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Objective To evaluate the efficacy,safety and cost-effectiveness of alirocumab for the treatment of hypercholesterolemia in a rapid health technology assessment(rHTA).Methods PubMed,Embase,Cochrane Library,CNKI,WanFang Data and health technology assessment(HTA)relative websites were electronically searched to collect HTA reports,systematic reviews/Meta-analyses and pharmacoeconomic literatures on the alirocumab for the treatment of hypercholesterolemia from inception to August 14th,2022.Two reviewers independently screened the literature,extracted the data results and accessed the quality of included studies.Descriptive analysis and summary were then performed.Results A total of 38 documents were included,including 28 systematic reviews/Meta analyses,7 pharmacoeconomic studies and 3 HTA reports.This study showed that,compared with placebo or other lipid lowering therapy,alirocumab lowered the levels of LDL-C,Lp(a),TC,TG,Apo B,non-HDL-C,increased the levels of HDL-C and Apo A1,reduced the risk of major adverse cardiovascular events(MACE),all-cause mortality,cerebrovascular events,and unstable angina,but did not reduce cardiovascular death,myocardial infarction or coronary revascularization.Safety studies showed that,compared with placebo or other lipid lowering therapy,alirocumab did not increase the risk of other adverse reactions but associated with higher injection site reactions.Pharmacoeconomic studies showed that alirocumab was cost-effective in patients with three branch coronary artery disease and acute coronary syndrome with LDL-C≥2.59 mmol·L-1.Conclusion Alirocumab is effective and safe for the treatment of hypercholesterolemia,and cost-effective for the patients of coronary arteriosclerotic heart disease with multi-vessel disease or with high base-line level of LDL-C.
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Objective To describe quantitatively the development of the capillary loop stage glomerulus (capG) with respect to the volume density of capillaries in the glomerulus based on the morphogenesis of the kidney. Methods The kidneys were obtained from mice at various developing time points and prepared for paraffin sections. The volume density of CD34 positive endothelial cells and surrounded capillary lumen in glomeruli was measured using a combination of immunohistochemical staining and the stereological grid system. Results The capG was divided into early, middle, and late phases, and middle phase capG was subdivided into early-middle and late-middle phases, according to the morphology of developing glomeruli and the arrangement of podocytes. As result, the volume density of capillary loops in early phase capG could not be measured due to the complex "glomerular" shape. The volume density of capillary loops increased from (35.95±6.45)% in the early-middle phase capG, to (58.36±6. 30) % in the late-middle phase capG, and to (79.89± 5.21) % in the late phase capG, compared to (93.61 ±1.96) % in the mature glomerulus. Furthermore, the volume density of capillary loops remained constant at same stage even though at different developmental time points. Conclusion This study demonstrated a significantly increased volume density of capillary loops with the kidney development. In addition, the results provide a descriptive and reliable parameter for the evaluation of glomerular development.
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Objective: To establish a method for the characteristic chromatogram and determination of indicative components of salt-fried Phellodendri Chinensis Cortex (sPCC) and Yihuang Decoction (YHD). Methods: An HPLC was established for characteristic chromatogram analysis and determination of four indicative components (phellodendrine, 4-O-feruloylquinic acid, 5-O- feruloylquinic acid and berberine) of sPCC and YHD. Results: The characteristic chromatogram of sPCC and YHD were established by HPLC from 10 batches. Among five common peaks, four indicative components (phellodendrine, 4-O-feruloylquinic acid, 5-O-feruloylquinic acid and berberine) were identified and determined. The mass fraction of phellodendrine, 4-O-feruloylquinic acid, 5-O-feruloylquinic acid and berberine in sPCC ranged from 0.841%-1.314%, 0.358%-1.841%, 2.495%-5.498%, and 4.259%-7.007%, respectively; The mass concentration of phellodendrine, 4-O-feruloylquinic acid, 5-O-feruloylquinic acid and berberine in YHD ranged from 69.71-117.80, 107.85-165.79, 252.96-348.20, and 213.61-361.45 μg/mL, respectively; and the mass fraction of phellodendrine, 4-O-feruloylquinic acid, 5-O-feruloylquinic acid and berberine converted from YHD based on the mass of sPCC ranged from 0.509%-0.865%, 0.788%-1.212%, 1.849%-2.545%, and 1.561%-2.655%, respectively. Conclusion: The established method not only provides more complete reference and basis for the quality control, but also provides a certain basis for the research of effect substance basis of sPCC and YHD.
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<p><b>OBJECTIVE</b>To explore the relationship and interaction of elevated fasting glucose and hypertension on cardiocerebral vascular disease.</p><p><b>METHODS</b>10 054 males and females were recruited for our cross-sectional study during May 2007 to August 2007. Unconditional logistic regression was used to analysis the relationship between fasting glucose and hypertension on cardiocerebral vascular disease. A product of fasting glucose and hypertension was added to the logistic regression model to evaluate the multiplicative interaction and relative excess risk of interaction (RERI), attributable proportion (AP) of interaction and synergy index (S) was applied to evaluate the additive interaction of the two factors. Bootstrap was used to calculate 95% confidence intervals (CI) of RERI, AP and S.</p><p><b>RESULTS</b>After adjusting age, gender, smoking, drinking, body mass index (BMI) and region, the product of fasting glucose and hypertension was not statistically significant, which means there was no multiplicative interaction between the two. But the additive indexes RERI, AP and S with 95%CI of diabetes and hypertension were 0.64 (0.03, 1.25), 0.27 (0.01, 0.47) and 1.83 (1.02, 5.13) respectively, which means significant additive interaction was shown between the two on cardiovascular disease but not no stroke. And there were no additive interaction between impaired fasting glucose on cardiovascular disease or stroke.</p><p><b>CONCLUSIONS</b>Hypertension was independently related to cardiovascular disease and stroke in Beijing citizens, and diabetes were independently related to stroke. There was additive interaction between diabetes and hypertension on cardiovascular disease.</p>
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Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Glycémie , Métabolisme , Pression sanguine , Maladies cardiovasculaires , Épidémiologie , Angiopathies intracrâniennes , Épidémiologie , Chine , Épidémiologie , Études transversales , Hypertension artérielle , Sang , Facteurs de risqueRésumé
<p><b>OBJECTIVE</b>To investigate the relationship between marital status and prevalence of peripheral arterial disease (PAD) among Beijing residents.</p><p><b>METHODS</b>From May to August 2007, 10 054 residents were interviewed to collect demographic and biochemistry information. Generalized linear mixed model was used to determine the relationship between marital status and prevalence of PAD in terms of OR and corresponding 95% confidence intervals.</p><p><b>RESULTS</b>After adjusting the traditional risk factors including age, area, lipid, serum glucose, blood pressure, central obesity, smoking, drinking and physical activities for PAD, relationship between marital status and prevalence of PAD was found both at the female and male groups of those with 45 years or older. Compared with married men, OR and 95% confidence interval of PAD for unmarried men were 1.56 (0.39 - 6.35) and 1.61 (0.77 - 3.35) for those with 45 years younger and older respectively, while compared with married women, OR and 95% confidence interval of PAD for unmarried women were 0.75 (0.22 - 2.57) and 1.78 (1.23 - 2.58) for those with 45 years younger and older respectively. Significant differences (all P < 0.01) were found between married and unmarried women of 45 years or older in terms of age, waist circumstances, systolic blood pressure, fasting glucose, total cholesterol, low-density lipoprotein and smoking.</p><p><b>CONCLUSIONS</b>Peripheral arterial disease was related to marital status for women of 45 years or older among Beijing residents. Estrogen level and the distribution of other PAD risk factors might contribute to the observed finding.</p>
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Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Consommation d'alcool , Épidémiologie , Pression sanguine , Cholestérol , Études transversales , Lipoprotéines LDL , Situation de famille , Maladie artérielle périphérique , Épidémiologie , Maladies vasculaires périphériques , Prévalence , Facteurs de risque , Fumer , ÉpidémiologieRésumé
<p><b>OBJECTIVES</b>To explore the effect of acute smoking on vascular endothelial function, arterial stiffness and the possible underlying mechanisms.</p><p><b>METHODS</b>We measured the endothelial function and arterial stiffness in 50 healthy chronic smokers before and after acute smoking with EndoPAT2000. The test was carried out on two separate finger tips. The endothelial function was evaluated by PAT ratio of the finger tip and systemic arterial stiffness was evaluated by augmentation index (AI). Plasma soluble intercellular adhesion molecule-1 (sICAM-1) and tissue plasminogen activator (tPA) before and 20 min after acute smoking were measured with enzyme linked immuno sorbent assay.</p><p><b>RESULTS</b>The PAT ratio was decreased (1.87 ± 0.40 vs. 1.73 ± 0.28, P = 0.004) while AI was significantly increased after acute smoking (2.94% ± 21.77% vs. 7.11% ± 20.65%, P = 0.01). There was no significant changes in sICAM [(306.5 ± 76.1) µg/L vs. (315.7 ± 90.9) µg/L, P = 0.402], but tPA [7.87 (5.41 - 10.08) µg/L vs. 5.77 (3.77 - 9.68) µg/L, P < 0.01] was significantly decreased after smoking.</p><p><b>CONCLUSIONS</b>Smoking could acutely affect endothelia function, arterial stiffness and deteriorate the activity of fibrinolytic system which could lead to coronary thrombosis in smokers.</p>
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Adulte , Humains , Mâle , Adulte d'âge moyen , Artères , Élasticité , Endothélium , Métabolisme , Endothélium vasculaire , Métabolisme , Molécule-1 d'adhérence intercellulaire , Sang , Fumer , Activateur tissulaire du plasminogène , Sang , Résistance vasculaireRésumé
<p><b>OBJECTIVE</b>To investigate the prevalence and percentage of dyslipidemia awareness among overweight and obese residents in Beijing community.</p><p><b>METHOD</b>Cross-sectional data of 9786 subjects from capital cholesterol education and intervention program (CCEIP) were analyzed. Participants were divided into 3 groups (Normal, overweight and obese) based on body mass index (BMI). Blood lipid levels were determined from overnight fasting plasma samples. Questionnaires were collected to estimate awareness of dyslipidemia.</p><p><b>RESULT</b>(1) Blood lipids levels were positively correlated with BMI (r = 0.17, 0.18, -0.26 and 0.35 between total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride and BMI, respectively, all P < 0.01). (2) Prevalence of dyslipidemia increased in proportion with increase of BMI. The age-standardized prevalence of dyslipidemia of normal, overweight and obese population was 23. 9%, 43.3% and 65.4% in men and 17.9%, 29.2% and 42.3% in women. Dyslipidemia was more frequent in obese men than obese women (65.4% vs. 42.3%, P < 0.01). However, this gender difference decreased gradually with the increase of age. Risk of hypercholesterolemia, high LDL-C, low HDL-C and hypertriglyceridemia in obese men was 1.6, 2.9, 2.4, and 2.7 folders higher than in the normal body weight men and was 1.3, 1.9, 1.7 and 2.1 folders higher in obese women than in normal body weight women. (3) Unexpectedly, the percentage of dyslipidemia awareness in overweight and obese population was not significantly higher than in the normal body weight group (P > 0.05).</p><p><b>CONCLUSION</b>The prevalence of dyslipidemia was high while the percentage of dyslipidemia awareness was rather low in obese population. Aggressive intervention should be taken in obese population, especially in the young obese men, to effectively reduce dyslipidemia.</p>
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Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Indice de masse corporelle , Chine , Épidémiologie , Cholestérol HDL , Sang , Cholestérol LDL , Sang , Études transversales , Dyslipidémies , Sang , Épidémiologie , Connaissances, attitudes et pratiques en santé , Obésité , Sang , Épidémiologie , Surpoids , Sang , Épidémiologie , Prévalence , Triglycéride , SangRésumé
<p><b>OBJECTIVE</b>To investigate the prevalence of dyslipidemia and borderline dyslipidemia and other coronary heart disease (CHD) risk factors in residents from Beijing communities.</p><p><b>METHODS</b>Resident samples were selected by random cluster multistage method. Serum lipid level and CHD factors were obtained through questionnaire, physical examination and biochemical analysis during June 2007 to August 2007 from 10 054 residents.</p><p><b>RESULTS</b>Age- and sex-adjusted standardized prevalence of hypercholesterolemia, high low-density lipoprotein cholesterolemia, low high-density lipoprotein cholesterolemia, and triglyceridemia were 9.3%, 2.56%, 18.79% and 16.84%, respectively. Incidence of borderline hypercholesterolemia was 23.96%. Incidence of dyslipidemia and borderline dyslipidemia was 31.23% and 23.30% respectively, 71.17% residents have at least 1 CHD major risk factor and 20.23% residents were in borderline CHD risks. Prevalence of hypertension, diabetes, smoking and obese was 41.57%, 11.08%, 35.81% and 22.89%, respectively. The odds ratio for dyslipidemia (95% confidence interval) in residents having 1 borderline CHD risk factor (RF), 2 RF, and 3 RF versus none RF was 1.668, (95%CI: 1.319 - 2.110), 2.537 (95%CI: 1.989 - 3.235), and 3.203 (95%CI: 2.007 - 5.114).</p><p><b>CONCLUSIONS</b>The prevalence of dyslipidemia of residents from Beijing communities is higher the average level of China (25.1%). Over 1 out of 5 residents were in increased risk for borderline dyslipidemia or CHD risks. Intensive control of dyslipidemia and CHD risk factors are warranted in Beijing residents.</p>
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Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Chine , Épidémiologie , Maladie coronarienne , Épidémiologie , Dyslipidémies , Épidémiologie , Lipides , Sang , Prévalence , Facteurs de risqueRésumé
<p><b>OBJECTIVE</b>To compare the prognostic value of B-type natriuretic peptide (BNP) and GRACE score in patients with acute coronary syndrome.</p><p><b>METHODS</b>A total of 246 patients with chest pain to hospital time < 24 hours were followed up to 30 days. Admission plasma B-type natriuretic peptide was measured by point-of-care. Endpoints included death, reinfarction, recurrent ischemia and new onset of congestive heart failure. The receiver operating characteristic (ROC) curve was used to evaluate prognostic value of BNP and GRACE score. The logistic regression models were used to assess the prognostic contribution of BNP level and GRACE score.</p><p><b>RESULTS</b>The mean age was (67.6 +/- 12.0) years (61.8% males) and ST elevation myocardial infarction (STEMI) was diagnosed in 135 patients (54.9%). During the follow up, 34 endpoints (13.8%) were recorded including 9 deaths (3.7%). The systolic blood pressure [(121 +/- 29) mm Hg vs. (130 +/- 23) mm Hg, P = 0.034; 1 mm Hg = 0.133 kPa] was significantly lower while the heart rate and plasma creatinine were significantly higher in the endpoints group than in non-endpoints group. TNI and CRP levels were similar between the two groups. The BNP level at admission (median 883.5 ng/L vs. 216.5 ng/L) and GRACE score (median 164.5 vs. 142.0) were significantly higher in the endpoints group than in non-endpoints group (all P < 0.05). The prognostic criteria for BNP level (area under cure, 0.704) was 194.5 ng/L determined by ROC (P = 0.043). For GRACE score, the predictive value for endpoints was 0.742 (P = 0.003) and the cut-off point was 158. In the logistic regression model, BNP concentration (> 194.5 ng/L, OR = 3.174) and GRACE score (> 158, OR = 4.031) were independent predictors of endpoints in patients with ACS.</p><p><b>CONCLUSION</b>Both BNP level at admission and GRACE score were independent predictors for endpoints at 30 days in patients with ACS.</p>