Objective To explore the therapeutic effects of trimetazidine(TMZ)on diabetic patients with coronary heart diseases.Methods We conducted a comprehensive electronic search of PubMed,EMBASE,and Cochrane databases betwee...Objective To explore the therapeutic effects of trimetazidine(TMZ)on diabetic patients with coronary heart diseases.Methods We conducted a comprehensive electronic search of PubMed,EMBASE,and Cochrane databases between the inception dates of databases and May 2019(last search conducted on 30 May 2019)to identify randomized controlled trials.The evaluation method recommended by Cochrane Collaboration for bias risk assessment was employed for quality assessment.Random or fixed models were used to investigate pooled mean differences in left ventricular function,serum glucose metabolism,serum lipid profile,myocardial ischemia episodes and exercise tolerance with effect size indicated by the 95%confidence interval(CI).Results Additional TMZ treatment contributed to considerable improvement of left ventricular ejection fraction(WMD=4.39,95%CI:3.83,4.95,P<0.00001),left ventricular end diastolic diameter(WMD=-3.17,95%CI:-4.90,-1.44,P=0.0003)and left ventricular end systolic diameter(WMD=-4.69,95%CI:-8.66,-0.72,P=0.02).TMZ administration also significantly decreased fasting blood glucose(SMD=-0.43,95%CI:-0.70,-0.17,P=0.001),glycosylated hemoglobin level(WMD=-0.59,95%CI:-0.95,-0.24,P=0.001),serum level of total cholesterol(WMD=-20.36,95%CI:-39.80,-0.92,P=0.04),low-density lipoprotein cholesterol(WMD=-20.12,95%CI:-32.95,-7.30,P=0.002)and incidence of myocardial ischemia episodes(SMD=-0.84,95%CI:-1.50,-0.18,P=0.01).However,there were no significant differences in serum triglyceride level,high-density lipoprotein cholesterol,exercise tolerance between the TMZ group and the control group.Conclusion TMZ treatment in diabetic patients with coronary heart disease is effective to improve cardiac function,serum glucose and lipid metabolism and clinical symptoms.展开更多
BACKGROUND： Intracerebral hemorrhage（ICH） and coronary heart disease （CHD） have the same pathological base, atherosclerosis, and the similar risk factors,such as smoking ,drinking, hypertension, hyperlipemia, dia...BACKGROUND： Intracerebral hemorrhage（ICH） and coronary heart disease （CHD） have the same pathological base, atherosclerosis, and the similar risk factors,such as smoking ,drinking, hypertension, hyperlipemia, diabetes mellitus, etc; but the distributions of two diseases are very different in the populations. This may be related to the exposure of risk factors and different effects of risk factors on two diseases. OBJECTIVE： To analyze the distribution difference of risk factors for ICH and CHD in the populations of Tongliao city of Nei Monggol Autonomous Region. DESIGN： Retrospective analysis. SETTING： School of Radiation Medicine and Public Health, Soochow University; Tongliao Hospital, Nei Monggol Autonomous Region. PARTICIPANTS： Random sampling was used to select 6 hospitals from 10 hospitals affiliated to Tongliao City of Nei Monggol Autonomous Region. Totally 1 672 medical records of patients with ICH and 2 195 medical records of patients with CHD admitted to Department of Neurology and Department of Cardiovascular Internal Medicine of above-mentioned 6 hospitals between January 2003 and December 2005 were collected according to the investigation need. METHODS： The subjects, whose medical records were involved, were performed retrospective analysis with pre-prepared questionnaire ＂Stroke and Coronary Heart Disease Epidemiologic Questionnaire＂. The main contents included： ①Social demography condition： The distributions of gender, age, nationality, etc. ②Previous history of disease： hypertension, diabetes mellitus, etc. ③Related risk factors： systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, smoking, drinking and glucose （GLU）. The database of Epidata was transformed to SPSS database. Single-and multiple-factor non-conditional Logistic regression analysis were performed on the data, and OR value and 95% CI were calculated. The distribution differences of risk factors for two diseases were compared. MAIN OUTCOME MEASURES： Single- and multi-factor non-conditional Logistic regression analysis results of each factor of patients. RESULTS： Single-factor non-conditional Logistic regression analysis showed that statistical significance existed in gender, age, nationality, smoking, drinking, history of hypertension, history of diabetes mellitus, hypertension, triglyceride （TG）, and GLU ten factors（OR =0.199, OR 95% CI 0.142-0.280 to OR =7.484, OR 95% CI 6.186-9.054, P 〈 0.01）. ②The results of multiple-factor non-conditional Logistic regression analysis showed 8 factors including age, gender, smoking, hypertension, history of hypertension, history of diabetes mellitus, GLU and TG（OR =0.203, OR 95% CI 0.114-0.361 to OR =8.262,OR 95% CI 5.466- 12.491, P 〈 0.01）. CONCLUSION： ICH and CHD are the diseases induced by various risk factors. Significant difference exists in gender, age, smoking, hypertension, history of hypertension, GLU, history of diabetes mellitus and TG.展开更多
Objective： To investigate the regulation of High sensitive C-reactive protein（Hs-CRP） and WBC count in patients with coronary heart disease（CHD） by percutaneous transluminal intervention（PCI） and to discuss the...Objective： To investigate the regulation of High sensitive C-reactive protein（Hs-CRP） and WBC count in patients with coronary heart disease（CHD） by percutaneous transluminal intervention（PCI） and to discuss the mechanism of inflammatory reaction after coronary stenting. Methods：127 patients who received successful percutaneous transluminal coronary stenting, were divided into groups of stable angina（SAP）, unstable angina（UAP）, and acute myocardial infarction（AMI） according to their clinical types. Another 41 stable angina patients with more than 70% of coronary artery tenosis who did not receive PCI served as control. Serum Hs-CRP levels and WBC count were determined before intervention, 3 days and 7 days post PCI and the data were analyzed statistically by t-test. Results： There showed no difference in clinical baseline characteristics between groups. The serum Hs-CRP level and WBC count was gradually raised in the UAP and AMI group（how about SAP group, andhad no difference in CAG group and SAP group）. After PCI serum HsCRP levels and WBC counts were significantly higher in the SAP group than in the coronary angiography group（CAG） at 3 days and had no difference at 7 days. In the UAP and AMI group, the serum Hs-CRP level at 3 days and 7 days declined obviously, however serum WBC count did not decrease apparently. Conclusion： The serum Hs-CRP level and WBC count elevate transiently after PCI. There are different inflammatory reactions in different types of coronary heart diseases after coronary stenting procedure.展开更多
As one of the main chronic diseases in modern society,coronary heart disease,as a major disease that affects people’s lives and health,has the characteristics of hidden onset and sudden onset.Coronary heart disease h...As one of the main chronic diseases in modern society,coronary heart disease,as a major disease that affects people’s lives and health,has the characteristics of hidden onset and sudden onset.Coronary heart disease has relatively clear risk factors.Among them,blood lipid levels and blood sugar levels,as two main risk factors,play an important role in promoting the onset of coronary heart disease.The two complement each other in a vicious cycle,synergize and promote each other,promote the process of coronary atherosclerosis,thereby causing coronary heart disease.Multiple components in blood lipids and poor management of long-term blood sugar levels play a major role in specific clinical problems.This article reviews the different components of blood lipids and the effects of hyperglycemia on coronary heart disease,and initially expounds the mechanism by which blood lipids and blood sugar levels synergize each other to aggravate the risk of coronary heart disease,and combines them with relevant clinical issues,in order to help clinicians guide the prevention of coronary heart disease in terms of blood lipids and blood sugar levels.展开更多
Objective： To explore characteristic of pulse signal to distinguish patients with coronary heart diseases （CHD） from patients without CHD and healthy adults, and accordingly evaluate the potential role of pulse sig...Objective： To explore characteristic of pulse signal to distinguish patients with coronary heart diseases （CHD） from patients without CHD and healthy adults, and accordingly evaluate the potential role of pulse signal to diagnosis CHD. Methods： Totally 407 patients enrolled from 4 collaborating medical centers were assigned to a CHD group （205 patients） and a non-CHD group （202 patients）. The healthy control group （62 adults） enrolled from Shanghai University of Traditional Chinese Medicine. Pulse signals were collected using the synchronous multiplex pulse signal acquisition system. The pulse signals were analyzed and extracted using Hilbert-Huang transformation （HHT） and time-domain, respectively. The time-domain parameters of pulse signal were processed by the analysis of variance （SNK test）. Results： Special patterns in the CHD group pulse signal were found in this study： （1） time-domain parameters of pulse signal, h1 , h3, h4, h3/h1, t, t5/t4 were increased and w was wider; （2） 44% of C2 waves in HHT were chaotic and disordered and 72% of C3 waves were exhibited irregularly with average amplitude over 10 g-forces, which were all significantly different from controls. Conclusion： Characteristic wave and time-domain parameters of pulse signal were extracted using HHT and time-domain which could be served as a non-invasive approach for assessing patients with CHD.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 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
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
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
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
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
文摘Objective To explore the therapeutic effects of trimetazidine(TMZ)on diabetic patients with coronary heart diseases.Methods We conducted a comprehensive electronic search of PubMed,EMBASE,and Cochrane databases between the inception dates of databases and May 2019(last search conducted on 30 May 2019)to identify randomized controlled trials.The evaluation method recommended by Cochrane Collaboration for bias risk assessment was employed for quality assessment.Random or fixed models were used to investigate pooled mean differences in left ventricular function,serum glucose metabolism,serum lipid profile,myocardial ischemia episodes and exercise tolerance with effect size indicated by the 95%confidence interval(CI).Results Additional TMZ treatment contributed to considerable improvement of left ventricular ejection fraction(WMD=4.39,95%CI:3.83,4.95,P<0.00001),left ventricular end diastolic diameter(WMD=-3.17,95%CI:-4.90,-1.44,P=0.0003)and left ventricular end systolic diameter(WMD=-4.69,95%CI:-8.66,-0.72,P=0.02).TMZ administration also significantly decreased fasting blood glucose(SMD=-0.43,95%CI:-0.70,-0.17,P=0.001),glycosylated hemoglobin level(WMD=-0.59,95%CI:-0.95,-0.24,P=0.001),serum level of total cholesterol(WMD=-20.36,95%CI:-39.80,-0.92,P=0.04),low-density lipoprotein cholesterol(WMD=-20.12,95%CI:-32.95,-7.30,P=0.002)and incidence of myocardial ischemia episodes(SMD=-0.84,95%CI:-1.50,-0.18,P=0.01).However,there were no significant differences in serum triglyceride level,high-density lipoprotein cholesterol,exercise tolerance between the TMZ group and the control group.Conclusion TMZ treatment in diabetic patients with coronary heart disease is effective to improve cardiac function,serum glucose and lipid metabolism and clinical symptoms.
文摘BACKGROUND： Intracerebral hemorrhage（ICH） and coronary heart disease （CHD） have the same pathological base, atherosclerosis, and the similar risk factors,such as smoking ,drinking, hypertension, hyperlipemia, diabetes mellitus, etc; but the distributions of two diseases are very different in the populations. This may be related to the exposure of risk factors and different effects of risk factors on two diseases. OBJECTIVE： To analyze the distribution difference of risk factors for ICH and CHD in the populations of Tongliao city of Nei Monggol Autonomous Region. DESIGN： Retrospective analysis. SETTING： School of Radiation Medicine and Public Health, Soochow University; Tongliao Hospital, Nei Monggol Autonomous Region. PARTICIPANTS： Random sampling was used to select 6 hospitals from 10 hospitals affiliated to Tongliao City of Nei Monggol Autonomous Region. Totally 1 672 medical records of patients with ICH and 2 195 medical records of patients with CHD admitted to Department of Neurology and Department of Cardiovascular Internal Medicine of above-mentioned 6 hospitals between January 2003 and December 2005 were collected according to the investigation need. METHODS： The subjects, whose medical records were involved, were performed retrospective analysis with pre-prepared questionnaire ＂Stroke and Coronary Heart Disease Epidemiologic Questionnaire＂. The main contents included： ①Social demography condition： The distributions of gender, age, nationality, etc. ②Previous history of disease： hypertension, diabetes mellitus, etc. ③Related risk factors： systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, smoking, drinking and glucose （GLU）. The database of Epidata was transformed to SPSS database. Single-and multiple-factor non-conditional Logistic regression analysis were performed on the data, and OR value and 95% CI were calculated. The distribution differences of risk factors for two diseases were compared. MAIN OUTCOME MEASURES： Single- and multi-factor non-conditional Logistic regression analysis results of each factor of patients. RESULTS： Single-factor non-conditional Logistic regression analysis showed that statistical significance existed in gender, age, nationality, smoking, drinking, history of hypertension, history of diabetes mellitus, hypertension, triglyceride （TG）, and GLU ten factors（OR =0.199, OR 95% CI 0.142-0.280 to OR =7.484, OR 95% CI 6.186-9.054, P 〈 0.01）. ②The results of multiple-factor non-conditional Logistic regression analysis showed 8 factors including age, gender, smoking, hypertension, history of hypertension, history of diabetes mellitus, GLU and TG（OR =0.203, OR 95% CI 0.114-0.361 to OR =8.262,OR 95% CI 5.466- 12.491, P 〈 0.01）. CONCLUSION： ICH and CHD are the diseases induced by various risk factors. Significant difference exists in gender, age, smoking, hypertension, history of hypertension, GLU, history of diabetes mellitus and TG.
文摘Objective： To investigate the regulation of High sensitive C-reactive protein（Hs-CRP） and WBC count in patients with coronary heart disease（CHD） by percutaneous transluminal intervention（PCI） and to discuss the mechanism of inflammatory reaction after coronary stenting. Methods：127 patients who received successful percutaneous transluminal coronary stenting, were divided into groups of stable angina（SAP）, unstable angina（UAP）, and acute myocardial infarction（AMI） according to their clinical types. Another 41 stable angina patients with more than 70% of coronary artery tenosis who did not receive PCI served as control. Serum Hs-CRP levels and WBC count were determined before intervention, 3 days and 7 days post PCI and the data were analyzed statistically by t-test. Results： There showed no difference in clinical baseline characteristics between groups. The serum Hs-CRP level and WBC count was gradually raised in the UAP and AMI group（how about SAP group, andhad no difference in CAG group and SAP group）. After PCI serum HsCRP levels and WBC counts were significantly higher in the SAP group than in the coronary angiography group（CAG） at 3 days and had no difference at 7 days. In the UAP and AMI group, the serum Hs-CRP level at 3 days and 7 days declined obviously, however serum WBC count did not decrease apparently. Conclusion： The serum Hs-CRP level and WBC count elevate transiently after PCI. There are different inflammatory reactions in different types of coronary heart diseases after coronary stenting procedure.
文摘As one of the main chronic diseases in modern society,coronary heart disease,as a major disease that affects people’s lives and health,has the characteristics of hidden onset and sudden onset.Coronary heart disease has relatively clear risk factors.Among them,blood lipid levels and blood sugar levels,as two main risk factors,play an important role in promoting the onset of coronary heart disease.The two complement each other in a vicious cycle,synergize and promote each other,promote the process of coronary atherosclerosis,thereby causing coronary heart disease.Multiple components in blood lipids and poor management of long-term blood sugar levels play a major role in specific clinical problems.This article reviews the different components of blood lipids and the effects of hyperglycemia on coronary heart disease,and initially expounds the mechanism by which blood lipids and blood sugar levels synergize each other to aggravate the risk of coronary heart disease,and combines them with relevant clinical issues,in order to help clinicians guide the prevention of coronary heart disease in terms of blood lipids and blood sugar levels.
基金Supported by the National 973 Basic Research and Development Program(No.2003CB517108)Supported by the National Natural Science Foundation of China(No.30600796,81373555,and 81403273)
文摘Objective： To explore characteristic of pulse signal to distinguish patients with coronary heart diseases （CHD） from patients without CHD and healthy adults, and accordingly evaluate the potential role of pulse signal to diagnosis CHD. Methods： Totally 407 patients enrolled from 4 collaborating medical centers were assigned to a CHD group （205 patients） and a non-CHD group （202 patients）. The healthy control group （62 adults） enrolled from Shanghai University of Traditional Chinese Medicine. Pulse signals were collected using the synchronous multiplex pulse signal acquisition system. The pulse signals were analyzed and extracted using Hilbert-Huang transformation （HHT） and time-domain, respectively. The time-domain parameters of pulse signal were processed by the analysis of variance （SNK test）. Results： Special patterns in the CHD group pulse signal were found in this study： （1） time-domain parameters of pulse signal, h1 , h3, h4, h3/h1, t, t5/t4 were increased and w was wider; （2） 44% of C2 waves in HHT were chaotic and disordered and 72% of C3 waves were exhibited irregularly with average amplitude over 10 g-forces, which were all significantly different from controls. Conclusion： Characteristic wave and time-domain parameters of pulse signal were extracted using HHT and time-domain which could be served as a non-invasive approach for assessing patients with CHD.
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.
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.
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.
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.
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.
