Total cholesterol mediates the effect of ABO blood group on coronary heart disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To find a potential link among ABO blood group, lipid profiles and coronary artery disease (CAD) and to estimate the effect size of connection using mediation analysis model.</p><p><b>METHODS</b>A total of 898 consecutive patients undergoing coronary angiography were enrolled, and divided into CAD group and non-CAD group according to angiographic findings. According to ABO blood group, patients were divided into O blood group and non-O blood group, as well as A blood group and non-A blood group. Baseline characteristics among various groups were compared and the association of ABO blood group, CAD and lipid profile was explored.</p><p><b>RESULTS</b>Subjects of blood type A had higher concentration of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) compared with that of non-A type (TC: (4.43 ± 1.12) mmol/L vs. (4.18 ± 1.09) mmol/L, LDL-C: (2.79 ± 0.99) mmo/L vs. (2.59 ± 1.01) mmol/L, all P < 0.01). TC and LDL-C were significantly higher while high density lipoprotein cholesterol (HDL-C) and ApoA I levels were significantly lower in CAD group than in non-CAD group (TC: (4.36 ± 1.05) mmol/L vs. (4.13 ± 1.16) mmol/L, LDL-C: (2.61 ± 0.87) mmol/L vs. (2.47 ± 0.94) mmol/L; ApoA I: (1.38 ± 0.29) mmol/L vs. (1.45 ± 0.33) mmol/L; all P < 0.01). After adjustment for traditional cardiovascular risk factors, blood group A and TC remained significantly associated with the risk of CAD (OR = 1.88, 95% CI 1.280-2.774, P < 0.01; OR = 1.03, 95% CI 1.018-1.033, P < 0.01, respectively). Specially, mediation analysis indicated that 10.5% of the effect of A blood group on CAD was mediated by TC levels (P < 0.01).</p><p><b>CONCLUSION</b>Our data indicate that there is an association between ABO blood group, TC levels and risk of CAD. Around 10.5% of the effect of A blood group on CAD is mediated by TC levels.</p>

Impact of estimated HDL particle size via the ratio of HDL-C and apoprotein A-I on short-term prognosis of diabetic patients with stable coronary artery disease / 老年心脏病学杂志（英文版）

BackgroundRevascularization and statin therapy are routinely used in the management of stable coronary artery disease. However, it is unclear whether the estimated high-density lipoprotein (HDL) particle size (eHDL-S), the ratio of HDL cholesterol (HDL-C) to apoprotein A-I (apoA-I), is associated with the clinical outcomes of diabetic patients with stablecoronary artery disease (CAD).MethodsWe per-formed a prospective cohort study of 328 patients diagnosed with stable CAD by coronary angiography. Patients were followed up for a mean duration of 12 months. The patients were divided into three groups by the tertiles of eHDL-S: low eHDL-S ( 0.79,n= 99). The associations between the baseline eHDL-S and short-term out-comes were evaluated using the Kaplan-Meier method and Cox proportional regression.Results The low eHDL-S group had higher trig-lyceride, hemoglobin A1c, uric acid, and leukocyte count than the other groups. During the follow-up period, 47/328 patients experienced a pre-specified outcome. According to the Kaplan-Meier analysis, the incidence of pre-specified outcomes was lower in the high eHDL-S group (P = 0.04). However, eHDL-S was not independently associated with adverse outcomes in Cox proportional hazards regression (haz-ard ratio (HR): 0.23, 95% confidence interval (95% CI): 0.01-11.24,P = 0.493).ConclusionAlthough the eHDL-S was associated with inflammatory biomarkers, it was not independently associated with the short-term prognosis of diabetic patients with stable CAD in the era of revascularization and potent statin therapy.

Relation of myocardial bridge to myocardial infarction: a meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Small case series have suggested an association of coronary myocardial bridge (MB) with myocardial infarction (MI). However, the relationship between MB and major adverse cardiac events (MACE) remains largely unknown. The aim of this study was to assess the relationship between MB and MACE involving MI.</p><p><b>METHODS</b>We performed a systematic search of MEDLINE, PreMEDLINE, and all EMB Reviews as well as a reference list of relevant articles according to the SPICO (Study design, Patient, Intervention, Control-intervention, and Outcome) criteria using the following keywords: myocardial bridging, myocardial bridge, intramural coronary artery, mural coronary artery, tunneled coronary artery, coronary artery overbridging, etc. Bibliographies of the retrieved publications were additionally hand searched. Studies were included for the meta-analysis if they satisfied the following criteria: (1) they evaluate the association of MB with cardiovascular endpoint event; (2) they included individuals with MB and those without MB; 3) they excluded individuals with obstructive coronary artery disease (CAD). Studies were reviewed by a predetermined protocol including quality assessment. Dates were pooled using a random effect model.</p><p><b>RESULTS</b>Seven observational studies that followed 5 486 patients eligible for the enrolled criteria were included from 7 136 initially identified articles. The prevalence of MB was 24.8% (1 363/5 486). During 0.5-7.0 years of follow-up of this cohort of population, crude outcome rates were 8.0% in the MB group and 7.7% in the non-MB group. The odds ratio of overall MACE and MI were 1.34 (95% confidence interval (CI): 0.57-3.17, P = 0.51, n = 7 studies) and 2.75 (95% CI: 1.08-7.02, P < 0.03, n = 5 studies) respectively for subjects of MB compared to non-MB.</p><p><b>CONCLUSION</b>Relationship between MB and MI appears to be a real one, although the study did not reveal a connection of MB to MACE, suggesting whether the necessity of antiplatelet therapy needs to be further studied in a larger cohort of patients with MB prospectively.</p>

Relationship between carotid sclerosis and lipoprotein(a) in patients with coronary artery disease / 中国医师进修杂志

ObjectiveTo study the relationship between carotid sclerosis and lipoprotein (LP) (a) in patients with coronary artery disease. MethodsOne hundred and fifty-nine coronary artery disease patients with coronary arteriongraphy (CAG) positive were selected as the study group, and Gensini points were taken in these patients. Forty CAG normal patients was in control group, and all of them were examined with ultrasound, and serum levels of LP (a) were tested. According to ultrasound, study group were divided into 4 subgroups: normal intima group(24 cases), mild stenosis group(41 cases), moderate stenosis group (82 cases) and severe stenosis group ( 12 cases). ResultsThe rate of carotid sclerosis in study group [84.9％ (135/159)] was significantly higher than that in control group [42.5％ ( 17/40 )] (P ＜ 0.01 ). Gensini points in moderate and severe stenosis group were significantly higher than those in normal intima and mild stenosis group (P ＜ 0.05 or ＜ 0.01 ), Gensini points in severe stenosis group were significantly higher than those in moderately group(P ＜ 0.01 ), but there was no significant difference between mild stenosis group and normal intima group(P ＞ 0.05 ). The level of LP(a) in study group[(35.27 + 23.38) mg/L] was significantly higher than that in control group[(23.13 ± 16.56) mg/L](P＜ 0.01 ). The level of LP(a) in mild stenosis group was significantly lower than that in moderate and severe stenosis group(P＜ 0.05 or ＜ 0.01 ), and there was no significantly difference compared with that in normal intima group(P＞ 0.05 ). ConclusionsCarotid sclerosis ultrasonic testing helps to predict the risk degree of coronary artery disease. The level of LP(a ) is closely related with carotid sclerosis and has important value in judging the condition of patients with coronary artery disease.

Surgical procedures treatment of severe acute pancreatitis / 中国基层医药

Objective To study the effect of forpart operation on reducing death rate of patients with severe acute pancreatitis.Methods A retrospective study was conducted to analyze 56 patients with severe acute pancreatitis.Results Among 56 patients,11 cases died,5 patients died from MODS after operation in 24 hours;6 patient died of abdominal infection etc;and other patients were cured.Conclusion To patients with severe acute pancreatitis,making use of different method according as clinic sign in appropriate time can reduce death rate and obtain satisfactory treatment outcome.