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This study aimed to determine the association of hyperlipidemia with clinical endpoints among hospitalized patients with COVID-19, especially those with pre-existing cardiovascular diseases (CVDs) and diabetes. This multicenter retrospective cohort study included all patients who were hospitalized due to COVID-19 from 21 hospitals in Hubei province, China between December 31, 2019 and April 21, 2020. Patients who were aged < 18 or ≥ 85 years old, in pregnancy, with acute lethal organ injury (e.g., acute myocardial infarction, severe acute pancreatitis, acute stroke), hypothyroidism, malignant diseases, severe malnutrition, and those with normal lipid profile under lipid-lowering medicines (e.g., statin, niacin, fenofibrate, gemfibrozil, and ezetimibe) were excluded. Propensity score matching (PSM) analysis at 1:1 ratio was performed to minimize baseline differences between patient groups of hyperlipidemia and non-hyperlipidemia. PSM analyses with the same strategies were further conducted for the parameters of hyperlipidemia in patients with increased triglyceride (TG), increased low-density lipoprotein cholesterol (LDL-C), and decreased high-density lipoprotein cholesterol (HDL-C). Mixed-effect Cox model analysis was performed to investigate the associations of the 28-days all-cause deaths of COVID-19 patients with hyperlipidemia and the abnormalities of lipid parameters. The results were verified in male, female patients, and in patients with pre-existing CVDs and type 2 diabetes. Of 10 945 inpatients confirmed as COVID-19, there were 9 822 inpatients included in the study, comprising 3513 (35.8%) cases without hyperlipidemia and 6309 (64.2%) cases with hyperlipidemia. Based on a mixed-effect Cox model after PSM at 1:1 ratio, hyperlipidemia was not associated with increased or decreased 28-day all-cause death [adjusted hazard ratio (HR), 1.17 (95% CI, 0.95-1.44), P =0.151]. We found that the parameters of hyperlipidemia were not associated with the risk of 28-day all-cause mortality [adjusted HR, 1.23 (95% CI, 0.98-1.55), P = 0.075 in TG increase group; 0.78 (95% CI, 0.57-1.07), P = 0.123 in LDL-C increase group; and 1.12 (95% CI, 0.9-1.39), P = 0.299 in HDL-C decrease group, respectively]. Hyperlipidemia was also not significantly associated with the increased mortality of COVID-19 in patients accompanied with CVDs or type 2 diabetes, and in both male and female cohorts. Our study support that the imbalanced lipid profile is not significantly associated with the 28-day all-cause mortality of COVID-19 patients, even in those accompanied with CVDs or diabetes. Similar results were also obtained in subgroup analyses of abnormal lipid parameters. Therefore, hyperlipidemia might be not a major causative factor for poor outcome of COVID-19, which provides guidance for the intervention of inpatients during the epidemic of COVID-19. [ABSTRACT FROM AUTHOR]

Background Acute myocardial infarction (AMI) has sharply increased and become a major cause of hospitalization and mortality in China over the past few decades, with the rapid economic development and substantial life-style changes. Methods We compared the characteristics, risk factors, and in-hospital outcomes among 1314 patients with AMI from Beijing Collaborative Group data in 1972 and 1973, and 2200 patients in Beijing from China AMI registry in 2013 and 2014. Results The proportions of patients with <30 and >70 years old in 2010s were significantly higher than those in 1970s (1970s vs 2010s: 0.2% vs 0.9% and 15.8% vs 25.6%, respectively, p  < 0.05). The proportion of male patients was higher in 2010s (75.6%) than that (68.3%) in 1970s ( p  < 0.001). Rural population with AMI markedly increased (1970s vs 2010s: 6.5% vs 14.5%, p  < 0.001). Patients with AMI in 2010s were more likely to have a history of diabetes mellitus (DM), prior stroke and myocardial infarction (MI) than those in 1970s (1970s vs 2010s: DM 6.2% vs 27.6%; prior stroke 6.2% vs 10.5%; prior MI 9.5% vs 11.9%; all p  < 0.05). The in-hospital mortality was significantly lower in 2010s (2.6%) than that in 1970s (24%; p  < 0.05). Conclusions Age, gender, rural population, diabetes, prior stroke and MI history as well as in-hospital mortality were significantly different among patients with AMI in Beijing over 40 years. The patterns most likely reflect big lifestyle changes, improved socioeconomic status, less targeted heart disease prevention programs, and advance in medical therapies. [ABSTRACT FROM AUTHOR]

Background In contrast with most developed countries, mortality from acute myocardial infarction (AMI) continues to rise in China. We examined secular trends and age, period, and cohort effects in mortality from AMI in China from 1987 to 2014. Methods Data on deaths from AMI between 1987 and 2014 were obtained from the Chinese Health Statistics Annual Report (1987–2001) and the Chinese Health Statistics Yearbook (2003–2015). We then conducted an age-period-cohort analysis using the intrinsic estimator approach. Results There was an upward trend in AMI mortality in both urban and rural populations that accelerated from 2004 onwards. AMI mortality increased 5.6-fold from 1987 to 2014. The net age effect on AMI mortality increased exponentially. AMI mortality risk in the 80–84 years of age bracket was 220.15 and 190.70 times higher than in the 15–19 years of age bracket in urban and rural populations, respectively. There was a V-shaped trend in the net period effect between 1999 and 2009. Meanwhile, although there was a global reduction in the cohort effect in urban and rural AMI mortality, we found a modest increase among urban populations born between 1975 and 1989 and rural populations born between 1990 and 1999. Conclusion The changes in exposure to lifestyle-related risk factors and triggers such as air pollution have contributed to the increase in AMI mortality in China over recent decades. The sharp increase in AMI mortality since 2004 is primarily attributable to population aging and the rise in AMI deaths among younger generations. [ABSTRACT FROM AUTHOR]

Aims: To investigate the association of severe hypoglycemia (SH) with all-cause mortality and complication risks among Chinese patients with type 2 diabetes mellitus (T2DM).Methods: Cohort study and nested case-control studies were conducted based on medical insurance database 2008-2015. The incidence of outcomes or the exposure of previous SH was compared among matched patients, respectively. The association between SH and outcomes was investigated and validated by different models.Results: Among cohort study participants (mean age of 59.0 ± 11.2 years), SH was associated with higher risk of all-cause mortality (HR = 1.80, P < 0.001) and transient ischemic attacks (TIA, HR = 1.51, P < 0.001), while no association was observed between SH and complications including myocardial infarction (MI), angina, arrhythmia and stroke. Similarly, SH was associated with about doubled all-cause mortality (OR = 1.76, P < 0.001) and TIA (OR = 2.00, P < 0.001), but not associated with risk of MI or stroke in nested case-control studies.Conclusions: In Chinese patients with T2DM, SH is associated with increased risk of all-cause mortality and TIA, but no significant differences were found regard to the other examined complication risks, which need to be further explored in future studies. [ABSTRACT FROM AUTHOR]