83 results on '"Jinfan Tian"'
Search Results
2. Drug-Coated Balloon-Only Strategy for De Novo Coronary Artery Disease: A Meta-analysis of Randomized Clinical Trials
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Wenyi Zhang, Mingduo Zhang, Jinfan Tian, Min Zhang, Yuan Zhou, and Xiantao Song
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Therapeutics. Pharmacology ,RM1-950 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Backgrounds. Many clinical trials have demonstrated the value of drug-coated balloons (DCB) for in-stent restenosis. However, their role in de novo lesions is not well documented. The aim of this study is to evaluate the safety and efficacy of the DCB-only strategy compared to other percutaneous coronary intervention strategies for de novo coronary lesions. Methods. The PubMed, Embase, Web of Science, and Cochrane Library Central Register of Controlled Trials (CENTRAL) electronic databases were searched for randomized controlled trials published up to May 6, 2023. The primary outcomes were major adverse cardiac events and late lumen loss. Results. A total of eighteen trials with 3336 participants were included. Compared with drug-eluting stents, the DCB-only strategy was associated with a similar risk of major adverse cardiac events (risk ratio RR=0.90; 95% confidence interval (CI): 0.59 to 1.37, P=0.631) and a significant decrease in late lumen loss (standardized mean difference SMD=−0.29, 95% CI: −0.53 to −0.04, P=0.021). This effect was consistent in subgroup analysis regardless of indication, follow-up time, drug-eluting stent type, and dual antiplatelet therapy duration. However, DCBs were inferior to DESs for minimum lumen diameter and percentage diameter stenosis. The DCB-only strategy showed significantly better outcomes for most endpoints compared to plain-old balloon angioplasty or bare metal stents. Conclusions. Interventions with a DCB-only strategy are comparable to those of drug-eluting stents and superior to plain-old balloon angioplasty or bare metal stents for the treatment of selected de novo coronary lesions. Additional evidence is still warranted to confirm the value of DCB before widespread clinical utilization can be recommended.
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- 2023
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3. Bone Marrow Mesenchymal Stem Cell-Derived Exosomes Alleviate Diabetic Kidney Disease in Rats by Inhibiting Apoptosis and Inflammation
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Libo Liu, Yuquan Zhou, Xin Zhao, Xueyao Yang, Xueqi Wan, Ziyu An, Huan Zhang, Jinfan Tian, Changjiang Ge, and Xiantao Song
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diabetic kidney disease ,bone marrow mesenchymal stem cells ,exosome ,apoptosis ,inflammation ,Biochemistry ,QD415-436 ,Biology (General) ,QH301-705.5 - Abstract
Background and Aims: Previous studies have confirmed the anti-inflammation effect of bone marrow mesenchymal stem cell-derived exosomes (BMSC-Exo). We aimed to investigate the therapeutic effect of BMSC-Exo on diabetic kidney disease (DKD), as well as the underlying mechanisms. Methods: SD rats were induced by streptozotocin combined with a high-fat diet to establish a diabetes disease model. BMSCs-Exo were injected via tail veins at a weekly dose of 100 µg for 12 weeks. Pathological changes in the rat kidneys were evaluated using HE, Masson, and Periodic Acid-Schiff and immunohistochemical staining. TUNEL staining and western blot were used to evaluate the expression levels of apoptosis-related proteins in the rat kidney cells. The TNF-α level was detected by PCR and NF-κB (p65) by western blotting to examine the inflammatory responses in the renal tissue. Results: BMSCs-Exo significantly alleviated the renal structural damage and the distribution of apoptotic cells in diabetic rats. Furthermore, BMSCs-Exo increased the expression of pro-apoptosis protein Bax and decreased the expression of apoptosis-executing protein Cleaved Caspase 9 and Cleaved caspase 3. In addition, the transcription level of TNF-α in kidney tissue and NF-κB (p65) expression was also decreased through BMSCs-Exo treatment. Besides, the levels of glucose (GLU), creatinine (Cr), and burea nitrogen (BUN) in diabetic rats were decreased by the BMSC-Exo treatment. Conclusions: BMSCs-Exo may alleviate diabetic kidney damage by inhibiting apoptosis and inflammation.
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- 2023
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4. Pathophysiology and molecular mechanism of caveolin involved in myocardial protection strategies in ischemic conditioning
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Xin Zhao, Xueyao Yang, Ziyu An, Libo Liu, Jingwen Yong, Haoran Xing, Rongchong Huang, Jinfan Tian, and Xiantao Song
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Myocardial protection ,Caveolins ,Pathophysiology ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Multiple pathophysiological pathways are activated during the process of myocardial injury. Various cardioprotective strategies protect the myocardium from ischemia, infarction, and ischemia/reperfusion (I/R) injury through different targets, yet the clinical translation remains limited. Caveolae and its structure protein, caveolins, have been suggested as a bridge to transmit damage-preventing signals and mediate the protection of ultrastructure in cardiomyocytes under pathological conditions. In this review, we first briefly introduce caveolae and caveolins. Then we review the cardioprotective strategies mediated by caveolins through various pathophysiological pathways. Finally, some possible research directions are proposed to provide future experiments and clinical translation perspectives targeting caveolin based on the investigative evidence.
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- 2022
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5. Corrigendum: Myocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries
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Xueyao Yang, Jinfan Tian, Lijun Zhang, Wei Dong, Hongzhi Mi, Jianan Li, Jiahui Li, Ye Han, Huijuan Zuo, Jing An, Yi He, and Xiantao Song
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chronic total occlusion ,myocardial viability ,coronary artery disease ,cardiovascular magnetic resonance ,cardiac function ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2022
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6. A Novel Classification for Predicting Chronic Total Occlusion Percutaneous Coronary Intervention
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Dongfeng Zhang, Haoran Xing, Rui Wang, Jinfan Tian, Zhiguo Ju, Lijun Zhang, Hui Chen, Yi He, and Xiantao Song
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chronic total occlusion ,percutaneous coronary intervention ,computed tomographic angiography ,plaque composition ,coronary artery disease ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
AimsChronic total occlusion (CTO) percutaneous coronary intervention (PCI) is characterized by a low success rate and an increase in complications. This study aimed to explore a new and simple classification method based on plaque composition to predict guidewire (GW) crossing within 30 min of CTO lesions.MethodsThis study consecutively enrolled individuals undergoing attempted PCI of CTO who underwent coronary computed tomographic angiography (CCTA) within 2 months. Lesions were divided into soft and hard CTO groups according to the necrotic core proportion.ResultsIn this study, 207 lesions were divided into soft (20.3%) and hard CTO (79.7%) groups according to a necrotic core percentage cutoff value of 72.7%. The rate of successful GW crossing within 30 min (57.6 vs. 85.7%, p = 0.004) and final success (73.3 vs. 95.2%, p = 0.001) were much lower in the hard CTO group. For patients with hard CTO, previous failed attempt, proximal side branch, bending > 45 degrees calcium ≥ 50% cross-sectional area (CSA), and distal reference diameter ≤ 2.5 mm were demonstrated to be associated with GW failure within 30 min. For patients with soft CTO, only blunt entry was proved to be an independent predictive factor of GW failure within 30 min.ConclusionsGrouping CTO lesions according to the proportion of necrotic core is reasonable and necessary in predicting GW crossing within 30 min. A soft CTO with a necrotic core is more likely to be recanalized compared with a hard CTO with fibrous and/or dense calcium. Different plaque types have variable predictive factors.
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- 2022
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7. Revascularization or medical therapy for stable coronary artery disease patients with different degrees of ischemia: a systematic review and meta-analysis of the role of myocardial perfusion
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JingWen Yong, JinFan Tian, Xin Zhao, XueYao Yang, MingDuo Zhang, Yuan Zhou, Yi He, and XianTao Song
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Therapeutics. Pharmacology ,RM1-950 - Abstract
Objective: This study explored the best treatment strategies for stable coronary artery disease (SCAD) patients with differing levels of ischemic severity. Methods: We conducted a comprehensive search of the PubMed, EMBASE, and Cochrane databases – searching for relevant articles through 4 February 2021. We selected studies comparing different treatments for patients with SCAD who had received ischemia assessments. The primary outcome was death. The secondary outcomes were major adverse cardiovascular events (MACEs) and myocardial infarction (MI). Results: A total of 11 studies, including 35,607 subjects, were selected for this meta-analysis. Results showed that, compared with medical therapy, revascularization could reduce MACE incidence (odds ratio (OR) 0.73, 95% confidence interval (CI): 0.57–0.94, p
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- 2022
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8. Myocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries
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Xueyao Yang, Jinfan Tian, Lijun Zhang, Wei Dong, Hongzhi Mi, Jianan Li, Jiahui Li, Ye Han, Huijuan Zuo, Jing An, Yi He, and Xiantao Song
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chronic total occlusion ,myocardial viability ,coronary artery disease ,cardiovascular magnetic resonance ,cardiac function ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: Viability and functional assessments are recommended for indication and intervention for chronic coronary total occlusion (CTO). We aimed to evaluate myocardial viability and left ventricular (LV) functional status by using cardiovascular magnetic resonance (CMR) and to investigate the relationship between them and collaterals in patients with CTO.Materials and Methods: We enrolled 194 patients with one CTO artery as detected by coronary angiography. Patients were scheduled for CMR within 1 week after coronary angiography.Results: A total of 128 CTO territories (66%) showed scar based on late gadolinium enhancement (LGE) imaging. There were 1,112 segments in CTO territory, while only 198 segments (18%) subtended by the CTO artery showed transmural scar (i.e., >50% extent on LGE). Patients with viable myocardium had higher LV ejection fraction (LVEF) (56.7 ± 13.5% vs. 48.3 ± 15.4%, p < 0.001) than those with transmural scar. Angiographically, well-developed collaterals were found in 164 patients (85%). There was no significant correlation between collaterals and the presence of myocardial scar (p = 0.680) or between collaterals and LVEF (p = 0.191). Nevertheless, more segments with transmural scar were observed in patients with poorly-developed collaterals than in those with well-developed collaterals (25 vs. 17%, p = 0.010).Conclusion: Myocardial infarction detected by CMR is widespread among patients with CTO, yet only a bit of transmural myocardial scar was observed within CTO territory. Limited number of segments with transmural scar is associated with preserved LV function. Well-developed collaterals are not related to the prevalence of myocardial scar or systolic functioning, but could be related to reduce number of non-viable segments subtended by the CTO artery.
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- 2021
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9. Optimal treatment strategies for coronary artery disease in patients with advanced kidney disease: a meta-analysis
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Jingwen Yong, Jinfan Tian, Xin Zhao, Xueyao Yang, Haoran Xing, Yi He, and Xiantao Song
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Therapeutics. Pharmacology ,RM1-950 - Abstract
Background: Coronary artery disease (CAD) is the leading cause of death in advanced kidney disease. However, its best treatment has not been determined. Methods: We searched PubMed and Cochrane databases and scanned references to related articles. Studies comparing the different treatments for patients with CAD and advanced CKD (estimated glomerular filtration rate 1 year). Results: A total of 32 studies were selected to enroll 84,498 patients with advanced kidney disease. Compared with medical therapy (MT) alone, percutaneous coronary intervention (PCI) was associated with low risk of short-, medium-term and long-term all-cause death (more than 3 years). For AMI patients, compared with MT, PCI was not associated with low risk of short- and medium-term all-cause death. For non-AMI patients, compared with MT, PCI was associated with low risk of long-term mortality (more than 3 years). Compared with MT, coronary artery bypass surgery (CABG) had no significant advantages in each follow-up period of all-cause death. Compared with PCI, CABG was associated with a high risk of short-term death, but low risk of long-term death: 1–3 years; more than 3 years. CABG could also reduce the risk of long-term risk of cardiac death, major adverse cardiovascular events (MACEs), myocardial infarction (MI), and repeat revascularization. Conclusions: In patients with advanced kidney disease and CAD, PCI reduced the risk of short-, medium- and long- term (more than 3 years) all-cause death compared with MT. Compared with PCI, CABG was associated with a high risk of short-term death and a low risk of long-term death and adverse events.
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- 2021
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10. Staged complete revascularization or culprit-only percutaneous coronary intervention for multivessel coronary artery disease in patients with ST-segment elevation myocardial infarction and diabetes
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Kongyong Cui, Shuzheng Lyu, Hong Liu, Xiantao Song, Fei Yuan, Feng Xu, Min Zhang, Wei Wang, Mingduo Zhang, Dongfeng Zhang, and Jinfan Tian
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Diabetes mellitus ,Multivessel disease ,Culprit-only percutaneous coronary artery intervention ,Staged complete revascularization ,Outcome ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Recently, several randomized trials have noted improved outcomes with staged percutaneous coronary intervention (PCI) of nonculprit vessels in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease. However, it remains unclear whether diabetes status affects the outcomes after different revascularization strategies. This study thus compared the impact of diabetes status on long-term outcomes after staged complete revascularization with that after culprit-only PCI. Methods From January 2006 to December 2015, 371 diabetic patients (staged PCI: 164, culprit-only PCI: 207) and 834 nondiabetic patients (staged PCI: 412, culprit-only PCI: 422) with STEMI and multivessel disease were enrolled. The primary endpoint was 5-year major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of all-cause death, myocardial infarction (MI), stroke or unplanned revascularization. Results The rate of the 5-year composite primary endpoint for diabetic patients was close to that for nondiabetic patients (34.5% vs. 33.7%; adjusted hazard ratio [HR] 1.012, 95% confidence interval [CI] 0.815–1.255). In nondiabetic patients, the 5-year risks of MACCE (31.8% vs. 35.5%; adjusted HR 0.638, 95% CI 0.500–0.816), MI (4.6% vs. 9.2%; adjusted HR 0.358, 95% CI 0.200–0.641), unplanned revascularization (19.9% vs. 24.9%; adjusted HR 0.532, 95% CI 0.393–0.720), and the composite of cardiac death, MI or stroke (11.4% vs. 15.2%; adjusted HR 0.621, 95% CI 0.419–0.921) were significantly lower after staged PCI than after culprit-only PCI. In contrast, no significant difference was found between the two groups with respect to MACCE, MI, unplanned revascularization, and the composite of cardiac death, MI or stroke in diabetic patients. Significant interactions were found between diabetes status and revascularization assignment for the composite of cardiac death, MI or stroke (Pinteraction = 0.013), MI (Pinteraction = 0.005), and unplanned revascularization (Pinteraction = 0.013) at 5 years. In addition, the interaction tended to be significant for the primary endpoint of MACCE (Pinteraction = 0.053). Moreover, the results of propensity score-matching analysis were concordant with the overall analysis in both diabetic and nondiabetic population. Conclusions In patients with STEMI and multivessel disease, diabetes is not an independent predictor of adverse cardiovascular events at 5 years. In nondiabetic patients, an approach of staged complete revascularization is superior to culprit-only PCI, whereas the advantage of staged PCI is attenuated in diabetic patients. Trial registration This study was not registered in an open access database
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- 2019
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11. Coronary artery bypass graft surgery stenting for patients with chronic kidney disease and complex coronary artery disease: a systematic review and meta-analysis
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Kongyong Cui, Hong Liu, Fei Yuan, Feng Xu, Min Zhang, Mingduo Zhang, Wei Wang, Dongfeng Zhang, Jinfan Tian, Shuzheng Lyu, and Kefei Dou
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Therapeutics. Pharmacology ,RM1-950 - Abstract
Background: The relative role of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with stent implantation in patients with chronic kidney disease (CKD) and complex coronary artery disease (CAD) remains debatable due to the lack of randomized controlled trials (RCTs). We therefore performed this meta-analysis to compare the outcomes of the two strategies in CKD patients with multivessel and/or left main disease. Methods: Electronic databases including PubMed, EMBASE and Cochrane Library were comprehensively searched to identify the eligible subgroup analysis of RCTs and propensity-matched registries. The primary endpoint was all-cause mortality during the longest follow-up. Results: Five subgroup analyses of RCTs and six propensity-matched registries involving 26,441 patients were analyzed. Overall, the strategy of CABG was associated with lower risks of long-term mortality [odds ratio (OR) 0.83, 95% confidence interval (CI) 0.74–0.93], myocardial infarction (OR, 0.41; 95% CI, 0.27–0.62), and repeat revascularization (OR, 0.25; 95% CI, 0.16–0.39) compared with PCI in CKD patients with complex CAD. However, CABG was slightly associated with higher risk of stroke than PCI (OR, 1.33; 95% CI, 1.00–1.77). Nonetheless, the higher stroke risk in the CABG group no longer existed during long-term follow-up (OR, 0.92; 95% CI, 0.37–2.25) (>3 years). Conclusion: This meta-analysis supports the current guideline advising CABG for patients with CKD and complex CAD. At the expense of slightly increased risk of stroke, CABG reduces the incidences of long-term all-cause death, myocardial infarction and repeat revascularization compared with PCI.
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- 2021
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12. Effects of Oral Drugs on Coronary Microvascular Function in Patients Without Significant Stenosis of Epicardial Coronary Arteries: A Systematic Review and Meta-Analysis of Coronary Flow Reserve
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Jingwen Yong, Jinfan Tian, Xueyao Yang, Haoran Xing, Yi He, and Xiantao Song
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oral drug ,coronary microvascular ,microvascular function ,coronary flow reserve (CFR) ,therapy ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: This study aims to investigate the impact of cardiovascular medications on the coronary flow reserve (CFR) in patients without obstructive coronary artery disease (CAD).Methods: We searched PubMed, EMBASE, and Cochrane databases from inception to 15 November 2019. Studies were included if they reported CFR from baseline to follow-up after oral drug therapy of patients without obstructive CAD. Data was pooled using random-effects modeling. The primary outcome was change in CFR from baseline to follow-up after oral drug therapy.Results: A total of 46 studies including 845 subjects were included in this study. Relative to baseline, the CFR was improved by angiotensin-converting enzymes (ACEIs), aldosterone receptor antagonists (ARBs) [standard mean difference (SMD): 1.12; 95% CI: 0.77–1.47], and statins treatments (SMD: 0.61; 95%CI: 0.36–0.85). Six to 12 months of calcium channel blocker (CCB) treatments improved CFR (SMD: 1.04; 95% CI: 0.51–1.58). Beta-blocker (SMD: 0.24; 95% CI: −0.39–0.88) and ranolazine treatment (SMD: 0.31; 95% CI: −0.39–1.01) were not associated with improved CFR.Conclusions: Therapy with ACEIs, ARBs, and statins was associated with improved CFR in patients with confirmed or suspicious CMD. CCBs also improved CFR among patients followed for 6–12 months. Beta-blocker and ranolazine had no impact on CFR.
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- 2020
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13. Artificial Intelligence Based Myocardial Ischemia Detection in Cardiac Radiology.
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Xiangru Li, Jinfan Tian, Nan Nan, Chenchen Tu, Dongfeng Zhang, Xiantao Song, and Hongjia Zhang
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- 2021
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14. Comparison of successful versus failed percutaneous coronary intervention in patients with chronic total occlusion: A systematic review and meta-analysis.
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Dongfeng Zhang, Nan Nan, Yuguo Xue, Mingduo Zhang, Jinfan Tian, Changzhe Chen, Min Zhang, and Xiantao Song
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- 2024
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15. Machine Learning–Based CT Angiography–Derived Fractional Flow Reserve for Diagnosis of Functionally Significant Coronary Artery Disease
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Ziyu An, Jinfan Tian, Xin Zhao, Mingduo Zhang, Lijun Zhang, Xueyao Yang, Libo Liu, and Xiantao Song
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Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine - Published
- 2023
16. <scp> Ginkgo biloba </scp> extract protects against diabetic cardiomyopathy by restoring autophagy via adenosine monophosphate‐activated protein kinase/mammalian target of the rapamycin pathway modulation
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Xueyao Yang, Xin Zhao, Yanfei Liu, Yue Liu, Libo Liu, Ziyu An, Haoran Xing, Jinfan Tian, and Xiantao Song
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Pharmacology - Published
- 2023
17. Efficacy of Colchicine in the Treatment of Patients With Coronary Artery Disease: A Mini-Review
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JingWen Yong, JinFan Tian, WenJian Jiang, Xin Zhao, HongJia Zhang, and XianTao Song
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Pharmacology ,Anti-Inflammatory Agents ,Myocardial Infarction ,Humans ,Pharmacology (medical) ,Coronary Artery Disease ,Acute Coronary Syndrome ,Colchicine - Abstract
This review of colchicine, an effective anti-inflammatory agent, examines whether the reduction in ischemic events produced by colchicine translates to a reduction in mortality, the optimal duration of treatment, and the patient populations that benefits the most from colchicine treatment.We performed a comprehensive PubMed database search using the key words colchicine and coronary heart disease on August 23, 2021. We also screened the included reference list of manuscripts.Colchicine's role in the secondary prevention of coronary artery disease has been the focus of recent large-scale randomized controlled trials in chronic coronary syndrome (ie, the Low-Dose Colchicine and Low-Dose Colchicine 2 trials), acute myocardial infarction (the Colchicine Cardiovascular Outcomes Trial and Colchicine in Patients With Acute Coronary Syndrome trial), and after percutaneous coronary intervention (the Colchicine-Percutaneous Coronary Intervention trial).Current evidence suggests that low-dose colchicine (0.5 mg once a day) reduces the risk of cardiovascular events among patients with acute myocardial infarction or chronic coronary syndrome. Colchicine has the potential to become a new standard therapy for the prevention of coronary artery disease-related atherothrombotic events because it is effective and cost-efficient and has a well-tolerated safety profile.
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- 2022
18. Quantitative coronary computed tomography angiography assessment of chronic total occlusion percutaneous coronary intervention
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Haoran, Xing, Lijun, Zhang, Dongfeng, Zhang, Rui, Wang, Jinfan, Tian, Yinghui, Le, Zhiguo, Ju, Hui, Chen, Yi, He, and Xiantao, Song
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Original Article ,Radiology, Nuclear Medicine and imaging - Abstract
BACKGROUND: Morphological and clinical characteristics are widely used to predict the success of percutaneous coronary intervention (PCI) in patients with chronic total occlusion (CTO). However, the impact of quantitative characteristics derived from coronary computed tomography angiography (CCTA) on guidewire crossing and PCI success is still unclear. This study aimed to explore the association between these quantitative characteristics and the difficulty of PCI for CTO. METHODS: A total of 207 CTO lesions from 201 patients (84.6% male; mean age 58.9 years) with pre-procedural CCTA scans who had undergone PCI for CTO were retrospectively enrolled in this case-control study. A semi-automated CCTA plaque-analysis software was adopted to obtain the total plaque volume and volume of each component according to the Hounsfield Unit (HU) value, including dense calcium (>351 HU), fibrous (131–350 HU), fibrofatty (76–130 HU), and necrotic core (−30–75 HU) tissue. Differences in the quantitative characteristics of the CTO lesions were compared between: (I) the group of lesions with successful guidewire crossing (≤30 min) and the group with failed guidewire crossing (≤30 min); (II) the group of lesions with procedural success [defined as achieving residual stenosis of
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- 2022
19. The cGAS-STING Pathway: A Ubiquitous Checkpoint Perturbing Myocardial Attributes
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Changjiang Ge, Xueqi wan, Jinfan Tian, Peng Hao, Jing Zhang, Yuquan Zhou, and Xiantao Song
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Pharmacology ,Cardiology and Cardiovascular Medicine - Abstract
Abstract: As an innate immune route of defense against microbial infringement, cyclic guanosine monophosphate (GMP)–adenosine monophosphate (AMP) synthase (cGAS)- stimulator of interferon genes (STING) signaling does not simply participate in amplifying inflammatory responses via releasing type-I interferon (IFN) or enhance the expression of pro-inflammatory genes, but also interplays with multifarious pathophysiological activities, such as autophagy, apoptosis, pyroptosis, ferroptosis, and senescence in a broad repertoire of cells like endothelial cells, macrophages and cardiomyocyte. Thus, the cGAS-STING pathway is closely linked with aberrant heart morphologically and functionally via these mechanisms. The past few decades have witnessed an increased interest in the exact relationship between the activation of the cGAS-STING pathway and the initiation or development of certain cardiovascular diseases (CVD). A group of scholars has gradually investigated the perturbation of myocardium affected by the overactivation or suppression of the cGAS-STING. This review focuses on how the cGAS-STING pathway interweaves with other pathways and creates a pattern of dysfunction associated with cardiac muscle. This sets treatments targeting the cGAS-STING pathway apart from traditional therapeutics for cardiomyopathy and achieves better clinical value.
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- 2023
20. Regulation of cardiovascular and cardiac functions by caveolins
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Ziyu An, Jinfan Tian, Xin Zhao, Libo Liu, Xueyao Yang, Mingduo Zhang, Lijun Zhang, and Xiantao Song
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Cell Biology ,Molecular Biology ,Biochemistry - Published
- 2023
21. Inclusion of quantitative high-density plaque in coronary computed tomographic score system to predict the time of guidewire crossing chronic total occlusion
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Rui Wang, Yi He, Haoran Xing, Dongfeng Zhang, Jinfan Tian, Yinghui Le, Lijun Zhang, Hui Chen, Xiantao Song, and Zhenchang Wang
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Male ,Percutaneous Coronary Intervention ,Treatment Outcome ,Coronary Occlusion ,Predictive Value of Tests ,Chronic Disease ,Humans ,Female ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Middle Aged ,Coronary Angiography - Abstract
Objective This study aimed to establish a new scoring system that includes histological quantitative features derived from coronary computed tomographic angiography (CCTA) to predict the efficiency of chronic total occlusion percutaneous coronary intervention (CTO-PCI). Methods This study analyzed clinical, morphological, and histological characteristics of 207 CTO lesions in 201 patients (mean age 60.0 [52.0–65.0] years, 85% male), which were recruited from two centers. The primary endpoint was a guidewire successfully crossing the lesions within 30 m. The new predictive model was generated by factors that were determined by multivariate analysis. The CCTA plaque (CTAP) score that included a quantitative plaque characteristic was developed by assigning an appropriate integer score to each independent predictor, then summing all points. In addition, the CTAP score was compared with other predictive scores based on CCTA. Results The endpoint was achieved in 63% of the lesions. The independent predictors included previous CTO-PCI failure, the proximal blunt stump, proximal side branch, distal side branch, occluded segment bending > 45°, and high-density plaque volume (fibrous volume + calcified volume) ≥ 19.9 mm3. As the score increased from 0 to 5, the success rate of the guidewire crossing within 30 m decreased from 96 to 0%. Comparing the CTAP score with other predictive scores, the CTAP score showed the highest discriminant power (c-statistic = 0.81 versus 0.73–0.77, p value 0.02–0.07). The CTAP score showed similar results for procedural success. Conclusion The CTAP score efficiently predicted the guidewire crossing efficiency and procedural success. Key Points • An increase in high-density plaque volume (fibrous + dense calcium) was more probable to reduce the efficiency of crossing and lead to procedural failure. • The new prediction scoring system with the addition of the quantitative characteristics of plaques had an improved predictive ability compared with the traditional prediction scoring system.
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- 2022
22. HbA1c is related to microcirculation blood perfusion in patients with coronary microvascular disease using stress perfusion cardiac magnetic resonance: An observational study
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JingWen Yong, JinFan Tian, HuiJuan Zuo, JiaXin Cao, HuiHui Kong, Xin Zhao, XueYao Yang, HongJia Zhang, Yi He, and XianTao Song
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Cell Biology ,Cardiology and Cardiovascular Medicine ,Biochemistry - Published
- 2023
23. Evaluation of Therapeutic Agents Targeting the Pathogenesis of Coronary Artery Spasm: A Mini Review
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Zhishuai Ye, Xiantao Song, Mingyue Xu, Xin Zhao, Jinfan Tian, and Rongchong Huang
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Pharmacology ,Vascular smooth muscle ,business.industry ,Myocardial Ischemia ,Coronary Vasospasm ,Disease ,medicine.disease ,Bioinformatics ,Sudden death ,eye diseases ,Angina ,Pathogenesis ,medicine.anatomical_structure ,embryonic structures ,medicine ,Humans ,Myocardial infarction ,Endothelial dysfunction ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Coronary artery spasm (CAS) plays an important role in the pathogenesis of ischemic heart disease. The clinical manifestations of CAS include variant angina, myocardial infarction and sudden death. Although endothelial dysfunction and hyperreactivity of vascular smooth muscle cells have been associated with CAS, the underlying mechanisms remain unclear. Thus, there is a long way to go to truly understand the pathogenesis of CAS to formulate effective treatments. This article discusses the pathophysiological mechanisms as well as downstream molecular pathways of CAS, with a focus on potential therapeutic targets.
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- 2021
24. Lyu Response to Ahmad et al
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Kuo Zhou, Jinfan Tian, Yunfeng Yan, and Shuzheng Lyu
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Cardiology and Cardiovascular Medicine - Published
- 2023
25. Comparison of successful versus failed percutaneous coronary intervention in patients with chronic total occlusion: A systematic review and meta-analysis
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Dongfeng, Zhang, Nan, Nan, Yuguo, Xue, Mingduo, Zhang, Jinfan, Tian, Changzhe, Chen, Min, Zhang, and Xiantao, Song
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General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
The optimal treatment strategy of chronic total occlusion (CTO) is currently debated. This meta-analysis aimed to evaluate the long-term clinical outcomes of successful percutaneous coronary intervention (PCI) of CTO.Electronic databases were searched for studies comparing long-term outcomes between successful PCI in patients with CTO using drug-eluting stents and failed procedures. Meta-analysis was conducted with major adverse cardiac events (MACE) and all-cause mortality during the longest follow-up as endpoints. The combined hazard ratios (HRs) were applied to assess the correlation between successful CTO PCI and MACE/all-cause mortality.Eight studies consisting of 6,211 patients published between 2012 and 2020 met our inclusion criteria, and the CTO PCI success rate was 81.2%. Patients in the failed group were much older, and more likely to have morbidities (hypertension and prior myocardial infarction), reduced left ventricular ejection fraction, and severe lesion characteristics (multivessel disease and moderate/severe calcification). Pooled results indicated that successful CTO PCI was significantly associated with prognosis. Compared to failed recanalization, patients receiving successful procedures had an improved MACE (HR: 0.50, 95% CI: 0.40-0.61, p0.001). Subgroup analyses further revealed the prognostic value of successful CTO PCI. However, no difference was observed regarding all-cause mortality (HR: 0.79, 95% CI: 0.61-1.02, p = 0.074).The present study showed that CTO recanalization was associated with improved long-term outcomes. However, randomized trials are needed to confirm the results due to the mismatch of baseline characteristics.
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- 2022
26. Complementary and Alternative Medicine for the Treatment of Insomnia: An Overview of Scientific Evidence from 2008 to 2018
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Jinfan Tian, Yue Liu, Bingli Cheng, Yanfei Liu, and Rui Gao
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Adult ,Complementary Therapies ,Male ,medicine.medical_specialty ,Adolescent ,Population ,Alternative medicine ,Risk Assessment ,law.invention ,Scientific evidence ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Sleep Initiation and Maintenance Disorders ,mental disorders ,Health care ,Insomnia ,Humans ,Medicine ,Risk factor ,Intensive care medicine ,education ,Aged ,Pharmacology ,education.field_of_study ,Sleep disorder ,business.industry ,Middle Aged ,Protective Factors ,medicine.disease ,Treatment Outcome ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Sleep Aids, Pharmaceutical ,030220 oncology & carcinogenesis ,Female ,Plant Preparations ,medicine.symptom ,Sleep ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Insomnia is a widespread sleep disorder in the general population, and it is a risk factor for impaired function, the development of other medical and mental disorders, and causes an increase in health care costs. In view of the health hazards of insomnia and the shortcomings of western medicine, Complementary and Alternative Medicine (CAM) should be considered in the management of insomnia. The present overview reports the potential role of herbal medicine and non-pharmacological therapies in the treatment of insomnia and summarizes the scientific evidence reported from 2008 to 2018. PubMed and Web of Science databases were searched for studies published from 2008 to 2018. 17 randomized controlled trials and 22 non-pharmacological therapies were included in this review, and the results showed that CAM had certain advantages in the treatment of insomnia. The safety of CAM for insomnia was acceptable. Meanwhile, based on pre-clinical trial, the possible mechanisms of CAM for insomnia were modulation of circadian rhythm, GABA receptor activation, antagonisms of 5-HT receptors, inhibition of glutamate-mediated pathways, and attenuation of inflammation. CAM for insomnia has made some progress, but high quality evidence-based medical evidence is still needed to provide guidance for clinical application.
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- 2020
27. Caveolin as a Novel Potential Therapeutic Target in Cardiac and Vascular Diseases: A Mini Review
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Rongchong Huang, Jinfan Tian, Xin Zhao, Min Zhang, Mohammad Sharif Popal, Xiantao Song, and Mingduo Zhang
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0301 basic medicine ,autophagy ,Caveolin ,Review Article ,Pathology and Forensic Medicine ,Nitric oxide ,target ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,cardiovascular disease ,Caveolae ,Medicine ,business.industry ,Autophagy ,Cell Biology ,Cell biology ,Crosstalk (biology) ,030104 developmental biology ,chemistry ,role ,Neurology (clinical) ,Geriatrics and Gerontology ,Signal transduction ,business ,030217 neurology & neurosurgery ,Biogenesis ,Homeostasis - Abstract
Caveolin, a structural protein of caveolae, play roles in the regulation of endothelial function, cellular lipid homeostasis, and cardiac function by affecting the activity and biogenesis of nitric oxide, and by modulating signal transduction pathways that mediate inflammatory responses and oxidative stress. In this review, we present the role of caveolin in cardiac and vascular diseases and the relevant signaling pathways involved. Furthermore, we discuss a novel therapeutic perspective comprising crosstalk between caveolin and autophagy.
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- 2020
28. Interplay between Exosomes and Autophagy in Cardiovascular Diseases: Novel Promising Target for Diagnostic and Therapeutic Application
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Yanfei Liu, Yue Liu, Ke-ji Chen, Jinfan Tian, Yingke Zhao, and Mohammad Sharif Popal
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0301 basic medicine ,autophagy ,Cellular homeostasis ,Context (language use) ,Disease ,Review ,exosomes ,Exosome ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Cell to cell communication ,cardiovascular disease ,Medicine ,myocardial ischemia/reperfusion injury ,business.industry ,Autophagy ,Cell Biology ,Microvesicles ,Cell biology ,030104 developmental biology ,Neurology (clinical) ,Geriatrics and Gerontology ,Nanocarriers ,atherosclerosis ,business ,030217 neurology & neurosurgery - Abstract
Exosome, is identified as a nature nanocarrier and intercellular messenger that regulates cell to cell communication. Autophagy is critical in maintenance of protein homeostasis by degradation of damaged proteins and organelles. Autophagy and exosomes take pivotal roles in cellular homeostasis and cardiovascular disease. Currently, the coordinated mechanisms for exosomes and autophagy in the maintenance of cellular fitness are now garnering much attention. In the present review, we discussed the interplay of exosomes and autophagy in the context of physiology and pathology of the heart, which might provide novel insights for diagnostic and therapeutic application of cardiovascular diseases.
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- 2019
29. Adenosine Triphosphate (ATP)- A Safe and Effective Vasodilator for Stress Perfusion Cardiac Magnetic Resonance
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Huihui Kong, Jing An, Jiaxin Cao, Zhenchao Tang, Jinfan Tian, Jingwen Yong, Xiantao Song, and Yi He
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cardiovascular system ,cardiovascular diseases - Abstract
Purpose The aim of this study was to evaluate the efficiency and safety of adenosine triphosphate (ATP) as a stress agent in a cohort of patients undergoing stress perfusion cardiac magnetic resonance imaging (CMR). Methods This retrospective study was conducted between December 2019 and October 2021 at the Beijing Friendship Hospital, Beijing, China. The study included 107 subjects (age range: 53±11 years; male: female, 62%:38%) with suspected non-obstructive coronary artery disease (NOCAD) that underwent stress CMR. These patients showed typical symptoms such as chest pain (stable and unstable angina pectoris) and
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- 2021
30. Myocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries
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Jing An, Wei Dong, Jinfan Tian, Ye Han, Jiahui Li, J.N. Li, Huijuan Zuo, Xueyao Yang, Lijun Zhang, Xiantao Song, Yi He, and Hongzhi Mi
- Subjects
Cardiac function curve ,medicine.medical_specialty ,Cardiovascular Medicine ,myocardial viability ,Coronary artery disease ,cardiovascular magnetic resonance ,Internal medicine ,Diseases of the circulatory (Cardiovascular) system ,Medicine ,In patient ,cardiovascular diseases ,chronic total occlusion ,Original Research ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Coronary arteries ,medicine.anatomical_structure ,RC666-701 ,Cardiology ,Functional status ,cardiac function ,Cardiology and Cardiovascular Medicine ,business ,coronary artery disease ,Artery - Abstract
Objective: Viability and functional assessments are recommended for indication and intervention for chronic coronary total occlusion (CTO). We aimed to evaluate myocardial viability and left ventricular (LV) functional status by using cardiovascular magnetic resonance (CMR) and to investigate the relationship between them and collaterals in patients with CTO.Materials and Methods: We enrolled 194 patients with one CTO artery as detected by coronary angiography. Patients were scheduled for CMR within 1 week after coronary angiography.Results: A total of 128 CTO territories (66%) showed scar based on late gadolinium enhancement (LGE) imaging. There were 1,112 segments in CTO territory, while only 198 segments (18%) subtended by the CTO artery showed transmural scar (i.e., >50% extent on LGE). Patients with viable myocardium had higher LV ejection fraction (LVEF) (56.7 ± 13.5% vs. 48.3 ± 15.4%, p < 0.001) than those with transmural scar. Angiographically, well-developed collaterals were found in 164 patients (85%). There was no significant correlation between collaterals and the presence of myocardial scar (p = 0.680) or between collaterals and LVEF (p = 0.191). Nevertheless, more segments with transmural scar were observed in patients with poorly-developed collaterals than in those with well-developed collaterals (25 vs. 17%, p = 0.010).Conclusion: Myocardial infarction detected by CMR is widespread among patients with CTO, yet only a bit of transmural myocardial scar was observed within CTO territory. Limited number of segments with transmural scar is associated with preserved LV function. Well-developed collaterals are not related to the prevalence of myocardial scar or systolic functioning, but could be related to reduce number of non-viable segments subtended by the CTO artery.
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- 2021
31. HbA1c Independently Predicts Declined Myocardial Perfusion Reserve Index in Patients With Coronary Microvascular Disease Using Stress Perfusion Cardiac Magnetic Resonance: an Observational Study
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Xueyao Yang, Xin Zhao, Jingwen Yong, HuiHui Kong, Yi He, Jinfan Tian, JiaXin Cao, and X T Song
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medicine.medical_specialty ,business.industry ,Internal medicine ,Stress perfusion ,medicine ,Cardiology ,Observational study ,In patient ,Perfusion reserve ,business ,Coronary Microvascular Disease ,Cardiac magnetic resonance - Abstract
Background We investigated whether glycated haemoglobin A1c (HbA1c) could independently predict the decline in the myocardial perfusion reserve index (MPRI) in patients with coronary microvascular disease (CMD) by stress perfusion cardiac magnetic resonance (CMR).Methods From November 2019, 174 patients with ischemic symptoms but without obstructive coronary disease were screened. The MPRI was recorded in 88 patients who underwent stress perfusion CMR detection. Eighty patients with an MPRI of < 2.5 were included in the study. The patients were divided into two groups based on whether their MPRI was greater or less than 1.47. The effects of each index on the MPRI were analysed using bivariate correlation analysis, and the risk factors for CMD were explored using logistic regression analysis.ResultsA total of 80 patients with an MPRI of 1.69±0.79 were included (mean age 54.07 ± 11.06 years; 66.3% male). CMD patients with an MPRI of ≤1.47 were higher than those in the group with an MPRI of >1.47 in age (57.61±9.65 years vs. 51.74±11.41 years), presence of diabetes mellitus (45.5% vs. 21.3%), fasting blood glucose levels [6.33(5.16, 8.01) vs. 5.30(5.15, 6.56)], and HbA1c levels [6.30(5.70, 7.70) vs. 5.80(5.60, 6.50)], (P < 0.05). The MPRI was negatively correlated with HbA1c (r=-0.378, P=0.004). Logistic regression analysis showed that HbA1c (OR=2.336, 95% CI: 1.119-4.876, P=0.024) was an independent risk factor for decreased MPRI in all patients with CMD, especially in patients without diabetes (OR=19.953, 95% CI: 1.743-93.449, P=0.029), but not in patients with diabetes (OR=0.984, 95% CI: 0.265-3.658, P=0.981).ConclusionsHbA1c is an independent predictor of MPRI decline in CMD patients, notably in CMD patients without diabetes, but not for those with diabetes.Trial RegistrationThis clinical trial has been registered in the Chinese clinical Trial Registry with an identifier: ChiCTR1900025810.
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- 2021
32. TLR4-Myd88 pathway upregulated caveolin-1 expression contributes to coronary artery spasm
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Jinfan Tian, Yue Liu, Xin Zhao, Mingyue Xu, Zhishuai Ye, Xiantao Song, and Rongchong Huang
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Lipopolysaccharides ,Spasm ,Physiology ,Caveolin 1 ,Mice ,Downregulation and upregulation ,In vivo ,Human Umbilical Vein Endothelial Cells ,Medicine ,Animals ,Humans ,Endothelial dysfunction ,Receptor ,Pharmacology ,business.industry ,Vasospasm ,medicine.disease ,Coronary Vessels ,Endothelial stem cell ,Toll-Like Receptor 4 ,Myeloid Differentiation Factor 88 ,cardiovascular system ,Cancer research ,TLR4 ,Molecular Medicine ,business - Abstract
Aim To study the role of toll-like receptors 4-myeloid differentiation factor 88 (TLR4-Myd88) dependent caveolin-1 (Cav-1) expression modulation in coronary artery spasm (CAS) and explore the underlying pathogenic mechanisms. Methods and results Lipopolysaccharide (LPS) and acetylcholine (Ach) were used to develop the in vitro and in vivo models mimicking the physiological CAS microenvironment. LPS-induced upregulation of Cav-1 expression in mouse coronary and aorta endothelial cells was shown by western blot and immunofluorescence (IF) staining (p Conclusion These findings suggested that Cav-1, which was upregulated by TLR4-Myd88, served as an important modulator of CAS microenvironment establishment in vivo and in vitro, making it a potential pharmacologic target for the treatment of vasospasm via reduced endothelial cell inflammation.
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- 2021
33. Quantification of strain analysis and late gadolinium enhancement in coronary chronic total occlusion: a cardiovascular magnetic resonance imaging follow-up study
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Xueyao Yang, Lijun Zhang, X T Song, Jinfan Tian, Yi He, and Jielin Liu
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medicine.diagnostic_test ,business.industry ,Follow up studies ,Magnetic resonance imaging ,Strain (injury) ,medicine.disease ,Total occlusion ,medicine ,Late gadolinium enhancement ,Radiology, Nuclear Medicine and imaging ,Original Article ,cardiovascular diseases ,Nuclear medicine ,business - Abstract
BACKGROUND: The present study aimed to investigate the benefits of percutaneous coronary intervention (PCI) in patients with chronic total occlusions (CTOs) by using cardiac magnetic resonance imaging (CMR) feature tracking. METHODS: Fifty-five CTOs with successful CTO-PCI underwent CMR at baseline and 12 months. Feature tracking was applied to measure left ventricle strain index in CTOs with decreased and preserved left ventricular ejection fraction (LVEF). CTOs were also divided into two groups according to the infarct size of 10% or combined with multi-vessel disease. We also measured these parameters in 40 healthy subjects. RESULTS: Three quarters of CTOs showed preserved ejection fraction and no enlargement of left ventricle at baseline, but the global strains were lower than the controls (all P
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- 2021
34. Optimal treatment strategies for coronary artery disease in patients with advanced kidney disease: a meta-analysis
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Yi He, Xiantao Song, Xueyao Yang, Jingwen Yong, Jinfan Tian, Haoran Xing, and Xin Zhao
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medicine.medical_specialty ,kidney disease ,medicine.medical_treatment ,030232 urology & nephrology ,Medicine (miscellaneous) ,RM1-950 ,030204 cardiovascular system & hematology ,Revascularization ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,coronary artery bypass graft ,Internal medicine ,Medicine ,In patient ,cardiovascular diseases ,Cause of death ,business.industry ,Optimal treatment ,percutaneous coronary intervention ,Percutaneous coronary intervention ,medicine.disease ,medical therapy ,Meta-analysis ,Cardiology ,revascularization ,Therapeutics. Pharmacology ,business ,coronary artery disease ,Meta-Analysis ,Kidney disease - Abstract
Background:Coronary artery disease (CAD) is the leading cause of death in advanced kidney disease. However, its best treatment has not been determined.Methods:We searched PubMed and Cochrane databases and scanned references to related articles. Studies comparing the different treatments for patients with CAD and advanced CKD (estimated glomerular filtration rate 2or dialysis) were selected. The primary result was all-cause death, classified according to the follow-up time: short-term (1 year).Results:A total of 32 studies were selected to enroll 84,498 patients with advanced kidney disease. Compared with medical therapy (MT) alone, percutaneous coronary intervention (PCI) was associated with low risk of short-, medium-term and long-term all-cause death (more than 3 years). For AMI patients, compared with MT, PCI was not associated with low risk of short- and medium-term all-cause death. For non-AMI patients, compared with MT, PCI was associated with low risk of long-term mortality (more than 3 years). Compared with MT, coronary artery bypass surgery (CABG) had no significant advantages in each follow-up period of all-cause death. Compared with PCI, CABG was associated with a high risk of short-term death, but low risk of long-term death: 1–3 years; more than 3 years. CABG could also reduce the risk of long-term risk of cardiac death, major adverse cardiovascular events (MACEs), myocardial infarction (MI), and repeat revascularization.Conclusions:In patients with advanced kidney disease and CAD, PCI reduced the risk of short-, medium- and long- term (more than 3 years) all-cause death compared with MT. Compared with PCI, CABG was associated with a high risk of short-term death and a low risk of long-term death and adverse events.
- Published
- 2021
35. Exosomes as a Cell-free Therapy for Myocardial Injury Following Acute Myocardial Infarction or Ischemic Reperfusion.
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Ziyu An, Jinfan Tian, Yue Liu, Xin Zhao, Xueyao Yang, Jingwen Yong, Libo Liu, Lijun Zhang, Wenjian Jiang, Xiantao Song, and Hongjia Zhang
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- *
MYOCARDIAL injury , *EXOSOMES , *REPERFUSION injury - Abstract
Exosomes, which contain miRNA, have been receiving growing attention in cardiovascular therapy because of their role in mediating cell-cell communication, autophagy, apoptosis, inflammation, and angiogenesis. Several studies have suggested that miRNA derived from exosomes can be used to detect myocardial infarctions (MI) in patients. Basic research also suggests that exosomes could serve as a potential therapeutic target for treating acute myocardial infarction. Ischemia/reperfusion (IR) injury is associated with adverse cardiac events after acute MI. We aim to review the potential benefits and mechanisms of exosomes in treating MI and IR injury. [ABSTRACT FROM AUTHOR]
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- 2022
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36. cGAS-STING Pathway Performance in the Vulnerable Atherosclerotic Plaque .
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Xueqi Wan, Jinfan Tian, Peng Hao, Kuo Zhou, Jing Zhang, Yuquan Zhou, Changjiang Ge, and Xiantao Song
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ATHEROSCLEROTIC plaque , *MEMBRANE proteins , *EXTRACELLULAR fluid - Abstract
The important role of Ca2+ in pathogenic store-operated calcium entry (SOCE) is well-established. Among the proteins involved in the calcium signaling pathway, Stromal interacting molecule 1 (STIM1) is a critical endoplasmic reticulum transmembrane protein. STIM1 is activated by the depletion of calcium stores and then binds to another calcium protein, Orai1, to form a channel through which the extracellular Ca2+ can enter the cytoplasm to replenish the calcium store. Multiple studies have shown that increased STIM1 facilitates the aberrant proliferation and apoptosis of vascular smooth cells (VSMC) and macrophages which can promote the formation of rupture-prone plaque. Together with regulating the cytosolic Ca2+ concentration, STIM1 also activates STING through altered intracellular Ca2+ concentration, a critical pro-inflammatory molecule. The cGAS-STING pathway is linked with cellular proliferation and phenotypic conversion of VSMC and enhances the progression of atherosclerosis plaque. In summary, we conclude that STIM1/cGAS-STING is involved in the progression of AS and plaque vulnerability. [ABSTRACT FROM AUTHOR]
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- 2022
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37. The Atherogenic Index of Plasma: A Powerful and Reliable Predictor for Coronary Artery Disease in Patients With Type 2 Diabetes
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Yunfeng Yan, Zheng Qin, Kuo Zhou, Jinfan Tian, Kongyong Cui, and Shuzheng Lyu
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Male ,medicine.medical_specialty ,030209 endocrinology & metabolism ,Type 2 diabetes ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Risk Assessment ,Coronary artery disease ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Insulin resistance ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,medicine ,Humans ,Risk factor ,Triglycerides ,Aged ,Dyslipidemias ,Cholesterol ,business.industry ,Incidence ,Cholesterol, HDL ,Type 2 Diabetes Mellitus ,Cholesterol, LDL ,Middle Aged ,medicine.disease ,Prognosis ,Cross-Sectional Studies ,chemistry ,Diabetes Mellitus, Type 2 ,Beijing ,Cardiology ,lipids (amino acids, peptides, and proteins) ,Female ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Dyslipidemia - Abstract
We evaluated the predictive power of the atherogenic index of plasma (AIP) for coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). A total of 3278 patients who underwent coronary angiography were consecutively enrolled, including 2052 patients with CAD and 1226 patients with T2DM but without CAD. Patients in the CAD group had higher levels of triglyceride (TG), total cholesterol, low-density lipoprotein cholesterol, AIP and a lower level of high-density lipoprotein cholesterol (HDL-C). In correlation analyses, AIP correlated positively with body mass index, log (homeostasis model assessment of insulin resistance), TG, remnant lipoprotein cholesterol, non–HDL-C, but negatively with age and HDL-C. Multivariate logistic regression analyses demonstrated that AIP was an independent risk factor for CAD in diabetic patients and was validated by multiple models. Furthermore, the ORs for CAD risk were raised with increasing AIP quartiles; ORs of AIP quartiles Q2–Q4 compared with Q1 were 1.56, 1.70, and 2.22, respectively ( Ps < .001), which suggested AIP was the lipid parameter that most strongly associated with incident CAD. In conclusion, AIP is a powerful and reliable biomarker for predicting CAD risk beyond individual lipid profiles in patients with T2DM.
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- 2021
38. Long-term outcomes of in-hospital staged revascularization versus culprit-only intervention for patients with ST-segment elevation myocardial infarction and multivessel disease
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Jinfan Tian, Kongyong Cui, Jing Dai, Shuzheng Lyu, Fei Yuan, Hong Liu, Feng Xu, Xiantao Song, Min Zhang, Mingduo Zhang, Wei Wang, and Dongfeng Zhang
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Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Revascularization ,Risk Assessment ,Culprit ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Recurrence ,Risk Factors ,Cause of Death ,Internal medicine ,medicine ,Humans ,ST segment ,Prospective Studies ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Prospective cohort study ,Aged ,Cause of death ,business.industry ,Incidence ,Percutaneous coronary intervention ,General Medicine ,Middle Aged ,medicine.disease ,Progression-Free Survival ,Stroke ,surgical procedures, operative ,Beijing ,Conventional PCI ,Cardiology ,ST Elevation Myocardial Infarction ,Female ,Cardiology and Cardiovascular Medicine ,business ,therapeutics - Abstract
The long-term relative benefit of culprit-only percutaneous coronary intervention (PCI) and staged PCI in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease remains disputable. This study aimed to compare the long-term outcomes of culprit-only PCI and in-hospital staged complete revascularization in real-world patients with STEMI and multivessel coronary artery disease.A total of 452 patients were treated with in-hospital staged complete revascularization (n=133) or culprit-only PCI (n=319) between May 2012 and December 2015 in our center. The primary end point was major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of all-cause death, nonfatal myocardial infarction, stroke, and unplanned revascularization.The median follow-up period was 3.2 years. Overall, treatment with in-hospital staged complete revascularization can reduce the incidence of the primary end point of MACCE in both the overall population [hazard ratio (HR): 0.48; 95% confidence interval (CI): 0.29-0.82] and the propensity-matched cohorts (HR: 0.51; 95% CI: 0.27-0.97). After correction of the possible confounders, staged PCI remained associated with decreased risk of MACCE (HR: 0.56; 95% CI: 0.33-0.96). Besides, the strategy of staged PCI tended to be associated with lower risk of a composite of cardiac death, myocardial infarction, and stroke than culprit-only PCI in multivariable-adjusted analysis (HR: 0.30; 95% CI: 0.09-1.01).In patients with STEMI and multivessel disease undergoing primary PCI, an approach of in-hospital staged complete revascularization was associated with a better 3-year composite outcome compared with culprit-only PCI.
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- 2019
39. sj-pdf-1-taj-10.1177_2040622321990273 – Supplemental material for Coronary artery bypass graft surgery versus stenting for patients with chronic kidney disease and complex coronary artery disease: a systematic review and meta-analysis
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Kongyong Cui, Liu, Hong, Yuan, Fei, Xu, Feng, Zhang, Min, Mingduo Zhang, Wang, Wei, Dongfeng Zhang, Jinfan Tian, Shuzheng Lyu, and Kefei Dou
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110203 Respiratory Diseases ,FOS: Clinical medicine ,Cardiology ,170199 Psychology not elsewhere classified ,FOS: Health sciences ,110319 Psychiatry (incl. Psychotherapy) ,110306 Endocrinology ,110308 Geriatrics and Gerontology ,FOS: Psychology ,cardiovascular system ,111702 Aged Health Care ,hormones, hormone substitutes, and hormone antagonists ,111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified ,110904 Neurology and Neuromuscular Diseases - Abstract
Supplemental material, sj-pdf-1-taj-10.1177_2040622321990273 for Coronary artery bypass graft surgery versus stenting for patients with chronic kidney disease and complex coronary artery disease: a systematic review and meta-analysis by Kongyong Cui, Hong Liu, Fei Yuan, Feng Xu, Min Zhang, Mingduo Zhang, Wei Wang, Dongfeng Zhang, Jinfan Tian, Shuzheng Lyu and Kefei Dou in Therapeutic Advances in Chronic Disease
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- 2021
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40. Efficacy and safety of drug-eluting balloon-only strategy (DEB-only) for de novo coronary artery disease: a systematic review and meta-analysis
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Ming Zhang, Xiantao Song, Jinfan Tian, W.Y Zhang, Mingduo Zhang, and Yanhua Zhou
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Oncology ,medicine.medical_specialty ,Cochrane collaboration ,Surrogate endpoint ,business.industry ,medicine.medical_treatment ,medicine.disease ,Revascularization ,Coronary heart disease ,Coronary artery disease ,Restenosis ,Internal medicine ,Meta-analysis ,medicine ,Cardiology and Cardiovascular Medicine ,Drug eluting balloon ,business - Abstract
Background Many clinical trials have demonstrated the value of drug-eluting balloon (DEB) for in-stent restenosis. Recently, DEB for de novo lesions has also attracted more attention. There have been promising results of PCI using DEB alone in selected de novo coronary diseases (small vessels, bifurcating lesions, acute myocardial infarction). However, the application of DEB for patients with de novo coronary artery disease remains controversial due to relatively limited evidence. Purpose The purpose of this study was to evaluate the efficacy and safety DEB-only strategy (bail-out stents were allowed when required) compared with other modalities for the treatment of de novo coronary lesions. Methods We searched PubMed, Embase, Web of Science and Cochrane Library Central Register of Controlled Trials (CENTRAL) electronic databases for randomized controlled trials as well as observational studies published up to Jan 22, 2020. Studies which compared DEB-only approach with other PCI strategies for treatment of any type of de novo coronary lesions were identified. The primary outcome was late lumen loss (LLL) during angiographic follow up. The secondary outcomes were major adverse cardiac events (MACE), target lesion revascularisation (TLR) and binary in-segment restenosis. Results Nineteen studies (eleven randomised controlled trials and eight observational studies) with a total of 3,356 patients were included in this meta-analysis. Angiographic observations were obtained at 6 or 9 months and clinical follow-up duration ranged from 6 months to 36 months. Among the overall studies, the results indicated that DEB-only strategy was superior to the control groups for LLL (mean difference (MD) = −0.30mm; 95% confidence interval (CI), −0.41 to −0.19; P Conclusion DEB-only intervention is an effective treatment associated with a significant reduction in late loss late lumen loss compared to other options. The efficacy and safety of DEB alone are comparable to those of DES and superior to POBA for treatment of selected de novo coronary lesions. Additional evidence is still warranted to confirm value of DEB before a widespread clinical utilization can be recommended. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Beijing Lab for Cardiovascular Precision Medicine
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- 2020
41. Prevalence of myocardial viability and ischemic burden in chronic total occluded coronary artery disease
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Jinfan Tian, Wei Dong, Ye Han, Jiahui Li, J.N. Li, Xiantao Song, Huijuan Zuo, Lijun Zhang, Xueyao Yang, Yuzhu He, and Hongzhi Mi
- Subjects
Coronary artery disease ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease - Abstract
Aims We assessed the viable myocardium status and investigated the relationship between collaterals with the ischemia burden and myocardial viability utilizing cardiac magnetic resonance imaging (CMR) and adenosine stress single-photon emission computed tomography (SPECT). Methods and results 150 consecutive patients with at least one native CTO artery, as confirmed by coronary arteriography or coronary CT angiography, were prospectively recruited. SPECT examination was accepted by only 50 patients while declined by the other 100 patients for reasons such as financial problems. Of all segments in the 173 CTO artery territories, only 10.4% exhibited transmural myocardial infarction and 60.2% showed no late gadolinium enhancement. Among 50 patients who completed SPECT examination, 36 patients showed inducible perfusion defect in CTO territory, and the proportion of the ischemic area of 42% patients was over 10%. Conclusion Most patients with CTO had different degrees of myocardial infarction detected by CMR, but only a minority of them showed transmural infarction and cardiac function in patients with transmural infarction declined compared to those without transmural infarction. Approximately half of CTO patients exhibited inducible ischemia in CTO territory. Based on this, a large proportion of patients potentially benefit from CTO-PCI. Figure 1. Relationship between WMSI, LVE Funding Acknowledgement Type of funding source: Other. Main funding source(s): Beijing Municipal Education Commission Science and Technology Plan for 2020, Capital Health Development Research Project (no. 2018-2-2063)
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- 2020
42. Coronary artery bypass graft surgery
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Kongyong, Cui, Hong, Liu, Fei, Yuan, Feng, Xu, Min, Zhang, Mingduo, Zhang, Wei, Wang, Dongfeng, Zhang, Jinfan, Tian, Shuzheng, Lyu, and Kefei, Dou
- Abstract
The relative role of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with stent implantation in patients with chronic kidney disease (CKD) and complex coronary artery disease (CAD) remains debatable due to the lack of randomized controlled trials (RCTs). We therefore performed this meta-analysis to compare the outcomes of the two strategies in CKD patients with multivessel and/or left main disease.Electronic databases including PubMed, EMBASE and Cochrane Library were comprehensively searched to identify the eligible subgroup analysis of RCTs and propensity-matched registries. The primary endpoint was all-cause mortality during the longest follow-up.Five subgroup analyses of RCTs and six propensity-matched registries involving 26,441 patients were analyzed. Overall, the strategy of CABG was associated with lower risks of long-term mortality [odds ratio (OR) 0.83, 95% confidence interval (CI) 0.74-0.93], myocardial infarction (OR, 0.41; 95% CI, 0.27-0.62), and repeat revascularization (OR, 0.25; 95% CI, 0.16-0.39) compared with PCI in CKD patients with complex CAD. However, CABG was slightly associated with higher risk of stroke than PCI (OR, 1.33; 95% CI, 1.00-1.77). Nonetheless, the higher stroke risk in the CABG group no longer existed during long-term follow-up (OR, 0.92; 95% CI, 0.37-2.25) (3 years).This meta-analysis supports the current guideline advising CABG for patients with CKD and complex CAD. At the expense of slightly increased risk of stroke, CABG reduces the incidences of long-term all-cause death, myocardial infarction and repeat revascularization compared with PCI.
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- 2020
43. Percutaneous Coronary Intervention Offers Survival Benefit to Stable Patients With One Single Chronic Total Occlusion and Diabetes: A Propensity Score-Matched Analysis
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Kuo Zhou, Min Zhang, Mingduo Zhang, Yunfeng Yan, Wei Wang, Lingxiao Chen, Fei Yuan, Jinfan Tian, Kongyong Cui, Shuzheng Lyu, Feng Xu, and Hong Liu
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Disease-Free Survival ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Interquartile range ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Propensity Score ,Aged ,Retrospective Studies ,business.industry ,Hazard ratio ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,Coronary Occlusion ,Propensity score matching ,Conventional PCI ,Chronic Disease ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Mace ,Diabetic Angiopathies - Abstract
Studies on chronic total occlusion (CTO) treatment strategy in stable patients have reported conflicting results. We focused on stable diabetic patients with a single CTO (other vessels have been successfully treated before). We attempted to identify which strategy (percutaneous coronary intervention [PCI] or medical therapy [MT]) is optimal; 545 patients were selected from a total of 39 952 patients. Based on the initial treatment strategy, we assigned patients to either the PCI or MT group. The primary end point was a major adverse cardiac event (MACE). After a median follow-up of 45 months (interquartile range: 25.7-79.2 months), we observed (1) no difference in MACE and myocardial infarction between groups, (2) multivariate analysis showed that PCI group was superior to MT group in cardiac death (hazard ratio: 4.758 (1.698-13.334); P = .003) and all-cause death (2.767 [1.157-6.618]; P = .022). The superiority was consistent in propensity score–matched analysis, and (3) a failed PCI group was not associated with higher risks in the clinical end points, except for target vessel revascularization, compared with MT. We concluded that for stable patients with diabetes and one single CTO, initial PCI strategy tended to offer patients survival benefits compared with MT.
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- 2019
44. Cellular and Molecular Mechanisms of Diabetic Atherosclerosis: Herbal Medicines as a Potential Therapeutic Approach
- Author
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Yue Liu, Jinfan Tian, Shuzheng Lyu, Yanfei Liu, and Ke-ji Chen
- Subjects
0301 basic medicine ,Aging ,Herbal Medicine ,MEDLINE ,Review Article ,Disease ,Pharmacology ,Bioinformatics ,Biochemistry ,03 medical and health sciences ,Therapeutic approach ,Diabetes mellitus ,medicine ,Animals ,Humans ,lcsh:QH573-671 ,Coronary atherosclerosis ,lcsh:Cytology ,business.industry ,Incidence (epidemiology) ,Type 2 Diabetes Mellitus ,Cell Biology ,General Medicine ,Atherosclerosis ,medicine.disease ,Diabetes Mellitus, Type 1 ,030104 developmental biology ,Diabetes Mellitus, Type 2 ,business - Abstract
An increasing number of patients diagnosed with diabetes mellitus eventually develop severe coronary atherosclerosis disease. Both type 1 and type 2 diabetes mellitus increase the risk of cardiovascular disease associated with atherosclerosis. The cellular and molecular mechanisms affecting the incidence of diabetic atherosclerosis are still unclear, as are appropriate strategies for the prevention and treatment of diabetic atherosclerosis. In this review, we discuss progress in the study of herbs as potential therapeutic agents for diabetic atherosclerosis.
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- 2017
45. Roles and Mechanisms of Herbal Medicine for Diabetic Cardiomyopathy: Current Status and Perspective
- Author
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Yue Liu, Yingke Zhao, Jinfan Tian, Ke-ji Chen, Shuzheng Lyu, and Yanfei Liu
- Subjects
0301 basic medicine ,MAPK/ERK pathway ,Aging ,medicine.medical_specialty ,Diabetic Cardiomyopathies ,Herbal Medicine ,p38 mitogen-activated protein kinases ,Review Article ,Pharmacology ,Left ventricular hypertrophy ,Biochemistry ,Renin-Angiotensin System ,03 medical and health sciences ,Diabetes mellitus ,Internal medicine ,Diabetic cardiomyopathy ,medicine ,Animals ,Humans ,lcsh:QH573-671 ,Protein kinase A ,Plants, Medicinal ,lcsh:Cytology ,Plant Extracts ,Kinase ,business.industry ,Cell Biology ,General Medicine ,medicine.disease ,MicroRNAs ,Oxidative Stress ,030104 developmental biology ,Cardiology ,Myocardial fibrosis ,Inflammation Mediators ,Mitogen-Activated Protein Kinases ,business ,Signal Transduction - Abstract
Diabetic cardiomyopathy is one of the major complications among patients with diabetes mellitus. Diabetic cardiomyopathy (DCM) is featured by left ventricular hypertrophy, myocardial fibrosis, and damaged left ventricular systolic and diastolic functions. The pathophysiological mechanisms include metabolic-altered substrate metabolism, dysfunction of microvascular, renin-angiotensin-aldosterone system (RAAS) activation, oxidative stress, cardiomyocyte apoptosis, mitochondrial dysfunction, and impaired Ca2+ handling. An array of molecules and signaling pathways such as p38 mitogen-activated protein kinase (p38 MAPK), c-Jun N-terminal kinase (JNK), and extracellular-regulated protein kinases (ERK) take roles in the pathogenesis of DCM. Currently, there was no remarkable effect in the treatment of DCM with application of single Western medicine. The myocardial protection actions of herbs have been gearing much attention. We present a review of the progress research of herbal medicine as a potential therapy for diabetic cardiomyopathy and the underlying mechanisms.
- Published
- 2017
46. Stent Versus Non-Stent in Treating Intermediate Stenosis Culprit Lesions in Acute ST-Segment Elevation Myocardial Infarction Patients
- Author
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Min Zhang, Xiantao Song, Hai Gao, Jinfan Tian, Wei Wang, Yu-Jie Zeng, Jing Dai, Shuzheng Lyu, Shaoping Nie, Mingduo Zhang, and Dongfeng Zhang
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Culprit ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Stroke ,business.industry ,Mortality rate ,Hazard ratio ,Stent ,General Medicine ,equipment and supplies ,medicine.disease ,Surgery ,Stenosis ,surgical procedures, operative ,Drug-eluting stent ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
To investigate the efficacy and safety of stent versus non-stent in treating acute ST-segment elevation myocardial infarction (STEMI) patients with single vessel disease and intermediate stenosis culprit lesions.Between September 2009 and May 2015, 475 acute STEMI patients (time from symptom onset < 12 hours) with single vessel disease and intermediate stenosis culprit lesions were retrospectively studied at Beijing Anzhen Hospital. The patients were divided into a stent group (n = 308) and non-stent group (n = 167) based on whether they received stent implantation or not during primary coronary angiography.During follow-up, the stent group patients had a lower major adverse cardiac and cerebrovascular event (MACCE) rate than the non-stent group: 5.5% versus 12.0%; P = 0.01; hazard ratio (HR) 0.35 [95% confidence interval (CI): 0.180.69]). The nonfatal myocardial infarction (MI) rate was lower in the stent group (2.9% versus 7.2%, P = 0.03). The cardiac death rate (1.9% versus 3%, P = 0.45) and stroke (0.6% versus 1.8%, P = 0.35) rate were similar between the stent and non-stent groups. The two groups shared similar all cause death rates: 4.9% versus 5.4%, respectively, P = 0.81; HR: 1.23 [95%CI: 0.51-2.99]. The composite ischemia outcome of death/MI/stroke was lower in the stent group (8.1% versus 14.4%, P = 0.02). The stent and non-stent groups had similar repeat revascularization rates (10.1% versus 11.4%, P = 0.67); ischemia driven readmission (19.5% versus 15.0%, P = 0.27), and bleeding (1.3% versus 1.2%, P = 1) rates.Stent implantation has a better efficacy and safety in reducing adverse ischemia events in acute STEMI patients with single vessel disease and intermediate stenosis culprit lesions.
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- 2017
47. Intra-aortic Balloon Pump Therapy for Anterior ST-elevation Myocardial Infarction with Cardiogenic Shock: An Observational Cohort Study
- Author
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Kuo Zhou, Shuzheng Lyu, Jing Dai, Jinfan Tian, Kongyong Cui, Yunfeng Yan, Lingxiao Chen, Zheng Qin, and Yutian Zhou
- Abstract
Background As a mechanical circulatory assistance, intra-aortic balloon pump (IABP) has been widely used for cardiogenic shock (CS), although recent clinical trials questioned its impact on acute myocardial infarction patients, nothing is hitherto known on the contribution of IABP to CS patients after anterior wall infarction. The aim of this study was to investigate the efficacy and safety of IABP therapy in patients presenting with anterior ST-elevation myocardial infarction (STEMI) complicated by CS.Methods We conducted a retrospective study of 215 consecutive patients presenting with CS after STEMI in the anterior wall between January 2006 and August 2017, including 125 patients in the IABP group and 90 patients in the control group.Results At 30 days, 60 (48.0%) patients in the IABP group and 58 (64.4%) patients in the control group had died (P=0.017). The Kaplan-Meier survival curves showed the cumulative survival rate in the IABP group was consistently higher than control group (P=0.009 by Log-Rank test). Nevertheless, IABP increased the occurrence of thrombocytopenia (21.6% vs. 2.2%, P
- Published
- 2019
48. Erratum to 'Ginkgo Biloba Leaf Extract Attenuates Atherosclerosis in Streptozotocin-Induced Diabetic ApoE-/- Mice by Inhibiting Endoplasmic Reticulum Stress via Restoration of Autophagy through the mTOR Signaling Pathway'
- Author
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Jinfan Tian, Shuzheng Lyu, Yue Liu, Yanfei Liu, Ke-ji Chen, Mohammad Sharif Popal, and Rui Gao
- Subjects
Blood Glucose ,Male ,Aging ,Pharmacology ,Biochemistry ,Models, Biological ,Proinflammatory cytokine ,Diabetes Mellitus, Experimental ,Apolipoproteins E ,medicine ,Autophagy ,Animals ,lcsh:QH573-671 ,PI3K/AKT/mTOR pathway ,lcsh:Cytology ,business.industry ,Plant Extracts ,Endoplasmic reticulum ,TOR Serine-Threonine Kinases ,Body Weight ,Ginkgo biloba ,Lipid metabolism ,Cell Biology ,General Medicine ,Streptozotocin ,Atherosclerosis ,Endoplasmic Reticulum Stress ,Lipids ,Plaque, Atherosclerotic ,Mice, Inbred C57BL ,Plant Leaves ,Apoptosis ,Cytokines ,Collagen ,Signal transduction ,Erratum ,Inflammation Mediators ,business ,medicine.drug ,Signal Transduction - Abstract
Background. There is a crosstalk between endoplasmic reticulum stress (ERS) and autophagy, and autophagy could attenuate endoplasmic reticulum stress-mediated apoptosis. Ginkgo biloba leaf extract (GBE) exerts vascular protection functions. The purpose of the present study is to investigate the role of autophagy in diabetic atherosclerosis (AS) and the effect of GBE on autophagy and ERS. Methods. Network pharmacology was utilized to predict the targets and pathways of the active chemical compounds of Gingko biloba leaf to attenuate AS. ApoE-/- mice were rendered diabetic by intraperitoneal ingestion with streptozotocin combined with a high-fat diet. The diabetic mice were divided into five groups: model group, atorvastatin group, rapamycin group, and low- and high-dose GBE groups. Serum and tissue markers of autophagy or ERS markers, including the protein expression, were examined. Results. The mammalian target of rapamycin (mTOR) and NF-κB signaling pathways were targeted by the active chemical compounds of GBE to attenuate AS predicted by network pharmacology. GBE reduced the plaque area/lumen area and the plaque lipid deposition area/intimal area and inhibited the expressions of CD68, MMP2, and MMP9. Rapamycin and GBE inhibited the expression of mTOR and SQSTM1/p62 which increased in the aorta of diabetic mice. In addition, GBE reduced the expression of ERS markers in diabetic mice. GBE reduced the serum lipid metabolism levels, blood glucose, and inflammatory cytokines. Conclusion. Impaired autophagy and overactive endoplasmic reticulum stress contributed to diabetic atherosclerosis. mTOR inhibitor rapamycin and GBE attenuated diabetic atherosclerosis by inhibiting ERS via restoration of autophagy through inhibition of mTOR.
- Published
- 2019
49. Staged complete revascularization or culprit-only percutaneous coronary intervention for multivessel coronary artery disease in patients with ST-segment elevation myocardial infarction and diabetes
- Author
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Wei Wang, Dongfeng Zhang, Hong Liu, Mingduo Zhang, Jinfan Tian, Kongyong Cui, Xiantao Song, Shuzheng Lyu, Feng Xu, Fei Yuan, and Min Zhang
- Subjects
Staged Percutaneous Coronary Intervention ,Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Time Factors ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Population ,Coronary Artery Disease ,Revascularization ,Risk Assessment ,Coronary artery disease ,Staged complete revascularization ,Percutaneous Coronary Intervention ,Diabetes mellitus ,Recurrence ,Risk Factors ,Internal medicine ,medicine ,Humans ,Myocardial infarction ,cardiovascular diseases ,education ,Stroke ,Aged ,Retrospective Studies ,Original Investigation ,Outcome ,education.field_of_study ,Multivessel disease ,business.industry ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,Treatment Outcome ,Culprit-only percutaneous coronary artery intervention ,lcsh:RC666-701 ,Beijing ,Conventional PCI ,ST Elevation Myocardial Infarction ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
BackgroundRecently, several randomized trials have noted improved outcomes with staged percutaneous coronary intervention (PCI) of nonculprit vessels in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease. However, it remains unclear whether diabetes status affects the outcomes after different revascularization strategies. This study thus compared the impact of diabetes status on long-term outcomes after staged complete revascularization with that after culprit-only PCI.MethodsFrom January 2006 to December 2015, 371 diabetic patients (staged PCI: 164, culprit-only PCI: 207) and 834 nondiabetic patients (staged PCI: 412, culprit-only PCI: 422) with STEMI and multivessel disease were enrolled. The primary endpoint was 5-year major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of all-cause death, myocardial infarction (MI), stroke or unplanned revascularization.ResultsThe rate of the 5-year composite primary endpoint for diabetic patients was close to that for nondiabetic patients (34.5% vs. 33.7%; adjusted hazard ratio [HR] 1.012, 95% confidence interval [CI] 0.815–1.255). In nondiabetic patients, the 5-year risks of MACCE (31.8% vs. 35.5%; adjusted HR 0.638, 95% CI 0.500–0.816), MI (4.6% vs. 9.2%; adjusted HR 0.358, 95% CI 0.200–0.641), unplanned revascularization (19.9% vs. 24.9%; adjusted HR 0.532, 95% CI 0.393–0.720), and the composite of cardiac death, MI or stroke (11.4% vs. 15.2%; adjusted HR 0.621, 95% CI 0.419–0.921) were significantly lower after staged PCI than after culprit-only PCI. In contrast, no significant difference was found between the two groups with respect to MACCE, MI, unplanned revascularization, and the composite of cardiac death, MI or stroke in diabetic patients. Significant interactions were found between diabetes status and revascularization assignment for the composite of cardiac death, MI or stroke (Pinteraction = 0.013), MI (Pinteraction = 0.005), and unplanned revascularization (Pinteraction = 0.013) at 5 years. In addition, the interaction tended to be significant for the primary endpoint of MACCE (Pinteraction = 0.053). Moreover, the results of propensity score-matching analysis were concordant with the overall analysis in both diabetic and nondiabetic population.ConclusionsIn patients with STEMI and multivessel disease, diabetes is not an independent predictor of adverse cardiovascular events at 5 years. In nondiabetic patients, an approach of staged complete revascularization is superior to culprit-only PCI, whereas the advantage of staged PCI is attenuated in diabetic patients.Trial registrationThis study was not registered in an open access database
- Published
- 2019
50. Long-Term Safety and Efficacy of Staged Percutaneous Coronary Intervention for Patients with ST-Segment Elevation Myocardial Infarction and Multivessel Coronary Disease
- Author
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Hong Liu, Kongyong Cui, Jinfan Tian, Shuzheng Lyu, Mingduo Zhang, Dongfeng Zhang, Fei Yuan, Xiantao Song, Feng Xu, Wei Wang, and Min Zhang
- Subjects
Staged Percutaneous Coronary Intervention ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Matched-Pair Analysis ,Population ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Revascularization ,Coronary Angiography ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Internal medicine ,medicine ,Diabetes Mellitus ,Myocardial Revascularization ,ST segment ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,education ,Propensity Score ,Aged ,Proportional Hazards Models ,Retrospective Studies ,education.field_of_study ,business.industry ,Coronary Stenosis ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Stroke ,surgical procedures, operative ,Cardiovascular Diseases ,Propensity score matching ,Conventional PCI ,Cardiology ,ST Elevation Myocardial Infarction ,Female ,Cardiology and Cardiovascular Medicine ,business ,therapeutics ,Follow-Up Studies - Abstract
The relative benefit of staged percutaneous coronary intervention (PCI) versus culprit-only PCI in patients with ST-segment elevation myocardial infarction and multivessel coronary disease remains disputable. Therefore, we conducted this study to compare the long-term outcomes of staged complete revascularization and culprit-only PCI in this population. A total of 1,205 patients were treated with staged PCI (n = 576) or culprit-only PCI (n = 629) from January 2006 to December 2015 in our center. After propensity-score matching, 415 pairs of patients were identified, and postmatching absolute standardized differences were10% for all covariates. The primary endpoint was major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of all-cause death, myocardial infarction (MI), stroke, or unplanned revascularization. The mean follow-up duration was 5 years. Overall, staged complete revascularization was associated with lower risks of MACCE, MI, unplanned revascularization, and a composite of cardiac death, MI or stroke compared with culprit-only PCI in both overall population and propensity-matched cohorts. In Cox proportional hazards regression analysis, the strategy of staged PCI was consistently a significant predictor of lower incidences of MACCE, MI, unplanned revascularization and a composite of cardiac death, MI, or stroke. However, there was no difference in the risks of MACCE, MI and unplanned revascularization between the 2 approaches for diabetic patients. In conclusion, among patients with ST-segment elevation myocardial infarction and multivessel disease who underwent primary PCI, an approach of staged complete revascularization is superior to culprit-only PCI at 5-year follow-up. Nevertheless, the advantage of staged PCI is attenuated in diabetic patients.
- Published
- 2019
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