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This study aimed to assess the prevalence of depression and anxiety in CHD patients and to explore the association between established cardiovascular risk factors and depression as well as anxiety. 2,216 patients with CHD confirmed by angiography were included in this cross-sectional study. Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety symptoms. The frequencies of individual depressive and anxiety symptoms grouped by age and gender were analyzed. Binary logistic regression analyses were used to identify cardiovascular risk factors associated with anxiety and depression. The overall prevalence rates of depression and anxiety in CHD patients were 8.2% and 5.4%, respectively. There were significant differences in the frequency of depression and anxiety symptoms between genders. However, age differences among individual depression and anxiety symptoms were insignificant. In multivariable analysis, female gender, smoking, and hyperlipidemia were associated with a more frequent depression occurrence, and female gender was associated with more frequent anxiety. Depression and anxiety were not associated with other cardiovascular risk factors. These findings suggest that a substantial proportion of CHD patients experienced anxiety and depression symptoms. Differences in depressive or anxiety symptoms among the distribution of individual symptoms need more attention. Depression was significantly associated with female gender, smoking, and hyperlipidemia. No anxiety symptom associations with cardiovascular risk factors were demonstrated to be significant except for the female. More research is needed to unravel the mechanisms of depression, anxiety, and cardiovascular disease.

Objective: To explore the differences of risk stratification of very high-risk or extreme high-risk atherosclerotic cardiovascular diseases (ASCVD) and the attainment rates of low-density lipoprotein cholesterol (LDL-C) management targets evaluated by three different criteria, and the causal attributions of these differences. Methods: Patients with ASCVD were consecutively enrolled from January 1 to December 31 in 2019, and were evaluated for very high-risk or extreme high-risk and LDL-C goal attainment rates with 2018 American guideline on the management of blood cholesterol (2018AG), 2019 China Cholesterol Education Program (CCEP) Expert Advice for the management of dyslipidemias (2019EA) and 2020 Chinese expert consensus on lipid management of very high-risk ASCVD patients(2020EC), respectively. The causal attributions of the differences in attainment rates were analyzed as well. Results: A total of 1 864 ASCVD patients were included in this study. According to 2018AG, 2019EA and 2020EC, the proportions of the patients with very high-risk or extreme high-risk were 59.4%, 90.7%, and 65.6%, respectively. The absolute LDL-C target attainment rates were 37.2%, 15.7%, and 13.7%, respectively, the differences between each two rates were statistically significant (all P <0.001). As to the differences in attainment rates between 2020EC and 2018AG, 61.5% were due to the different LDL-C goal attainment values and 38.5% were caused by the different risk stratifications, while for the differences between 2020EC and 2019EA attainment rates, different LDL-C goal attainment values were responsible for 13.2%, and different risk stratifications were responsible for 86.8% of the differences. Conclusions: There are significant differences in the proportions and LDL-C attainment rates among the three different criteria for very high-risk or extreme high-risk ASCVD. 2020EC showed a moderate proportion of patients with extreme high-risk, and had the lowest LDL-C attainment rate. The differences between 2020EC and 2018AG are mainly due to the LDL-C target values, and the differences between 2020EC and 2019EA are mainly caused by the risk stratifications.

Background: There is limited data on the characteristics of conventional risk factors (RFs) in young Chinese men hospitalized with a first acute myocardial infarction (AMI)., Hypothesis: We analyzed the trends in and prevalence of cardiovascular RFs and subtypes of MI during the first AMI in young Chinese men., Methods: A total of 2739 men aged 18-44 years hospitalized for a first AMI were identified from 2007 to 2017. The overall prevalence of RFs and their respective temporal trends and subtypes of AMI were evaluated., Results: The most prevalent conditions were smoking, followed by hypertension and then obesity. Patients aged <35 years had a much higher prevalence of hypercholesterolemia and obesity. Compared with a similar reference population in the United States, young Chinese men had a higher prevalence of smoking and dyslipidemia, but a lower prevalence of obesity, hypertension, and diabetes. The prevalence of hypertension increased from 2007 through 2017 (p trend <.001), whereas smoking decreased gradually. AMI frequently presented as ST-segment elevation MI (STEMI) (77.5%). Cluster of conventional RFs (3 RFs, odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.11-2.57; ≥4 RFs, OR: 2.50, 95% CI: 1.55-4.03] and multivessel disease (OR = 1.32, 95% CI: 1.08-1.60) increased the risk of non-STEMI (NSTEMI)., Conclusions: Conventional RFs were highly prevalent in young Chinese men who were hospitalized for first AMI events, and the temporal trends varied different between China and US populations. Multivessel disease and cluster of conventional RFs are closely related to NSTEMI. Optimized preventive strategies among young adults are warranted., (© 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.)

Objective: To compare the consistency and accuracy of using 2 criteria for decision making of aspirin use for the primary prevention of ischemic cardiovascular disease (ISCVD) and explore the current status and related factors of aspirin use for the primary prevention of ISCVD in Chinese outpatients. Methods: This cross-sectional study enrolled 3 018 outpatients with hypertension, diabetes, or hypercholesterolemia, who visited the General Practice (GP) clinics of Anzhen hospital in Beijing from September to December 2015 were enrolled in. The information of risk factors for ISCVD and use of aspirin was collected. Both quantitative and qualitative criteria were used to make the decision of aspirin use for primary prevention of ISCVD in this patient cohort. Quantitative criteria were derived from the 2011 Chinese guideline of cardiovascular disease prevention: aspirin use for primary cardiovascular disease prevention in population with risk of ISCVD in the next 10 years≥10%. Qualitative criteria were derived from the Chinese expert consensus on the aspirin use issued in 2013: aspirin should be given for the purpose of primary ISCVD in population with≥3 risk factors:(1) men aged ≥50 years or postmenopausal women; (2) hypertensive subjects with blood pressure ≤150/90 mmHg(1 mmHg=0.133 kPa);(3) diabetes; (4) hypocholesteremia; (5) obesity with body mass index (BMI)≥28 kg/m(2); (6) Smokers;(7) with familiar premature ISCVD history (male<55 years, female<65 years). Demographic data of participants were obtained by questionnaire, on-site measurements or screening previous medical records. Results: 67.1% participants ( n= 2 024) should be recommended to take aspirin as primary prevention medication using 10-year risk of ISCVD≥10% as the criteria, and 77.9% participants ( n= 2 350) should be recommended to take aspirin as primary prevention medication using number of risk factors≥3 as the criteria. With 10-year risk of ISCVD≥10% as the gold standard and risk factors≥3 as the evaluation criteria, the sensitivity was 97%, specificity was 61%, the consistency rate was 85%, Kappa value was 0.628 ( U =35.824, P< 0.001) , indicating that the consistency of the 2 criteria was good. The percentage of real-world aspirin use for primary prevention of ISCVD in this cohort was significantly higher for participants evaluated with the 10-year risk of ISCVD≥10% than that evaluated with 3 risk factors (53.1% vs. 49.2%, χ(2)=6.523, P= 0.011). 12.7% participants with 10-year risk of ISCVD<10% and 6.6% participants with<3 risk factors took aspirin for the primary prevention of ISCVD in this cohort. Age, smoking, hypertension, diabetes and hypercholesterolemia were significantly related to the aspirin use in this cohort, relative ORs were 1.047 (95% CI 1.035-1.060) , 1.969 (95% CI 1.403-2.762) , 2.065 (95% CI 1.623-3.629) , 3.493 (95% CI 2.726-4.475, and 1.344 (95% CI 1.109-1.628) , respectively. Obesity and familial history of premature ISCVD were not related to the aspirin use, relative ORs were 1.137 (95% CI 0.828-1.562) and 0.986 (95% CI 0.767-1.266) . Conclusions: The consistency of the 2 criteria for decision making of aspirin use for the primary prevention of ISCVD is good and about 50% participants who should be recommended to the use of aspirin for the primary prevention of ISCVD took the aspirin in the real-world scenario. The use of aspirin as primary prevention strategy for ISCVD in the real-world scenario is related to age, smoking, hypertension, diabetes and hypercholesterolemia.