Objective:The goal of this study was to examine the prognostic performance of optical flow ratio(OFR)among patients with coronary artery disease(CAD)after percutaneous coronary intervention(PCI).Methods:We recruited p...Objective:The goal of this study was to examine the prognostic performance of optical flow ratio(OFR)among patients with coronary artery disease(CAD)after percutaneous coronary intervention(PCI).Methods:We recruited patients with CAD undergoing optical coherence tomography(OCT)-directed PCI between January 2019 and June 2021 for our single-center,hospital-based,retrospective cohort investigation.We assessed the link between post-PCI OFR and major adverse cardiovascular events(MACE)via multivariate Cox regression analy-sis.Results:Receiver operating characteristic analysis revealed that the best post-PCI OFR threshold for MACE was 0.91,and introduction of OFR into the baseline profile and OCT results markedly enhanced MACE identification after PCI.On the basis of survival curves,patients with OFR≤0.91(P<0.001)and thin-cap fibroatheroma(TCFA)(P=0.007)exhibited higher MACE incidence,and myocardial infarction(MI)incidence was considerably greater among patients with OFR≤0.91(P<0.001),compared with OFR>0.91.Multivariate Cox regression analysis suggested that OFR≤0.91(hazard ratio[HR]:3.60;95%confidence interval[CI]:1.24–10.44;P=0.019),and TCFA(HR:3.63;95%CI:1.42–9.20;P=0.007)were independent risk factors for MACE,and OFR≤0.91 was independently associated with MI(HR:14.64;95%CI:3.27–65.54;P<0.001).Conclusion:OFR after PCI is an independent MACE bio-indicator among patients with CAD.Adding OFR to post-PCI OCT results may potentially enhance MACE prediction.展开更多
Objective To explore the relationship between polymorphisms of XbaI and MspI loci of apolipoprotein B （ApoB） gene and -75 bp,＋83 bp loci of apolipoprotein AI （ApoAI） gene and coronary heart disease （CHD） in Kaz...Objective To explore the relationship between polymorphisms of XbaI and MspI loci of apolipoprotein B （ApoB） gene and -75 bp,＋83 bp loci of apolipoprotein AI （ApoAI） gene and coronary heart disease （CHD） in Kazaks of Xinjiang Uyghur Autonomous Region,China.Methods These loci were analyzed by PCR-restriction fragment length polymorphism （PCR-PFLP）.Two hundred and five patients with CHD and two hundred and thirty six controls were involved.Results There were significant distinctions among low-density lipoprotein cholesterol （LDL-C）,triglyceride （TG） and the ApoAI/ApoB ratio between the two groups,but no significant distinction among the polymorphism frequencies of the four sites between the two groups.The polymorphism coalition frequency of X-/Ms＋＋/M1＋-/M2＋＋ （named Coalition 11） was significantly higher in CHD compared to the control group （14.6％ vs.7.2％,P ＜ 0.05）.The level of total cholesterol （TC） in Coalition 1 1 was significantly higher and the level of the ApoAI/ApoB ratio in Coalition 11 was significantly lower than Coalition 1～10 in CHD patients.The level of the ApoAI/ApoB ratio of Coalition 11 was significantly lower than the Coalition 1～10 in control group.The levels of ApoAI/ApoB ratio of Coalition 3 were significantly higher compared to Coalition 11 in the two groups,respectively.The level of LDL-C of Coalition 3 was significantly lower than in the Coalition 11 in control group.The level of TC of Coalition 5 was significantly higher than Coalition 3 in the CHD group.The level of the ApoAI/ApoB ratio of Coalition 5 was significantly lower than in Coalition 3 or Coalition 1～10 of the two groups,respectively.The level of LDL-C of Coalition 5 was significantly higher than in Coalition 3 in control group.The ratio of ApoAI/ApoB was negatively related to TC,LDL-C and was positively related to HDL-C,both in CHD and control groups.Conclusion Coalition 11 of the 4 loci polymorphisms of the ApoB and ApoAI genes was correlated with CHD in Kazaks,and perhaps the ratio of ApoAI/ApoB was the most diagnostic parameter related with CHD among all lipid parameters.CHD may also be associated with Coalition 5,and,perhaps,Coalition 3 may have been confirmed as a protection factor against CHD,if more samples were enrolled.展开更多
Background Systemic-to-pulmonary shunt(SPS) is an effective surgery for newborns diagnosed with atresia or severe pulmonary stenosis leading to insufficient pulmonary blood flow. However, there is no consistent conclu...Background Systemic-to-pulmonary shunt(SPS) is an effective surgery for newborns diagnosed with atresia or severe pulmonary stenosis leading to insufficient pulmonary blood flow. However, there is no consistent conclusion on surgical plan chosen for the particular patient. Methods Shunt configurations including central shunt(CS) and MBTS(Right mb T innominate;Left m BT subclavian) were virtually reconstructed for newborn based on preoperative CT data. Candidate shunt configurations were evaluated based on the parameters that were computed from the flow simulations. Results Vortex occurred at the anastomosis of the shunt and the aorta for all three shunt configurations. For CS, it produced the highest pulmonary artery(PA) flow, with the shunt ratio of44.6%. Blood flow in LPA was 8.5% higher than blood flow in RPA. For MBTS, the indexed power loss(i PL)of Right m BT innominate configuration was lower than that of Left m BT subclavian, which was 28.4% and 36.1%respectively. Conclusions The anastomosis of the shunt and the aorta is prone to cause thrombosis. CS configuration is prone to cause hyperemia due to excessive pulmonary blood flow. So, it could be considered for patients without a risk of overflow. It also causes non-symmetric PA flow in favor of LPA. For Right m BT innominate,which has the lowest i PL, tends to produce smaller vortex regions compared to CS and Left m BT subclavian. As for Left m BT subclavian, vortex currents formed when blood flows into the LPA could prevent the formation of thrombosis.[S Chin J Cardiol 2019;20(4):217-227]展开更多
Background Though drug-eluting stent （DES） almost solved a problem of restenosis, safety issues related to stent thrombosis are still the major concern of DES. We hypothesized that hybrid stent implantation may decr...Background Though drug-eluting stent （DES） almost solved a problem of restenosis, safety issues related to stent thrombosis are still the major concern of DES. We hypothesized that hybrid stent implantation may decrease the use of DES, probably improving the long-term safety but not affecting efficacy adversely when treating multilesion coronary artery disease in the DES era. Methods From April 2004 to October 2006, 848 patients with multilesion disease underwent hybrid stent implantation. During the same period 5647 patients with multilesion coronary heart disease were treated by exclusive DES implantation in Fu Wai Hospital. According to propensity score matching, we chose 823 pairs of patients with multileison coronary artery disease for inclusion into our study. We obtained the 24-month clinical outcome including death, myocardial infarction （MI）, thrombosis, target lesion revascularization （TLR）, target vessel revascularization （TVR）, and major adverse cardiac events （MACE, the composite of death, MI, and TVR）. We used Cox＇s proportional-hazard models to assess relative risks of all the outcome measures after propensity match. Results At 24 months, patients in the hybrid stent implantation group showed a significantly higher risk of TLR （8.39% vs. 3.28%, HR2.38, 95% Cl. 1.50-3.70）, TVR （11.07% vs. 6.32%,/-/R 1.61, 95% Cl. 1.15-2.27） and MACE （13.75% vs. 8.75%, FIR 1.37, 95% Cl. 1.02-1.85）. No significant difference was apparent in terms of mortality （1.22% vs. 1.70%, HR 0.55, 95% Cl. 0.24-1.25）, MI （1.95% vs. 2.31%, HR0.73, 95% Cl. 0.37-1.42）, or thrombosis （definite＋probable） （0.73% vs. 1.58%, HR0.40, 95% Cl. 0.15-1.05）. Conclusions In patients with multilesion coronary artery disease, the exclusive DES implantation was associated with significantly lower risks of TLR, TVR and MACE, and the hybrid stent implantation did not result in any significant improvements regarding safety issues. Prospective studies are needed to confirm our results.展开更多
基金supported by the Outstanding Young Talent Program of Guangdong Provincial People’s Hospital(grant number KJ012019084)the High-level Hospital Construction Project(grant number DFJH2020021).
文摘Objective:The goal of this study was to examine the prognostic performance of optical flow ratio(OFR)among patients with coronary artery disease(CAD)after percutaneous coronary intervention(PCI).Methods:We recruited patients with CAD undergoing optical coherence tomography(OCT)-directed PCI between January 2019 and June 2021 for our single-center,hospital-based,retrospective cohort investigation.We assessed the link between post-PCI OFR and major adverse cardiovascular events(MACE)via multivariate Cox regression analy-sis.Results:Receiver operating characteristic analysis revealed that the best post-PCI OFR threshold for MACE was 0.91,and introduction of OFR into the baseline profile and OCT results markedly enhanced MACE identification after PCI.On the basis of survival curves,patients with OFR≤0.91(P<0.001)and thin-cap fibroatheroma(TCFA)(P=0.007)exhibited higher MACE incidence,and myocardial infarction(MI)incidence was considerably greater among patients with OFR≤0.91(P<0.001),compared with OFR>0.91.Multivariate Cox regression analysis suggested that OFR≤0.91(hazard ratio[HR]:3.60;95%confidence interval[CI]:1.24–10.44;P=0.019),and TCFA(HR:3.63;95%CI:1.42–9.20;P=0.007)were independent risk factors for MACE,and OFR≤0.91 was independently associated with MI(HR:14.64;95%CI:3.27–65.54;P<0.001).Conclusion:OFR after PCI is an independent MACE bio-indicator among patients with CAD.Adding OFR to post-PCI OCT results may potentially enhance MACE prediction.
文摘Objective To explore the relationship between polymorphisms of XbaI and MspI loci of apolipoprotein B （ApoB） gene and -75 bp,＋83 bp loci of apolipoprotein AI （ApoAI） gene and coronary heart disease （CHD） in Kazaks of Xinjiang Uyghur Autonomous Region,China.Methods These loci were analyzed by PCR-restriction fragment length polymorphism （PCR-PFLP）.Two hundred and five patients with CHD and two hundred and thirty six controls were involved.Results There were significant distinctions among low-density lipoprotein cholesterol （LDL-C）,triglyceride （TG） and the ApoAI/ApoB ratio between the two groups,but no significant distinction among the polymorphism frequencies of the four sites between the two groups.The polymorphism coalition frequency of X-/Ms＋＋/M1＋-/M2＋＋ （named Coalition 11） was significantly higher in CHD compared to the control group （14.6％ vs.7.2％,P ＜ 0.05）.The level of total cholesterol （TC） in Coalition 1 1 was significantly higher and the level of the ApoAI/ApoB ratio in Coalition 11 was significantly lower than Coalition 1～10 in CHD patients.The level of the ApoAI/ApoB ratio of Coalition 11 was significantly lower than the Coalition 1～10 in control group.The levels of ApoAI/ApoB ratio of Coalition 3 were significantly higher compared to Coalition 11 in the two groups,respectively.The level of LDL-C of Coalition 3 was significantly lower than in the Coalition 11 in control group.The level of TC of Coalition 5 was significantly higher than Coalition 3 in the CHD group.The level of the ApoAI/ApoB ratio of Coalition 5 was significantly lower than in Coalition 3 or Coalition 1～10 of the two groups,respectively.The level of LDL-C of Coalition 5 was significantly higher than in Coalition 3 in control group.The ratio of ApoAI/ApoB was negatively related to TC,LDL-C and was positively related to HDL-C,both in CHD and control groups.Conclusion Coalition 11 of the 4 loci polymorphisms of the ApoB and ApoAI genes was correlated with CHD in Kazaks,and perhaps the ratio of ApoAI/ApoB was the most diagnostic parameter related with CHD among all lipid parameters.CHD may also be associated with Coalition 5,and,perhaps,Coalition 3 may have been confirmed as a protection factor against CHD,if more samples were enrolled.
基金funded by the key Program of Union of National Natural Science Foundation of China-Guangdong Province(No.U1401255)the Natural Science Foundation of Guangdong Province(No.2018A030313785)+2 种基金the National key Research and Development Program(No.2018YFC1002600)the Science and Technology Planning Project of Guangdong Province(No.2019B020230003/No.2018B090944002/No.2017A070701013/No.2017B090904034/No.2017B030314109)Guangdong Medical Science and Technology Research Fund(No.A2018038)
文摘Background Systemic-to-pulmonary shunt(SPS) is an effective surgery for newborns diagnosed with atresia or severe pulmonary stenosis leading to insufficient pulmonary blood flow. However, there is no consistent conclusion on surgical plan chosen for the particular patient. Methods Shunt configurations including central shunt(CS) and MBTS(Right mb T innominate;Left m BT subclavian) were virtually reconstructed for newborn based on preoperative CT data. Candidate shunt configurations were evaluated based on the parameters that were computed from the flow simulations. Results Vortex occurred at the anastomosis of the shunt and the aorta for all three shunt configurations. For CS, it produced the highest pulmonary artery(PA) flow, with the shunt ratio of44.6%. Blood flow in LPA was 8.5% higher than blood flow in RPA. For MBTS, the indexed power loss(i PL)of Right m BT innominate configuration was lower than that of Left m BT subclavian, which was 28.4% and 36.1%respectively. Conclusions The anastomosis of the shunt and the aorta is prone to cause thrombosis. CS configuration is prone to cause hyperemia due to excessive pulmonary blood flow. So, it could be considered for patients without a risk of overflow. It also causes non-symmetric PA flow in favor of LPA. For Right m BT innominate,which has the lowest i PL, tends to produce smaller vortex regions compared to CS and Left m BT subclavian. As for Left m BT subclavian, vortex currents formed when blood flows into the LPA could prevent the formation of thrombosis.[S Chin J Cardiol 2019;20(4):217-227]
文摘Background Though drug-eluting stent （DES） almost solved a problem of restenosis, safety issues related to stent thrombosis are still the major concern of DES. We hypothesized that hybrid stent implantation may decrease the use of DES, probably improving the long-term safety but not affecting efficacy adversely when treating multilesion coronary artery disease in the DES era. Methods From April 2004 to October 2006, 848 patients with multilesion disease underwent hybrid stent implantation. During the same period 5647 patients with multilesion coronary heart disease were treated by exclusive DES implantation in Fu Wai Hospital. According to propensity score matching, we chose 823 pairs of patients with multileison coronary artery disease for inclusion into our study. We obtained the 24-month clinical outcome including death, myocardial infarction （MI）, thrombosis, target lesion revascularization （TLR）, target vessel revascularization （TVR）, and major adverse cardiac events （MACE, the composite of death, MI, and TVR）. We used Cox＇s proportional-hazard models to assess relative risks of all the outcome measures after propensity match. Results At 24 months, patients in the hybrid stent implantation group showed a significantly higher risk of TLR （8.39% vs. 3.28%, HR2.38, 95% Cl. 1.50-3.70）, TVR （11.07% vs. 6.32%,/-/R 1.61, 95% Cl. 1.15-2.27） and MACE （13.75% vs. 8.75%, FIR 1.37, 95% Cl. 1.02-1.85）. No significant difference was apparent in terms of mortality （1.22% vs. 1.70%, HR 0.55, 95% Cl. 0.24-1.25）, MI （1.95% vs. 2.31%, HR0.73, 95% Cl. 0.37-1.42）, or thrombosis （definite＋probable） （0.73% vs. 1.58%, HR0.40, 95% Cl. 0.15-1.05）. Conclusions In patients with multilesion coronary artery disease, the exclusive DES implantation was associated with significantly lower risks of TLR, TVR and MACE, and the hybrid stent implantation did not result in any significant improvements regarding safety issues. Prospective studies are needed to confirm our results.
