Protective Effects of Salvianolate on Myocardial Injury or Myocardial Infarction after Elective Percutaneous Coronary Intervention in NSTE-ACS Patients: A Randomized Placebo-Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the protective effects of salvianolate on percutaneous coronary intervention (PCI) related myocardial injury or myocardial infarction after elective PCI in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients.@*METHODS@#A total of 149 patients with NSTE-ACS who underwent elective PCI were enrolled. The patients were randomly allocated in a 1:1 ratio to the salvianolate group (74 cases) or the control group (75 cases). After exclusion criteria of coronary angiography, 60 patients with PCI therapy remained in the salvianolate group and 68 in the control group. The incidence and the severity of PCI related myocardial injury or myocardial infarction, in addition to major adverse cardiac events (MACEs) during 1 year follow-up after PCI were studied between the two groups. Multivariate logistic regression analysis was used to determine the independent factors for PCI related myocardial injury or myocardial infarction after elective PCI.@*RESULTS@#Compared with the control group, salvianolate treatment reduced the incidence of PCI related severe myocardial injury or myocardial infarction (11.7% vs. 26.5%, P=0.035). The rate of MACEs or all-cause death within 1 month or 1 year after the procedure was not significantly different between the two groups.@*CONCLUSIONS@#Periprocedural treatment with salvianolate reduces the incidence of PCI related severe myocardial injury or myocardial infarction, although it does not influence clinical prognosis. [Chinese clinical trial registry: ChiCTR1800016992].

Protective Effects of Salvianolate on Myocardial Injury or Myocardial Infarction after Elective Percutaneous Coronary Intervention in NSTE-ACS Patients: A Randomized Placebo-Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the protective effects of salvianolate on percutaneous coronary intervention (PCI) related myocardial injury or myocardial infarction after elective PCI in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients.@*METHODS@#A total of 149 patients with NSTE-ACS who underwent elective PCI were enrolled. The patients were randomly allocated in a 1:1 ratio to the salvianolate group (74 cases) or the control group (75 cases). After exclusion criteria of coronary angiography, 60 patients with PCI therapy remained in the salvianolate group and 68 in the control group. The incidence and the severity of PCI related myocardial injury or myocardial infarction, in addition to major adverse cardiac events (MACEs) during 1 year follow-up after PCI were studied between the two groups. Multivariate logistic regression analysis was used to determine the independent factors for PCI related myocardial injury or myocardial infarction after elective PCI.@*RESULTS@#Compared with the control group, salvianolate treatment reduced the incidence of PCI related severe myocardial injury or myocardial infarction (11.7% vs. 26.5%, P=0.035). The rate of MACEs or all-cause death within 1 month or 1 year after the procedure was not significantly different between the two groups.@*CONCLUSIONS@#Periprocedural treatment with salvianolate reduces the incidence of PCI related severe myocardial injury or myocardial infarction, although it does not influence clinical prognosis. [Chinese clinical trial registry: ChiCTR1800016992].

The anticoagulation status:a cross-sectional survey of 1 000 cases single center study of patients with atrial fibrillation / 复旦学报（医学版）

Objective To investigate the epidemiological status and the anticoagulation treatment of atrial fibrillation (AF) patients,and to provide evidence for improving anticoagulation therapeutic effect in AF patients.Methods We performed a cross-sectional epidemiological investigation of 1 000 patients and out-patients with AF in Huashan Hospital.The clinical data including clinical feature,coexistent diseases,auxiliary examination,and treatment regimen of these patients were collected.The clinical features and anticoagulation status of AF patients were analyzed based on the stroke history,stroke risk evaluation and CHA2DS2-VASc score stratification.Results The mean age of these AF patients was (72.1 ± 11.1) years old.The most common coexistent diseases were hypertension (65％),coronary heart disease (32％) and diabetes (27％).About 6％ of the AF patients were diagosed with non-valvularatrial fibrillation (NVAF),and 22％ had stroke history.Patients were divided into two groups according to their stroke history.Compared with the non-stroke group,the stroke group was found to be older,with longer course of AF and poorer hypertension control.The overall anticoagulation rate was 32 ％ and antiplatelet rate was 46 ％.The anticoagulation rate of stroke group was 44％,higher than the non-stroke group (P＜0.001) but 78％ of these patients began anticoagulation therapy after the occurrence of stroke.When CHA2 DS2-VASc scores of NVAF patients were 2 to 5,the anticoagulation proportion increased gradually.When the scores were 2 to 6,the antiplatelet ratio increased gradually.But when the scores were 7-8 points,both anticoagulation and antiplatelet rates were in decline.Conclusions The anticoagulation rate in AF patients was still low at present,while relatively higher in patients with stroke.Anticoagulation could prevent stroke,AF patients still could benefit from anticoagulation after stroke,but anticoagulation before stroke could get more benefits.

Association of TCF7L2 and GCG Gene Variants with Insulin Secretion, Insulin Resistance, and Obesity in New-onset Diabetes / 生物医学与环境科学（英文）

This cohort study was designed to evaluate the association of transcription factor 7-like 2 (TCF7L2) and proglucagon gene (GCG) variants with disordered glucose metabolism and the incidence of type 2 diabetes mellitus (T2DM) in a rural adult Chinese population. A total of 7,751 non-T2DM participants ⋝18 years old genotyped at baseline were recruited. The same questionnaire interview and physical and blood biochemical examinations were performed at both baseline and follow-up. During a median 6 years of follow-up, T2DM developed in 227 participants. After adjustment for potential contributory factors, nominally significant associations were seen between TT genotype and the recessive model of TCF7L2 rs7903146 and increased risk of T2DM [hazard ratio (HR)=4.068, 95% confidence interval (CI): 1.270-13.026; HR=4.051, 95% CI: 1.268-12.946, respectively]. The TT genotype of rs7903146 was also significantly associated with higher fasting plasma insulin level and the homeostasis model assessment of insulin resistance in case of new-onset diabetes. In addition, the TCF7L2 rs290487 TT genotype was associated with abdominal obesity and the GCG rs12104705 CC genotype was associated with both general obesity and abdominal obesity in case of new-onset diabetes.

Association between Low-density Lipoprotein Receptor-related Protein 5 Polymorphisms and Type 2 Diabetes Mellitus in Han Chinese: a Case-control Study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the association between low-density lipoprotein receptor-related protein 5 (LRP5) variants (rs12363572 and rs4930588) and type 2 diabetes mellitus (T2DM) in Han Chinese.</p><p><b>METHODS</b>A total of 1842 T2DM cases (507 newly diagnosed cases and 1335 previously diagnosed cases) and 7777 controls were included in this case-control study. PCR-RFLP was conducted to detect the genotype of the two single nucleotide polymorphisms (SNPs). Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated to describe the strength of the association by logistic regression.</p><p><b>RESULTS</b>In the study subjects, neither rs12363572 nor rs4930588 was significantly associated with T2DM, even after adjusting for relevant covariates. When stratified by body mass index (BMI), the two SNPs were also not associated with T2DM. Among the 3 common haplotypes, only haplotype TT was associated with reduced risk of T2DM (OR 0.820, 95% CI 0.732-0.919). In addition, rs12363572 was associated with BMI (P<0.001) and rs4930588 was associated with triglyceride levels (P=0.043) in 507 newly diagnosed T2DM cases but not in healthy controls.</p><p><b>CONCLUSION</b>No LRP5 variant was found to be associated with T2DM in Han Chinese, but haplotype TT was found to be associated with T2DM.</p>

Relationship between post-stenting coronary thrombolysis in myocardial infarction flow and plasma von Willebrand factor and ADAMTS-13 levels in patients with ST segment elevation myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the relationship between post-stenting coronary thrombolysis in myocardial infarction (TIMI) flow and plasma von Willebrand factor (vWF) and its cleaving protease (ADAMTS-13) levels in patients with ST segment elevation myocardial infarction (STEMI).</p><p><b>METHODS</b>STEMI patients who underwent primary percutaneous coronary intervention (PCI) and stenting between September, 2007 and December, 2009 were enrolled. According to the post-stenting TIMI flow, patients were divided to TIMI ≤ 2 group (n = 43) and TIMI 3 group (n = 43). Patients with chest pain or dyspnea and normal coronary angiographic results served as control group (n = 43). The levels of vWF and ADAMTS-13 were measured by ELISA at three time points: immediately after admission, beginning of PCI and 1 week after PCI.</p><p><b>RESULTS</b>Levels of vWF in STEMI patients at all 3 time points were significantly higher than in control patients, and the level of vWF was significantly higher in TIMI ≤ 2 group than in TIMI 3 group [at admission: (6721.83 ± 1380.58) U/L vs. (4786.12 ± 2362.01) U/L, P < 0.05; at the beginning of PCI: (5744.65 ± 1240.71) U/L vs. (3011.33 ± 2270.40) U/L, P < 0.05 and at 1 week after PCI: (2001.48 ± 931.70) U/L vs. (1365.17 ± 724.12) U/L, P < 0.05]. ADAMTS-13 levels were similar among groups at admission and at beginning of PCI, however, the level of ADAMTS-13 at 1 week after PCI was significantly higher in TIMI ≤ 2 group than that in TIMI 3 group [(406.93 ± 101.44) mg/L vs. (270.34 ± 115.12) mg/L, P < 0.001]. Logistic regression analysis showed that both vWF at admission (OR = 1.917, P < 0.01) and vWF at the beginning of PCI (OR = 2.016, P < 0.01) were risk factors of TIMI ≤ 2.</p><p><b>CONCLUSION</b>Increased vWF during peri-PCI periods was associated with post-stenting coronary TIMI ≤ 2 after primary PCI in STEMI patients, and the imbalance between vWF and ADAMTS-13 may thus play an important role in the development of slow flow post PCI.</p>

Evaluation on clinical effect of long-term shexiang baoxin pill administration for treatment of coronary heart disease / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the effect of long-term Shexiang Baoxin Pill (SXBXP) administration on cardiovascular events in patients with stable angina pectoris (SAP).</p><p><b>METHODS</b>A prospective randomized non-blind parallel controlled study was conducted in the early stage (the first 6 months) of the trial, then a cohort study was succeeded in the later stage. Two hundred patients with SAP, who visited the hospital between May 2005 and June 2006, were selected and randomly assigned to the trial group and the control group, 100 patients in each group. Both were treated with conventional therapy, including treatment for anti-platelet, blood lipid regulating, anti-ischemia, etc, and to patients in the trial group, SXBXP was administered additionally for 2 pills, three times a day by oral intake. The therapeutic course lasted for at least 6 months. All patients were followed up until January 2008, the clinical events and conditions of treatment were recorded. The composite terminal of various cardiovascular events was regarded as the primary endpoint.</p><p><b>RESULTS</b>The median follow-up time of the study was 2.25 years (ranging from 0.5 to 2.75 years). In the trial group, the occurrence (cases) was 23 for all-clinical event, 20 for primary-clinical event and 9 for angina pectoris event, which were lesser than those in the control group, 33, 29 and 19 cases respectively, showing a significant difference between groups (P < 0.05). The dosage of nitrates used in the trial was decreased more than that before treatment. Besides, all the incidences (cases), in terms of all-cause death (2 vs 5), cardiovascular death (1 vs 2), congestive heart failure (3 vs 4), stroke (2 vs 4), and other clinical (5 vs 6) events, as well as in the need for percutaneous coronary intervention or coronary artery bypass graft (2 vs 4), showed somewhat lowering in the trial group as compared with the corresponding items in the control group, but statistical analysis showed an insignificant difference between them (P > 0.05).</p><p><b>CONCLUSION</b>Long-term SXBXP administration could reduce the occurrence of angina pectoris events and some other clinical events, and cut down the dosage of nitrates used in patients with SAP.</p>

Evaluation on tolerability and safety of long-term administration with shexiang baoxin pill in patients with coronary heart disease of stable angina pectoris / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the safety and tolerability of long-term (6 months) administration with Shexiang Baoxin Pill (SBP) in patients with coronary heart disease (CHD) of stable angina pectoris.</p><p><b>METHODS</b>Adopting randomized non-blinded and parallel controlled trial, 200 patients with CHD were randomly and equally assigned to the SBP group and the control group. Both received basic therapy for CHD, including anti-platelet, lipid regulating and anti-ischemia with additional SBP 2 pills, taken orally three times per day in the SBP group. They were followed up for 6 months. The drug tolerability and adverse drug reactions occurred in the observation period were recorded, and the laboratory indexes involving blood routine, liver function, renal function, blood glucose and blood lipids were detected before and after treatment.</p><p><b>RESULTS</b>The trial was completed in 92% of the patients, 5 patients withdrew in the SBP group and 11 patients in the control group; but none for the intolerable therapy. There were 1 case of adverse reaction related to SBP. No obvious change was found in blood glucose and blood lipids in the two groups before and after treatment. No serious adverse reaction and injury of liver and renal function or others happened.</p><p><b>CONCLUSION</b>Long-term administration of SBP has favorable clinical tolerability and safety for CHD patients.</p>

Glycated Hemoglobin and Blood Pressure Related to Carotid Artery Atherosclerosis in Continuum in Non-diabetic Persons / 中华高血压杂志

Objective To analyze the relationship between glyeated hemoglobin,blood pressure and carotid ar- tery atheroselerosis (AS) in non-diabetic patients.Methods To recruite 300 non-diabetic patients and retrospec tively study the relationship between glycated hemoglobin HbAlc,blood pressure and carotid artery AS.Carotid AS was determined by carotid uhrasound.Carotid AS was defined as intima-media thickness (IMT) of common ca- rotid artery≥0.9 mm,or occurrence of carotid plaque.Results Compared with the carotid AS negative subjects, the carotid AS positive patients had significant higher fasting glucose,2 h glucose,HbAlc and systolic blood pres- sure (SBP) level,without difference in DBP.Higher HbAlc or SBP levels were associated with increased incidence of carotid AS.For patients with similar SBP levels,higher HbAlc was associated with more prevalence of carotid AS.Logistic regression analysis shows HbAlc (OR=4.1,P=0.009) was an independent predictor of carotid AS,after adjusting for sex,BMI,SBP,DBP,LDL-C,HDL-C,hypersensitive C-reactive protein (hsCRP),and fasting and 2 h glucose.Conclusion These results suggests that even a slight increase of HbAlc may be independ- ently associated with carotid AS in non-diabetic subjects;and the coexistence of elevated systolic blood pressure syn- ergetically enhance the carotid atherosclerosis.