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Obstructive sleep apnea (OSA) is one of the most common sleep disorders, which is closely related to a variety of cardiovascular diseases, and has become one of the key directions for the control and prevention of cardiovascular disease risk factors. In recent years, many clinical studies have confirmed that OSA is closely related to the initiation and evolution of acute coronary syndrome (ACS). Therefore, this article summarized the status quo of clinical studies on OSA and ACS, the shortcomings of current studies, and prospects for future research directions.

Standard time is a key indicator to measure the production efficiency of the sewing department, and it plays a vital role in the production forecast for the apparel industry. In this article, the grey correlation analysis was adopted to identify seven sources as the main influencing factors for determination of the standard time in the sewing process, which are sewing length, stitch density, bending stiffness, fabric weight, production quantity, drape coefficient, and length of service. A novel forecasting model based on support-vector machine (SVM) with particle swarm optimization (PSO) is then proposed to predict the standard time of the sewing process. On the ground of real data from a clothing company, the proposed forecasting model is verified by evaluating the performance with the squared correlation coefficient (R2) and mean square error (MSE). Using the PSO-SVM method, the R2 and MSE are found to be 0.917 and 0.0211, respectively. In conclusion, the high accuracy of the PSO-SVM method presented in this experiment states that the proposed model is a reliable forecasting tool for determination of standard time and can achieve good predicted results in the sewing process.

Standard time is a key indicator to measure the production efficiency of the sewing department, and it plays a vital role in the production forecast for the apparel industry. In this article, the grey correlation analysis was adopted to identify seven sources as the main influencing factors for determination of the standard time in the sewing process, which are sewing length, stitch density, bending stiffness, fabric weight, production quantity, drape coefficient, and length of service. A novel forecasting model based on support-vector machine (SVM) with particle swarm optimization (PSO) is then proposed to predict the standard time of the sewing process. On the ground of real data from a clothing company, the proposed forecasting model is verified by evaluating the performance with the squared correlation coefficient (R2) and mean square error (MSE). Using the PSO-SVM method, the R2 and MSE are found to be 0.917 and 0.0211, respectively. In conclusion, the high accuracy of the PSO-SVM method presented in this experiment states that the proposed model is a reliable forecasting tool for determination of standard time and can achieve good predicted results in the sewing process. [ABSTRACT FROM AUTHOR]

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Following percutaneous coronary intervention with stent placement to treat acute coronary syndromes, international clinical guidelines generally recommend dual antiplatelet therapy with aspirin plus a P2Y 12 receptor inhibitor for 12 months to prevent myocardial infarction and stent thrombosis. However, data on single antiplatelet therapy with a potent P2Y 12 inhibitor earlier than 12 months after percutaneous coronary intervention for patients with an acute coronary syndrome are scarce. The aim of this trial was to assess whether the use of ticagrelor alone, compared with ticagrelor plus aspirin, could reduce the incidence of clinically relevant bleeding events without an accompanying increase in major adverse cardiovascular or cerebrovascular events (MACCE). In this randomised, placebo-controlled, double-blind clinical trial, patients aged 18 years or older with an acute coronary syndrome who completed the IVUS-ACS study and who had no major ischaemic or bleeding events after 1-month treatment with dual antiplatelet therapy were randomly assigned to receive oral ticagrelor (90 mg twice daily) plus oral aspirin (100 mg once daily) or oral ticagrelor (90 mg twice daily) plus a matching oral placebo, beginning 1 month and ending at 12 months after percutaneous coronary intervention (11 months in total). Recruitment took place at 58 centres in China, Italy, Pakistan, and the UK. Patients were required to remain event-free for 1 month on dual antiplatelet therapy following percutaneous coronary intervention with contemporary drug-eluting stents. Randomisation was done using a web-based system, stratified by acute coronary syndrome type, diabetes, IVUS-ACS randomisation, and site, using dynamic minimisation. The primary superiority endpoint was clinically relevant bleeding (Bleeding Academic Research Consortium [known as BARC] types 2, 3, or 5). The primary non-inferiority endpoint was MACCE (defined as the composite of cardiac death, myocardial infarction, ischaemic stroke, definite stent thrombosis, or clinically driven target vessel revascularisation), with an expected event rate of 6·2% in the ticagrelor plus aspirin group and an absolute non-inferiority margin of 2·5 percentage points between 1 month and 12 months after percutaneous coronary intervention. The two co-primary endpoints were tested sequentially; the primary superiority endpoint had to be met for hypothesis testing of the MACCE outcome to proceed. All principal analyses were assessed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov , NCT03971500 , and is completed. Between Sept 21, 2019, and Oct 27, 2022, 3400 (97·0%) of the 3505 participants in the IVUS-ACS study were randomly assigned (1700 patients to ticagrelor plus aspirin and 1700 patients to ticagrelor plus placebo). 12-month follow-up was completed by 3399 (>99·9%) patients. Between month 1 and month 12 after percutaneous coronary intervention, clinically relevant bleeding occurred in 35 patients (2·1%) in the ticagrelor plus placebo group and in 78 patients (4·6%) in the ticagrelor plus aspirin group (hazard ratio [HR] 0·45 [95% CI 0·30 to 0·66]; p<0·0001). MACCE occurred in 61 patients (3·6%) in the ticagrelor plus placebo group and in 63 patients (3·7%) in the ticagrelor plus aspirin group (absolute difference –0·1% [95% CI –1·4% to 1·2%]; HR 0·98 [95% CI 0·69 to 1·39]; p non-inferiority <0·0001, p superiority =0·89). In patients with an acute coronary syndrome who had percutaneous coronary intervention with contemporary drug-eluting stents and remained event-free for 1 month on dual antiplatelet therapy, treatment with ticagrelor alone between month 1 and month 12 after the intervention resulted in a lower rate of clinically relevant bleeding and a similar rate of MACCE compared with ticagrelor plus aspirin. Along with the results from previous studies, these findings show that most patients in this population can benefit from superior clinical outcomes with aspirin discontinuation and maintenance on ticagrelor monotherapy after 1 month of dual antiplatelet therapy. The Chinese Society of Cardiology, the National Natural Scientific Foundation of China, and the Jiangsu Provincial & Nanjing Municipal Clinical Trial Project. For the Mandarin translation of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

Introduction Atrial fibrillation (AF) is associated with increased thrombo-embolic events, with thrombi most frequently located in the left atrial appendage (LAA). Asymmetric dimethylarginine (ADMA), a potent endogenous inhibitor of nitric oxide synthase, is elevated in subjects with AF. We investigated the relationship between ADMA and risk of LAA thrombus in patients with non-valvular AF. Methods and results A total of 223 consecutive patients with non-valvular AF were enrolled (63 ± 10 years, 65% male). LAA thrombus was detected in 27 subjects by transesophageal echocardiography. Serum ADMA was significantly increased (2.5 ± 0.6 μmol/L vs 1.8 ± 0.4 μmol/L, p < 0.001), while serum nitrite/nitrate was significantly reduced in patients with LAA thrombus (30.3 ± 7.1 μmol/L vs 48.4 ± 9.3 μmol/L, p < 0.001). ADMA was positively correlated with age and left atrium diameter, and was negatively correlated with nitrite/nitrate and LAA peak flow velocity. The area under the receiver operating characteristic curve of ADMA predicting thrombus was 0.84. In multivariate logistic regression analysis, ADMA (OR 4.0, 95% CI 1.2–13.0; p = 0.003) was one of independent risk factors for LAA thrombus. Conclusions Our study suggested that high ADMA was independently associated with the presence of LAA thrombus in patients with non-valvular AF. [ABSTRACT FROM AUTHOR]

Background: Severe degenerative mitral regurgitation (DMR) can cause a poor prognosis if left untreated. For patients considered at prohibitive surgical risk, transcatheter edge-to-edge repair (TEER) has become an accepted alternative therapy. The DragonFly transcatheter valve repair system is an innovative evolution of the mitral TEER device family to treat DMR., Aims: Herein we report on the DRAGONFLY-DMR trial (ClinicalTrials.gov: NCT04734756), which was a prospective, single-arm, multicentre study on the safety and effectiveness of the DragonFly system., Methods: A total of 120 eligible patients with prohibitive surgical risk and DMR ≥3+ were screened by a central eligibility committee for enrolment. The study utilised an independent echocardiography core laboratory and clinical event committee. The primary endpoint was the clinical success rate, which measured freedom from all-cause mortality, mitral valve reintervention, and mitral regurgitation (MR) >2+ at 1-year follow-up., Results: At 1 year, the trial successfully achieved its prespecified primary efficacy endpoint, with a clinical success rate of 87.5% (95% confidence interval: 80.1-92.3%). The rates of major adverse events, all-cause mortality, mitral valve reintervention, and heart failure hospitalisation were 9.0%, 5.0%, 0.8%, and 3.4%, respectively. MR ≤2+ was 90.4% at 1 month and 92.0% at 1 year. Over time, left ventricular reverse remodelling was observed (p<0.05), along with significant improvements in the patients' functional and quality-of-life outcomes, shown by an increase in the New York Heart Association Class I/II from 32.4% at baseline to 93.6% at 12 months (p<0.001) and increased Kansas City Cardiomyopathy Questionnaire (KCCQ) score of 31.1±18.2 from baseline to 12 months (p<0.001)., Conclusions: The DRAGONFLY-DMR trial contributes to increasing evidence supporting the safety and efficacy of TEER therapy, specifically the DragonFly system, for treating patients with chronic symptomatic DMR 3+ to 4+ at prohibitive surgical risk.

Objective: To identify the casual mutation of a Chinese pedigree with hypertrophic cardiomyopathy (HCM), and to analyze the genotype-phenotype relationship., Methods: The coding exons of 26 reported disease genes were sequenced by targeted resequencing in the proband and the identified mutation were detected with bi-directional Sanger sequencing in all family members and 307 healthy controls. The genotype-phenotype correlation was analyzed in the family., Results: A missense mutation (c.2191C > T, p. Pro731Ser) in the 20th exon of MYH7 gene was identified. This mutation was absent in 307 healthy controls and predicted to be pathogenic by PolyPhen-HCM. Totally 13 family members carried this mutation, including 10 patients with HCM and 3 asymptomatic mutation carriers. The proband manifested severe congestive heart failure and 8 patients expressed various clinical manifestations of heart failure, including dyspnea, palpitations, chest pain, amaurosis or syncope. Five patients were diagnosed as HCM at the age of 16 or younger. One family member suffered sudden cardiac death., Conclusions: The Pro731Ser of MYH7 gene mutation is a causal and malignant mutation linked with familiar HCM.

We describe a case of a 43-year-old male who had blunt chest trauma in a previous traffic accident. He presented shortness of breath and palpitation on mild exertion 1 month later. Echocardiography showed dilated left atrium and ventricular with reduced left ventricular ejection fraction. Coronary angiography revealed a dissection of the left anterior descending coronary artery with impaired blood flow and diffuse dissection from proximal to mid right coronary artery. To our knowledge, this is the first case presenting cardiac insufficiency secondary to bilateral coronary artery dissection after blunt trauma., (Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)