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Huocheng Liao, Qiuyue Chen, Lin Liu, Sigan Zhong, Chun Xiao Department of Cardiology, The Third People’s Hospital of Huizhou and the Affiliated Hospital of Guangzhou Medical University, Huizhou City, Guangdong Province, People’s Republic of ChinaCorrespondence: Chun Xiao, Department of Cardiology, The Third People Hospital of Huizhou, The Affiliated Hospital of Guangzhou Medical University, Huizhou City, Guangdong Province, People’s Republic of China, Email lhcdoctor@tom.comObjective: The current study was to design a cardiovascular risk score for the diagnosis of coronary heart disease (CHD) in the rural area of China and the sensitivity and specificity of this score would be assessed.Methods: A total of 520 patients were enrolled and based on the results from coronary artery angiography, patients were divided into three groups: CHD group (coronary artery ≥ 50% stenosis), atherosclerosis group (coronary artery < 50% stenosis) and normal groups (without stenosis). Between-group differences were evaluated and the sensitivity and specificity of cardiovascular risk score were evaluated.Results: Compared to the normal and atherosclerosis groups, patients in the CHD group were older, had higher body mass index, and more likely to be smoking and obese, and had dyslipidemia, hypertension and diabetes, and had higher cardiovascular risk score (4.05 ± 2.15 vs 2.94 ± 1.90 vs 2.54 ± 1.59). Patients in the CHD group were more likely to have cardiovascular risk scores ≥ 2 (90.2% CHD group vs 74.2% atherosclerosis group vs 76.1% normal group, P < 0.05). The area under the ROC was 0.673, with 95% confidence interval was 0.623– 0.722 (P < 0.001), and the sensitivity and specificity were highest when the cardiovascular risk score was 4, indicating that the value of cardiovascular risk score of 4 was a good cutoff point for CHD diagnosis.Conclusion: Using cardiovascular risk score can improve CHD diagnosis which may help to reduce health disparities between rural and urban area.Keywords: coronary heart disease, cardiovascular risk score, sensitivity, specificity

Objective: The current study was to evaluate the association of Etoricoxib treatment and incident hypoxia among type-B aortic dissection (AD) patients undergoing endovascular aortic repair (EVAR). Methods: Patients undergoing EVAR were retrospectively recruited. Based on Etoricoxib use, patients were divided into the non-treated and Etoricoxib-treated groups. Baseline characteristics including demographics, laboratory parameters, characteristics of aortic computer tomography and echocardiography, medications used, and procedural characteristics were collected from the electronic health record. Results: Compared to non-treated group (n = 36), prevalence of obesity and fever at baseline was higher in Etoricoxib-treated group (n = 24; P

BACKGROUND The objective of this study was to investigate the clinical characteristics and prognosis of coronary heart disease (CHD) in young patients. MATERIAL AND METHODS We included 972 CHD patients (≤50 years old) with coronary artery stenting who were prospectively enrolled and followed for 1 year. Clinical characteristics, risk factors, and predictors of outcomes were evaluated. RESULTS The prevalence of current smoker, hypertension, diabetes mellitus, dyslipidemia and positive family history of CHD were 18.9%, 34.3%, 14.5%, 4.4%, and 44.2%, respectively. Most of the patients underwent coronary stenting due to stable angina (48.8%) and unstable angina (UA; 48.1%). After 1-year follow-up, 64 patients (6.6%) experienced clinical outcomes and the most common event was UA (n=56). Compared to patients without clinical outcomes, those with outcomes were more likely to be male, have higher systolic blood pressure, more likely to have hypertension and diabetes mellitus, and more likely to be presented as unstable angina. Multivariate regression analysis showed only age (hazard ratio [HR]: 1.12 and 95% confidence interval [CI]: 1.07-1.26), smoking (HR: 1.15 and 95% CI: 1.06-1.23), presence of hypertension (HR: 1.19 and 95% CI: 1.13-1.31), and diabetes mellitus (HR: 1.16 and 95% CI: 1.09-1.28), more vessels with stenosis (HR: 1.27 and 95% CI: 1.20-1.48) and presented with acute coronary syndrome (HR: 1.35 and 95% CI: 1.21-1.55) were independently associated with clinical outcomes. CONCLUSIONS Most of the young (≤50 years of age) CHD patients had poor management of risk factors and better controlling these risk factors would be helpful for the primary and secondary prevention of premature CHD in Guangdong province.

To compare in-hospital outcomes between left ventricular myocardial infarction (LVMI) patients with and without right ventricular myocardial infarction (RVMI). Patients with acute ST-segment elevation MI (STEMI) undergoing primary percutaneous coronary intervention (PCI) were enrolled and divided into LVMI with and without RVMI groups. Between-group differences and in-hospital outcomes were compared. Compared to patients without RVMI, patients with RVMI were more likely to be male, have higher body mass index, serum levels of C-reactive protein (8.9 ± 2.4 vs 6.2 ± 2.1 mg/dL), B-type natriuretic peptide (1295 ± 340 vs 872 ± 166 pg/mL) and cardiac troponin-I (8.6 ± 2.9 vs 5.2 ± 2.1 ng/mL), and have diabetes (36.3% vs 3.4%) and dyslipidemia (53.4% vs 48.1%). Patients with RVMI had lower left and right ventricular ejection fraction (50.5 ± 5.6% vs 53.4 ± 3.8% and 33.6 ± 2.9% vs 45.7 ± 2.0%), but had higher mean pulmonary artery pressure (30.6 ± 3.3 vs 23.8 ± 3.1 mm Hg). Compared to patients without RVMI, patients with RVMI had higher odds of in-hospital all-cause mortality (4.1% vs 1.0%) and new onset acute heart failure (3.4% vs 1.0%). After adjusted for confounding factors, LVMI with RVMI remained independently associated with composite outcomes, with odds ratio 1.66 (95% confidence interval 1.39–2.04). Compared to isolated LVMI patients, those with concomitant RVMI have higher odds of in-hospital complications, particularly all-cause mortality and new onset acute heart failure.

Present study was to evaluate whether switching ticagrelor to clopidogrel would impact platelet reactivity and cardiovascular outcomes in acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI). A total of 202 ACS patients after PCI were enrolled and prescribed ticagrelor. Before discharge, 138 (68%) patients were switched to clopidogrel. Peripheral blood was obtained before switching and at 48 hours after switching to measure platelet reactivity. Patients were followed for 30 days to evaluate cardiovascular events. Compared to ticagrelor group, patients in clopidogrel group were more likely to be male (69.6% vs 65.6%), smokers (34.1% vs 31.3%) and had higher prevalence of hypertension (75.4% vs 71.9%). The frequency of right coronary artery lesion was significantly higher in ticagrelor group (34.4% vs 30.4%). There were no significant differences in baseline platelet reactivity (37.6 ± 5.2% vs 38.4 ± 4.9%). Forty-eight hours after switching to clopidogrel, platelet reactivity in clopidogrel group was significantly higher (46.3 ± 5.6% vs 38.1 ± 5.0%, P

Introduction : The aim was to evaluate the association of serum total cholesterol (TC) level and left ventricular ejection fraction (LVEF) in patients with heart failure (HF) caused by coronary heart disease (CHD). Material and methods : A total of 236 participants were enrolled. Participants were divided into severely reduced (≤ 35%) and moderately reduced (> 35%) LVEF groups and the between-group difference was evaluated. Multivariate regression analysis was used to evaluate the association between LVEF and parameters of interest. Linear regression analysis was applied to analyze the odds ratio of per 1-SD increase in serum TC level for LVEF change. Results : Mean age was 57.3 years and males accounted for 58.1%. Mean serum TC level was 4.6 mmol/l, albumin (ALB) 33.6 g/l, and C-reactive protein (CRP) 11.4 mg/l. Mean LVEF was 38.3%. Compared to high-reduced LVEF group, participants in moderate-reduced LVEF group had significantly higher TC (4.8 ±0.9 mmol/l vs. 4.4 ± 0.7 mmol/l) and ALB (35.8 ±6.7 g/l vs. 31.4 ±6.0 g/l) but lower CRP (9.6 ±4.7 mg/l vs. 14.2 ±7.0 mg/l) levels (p < 0.05 for all comparisons). Increased TC and ALB levels were associated with higher LVEF, and increased CRP level was associated with lower LVEF. After adjusted for CRP, although per 1-SD increase in TC level was still associated with an increment in 4 % in LVEF, it did not achieve achieve statistic significance. Conclusions : In patients with HF caused by CHD, higher serum TC level appeared to be associated with higher LVEF, which might be associated with systemic inflammation improvement.

The present study is to investigate whether spironolactone is better than hydrochlorothiazide (HCTZ) for blood pressure (BP) control and arterial stiffness improvement. Five-hundred-sixty-six uncontrolled hypertensive patients with 2 different classes of antihypertensive medications treatmen

Background Exercise is beneficial for blood glucose metabolism. However, whether moderate aerobic exercise could improve impaired fasting glucose is unknown. And the mechanism is also needed to investigate. Methods A cross-sectional research was performed and 120 participants with impaired fasting glucose (IFG) were randomly assigned into active and controlled groups. Briefly, participants in active group were required to take moderate aerobic exercise at least 30 min for five times per week, whereas in controlled group, participants were also advised to take exercise but not mandatorily required the same degree as that of active group. At baseline and 3 month’s follow-up, laboratory and demographic variables were compared. Results At baseline, no significant between-group differences were observed. Generally, leukocyte ROCK2 activity in the active and controlled groups were 58.7 ± 6.0 mg/mL and 60.2 ± 7.3 mg/mL, and daily average exercise time at baseline in both groups was extremely little, with 5.2 ± 3.8 min and 5.9 ± 3.5 min, respectively. After 3 months’ follow-up, 52 and 56 participants in the active and controlled groups completed the whole program. Compared to baseline, leukocyte ROCK2 activity and daily average exercise time were improved in both groups. Nonetheless, compared to the controlled group, leukocyte ROCK2 activity was reduced more profoundly and the daily average exercise time was longer in the active group (37.5 ± 6.3 min versus 18.3 ± 7.2 min, p

Background Lipoprotein associated phospholipase A2 (Lp-PLA2) is a novel biomarker for cardiovascular risk prediction. Whether increased Lp-PLA2 level is associated with re-stenosis after stent-placement is unclear. Methods Totally 326 participants eligible for stent-placement were enrolled and divided into two groups according to baseline Lp-PLA2 levels (named normal and elevated groups). Baseline characteristics and clinical outcomes were compared between normal and elevated groups. The relationships between Lp-PLA2 and other risk factors with re-stenosis were evaluated. Results Only the between-group difference of Lp-PLA2 was significant (123.2 ± 33.6 ng/mL vs 336.8 ± 85.4 ng/mL, P

Background High sensitivity C-reactive protein (Hs-CRP) and adiponectin (APN) are two critical cytokines and exert inverse effects on atherosclerosis initiation and progression. The purpose of our study was to investigate the value of Hs-CRP and ANP ratio (Hs-CRP/APN ratio) on evaluating atherosclerosis progression. Method One hundred sixty consecutive participants underwent carotid intima-media thickness (CIMT) measured by ultrasound were enrolled and drawn fasting blood samples for plasma levels Hs-CRP and APN, serum levels of lipid profiles and fasting blood glucose evaluation. Other anthropometrics and clinical status were collected by questionnaire. All participants were divided into 4 groups according to the baseline Hs-CRP/APN ratio and underwent CIMT measurement every 6 months. CIMT increment and composite cardiovascular endpoints were compared after 24 months’ follow-up. Results At baseline, body mass index (BMI), smoking, diabetic mellitus, usage of statins, Hs-CRP and APN independently correlated with Hs-CRP/APN ratio as analyzed by spearman rank correlation. Smoking, serum level of LDL-C, plasma level of Hs-CRP and Hs-CRP/APN ratio were positively correlated with CIMT while usage of statins and plasma level of APN were negatively correlated with CIMT as analyzed by multiple linear regression analysis. After 24 months’ follow-up, the progression of CIMT was the most prominent in the fourth quartile of baseline Hs-CRP/APN ratio. In addition, the incidence of composite cardiovascular endpoint was also higher in the fourth quartile as compared to the other 3 lower quartiles. Conclusion Hs-CRP/APN ratio was a useful predictor to discriminate subjects who were at increased risk of atherosclerosis progression.