40)and 1.43(1.19-1.73),respectively.These findings remained consistent in subgroup analyses and sensitivity analyses.CONCLUSIONS There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly.This suggests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.展开更多
Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods W...Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen,China.Patients were categorized into 6 groups based on baseline fasting plasma glucose(FPG)levels and diabetes duration(from the date of diabetes diagnosis to the baseline date)to examine their combined effects on subsequent MI.Cox proportional hazards regression models were used,with further stratification by age,sex,and comorbidities to assess potential interactions.Results Over a median follow-up of 2.4 years,2,110 patients experienced MI.Compared to those with optimal glycemic control(FPG<6.1 mmol/L)and shorter diabetes duration(<10 years),the fullyadjusted hazard ratio(HR)(95%Confidence Interval[95%CI])for those with a diabetes duration of≥10 years and FPG>8.0 mmol/L was 1.93(95%CI:1.59,2.36).The combined effects of FPG and diabetes duration on MI were largely similar across different age,sex,and comorbidity groups,although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation.Conclusion Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D.Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.展开更多
BACKGROUND Coronary heart disease(CHD)has shown a consistent upward trend in global incidence in recent years.Notably,older adults with CHD complicated by arrhy-thmia exhibit significantly higher susceptibility to psy...BACKGROUND Coronary heart disease(CHD)has shown a consistent upward trend in global incidence in recent years.Notably,older adults with CHD complicated by arrhy-thmia exhibit significantly higher susceptibility to psychological distress com-pared with the general CHD population.This increased vulnerability has garn-ered growing clinical and research interest in the potential therapeutic benefits of structured psychological interventions for alleviating comorbid depressive and anxiety symptoms in this high-risk demographic.AIM To evaluate the efficacy of psychological care in reducing anxiety and depressive symptoms among older adult patients with CHD and comorbid arrhythmia.METHODS This retrospective analysis included 100 patients with CHD and arrhythmia admitted to the First Affiliated Hospital of Jinzhou Medical University from June 2024 to December 2024.Of these,49 patients in the control group received routine care,whereas 51 patients in the observation group received psychological care in addition to routine care.Therapeutic outcomes were compared between the two groups.Psychological distress was assessed before and after providing nursing care.A treatment compliance scale developed by the hospital was used to assess adherence.Complication rates were also compared.Quality of life was evaluated using the Short Form-36 Health Survey after providing nursing care.Patient satisfaction with nursing care was assessed using a self-designed questionnaire.RESULTS The observation group demonstrated a higher overall treatment effectiveness compared with the control group(P<0.05).After nursing care,both groups showed reduced scores on the Self-Rating Anxiety Scale and Self-Rating Depression Scale compared with baseline(P<0.05),with significantly greater improvements in the observation group(P<0.05).Treatment compliance was higher and complication rates were lower in the observation group(P<0.05).Additionally,the observation group demonstrated better quality of life after 1 month of care and higher satisfaction with nursing services(P<0.05).CONCLUSION Psychological care for patients with CHD and comorbid arrhythmia effectively enhanced therapeutic outcomes,reduced anxiety and depression,improved treatment compliance and quality of life,and lowered the risk of complications.These findings support the broader implementation of psychological care for patients with CHD in clinical practice.展开更多
Interleukins(ILs),a subset of cytokines,play a critical role in the pathogenesis of coronary heart disease(CHD)by mediating inflammation.This review article summarizes the role of ILs such as IL-1,IL-2,IL-3,IL-4,IL-5,...Interleukins(ILs),a subset of cytokines,play a critical role in the pathogenesis of coronary heart disease(CHD)by mediating inflammation.This review article summarizes the role of ILs such as IL-1,IL-2,IL-3,IL-4,IL-5,IL-6,IL-7,IL-8,IL-9,and IL-10 in the pathogenesis of CHD.Individuals with mild coronary artery disease(CAD)and angina who have ischemic heart disease have higher serum concentrations of IL-1b.Larger studies are needed to verify the safety and assess the effectiveness of low-dose IL-2 as an anti-inflammatory treatment.IL-3 is found more often in patients receiving coronary angioplasty compared to patients with asymptomatic CAD or without CAD.Serum levels of IL-4 are reliable indicators of CAD.An independent correlation between IL-5 and the incidence of CAD was demonstrated.IL-6 helps serve as a reliable biomarker for the degree of CAD,as determined by the Gensini score,and is a key factor in the development of atherosclerosis.Also,variants of IL-7/7R have been linked to the Han Chinese population's genetic susceptibility to CHD.IL-8 plays a role in the progression of CAD occurrences.By interacting with conventional risk factors for CAD,IL-9 may contribute to the development of CAD and offer an innovative approach to its prevention and management.There was a 34%increased risk of a CHD incident for every standard deviation rise in baseline IL-10 levels.展开更多
Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design...Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design and included 3244 participants aged ≥ 65 years in Beijing,China. The Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA) were used to assess cognitive function. Serum HbA1c was detected at admission. All patients were divided into high HbA1c group(≥ 6.5 mmol/L) and low HbA1c group(< 6.5 mmol/L) based on their HbA1c levels. Logistic regression analyses were used to evaluate the association between HbA1c and cognitive impairment.Results In this study of 3244 participants, 1201(37.0%) patients were in high HbA1c group and 2045(63.0%) patients were in a state of cognitive impairment. Logistic regression analyses demonstrated that HbA1c was an independent risk factor for cognitive impairment regardless of whether the HbA1c was a continuous or categorical variable(OR = 1.27, 95% CI: 1.15–1.40, P < 0.001;OR = 1.79, 95% CI: 1.41–2.26, P ≤ 0.001, respectively). The restricted cubic spline curve exhibited that the relationship between the HbA1c and cognitive impairment was linear(p for non-linear = 0.323, P < 0.001).Conclusion Elevated levels of HbA1c were associated with an increased risk of cognitive impairment in older patients with CHD. These insights could be used to improve the accuracy and sensitivity of cognitive screening in these patient populations.展开更多
BACKGROUND Coronary heart disease(CHD)and pulmonary embolism(PE)are thrombotic diseases.Patients with CHD and PE are common in clinical practice.However,the clinical diagnosis of PE is challenging due to overlapping p...BACKGROUND Coronary heart disease(CHD)and pulmonary embolism(PE)are thrombotic diseases.Patients with CHD and PE are common in clinical practice.However,the clinical diagnosis of PE is challenging due to overlapping primary symptoms,such as chest tightness and dyspnea.This confluence frequently leads to the misdiagnosis of PE,thus precipitating treatment delays and compromising patient outcomes.Herein,we report the case of a patient with both diseases who under-went surgery and medication therapy.CASE SUMMARY A 51-year-old man with a history of hypertension for 2 years visited a local hospital because of paroxysmal chest tightness for 1 d and was diagnosed with CHD.However,he refused hospitalization.He visited our hospital for the treatment of recurring symptoms.A comprehensive examination after admission revealed elevated D-dimer levels,and computed tomography pulmonary angio-graphy was performed to confirm the diagnosis of PE.The patient successfully underwent coronary artery bypass grafting with anticoagulant and antiplatelet drugs and had a prognosis.CONCLUSION D-dimer is useful in screening for PE,whereas computed tomography pulmonary angiography is important for diagnosis.For patients with CHD and PE,coronary artery bypass grafting combined with anticoagulant and antiplatelet therapy is feasible.展开更多
BACKGROUND Coronary heart disease(CHD)is a prominent cause of mortality and disability worldwide.Like most complex diseases,the risk of CHD in individuals is regulated by the interaction between genetic factors and li...BACKGROUND Coronary heart disease(CHD)is a prominent cause of mortality and disability worldwide.Like most complex diseases,the risk of CHD in individuals is regulated by the interaction between genetic factors and lifestyle.APOE and SLCO1B1 genetic polymorphisms and LPA KIV-2 copy number variation may influence the development and progression of CHD.Clarifying gene polymor-phisms can guide clinical precision and prevention,thereby improving treatment outcomes.AIM To investigate the influence of APOE and SLCO1B1 gene polymorphisms,as well as LPA KIV-2 copy number variation on CHD in the Teochew population.METHODS A total of 324 patients with CHD and 143 control participants were involved in this study.Single nucleotide polymorphisms rs429358 and rs7412 in the APOE gene,and rs2306283 and rs4149056 in the SLCO1B1 gene were analyzed via high-resolution melting curve analysis.Additionally,PCR was performed to detect KIV-2 copy number variations.Clinical risk factors and potential effects on CHD patients were subsequently assessed.RESULTS In the CHD group,the frequencies of APOE alleleε2,ε3,ε4 were 8.02%,82.97%,and 9.10%,respectively.Compared to the control groups(13.29%,79.37%,and 7.34%,respectively),theε2 allele frequency showed a significant difference(8.02%vs 13.29%,P=0.012).SLCO1B1 allele frequencies in the CHD group were not significantly different from those in the control group(*1a:26.69%vs 25.52%,*1b:61.17%vs 65.38%,*5:0.15%vs 0.35%,*15:11.83%vs 8.74%).The number of copies of the KIV-2 gene was significantly lower in the CHD group when compared to controls(23.35±8.78 vs 27.21±9.48;P<0.01).Logistic regression analysis revealed that sex,age,hypertension,diabetes,smoking,theε2 allele and KIV-2 copy number were factors influencing the presence of CHD.CONCLUSION In the Teochew population,the APOEε2 allele and a higher KIV-2 copy number were associated with a reduced risk of CHD.In contrast,the APOEε4 allele and SLCO1B1 gene were not associated with CHD.展开更多
BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investi...BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investigated the coronary imaging characteristics and risk factors of patients with T2DM complicated with CHD.AIM To compare the differences in coronary imaging between patients with T2DM with and without CHD,determine the risk factors of T2DM complicated with CHD,and establish a predictive tool for diagnosing CHD in T2DM.METHODS This study retrospectively analyzed 103 patients with T2DM from January 2022 to May 2024.They are categorized based on CHD occurrence into:(1)The control group,consisting of patients with T2DM without CHD;and(2)The observation group,which includes patients with T2MD with CHD.Age,sex,smoking and drinking history,CHD family history,metformin(MET)treatment pre-admission,body mass index,fasting blood glucose(FBG),triglyceride(TG),total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol(LDL-C),serum creatinine,blood urea nitrogen(BUN),alanine aminotransferase,aspartate aminotransferase,glycosylated hemoglobin(HbA1c),and coronary imaging data of both groups were collected from the medical record system.Logistic risk analysis was conducted to screen risk factors.The prediction model’s prediction efficiency was evaluated with receiver operating characteristic curves.RESULTS The control and observation groups consisted of 48 and 55 cases,respectively.The two groups were statistically different in terms of age(t=2.006,P=0.048),FBG(t=6.038,P=0.000),TG(t=2.015,P=0.047),LDL-C(t=2.017,P=0.046),and BUN(t=2.035,P=0.044).The observation group demonstrated lower proportions of patients receiving MET(χ^(2)=5.073,P=0.024)and higher proportions of patients with HbA1c of>7.0%(χ^(2)=6.980,P=0.008)than the control group.The observation group consisted of 15,17,and 23 cases of moderate stenosis,severe stenosis,and occlusion,respectively,with a greater number of coronary artery occlusion cases than the control group(χ^(2)=6.399,P=0.041).The observation group consisted significantly higher number of diffuse lesion cases at 35 compared with the control group(χ^(2)=15.420,P=0.000).The observation group demonstrated a higher right coronary artery(RCA)stenosis index(t=6.730,P=0.000),circumflex coronary artery(LCX)stenosis index(t=5.738,P=0.000),and total stenosis index(t=7.049,P=0.000)than the control group.FBG[odds ratio(OR)=1.472;95%confidence interval(CI):1.234-1.755;P=0.000]and HbA1c(OR=3.197;95%CI:1.149-8.896;P=0.026)were independent risk factors for T2DM complicated with CHD,whereas MET(OR=0.350;95%CI:0.129-0.952;P=0.040)was considered a protective factor for CHD in T2DM.CONCLUSION Coronary artery occlusion is a prevalent complication in patients with T2DM.Patients with T2MD with CHD demonstrated a higher degree of RCA and LCX stenosis than those with T2DM without CHD.FBG,HbA1c,and MET treatment history are risk factors for T2DM complicated with CHD.展开更多
BACKGROUND Cardiac autonomic neuropathy correlates intimately with cardiovascular complications and unexpected death.It is a typical clinical abnormality seen in coronary artery disease-affected individuals with concu...BACKGROUND Cardiac autonomic neuropathy correlates intimately with cardiovascular complications and unexpected death.It is a typical clinical abnormality seen in coronary artery disease-affected individuals with concurrent type 2 diabetes mellitus(T2DM).Moreover,blood glucose(BG)variability has been clinically shown to induce cardiovascular events and sudden death.AIM To investigate how BG variability impacts heart rate(HR)dynamics in older adults with T2DM+coronary heart disease(CHD)and to evaluate the ability of functional myocardial ischemia to predict outcomes in this cohort.METHODS We enrolled 143 older T2DM+CHD patients admitted to the First Affiliated Hospital,Hengyang Medical School,University of South China over a 3.5-year period(January 2018 to July 2021).Using a standard deviation of BG cutoff of 1.4 mmol/L,subjects were stratified into abnormal(n=75)and normal(n=68)fluctuation groups.All patients underwent 72-hour dynamic BG monitoring to detect BG fluctuation parameters.The time domain index of HR variability was measured by dynamic electrocardiogram.To determine how well glucose fluctuation measures predicted functional myocardial ischemia,the area under the receiver operating characteristic curve(AUC)was calculated.RESULTS The abnormal fluctuation group showed greater levels of mean amplitude of glycemic excursions(MAGE),mean of daily differences(MODD),largest amplitude of glycemic excursions(LAGE),and mean postprandial glucose excursions(MPPGE)relative to the normal group(P<0.05),along with lower levels of standard deviation of normal-to-normal(NN)interval(SDNN),standard deviation of the average NN interval(SDANN),standard deviation of NN intervals over every 5-minute period(SDNNindex),root mean square of successive differences(rMSSD),and percentage of NN intervals differing by>50 ms(pNN50;P<0.05).Pearson correlation analysis showed that MAGE,MODD,LAGE,and MPPGE were negatively correlated with SDNN,SDANN,SDNNindex,rMSSD,and pNN50 in older patients with T2DM complicated by CHD(P<0.05).The AUC of MAGE combined with MPPGE in predicting the occurrence of functional myocardial ischemia was 0.912,which was significantly higher than 0.694 of SDNN(P<0.05).CONCLUSION A negative correlation was found between BG variability and HR dynamics in older CHD+T2DM patients,and MAGE combined with MPPGE demonstrated better efficacy in predicting functional myocardial ischemia,which deserves clinical attention.展开更多
Objective:To explore the improvement effect of implementing Buzhong Yiqi Decoction combined with Xuefu Zhuyu Decoction on cardiac function and quality of life of patients during the treatment of coronary heart disease...Objective:To explore the improvement effect of implementing Buzhong Yiqi Decoction combined with Xuefu Zhuyu Decoction on cardiac function and quality of life of patients during the treatment of coronary heart disease complicated with heart failure.Methods:Eighty cases were included in the study,and they were equally divided into a control group(n=40,treated with basic western medicine)and a study group(n=40,treated with Buzhong Yiqi Decoction combined with Xuefu Zhuyu Decoction)according to random sampling grouping method.The intervention index results of the two groups were compared.Results:The improvement of cardiac function index,TCM syndrome score,and quality of life in the study group was more prominent,with a statistical value of P<0.05.Conclusion:Buzhong Yiqi Decoction combined with Xuefu Zhuyu Decoction and conventional western medicine treatment can effectively improve the cardiac function of patients with coronary heart disease complicated with heart failure and enhance their quality of life.It is worthy of clinical promotion and application.展开更多
In recent years,with the rapid development of digital technology,mobile health technology has been widely used in the medical field.This article reviews the application forms,application effects,and existing problems ...In recent years,with the rapid development of digital technology,mobile health technology has been widely used in the medical field.This article reviews the application forms,application effects,and existing problems of mobile health technology in patients with comorbid coronary heart disease,aiming to provide a reference for the future development of mobile health technology services for patients with comorbid coronary heart disease in China.展开更多
This study aimed to investigate the mediating role of knowledge,attitude,and practice(KAP)in the relationship between fatigue and kinesiophobia in 200 coronary heart disease patients from three Chinese tertiary hospit...This study aimed to investigate the mediating role of knowledge,attitude,and practice(KAP)in the relationship between fatigue and kinesiophobia in 200 coronary heart disease patients from three Chinese tertiary hospitals.Using validated scales(MFSI-SF,TSK-SV Heart,and the Rehabilitation Exercise Knowledge-Attitude-Practice Scale for Patients),data analysis via SPSS 25.0 and AMOS 24.0 structural equation modeling identified a significant KAP-mediated pathway(total indirect effect=0.377).KAP of rehabilitation was significantly negatively correlated with fatigue(r=-0.51,p<0.01)and kinesiophobia(r=-0.60,p<0.01),whereas fatigue was significantly positively correlated with kinesiophobia(r=0.678,p<0.01).Results indicate that fatigue amplifies kinesiophobia by compromising KAP of rehabilitation.A significant mediating effect of KAP of rehabilitation on the relationship between fatigue and kinesiophobia was found.Improving patient fatigue and the knowledge,attitudes,and practices of rehabilitation can help reduce kinesiophobia.展开更多
Objective:To analyze the efficacy of Tongxinluo Capsules in treating coronary heart disease(CHD)with angina pectoris.Methods:A total of 98 patients with CHD and angina pectoris admitted between May 2022 and May 2025 w...Objective:To analyze the efficacy of Tongxinluo Capsules in treating coronary heart disease(CHD)with angina pectoris.Methods:A total of 98 patients with CHD and angina pectoris admitted between May 2022 and May 2025 were enrolled and randomly divided into a control group and an experimental group,with 49 cases each.The control group was treated with atorvastatin+clopidogrel,while the experimental group received atorvastatin+clopidogrel+Tongxinluo Capsules.Clinical efficacy,cardiac function,angina attack frequency and duration,and adverse reactions were compared between the two groups.Results:The experimental group showed higher clinical efficacy than the control group(P<0.05).Cardiac function in the experimental group was superior to that of the control group(P<0.05).The duration and frequency of angina attacks in the experimental group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The use of Tongxinluo Capsules in the clinical treatment of CHD with angina pectoris can improve various clinical indicators,enhance therapeutic efficacy,and promote faster patient recovery.展开更多
Different dosage forms can significantly impact pharmacokinetics in vivo,leading to varied effects and potential adverse reactions.This study aimed to evaluate the efficacy,safety,and cost-effectiveness of isosorbide ...Different dosage forms can significantly impact pharmacokinetics in vivo,leading to varied effects and potential adverse reactions.This study aimed to evaluate the efficacy,safety,and cost-effectiveness of isosorbide mononitrate sustained-release capsules(IMSRC)combined with conventional treatments,compared to isosorbide mononitrate tablets(IMT)combined with conventional treatments,for managing angina pectoris in patients with coronary heart diseases.A network meta-analysis(NMA)was conducted to assess the efficacy and safety of IMSRC and IMT.Relevant literature was sourced from databases,including PubMed,Embase,Cochrane Library,ScienceDirect,Web of Science,CNKI,Wanfang,and VIP,covering publications up to July 2023.The cost-effectiveness analysis(CEA)was performed from the perspective of China’s healthcare system,utilizing inputs derived from the NMA.The analysis included 15 studies.The NMA results revealed no significant difference in efficacy and safety between IMSRC plus conventional treatments and IMT plus conventional treatments.However,both combinations were more effective than conventional treatments without isosorbide mononitrate.No differences in safety were observed among the three groups.The surface under the cumulative ranking(SUCRA)of the NMA indicated that IMT had a slight edge over IMSRC in the total effective rate of angina pectoris,whereas IMSRC showed higher probabilities for markedly effective rate and ECG effective rate compared to IMT.The incidence of adverse events was ranked as IMT>conventional preparation>IMSRC.The CEA results highlighted that the incremental cost-effectiveness ratios(ICERs)for the markedly effective and total effective rates of angina pectoris were-133.41 and-260.20,respectively.The ICERs for ECG effective rates were-83.34 and-234.24,respectively.In conclusion,while IMSRC combined with conventional treatments and IMT combined with conventional treatments were similar in efficacy and safety,IMSRC proved to be more economical.展开更多
This study aims to understand the current status of fear of disease progression(FoP)in patients with coronary heart disease(CHD)following percutaneous coronary intervention(PCI),and to explore the relationship between...This study aims to understand the current status of fear of disease progression(FoP)in patients with coronary heart disease(CHD)following percutaneous coronary intervention(PCI),and to explore the relationship between FoP levels,perceived control,and medical coping strategies in these patients.A total of 360 CHD patients who underwent PCI at Xijing Hospital in Shaanxi Province between June and November 2024 were selected using a convenience sampling method.Surveys included a general information questionnaire,the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),the revised Control Attitudes Scale(CAS-R),and the Medical Coping Modes Questionnaire(MCMQ).Pearson correlation analysis was used to examine the relationships between disease perception,positive coping strategies,and FoP.A total of 360 patients completed the study.The average score for FoP in patients with CHD after PCI was 31.64±4.61.FoP was negatively correlated with perceived control(r=-0.106,P<0.01)and medical coping(r=-0.194,P<0.01).Multivariate regression analysis showed that the type of intervention,family history of CHD,smoking status,perceived control,and total medical coping score were significant factors influencing FoP(P<0.01).Enhancing perceived control and identifying positive coping strategies can improve FoP levels in patients with CHD after PCI.Therefore,clinicians should focus on perceived control and medical coping levels in patients and develop targeted interventions to alleviate negative emotions related to FoP.展开更多
Background In recent years,the incidence of coronary heart disease(CHD)has continued to rise,and its comorbidity with hyperlipidemia significantly increases the mortality risk in patients.Statin monotherapy faces limi...Background In recent years,the incidence of coronary heart disease(CHD)has continued to rise,and its comorbidity with hyperlipidemia significantly increases the mortality risk in patients.Statin monotherapy faces limitations in efficacy for some patients and raises potential safety concerns.Ezetimibe,as a novel lipid-modulating agent,exhibits potential advantages in the treatment of hyperlipidemia.Based on this,the present study investigated the therapeutic efficacy of ezetimibe in CHD patients with hyperlipidemia,as well as its effects on lipid metabolism and the amelioration of atherosclerosis.Methods In this study,150 clinical cases with CHD and hyperlipidemia admitted in our hospital from July 2022 to July 2024 were collected for retrospective analysis.According to different treatment methods,they were randomly divided into the Atorvastatin group(control group,n=75)and the Atorvastatin+Ezetimibe group(experimental group,n=75).Control group received atorvastatin monotherapy,while experimental group were administered additional ezetimibe as an adjunct to the atorvastatin-based treatment regimen.The clinical efficacy of the two treatment groups was analyzed,including cardiac function-related parameters such as the cardiac index(CI),cardiac output(CO),left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)before and after treatment.The observed indicators encompassed coronary angiography findings,the Gensini score for assessing coronary stenosis severity,the inflammatory marker high-sensitivity C-reactive protein(hs-CRP),and lipid profile parameters including total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C).Additionally,the occurrence of adverse reactions during treatment was monitored.Results After treatment,the total effective rate in experimental group was significantly higher than that in control group,with a statistically significant difference(P<0.05).In the comparison of the baseline data,both groups showed marked improvements in CI,CO,LVEF,and HDL-C.However,at the same time points,the experimental group demonstrated significantly better results in these parameters than control group(P<0.05).Additionally,LVEDD,LDL-C,hs-CRP and Gensini scores were significantly reduced after treatment in both groups compared to pretreatment levels.Moreover,at identical time points,the aforementioned parameters in the experimental group demonstrated significantly greater reductions compared to control group(P<0.05).Regarding safety assessment,comparative analysis of adverse drug reaction(ADR)incidence rates between the two treatment groups revealed no statistically significant difference(P>0.05).Conclusions In patients with CHD complicated by hyperlipidemia,ezetimibe demonstrates significant therapeutic advantages.It effectively enhances treatment efficacy,regulates lipid profiles,improves cardiac function,and mitigates the progression of atherosclerosis.This regimen exhibits a favorable safety profile and holds substantial clinical value for both therapeutic processes and rehabilitation outcomes in this patient population.展开更多
Coronary artery disease is a highly lethal cardiovascular condition,making early diagnosis crucial for patients.Echocardiograph is employed to identify coronary heart disease(CHD).However,due to issues such as fuzzy o...Coronary artery disease is a highly lethal cardiovascular condition,making early diagnosis crucial for patients.Echocardiograph is employed to identify coronary heart disease(CHD).However,due to issues such as fuzzy object boundaries,complex tissue structures,and motion artifacts in ultrasound images,it is challenging to detect CHD accurately.This paper proposes an improved Transformer model based on the Feedback Self-Attention Mechanism(FSAM)for classification of ultrasound images.The model enhances attention weights,making it easier to capture complex features.Experimental results show that the proposed method achieves high levels of accuracy,recall,precision,F1 score,and area under the receiver operating characteristic curve(72.3%,79.5%,82.0%,81.0%,and 0.73%,respectively).The proposed model was compared with widely used models,including convolutional neural network and visual Transformer model,and the results show that our model outperforms others in the above evaluation metrics.In conclusion,the proposed model provides a promising approach for diagnosing CHD using echocardiogram.展开更多
Objective:To analyze the impact and mechanism of the SOC model intervention on improving health literacy and reducing disease uncertainty among young and middle-aged patients with coronary heart disease.Methods:A hund...Objective:To analyze the impact and mechanism of the SOC model intervention on improving health literacy and reducing disease uncertainty among young and middle-aged patients with coronary heart disease.Methods:A hundred young and middle-aged patients with coronary heart disease from our hospital between March and October 2024 were randomly divided into an observation group and a control group,with 50 patients in each group.Both groups received routine nursing intervention,while the observation group also received intervention based on the Stages of Change(SOC)model.The intervention period was 30 days.Changes in self-efficacy,health literacy,and disease uncertainty were compared between the two groups before and after the intervention.Results:After the intervention,the self-efficacy scores of both groups increased significantly,and the observation group had higher self-efficacy scores than the control group,with a significant difference(P<0.05).Additionally,the observation group showed significantly higher levels of health literacy than the control group(P<0.001).Furthermore,the observation group had significantly lower scores for disease uncertainty compared to the control group(P<0.001).Conclusion:The SOC model,in addition to routine nursing,significantly affects self-efficacy,disease uncertainty,and health literacy among young and middle-aged patients with coronary heart disease.It helps to enhance patients’knowledge of coronary heart disease,improve health literacy levels,and reduce disease uncertainty,making it worthy of clinical promotion and application.展开更多
Objective:To investigate the clinical efficacy of Shexiang Tongxin Dropping Pills combined with rosuvastatin calcium and clopidogrel bisulfate tablets in treating phlegm-heat and blood stasis type angina pectoris of c...Objective:To investigate the clinical efficacy of Shexiang Tongxin Dropping Pills combined with rosuvastatin calcium and clopidogrel bisulfate tablets in treating phlegm-heat and blood stasis type angina pectoris of coronary heart disease.Methods:Sixty-four patients with phlegm-heat and blood stasis type angina pectoris of coronary heart disease,hospitalized at Lin’an District Hospital of Traditional Chinese Medicine from January 2024 to April 2025,were selected and randomly divided into a control group(administered 10mg of rosuvastatin calcium and 75mg of clopidogrel bisulfate once daily)and an observation group(administered 2 Shexiang Tongxin Dropping Pills three times daily in addition to the control group’s treatment regimen),with 32 patients in each group.The therapeutic effects of the two groups were compared.Results:After 56 days of treatment,the angina pectoris score in the observation group was significantly lower than that in the control group(4.49±0.39 vs 4.88±0.47,p<0.05);the Seattle Angina Questionnaire(SAQ)score indicated improvement in the frequency of angina pectoris attacks.(SAQ-AF:71.35±5.29 vs.64.25±7.55,p<0.05)and treatment satisfaction(SAQ-TS:58.79±6.22 vs.54.16±5.02,p<0.05)were more significantly improved in the observation group.The total effective rate(96.87%vs.90.62%,p<0.05)and marked effective rate(62.50%vs.31.25%)were higher in the observation group than in the control group.The Traditional Chinese Medicine(TCM)syndrome score(4.49±0.39 vs.4.88±0.47,p<0.05)and lipid index(LDL-C:1.79±0.31 vs.1.99±0.33 mmol/L,p<0.05)decreased more significantly in the observation group.Conclusion:Shexiang Tongxin Dropping Pills combined with rosuvastatin calcium and clopidogrel bisulfate tablets demonstrated good efficacy and high safety in the treatment of phlegm-heat and blood stasis type angina pectoris associated with coronary heart disease.展开更多
With the development of the social economy and the continuous improvement of people’s living standards,the number of coronary heart disease patients is on the rise,even affecting some younger groups.When a patient’s...With the development of the social economy and the continuous improvement of people’s living standards,the number of coronary heart disease patients is on the rise,even affecting some younger groups.When a patient’s coronary artery stenosis endangers their life,doctors usually recommend coronary artery stent surgery to effectively improve myocardial ischemia and prevent sudden death.After a successful operation,it is necessary to clarify the key points of clinical nursing and prevent complications.Starting from the situation after coronary heart disease stent implantation,this article analyzes the key points of clinical nursing and proposes specific strategies for preventing complications,aiming to improve the surgical effect and provide a reference for complication prevention activities.展开更多
基金supported by the National Key Research and Development Program of China(2017YFC1307705).
文摘BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disease(CHD).Therefore,the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people.METHODS 19,194 participants aged≥60 years who had three AIP measurements between 2018 and 2020 were included in this study.AIP was defined as log10(triglyceride/high-density lipoprotein cholesterol).The group-based trajectory model was used to identify different trajectory patterns of AIP from 2018 to 2020.Cox proportional hazards models were used to estimate the hazard ratio(HR)with 95%CI of CHD events between different trajectory groups from 2020 to 2023.RESULTS Three different trajectory patterns were identified through group-based trajectory model:the low-level group(n=7410,mean AIP:-0.25 to-0.17),the medium-level group(n=9981,mean AIP:0.02-0.08),and the high-level group(n=1803,mean AIP:0.38-0.42).During a mean follow-up of 2.65 years,a total of 1391 participants developed CHD.After adjusting for potential confounders,compared with the participants in the low-level group,the HR with 95%CI of the medium-level group and the high-level group were estimated to be 1.24(1.10-1.40)and 1.43(1.19-1.73),respectively.These findings remained consistent in subgroup analyses and sensitivity analyses.CONCLUSIONS There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly.This suggests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.
基金supported by the R&D project of Pazhou Lab(Huangpu)under Grant 2023K0610the National Natural Science Foundation of China(Grants 12126602)+4 种基金the National Natural Science Foundation of China(Grants 82030102)the Shenzhen Medical Research Fund(Grants C2302001)the Shenzhen Science and Technology Innovation Committee(No.ZDSYS20200810171403013)the Chinese Postdoctoral Science Foundation(No.2022M721463)the Ministry of Science and Technology of China(Grants 2022YFC3702703).
文摘Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen,China.Patients were categorized into 6 groups based on baseline fasting plasma glucose(FPG)levels and diabetes duration(from the date of diabetes diagnosis to the baseline date)to examine their combined effects on subsequent MI.Cox proportional hazards regression models were used,with further stratification by age,sex,and comorbidities to assess potential interactions.Results Over a median follow-up of 2.4 years,2,110 patients experienced MI.Compared to those with optimal glycemic control(FPG<6.1 mmol/L)and shorter diabetes duration(<10 years),the fullyadjusted hazard ratio(HR)(95%Confidence Interval[95%CI])for those with a diabetes duration of≥10 years and FPG>8.0 mmol/L was 1.93(95%CI:1.59,2.36).The combined effects of FPG and diabetes duration on MI were largely similar across different age,sex,and comorbidity groups,although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation.Conclusion Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D.Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.
文摘BACKGROUND Coronary heart disease(CHD)has shown a consistent upward trend in global incidence in recent years.Notably,older adults with CHD complicated by arrhy-thmia exhibit significantly higher susceptibility to psychological distress com-pared with the general CHD population.This increased vulnerability has garn-ered growing clinical and research interest in the potential therapeutic benefits of structured psychological interventions for alleviating comorbid depressive and anxiety symptoms in this high-risk demographic.AIM To evaluate the efficacy of psychological care in reducing anxiety and depressive symptoms among older adult patients with CHD and comorbid arrhythmia.METHODS This retrospective analysis included 100 patients with CHD and arrhythmia admitted to the First Affiliated Hospital of Jinzhou Medical University from June 2024 to December 2024.Of these,49 patients in the control group received routine care,whereas 51 patients in the observation group received psychological care in addition to routine care.Therapeutic outcomes were compared between the two groups.Psychological distress was assessed before and after providing nursing care.A treatment compliance scale developed by the hospital was used to assess adherence.Complication rates were also compared.Quality of life was evaluated using the Short Form-36 Health Survey after providing nursing care.Patient satisfaction with nursing care was assessed using a self-designed questionnaire.RESULTS The observation group demonstrated a higher overall treatment effectiveness compared with the control group(P<0.05).After nursing care,both groups showed reduced scores on the Self-Rating Anxiety Scale and Self-Rating Depression Scale compared with baseline(P<0.05),with significantly greater improvements in the observation group(P<0.05).Treatment compliance was higher and complication rates were lower in the observation group(P<0.05).Additionally,the observation group demonstrated better quality of life after 1 month of care and higher satisfaction with nursing services(P<0.05).CONCLUSION Psychological care for patients with CHD and comorbid arrhythmia effectively enhanced therapeutic outcomes,reduced anxiety and depression,improved treatment compliance and quality of life,and lowered the risk of complications.These findings support the broader implementation of psychological care for patients with CHD in clinical practice.
文摘Interleukins(ILs),a subset of cytokines,play a critical role in the pathogenesis of coronary heart disease(CHD)by mediating inflammation.This review article summarizes the role of ILs such as IL-1,IL-2,IL-3,IL-4,IL-5,IL-6,IL-7,IL-8,IL-9,and IL-10 in the pathogenesis of CHD.Individuals with mild coronary artery disease(CAD)and angina who have ischemic heart disease have higher serum concentrations of IL-1b.Larger studies are needed to verify the safety and assess the effectiveness of low-dose IL-2 as an anti-inflammatory treatment.IL-3 is found more often in patients receiving coronary angioplasty compared to patients with asymptomatic CAD or without CAD.Serum levels of IL-4 are reliable indicators of CAD.An independent correlation between IL-5 and the incidence of CAD was demonstrated.IL-6 helps serve as a reliable biomarker for the degree of CAD,as determined by the Gensini score,and is a key factor in the development of atherosclerosis.Also,variants of IL-7/7R have been linked to the Han Chinese population's genetic susceptibility to CHD.IL-8 plays a role in the progression of CAD occurrences.By interacting with conventional risk factors for CAD,IL-9 may contribute to the development of CAD and offer an innovative approach to its prevention and management.There was a 34%increased risk of a CHD incident for every standard deviation rise in baseline IL-10 levels.
基金funded by National Natural Science Foundation of China (grant numbers 82270258,82100260)National Key Research&Development Prog ram of China (grant number 2020YFC2004800)。
文摘Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design and included 3244 participants aged ≥ 65 years in Beijing,China. The Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA) were used to assess cognitive function. Serum HbA1c was detected at admission. All patients were divided into high HbA1c group(≥ 6.5 mmol/L) and low HbA1c group(< 6.5 mmol/L) based on their HbA1c levels. Logistic regression analyses were used to evaluate the association between HbA1c and cognitive impairment.Results In this study of 3244 participants, 1201(37.0%) patients were in high HbA1c group and 2045(63.0%) patients were in a state of cognitive impairment. Logistic regression analyses demonstrated that HbA1c was an independent risk factor for cognitive impairment regardless of whether the HbA1c was a continuous or categorical variable(OR = 1.27, 95% CI: 1.15–1.40, P < 0.001;OR = 1.79, 95% CI: 1.41–2.26, P ≤ 0.001, respectively). The restricted cubic spline curve exhibited that the relationship between the HbA1c and cognitive impairment was linear(p for non-linear = 0.323, P < 0.001).Conclusion Elevated levels of HbA1c were associated with an increased risk of cognitive impairment in older patients with CHD. These insights could be used to improve the accuracy and sensitivity of cognitive screening in these patient populations.
基金Supported by the National Natural Science Foundation of China,No.82200981Natural Science Foundation of Shandong Province,No.ZR2022QH358and Special Funds of Taishan Scholars Project of Shandong Province,No.tsqn202312384.
文摘BACKGROUND Coronary heart disease(CHD)and pulmonary embolism(PE)are thrombotic diseases.Patients with CHD and PE are common in clinical practice.However,the clinical diagnosis of PE is challenging due to overlapping primary symptoms,such as chest tightness and dyspnea.This confluence frequently leads to the misdiagnosis of PE,thus precipitating treatment delays and compromising patient outcomes.Herein,we report the case of a patient with both diseases who under-went surgery and medication therapy.CASE SUMMARY A 51-year-old man with a history of hypertension for 2 years visited a local hospital because of paroxysmal chest tightness for 1 d and was diagnosed with CHD.However,he refused hospitalization.He visited our hospital for the treatment of recurring symptoms.A comprehensive examination after admission revealed elevated D-dimer levels,and computed tomography pulmonary angio-graphy was performed to confirm the diagnosis of PE.The patient successfully underwent coronary artery bypass grafting with anticoagulant and antiplatelet drugs and had a prognosis.CONCLUSION D-dimer is useful in screening for PE,whereas computed tomography pulmonary angiography is important for diagnosis.For patients with CHD and PE,coronary artery bypass grafting combined with anticoagulant and antiplatelet therapy is feasible.
基金Supported by Special Research Plan 2023 of Chaozhou,No.202303GY05。
文摘BACKGROUND Coronary heart disease(CHD)is a prominent cause of mortality and disability worldwide.Like most complex diseases,the risk of CHD in individuals is regulated by the interaction between genetic factors and lifestyle.APOE and SLCO1B1 genetic polymorphisms and LPA KIV-2 copy number variation may influence the development and progression of CHD.Clarifying gene polymor-phisms can guide clinical precision and prevention,thereby improving treatment outcomes.AIM To investigate the influence of APOE and SLCO1B1 gene polymorphisms,as well as LPA KIV-2 copy number variation on CHD in the Teochew population.METHODS A total of 324 patients with CHD and 143 control participants were involved in this study.Single nucleotide polymorphisms rs429358 and rs7412 in the APOE gene,and rs2306283 and rs4149056 in the SLCO1B1 gene were analyzed via high-resolution melting curve analysis.Additionally,PCR was performed to detect KIV-2 copy number variations.Clinical risk factors and potential effects on CHD patients were subsequently assessed.RESULTS In the CHD group,the frequencies of APOE alleleε2,ε3,ε4 were 8.02%,82.97%,and 9.10%,respectively.Compared to the control groups(13.29%,79.37%,and 7.34%,respectively),theε2 allele frequency showed a significant difference(8.02%vs 13.29%,P=0.012).SLCO1B1 allele frequencies in the CHD group were not significantly different from those in the control group(*1a:26.69%vs 25.52%,*1b:61.17%vs 65.38%,*5:0.15%vs 0.35%,*15:11.83%vs 8.74%).The number of copies of the KIV-2 gene was significantly lower in the CHD group when compared to controls(23.35±8.78 vs 27.21±9.48;P<0.01).Logistic regression analysis revealed that sex,age,hypertension,diabetes,smoking,theε2 allele and KIV-2 copy number were factors influencing the presence of CHD.CONCLUSION In the Teochew population,the APOEε2 allele and a higher KIV-2 copy number were associated with a reduced risk of CHD.In contrast,the APOEε4 allele and SLCO1B1 gene were not associated with CHD.
基金Supported by the Science and Technology Major Project of Changzhou Science and Technology Bureau,No.CE20205047Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01F52Changzhou A Major Scientific Research Project of the Municipal Health Commission,No.ZD202220.
文摘BACKGROUND Coronary heart disease(CHD)is a prevalent type 2 diabetes mellitus(T2DM)complication.Further,the risk stratification before angiography may help diagnose T2DM with CHD early.However,few studies have investigated the coronary imaging characteristics and risk factors of patients with T2DM complicated with CHD.AIM To compare the differences in coronary imaging between patients with T2DM with and without CHD,determine the risk factors of T2DM complicated with CHD,and establish a predictive tool for diagnosing CHD in T2DM.METHODS This study retrospectively analyzed 103 patients with T2DM from January 2022 to May 2024.They are categorized based on CHD occurrence into:(1)The control group,consisting of patients with T2DM without CHD;and(2)The observation group,which includes patients with T2MD with CHD.Age,sex,smoking and drinking history,CHD family history,metformin(MET)treatment pre-admission,body mass index,fasting blood glucose(FBG),triglyceride(TG),total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol(LDL-C),serum creatinine,blood urea nitrogen(BUN),alanine aminotransferase,aspartate aminotransferase,glycosylated hemoglobin(HbA1c),and coronary imaging data of both groups were collected from the medical record system.Logistic risk analysis was conducted to screen risk factors.The prediction model’s prediction efficiency was evaluated with receiver operating characteristic curves.RESULTS The control and observation groups consisted of 48 and 55 cases,respectively.The two groups were statistically different in terms of age(t=2.006,P=0.048),FBG(t=6.038,P=0.000),TG(t=2.015,P=0.047),LDL-C(t=2.017,P=0.046),and BUN(t=2.035,P=0.044).The observation group demonstrated lower proportions of patients receiving MET(χ^(2)=5.073,P=0.024)and higher proportions of patients with HbA1c of>7.0%(χ^(2)=6.980,P=0.008)than the control group.The observation group consisted of 15,17,and 23 cases of moderate stenosis,severe stenosis,and occlusion,respectively,with a greater number of coronary artery occlusion cases than the control group(χ^(2)=6.399,P=0.041).The observation group consisted significantly higher number of diffuse lesion cases at 35 compared with the control group(χ^(2)=15.420,P=0.000).The observation group demonstrated a higher right coronary artery(RCA)stenosis index(t=6.730,P=0.000),circumflex coronary artery(LCX)stenosis index(t=5.738,P=0.000),and total stenosis index(t=7.049,P=0.000)than the control group.FBG[odds ratio(OR)=1.472;95%confidence interval(CI):1.234-1.755;P=0.000]and HbA1c(OR=3.197;95%CI:1.149-8.896;P=0.026)were independent risk factors for T2DM complicated with CHD,whereas MET(OR=0.350;95%CI:0.129-0.952;P=0.040)was considered a protective factor for CHD in T2DM.CONCLUSION Coronary artery occlusion is a prevalent complication in patients with T2DM.Patients with T2MD with CHD demonstrated a higher degree of RCA and LCX stenosis than those with T2DM without CHD.FBG,HbA1c,and MET treatment history are risk factors for T2DM complicated with CHD.
基金Supported by National Natural Science Foundation of China,No.82270939The Clinical Research 4310 Program of the First Affiliated Hospital of the University of South China,No.20214310NHYCG02。
文摘BACKGROUND Cardiac autonomic neuropathy correlates intimately with cardiovascular complications and unexpected death.It is a typical clinical abnormality seen in coronary artery disease-affected individuals with concurrent type 2 diabetes mellitus(T2DM).Moreover,blood glucose(BG)variability has been clinically shown to induce cardiovascular events and sudden death.AIM To investigate how BG variability impacts heart rate(HR)dynamics in older adults with T2DM+coronary heart disease(CHD)and to evaluate the ability of functional myocardial ischemia to predict outcomes in this cohort.METHODS We enrolled 143 older T2DM+CHD patients admitted to the First Affiliated Hospital,Hengyang Medical School,University of South China over a 3.5-year period(January 2018 to July 2021).Using a standard deviation of BG cutoff of 1.4 mmol/L,subjects were stratified into abnormal(n=75)and normal(n=68)fluctuation groups.All patients underwent 72-hour dynamic BG monitoring to detect BG fluctuation parameters.The time domain index of HR variability was measured by dynamic electrocardiogram.To determine how well glucose fluctuation measures predicted functional myocardial ischemia,the area under the receiver operating characteristic curve(AUC)was calculated.RESULTS The abnormal fluctuation group showed greater levels of mean amplitude of glycemic excursions(MAGE),mean of daily differences(MODD),largest amplitude of glycemic excursions(LAGE),and mean postprandial glucose excursions(MPPGE)relative to the normal group(P<0.05),along with lower levels of standard deviation of normal-to-normal(NN)interval(SDNN),standard deviation of the average NN interval(SDANN),standard deviation of NN intervals over every 5-minute period(SDNNindex),root mean square of successive differences(rMSSD),and percentage of NN intervals differing by>50 ms(pNN50;P<0.05).Pearson correlation analysis showed that MAGE,MODD,LAGE,and MPPGE were negatively correlated with SDNN,SDANN,SDNNindex,rMSSD,and pNN50 in older patients with T2DM complicated by CHD(P<0.05).The AUC of MAGE combined with MPPGE in predicting the occurrence of functional myocardial ischemia was 0.912,which was significantly higher than 0.694 of SDNN(P<0.05).CONCLUSION A negative correlation was found between BG variability and HR dynamics in older CHD+T2DM patients,and MAGE combined with MPPGE demonstrated better efficacy in predicting functional myocardial ischemia,which deserves clinical attention.
文摘Objective:To explore the improvement effect of implementing Buzhong Yiqi Decoction combined with Xuefu Zhuyu Decoction on cardiac function and quality of life of patients during the treatment of coronary heart disease complicated with heart failure.Methods:Eighty cases were included in the study,and they were equally divided into a control group(n=40,treated with basic western medicine)and a study group(n=40,treated with Buzhong Yiqi Decoction combined with Xuefu Zhuyu Decoction)according to random sampling grouping method.The intervention index results of the two groups were compared.Results:The improvement of cardiac function index,TCM syndrome score,and quality of life in the study group was more prominent,with a statistical value of P<0.05.Conclusion:Buzhong Yiqi Decoction combined with Xuefu Zhuyu Decoction and conventional western medicine treatment can effectively improve the cardiac function of patients with coronary heart disease complicated with heart failure and enhance their quality of life.It is worthy of clinical promotion and application.
文摘In recent years,with the rapid development of digital technology,mobile health technology has been widely used in the medical field.This article reviews the application forms,application effects,and existing problems of mobile health technology in patients with comorbid coronary heart disease,aiming to provide a reference for the future development of mobile health technology services for patients with comorbid coronary heart disease in China.
基金Guided Scientific Research Projects of Shiyan City(Project No.:24Y006)。
文摘This study aimed to investigate the mediating role of knowledge,attitude,and practice(KAP)in the relationship between fatigue and kinesiophobia in 200 coronary heart disease patients from three Chinese tertiary hospitals.Using validated scales(MFSI-SF,TSK-SV Heart,and the Rehabilitation Exercise Knowledge-Attitude-Practice Scale for Patients),data analysis via SPSS 25.0 and AMOS 24.0 structural equation modeling identified a significant KAP-mediated pathway(total indirect effect=0.377).KAP of rehabilitation was significantly negatively correlated with fatigue(r=-0.51,p<0.01)and kinesiophobia(r=-0.60,p<0.01),whereas fatigue was significantly positively correlated with kinesiophobia(r=0.678,p<0.01).Results indicate that fatigue amplifies kinesiophobia by compromising KAP of rehabilitation.A significant mediating effect of KAP of rehabilitation on the relationship between fatigue and kinesiophobia was found.Improving patient fatigue and the knowledge,attitudes,and practices of rehabilitation can help reduce kinesiophobia.
文摘Objective:To analyze the efficacy of Tongxinluo Capsules in treating coronary heart disease(CHD)with angina pectoris.Methods:A total of 98 patients with CHD and angina pectoris admitted between May 2022 and May 2025 were enrolled and randomly divided into a control group and an experimental group,with 49 cases each.The control group was treated with atorvastatin+clopidogrel,while the experimental group received atorvastatin+clopidogrel+Tongxinluo Capsules.Clinical efficacy,cardiac function,angina attack frequency and duration,and adverse reactions were compared between the two groups.Results:The experimental group showed higher clinical efficacy than the control group(P<0.05).Cardiac function in the experimental group was superior to that of the control group(P<0.05).The duration and frequency of angina attacks in the experimental group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The use of Tongxinluo Capsules in the clinical treatment of CHD with angina pectoris can improve various clinical indicators,enhance therapeutic efficacy,and promote faster patient recovery.
基金The 2022 Ministry of Education General Project for Humanities and Social Sciences Research(Grant No.22YJAZH147)the General Subject of Guangzhou Philosophy and Social Science Development“14th Five-Year Plan”in 2023(Grant No.2023GZYB68)+2 种基金China University Industry-Academia-Research Innovation Fund-Huatong Guokang Medical Research Special Project(Grant No.2023HT017)2024 Guangdong Province General Project for the Planning of Philosophy and Social Sciences(Grant No.GD24CGL29)the Innovation Team Project of Colleges and Universities in Guangdong Province(Grant No.2022WCXTD011).
文摘Different dosage forms can significantly impact pharmacokinetics in vivo,leading to varied effects and potential adverse reactions.This study aimed to evaluate the efficacy,safety,and cost-effectiveness of isosorbide mononitrate sustained-release capsules(IMSRC)combined with conventional treatments,compared to isosorbide mononitrate tablets(IMT)combined with conventional treatments,for managing angina pectoris in patients with coronary heart diseases.A network meta-analysis(NMA)was conducted to assess the efficacy and safety of IMSRC and IMT.Relevant literature was sourced from databases,including PubMed,Embase,Cochrane Library,ScienceDirect,Web of Science,CNKI,Wanfang,and VIP,covering publications up to July 2023.The cost-effectiveness analysis(CEA)was performed from the perspective of China’s healthcare system,utilizing inputs derived from the NMA.The analysis included 15 studies.The NMA results revealed no significant difference in efficacy and safety between IMSRC plus conventional treatments and IMT plus conventional treatments.However,both combinations were more effective than conventional treatments without isosorbide mononitrate.No differences in safety were observed among the three groups.The surface under the cumulative ranking(SUCRA)of the NMA indicated that IMT had a slight edge over IMSRC in the total effective rate of angina pectoris,whereas IMSRC showed higher probabilities for markedly effective rate and ECG effective rate compared to IMT.The incidence of adverse events was ranked as IMT>conventional preparation>IMSRC.The CEA results highlighted that the incremental cost-effectiveness ratios(ICERs)for the markedly effective and total effective rates of angina pectoris were-133.41 and-260.20,respectively.The ICERs for ECG effective rates were-83.34 and-234.24,respectively.In conclusion,while IMSRC combined with conventional treatments and IMT combined with conventional treatments were similar in efficacy and safety,IMSRC proved to be more economical.
文摘This study aims to understand the current status of fear of disease progression(FoP)in patients with coronary heart disease(CHD)following percutaneous coronary intervention(PCI),and to explore the relationship between FoP levels,perceived control,and medical coping strategies in these patients.A total of 360 CHD patients who underwent PCI at Xijing Hospital in Shaanxi Province between June and November 2024 were selected using a convenience sampling method.Surveys included a general information questionnaire,the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),the revised Control Attitudes Scale(CAS-R),and the Medical Coping Modes Questionnaire(MCMQ).Pearson correlation analysis was used to examine the relationships between disease perception,positive coping strategies,and FoP.A total of 360 patients completed the study.The average score for FoP in patients with CHD after PCI was 31.64±4.61.FoP was negatively correlated with perceived control(r=-0.106,P<0.01)and medical coping(r=-0.194,P<0.01).Multivariate regression analysis showed that the type of intervention,family history of CHD,smoking status,perceived control,and total medical coping score were significant factors influencing FoP(P<0.01).Enhancing perceived control and identifying positive coping strategies can improve FoP levels in patients with CHD after PCI.Therefore,clinicians should focus on perceived control and medical coping levels in patients and develop targeted interventions to alleviate negative emotions related to FoP.
文摘Background In recent years,the incidence of coronary heart disease(CHD)has continued to rise,and its comorbidity with hyperlipidemia significantly increases the mortality risk in patients.Statin monotherapy faces limitations in efficacy for some patients and raises potential safety concerns.Ezetimibe,as a novel lipid-modulating agent,exhibits potential advantages in the treatment of hyperlipidemia.Based on this,the present study investigated the therapeutic efficacy of ezetimibe in CHD patients with hyperlipidemia,as well as its effects on lipid metabolism and the amelioration of atherosclerosis.Methods In this study,150 clinical cases with CHD and hyperlipidemia admitted in our hospital from July 2022 to July 2024 were collected for retrospective analysis.According to different treatment methods,they were randomly divided into the Atorvastatin group(control group,n=75)and the Atorvastatin+Ezetimibe group(experimental group,n=75).Control group received atorvastatin monotherapy,while experimental group were administered additional ezetimibe as an adjunct to the atorvastatin-based treatment regimen.The clinical efficacy of the two treatment groups was analyzed,including cardiac function-related parameters such as the cardiac index(CI),cardiac output(CO),left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)before and after treatment.The observed indicators encompassed coronary angiography findings,the Gensini score for assessing coronary stenosis severity,the inflammatory marker high-sensitivity C-reactive protein(hs-CRP),and lipid profile parameters including total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C).Additionally,the occurrence of adverse reactions during treatment was monitored.Results After treatment,the total effective rate in experimental group was significantly higher than that in control group,with a statistically significant difference(P<0.05).In the comparison of the baseline data,both groups showed marked improvements in CI,CO,LVEF,and HDL-C.However,at the same time points,the experimental group demonstrated significantly better results in these parameters than control group(P<0.05).Additionally,LVEDD,LDL-C,hs-CRP and Gensini scores were significantly reduced after treatment in both groups compared to pretreatment levels.Moreover,at identical time points,the aforementioned parameters in the experimental group demonstrated significantly greater reductions compared to control group(P<0.05).Regarding safety assessment,comparative analysis of adverse drug reaction(ADR)incidence rates between the two treatment groups revealed no statistically significant difference(P>0.05).Conclusions In patients with CHD complicated by hyperlipidemia,ezetimibe demonstrates significant therapeutic advantages.It effectively enhances treatment efficacy,regulates lipid profiles,improves cardiac function,and mitigates the progression of atherosclerosis.This regimen exhibits a favorable safety profile and holds substantial clinical value for both therapeutic processes and rehabilitation outcomes in this patient population.
基金supported by the National Natural Science Foundation of China(82071948,82472003)Discovery Partners Institute and Shield of Illinois,Guangdong Natural Science Foundation(2022A1515011675)the Scientific Research Fund for Hundred Talents Program Talent Introduction of Sun Yat-sen University(1320323001).
文摘Coronary artery disease is a highly lethal cardiovascular condition,making early diagnosis crucial for patients.Echocardiograph is employed to identify coronary heart disease(CHD).However,due to issues such as fuzzy object boundaries,complex tissue structures,and motion artifacts in ultrasound images,it is challenging to detect CHD accurately.This paper proposes an improved Transformer model based on the Feedback Self-Attention Mechanism(FSAM)for classification of ultrasound images.The model enhances attention weights,making it easier to capture complex features.Experimental results show that the proposed method achieves high levels of accuracy,recall,precision,F1 score,and area under the receiver operating characteristic curve(72.3%,79.5%,82.0%,81.0%,and 0.73%,respectively).The proposed model was compared with widely used models,including convolutional neural network and visual Transformer model,and the results show that our model outperforms others in the above evaluation metrics.In conclusion,the proposed model provides a promising approach for diagnosing CHD using echocardiogram.
基金Handan City Science and Technology Research and Development Program Project Application(Project No.:23422083096ZC)。
文摘Objective:To analyze the impact and mechanism of the SOC model intervention on improving health literacy and reducing disease uncertainty among young and middle-aged patients with coronary heart disease.Methods:A hundred young and middle-aged patients with coronary heart disease from our hospital between March and October 2024 were randomly divided into an observation group and a control group,with 50 patients in each group.Both groups received routine nursing intervention,while the observation group also received intervention based on the Stages of Change(SOC)model.The intervention period was 30 days.Changes in self-efficacy,health literacy,and disease uncertainty were compared between the two groups before and after the intervention.Results:After the intervention,the self-efficacy scores of both groups increased significantly,and the observation group had higher self-efficacy scores than the control group,with a significant difference(P<0.05).Additionally,the observation group showed significantly higher levels of health literacy than the control group(P<0.001).Furthermore,the observation group had significantly lower scores for disease uncertainty compared to the control group(P<0.001).Conclusion:The SOC model,in addition to routine nursing,significantly affects self-efficacy,disease uncertainty,and health literacy among young and middle-aged patients with coronary heart disease.It helps to enhance patients’knowledge of coronary heart disease,improve health literacy levels,and reduce disease uncertainty,making it worthy of clinical promotion and application.
基金2023 Special Scientific Research Funding Project for Hospital Pharmacy by the Zhejiang Pharmaceutical Association(Project No.:2023ZYY33)。
文摘Objective:To investigate the clinical efficacy of Shexiang Tongxin Dropping Pills combined with rosuvastatin calcium and clopidogrel bisulfate tablets in treating phlegm-heat and blood stasis type angina pectoris of coronary heart disease.Methods:Sixty-four patients with phlegm-heat and blood stasis type angina pectoris of coronary heart disease,hospitalized at Lin’an District Hospital of Traditional Chinese Medicine from January 2024 to April 2025,were selected and randomly divided into a control group(administered 10mg of rosuvastatin calcium and 75mg of clopidogrel bisulfate once daily)and an observation group(administered 2 Shexiang Tongxin Dropping Pills three times daily in addition to the control group’s treatment regimen),with 32 patients in each group.The therapeutic effects of the two groups were compared.Results:After 56 days of treatment,the angina pectoris score in the observation group was significantly lower than that in the control group(4.49±0.39 vs 4.88±0.47,p<0.05);the Seattle Angina Questionnaire(SAQ)score indicated improvement in the frequency of angina pectoris attacks.(SAQ-AF:71.35±5.29 vs.64.25±7.55,p<0.05)and treatment satisfaction(SAQ-TS:58.79±6.22 vs.54.16±5.02,p<0.05)were more significantly improved in the observation group.The total effective rate(96.87%vs.90.62%,p<0.05)and marked effective rate(62.50%vs.31.25%)were higher in the observation group than in the control group.The Traditional Chinese Medicine(TCM)syndrome score(4.49±0.39 vs.4.88±0.47,p<0.05)and lipid index(LDL-C:1.79±0.31 vs.1.99±0.33 mmol/L,p<0.05)decreased more significantly in the observation group.Conclusion:Shexiang Tongxin Dropping Pills combined with rosuvastatin calcium and clopidogrel bisulfate tablets demonstrated good efficacy and high safety in the treatment of phlegm-heat and blood stasis type angina pectoris associated with coronary heart disease.
文摘With the development of the social economy and the continuous improvement of people’s living standards,the number of coronary heart disease patients is on the rise,even affecting some younger groups.When a patient’s coronary artery stenosis endangers their life,doctors usually recommend coronary artery stent surgery to effectively improve myocardial ischemia and prevent sudden death.After a successful operation,it is necessary to clarify the key points of clinical nursing and prevent complications.Starting from the situation after coronary heart disease stent implantation,this article analyzes the key points of clinical nursing and proposes specific strategies for preventing complications,aiming to improve the surgical effect and provide a reference for complication prevention activities.
