Benefits and risks of prolonged dual antiplatelet therapy after percutaneous coronary intervention with drug-eluting stent in patients with stable coronary artery disease and diabetes / 中华心血管病杂志

Objective: To compare the efficacy and safety of prolonged dual antiplatelet therapy (DAPT>1 year) in patients with stable coronary artery disease (CAD) and diabetes who were event-free at 1 year after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) in a large and contemporary PCI registry. Methods: A total of 1 661 eligible patients were selected from the Fuwai PCI Registry, of which 1 193 received DAPT>1 year and 468 received DAPT ≤1 year. The primary endpoint was major adverse cardiac and cerebrovascular event (MACCE) and Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding, MACCE was defined as a composite of all-cause death, myocardial infarction or stroke. Multivariate Cox regression analysis and inverse probability of treatment weighting (IPTW) Cox regression analysis were performed. Results: After a median follow-up of 2.5 years, patients who received DAPT>1 year were associated with lower risks of MACCE (1.4% vs. 3.2%; hazard ratio (HR) 0.412, 95% confidence interval (CI) 0.205-0.827) compared with DAPT ≤1 year, which was primarily caused by the lower all-cause mortality (0.1% vs. 2.6%; HR 0.031, 95%CI 0.004-0.236). Risks of cardiac death (0.1% vs. 1.5%; HR 0.051, 95%CI 0.006-0.416) and definite/probable ST (0.3% vs. 1.1%; HR 0.218, 95%CI 0.052-0.917) were also lower in patients received DAPT>1 year than those received DAPT ≤ 1 year. No difference was found between the two groups in terms of BARC type 2, 3, or 5 bleeding (5.3% vs. 4.1%; HR 1.088, 95%CI 0.650-1.821). Conclusions: In patients with stable CAD and diabetes who were event-free at 1 year after PCI with DES, prolonged DAPT (>1 year) provides a substantial reduction in ischemic cardiovascular events, including MACCE, all-cause mortality, cardiac mortality, and definite/probable ST, without increasing the clinically relevant bleeding risk compared with ≤ 1-year DAPT. Further well-designed, large-scale randomized trials are needed to verify the beneficial effect of prolonged DAPT in this population.

Preparation of Silicon and Boron-doped Carbon Dots and Their Application in Hemoglobin Sensing / 分析化学

Heteroatom doping is an effective way to elevate the fluorescent performance of carbon dots. In this study, a microwave one-pot approach for the synthesis of SiBCDs was proposed by using citric acid ( C6 H8 O7 ) , boric acid ( H3 BO3 ) and (3-aminopropyl) triethoxy sliane ( APTES) as source materials. PAAS-SiBCDs were prepared with the assistance of microwave when sodium polyacrylate ( PAAS) was added in the precursor of SiBCDs. The products were characterized by X-ray diffraction ( XRD ) , X-ray photoelectron spectroscopy ( XPS ) and Fourier transform infrared ( FT-IR ) spectra, respectively, confirming that the product was amorphous CDs, with small amount of Si and B. The synthesized SiBCDs had good monodispersity with size of 4-8 nm, the average size of PAAS-SiBCDs was 5. 2 nm, and the excitation/emission maximum was 350 nm/445 nm. The quantum yield of SiBCDs was 20. 1%, and that of PAAS-SiBCDs was 34. 6%. Based on the quenching effect of hemoglobin ( Hb ) on the fluorescence PAAS-SiBCDs, a sensitive Hb detection method was developed. A linear range of 0. 21-5. 22 μmol/L was obtained together with a detection limit of 0. 06 μmol/L. The method was applied in the determination of Hb in human blood samples.