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@#Objective To investigate whether metformin has protective effect on myocardial injury in patients with coronavirus disease 2019 (COVID-19) combined with coronary heart diseases and diabetes. Methods COVID-19 patients with coronary heart disease and diabetes who were admitted to Tongji Hospital from January 18 to April 25 in 2020 were enrolled. They were divided into a metformin group and a none-metformin group according to whether the metformin was used. The demographic characteristics, clinical symptoms, laboratory parameters, treatment and clinical outcomes of the two groups were analyzed retrospectively. Results There were 29 patients in the metformin group, 3 patients (12.0%, 3/25) suffered myocardial injury and 1 (3.4%) died of acute respiratory failure complicated by septic shock; 67 patients were in the non-metformin group and 24 (37.5%, 24/64) had myocardial injury but 15 died in hospital among whom 1 died of septic shock complicated by disseminated intravascular coagulation, 1 acute respiratory failure complicated by possible cerebral hemorrhage, 2 acute respiratory failure, 1 fulminant myocarditis, 3 acute myocardial infarction and 7 cardiac arrest. The incidence of myocardial injury (12.0% vs. 37.5%, P=0.019), hospital mortality (3.4% vs. 22.4%, P=0.034) and mortality of cardiovascular events (0.0% vs. 16.4%, P=0.049) in the metformin group were significantly lower than those in the non-metformin group. Multivariate analysis showed that the use of insulins (OR=11.235, P=0.003) was an influencing factor for in-hospital mortality of patients. The use of metformin (OR=0.154, P=0.013) was positively correlated with the myocardial injury. Conclusion When patients with coronary heart disease and diabetes are infected with COVID-19, metformin can effectively reduce myocardial damage and has a certain effect on reducing hospital mortality. Combined with clinical considerations, it is worthy of popularization.
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Background: Older women have a high chance of suffering from coronary heart diseases and heart failure. Possessing high-sensitive tests will permit early detection of cardiac troponin and lipid proteins (HDL, LDL, VLDL, & Triglyceride) I in levels that are below the diagnostic endpoint for the acute coronary syndrome. Aim of the study: The intent in this study is to analyze the association among the 3 ranks taking into consideration any future cardiac happening within the community setting and involving elderly women who are aged seventy years and above. Patients and Methods: 212 women were grouped for this study, and this lot was lacking any CHD within the set baseline or the troponin and lipid proteins (HDL, LDL, VLDL, & Triglyceride) established above the analytical limits for the disease to be studied (acute coronary syndrome). These elderly women had a 15-year continuation of hospitalization and mortality measures. Results: The analysis showed 22 percent of the study group to be suffering from CHD, there was 15 percent of myocardial infarction or death brought about by CHD, and 10 percent of the heart failure. The 99 percent of assessed serum illustrations, troponin, and lipid proteins (HDL, LDL, VLDL, & Triglyceride) levels were above recognition. Taking into consideration of the Framingham risk features, the correction done for each SD normal linear changed troponin and lipid proteins (HDL, LDL, VLDL, & Triglyceride) upsurge was connected to an upsurge uncertainty for the coronary heart disease. Conclusions: conclusively, the troponin and lipid profile (HDL, LDL, VLDL, & Triglyceride) I am autonomously linked with the foreseeable cardiac happenings in older women across Iraq without seeming clinical indicators. Adding cardiac troponin and lipid proteins (HDL, LDL, VLDL, & Triglyceride) 1 to the conventional risk factor can greatly enhance the risk prediction in this background.
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Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Troponina/análise , Estudos Longitudinais , Intervenção Médica Precoce , Insuficiência Cardíaca/complicações , Lipídeos/análiseRESUMO
Abstract@#Introduction: Introduction: Coronary heart disease (CHD) is the leading cause of death in Malaysia. This study aims to explore the treatment experiences of patients with recurrent coronary heart disease during hospital admission and after discharge. This research also attempts to understand patients’ adherence to the prescribed treatment. Method: The main sample for this study includes inpatients and outpatients with recurrent CHD who have undergone secondary prevention treatment at certain tertiary hospitals which were purposively sampled. The transcripts of one-to-one semi-structured interviews (N=22) were analyzed using the Interpretative Phenomenological Analysis (IPA). Results: Three themes emerged in the analysis of treatment adherence among multi-ethnic patients with CHD: (i) doctor-patient relationships; (ii) information-seeking behaviour; and (iii) psychosocial beliefs. Other factors that influence treatment adherence include patients’ cultural, religious, or spiritual beliefs-based complementary alternative medicines (CAM), if these factors were inadequately addressed by their respective heath professional. Conclusion: The results demonstrate that for future cardiac rehabilitation program development, health professionals must not only focus on the patient’s care improvement but must also be knowledgeable on the patient’s preferred alternative treatment.
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Phlegm syndrome, as the main syndrome of coronary heart diseases, not only its clinical signs and symptoms are clear, but also related with gene polymorphism, plasma metabolomics, genomics protein metabolism and urine metabolomics indicators, especially the close connection between serum lipids and phlegm syndrome in coronary heart diseases. The further research on the connection can be used as the references for the syndrome diagnosis and clinical treatment guidance, and provide solid foundation for TCM syndromes toward internationalization. This article pointed out that the treatment of coronary heart diseases should retain Chinese characteristics, focus on the basis of the phlegm syndrome, and pay attention to control lipid levels, in order to improve the clinical efficacy, and look forward to making progress in in-depth study on efficacy evaluation system of phlegm syndrome in coronary heart diseases.
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Objective To explore the expression of and its clinical significance of plasma omentin-1 in coronary heart disease in central obesity. Methods Plasma omentin-1 levels were measured by enzyme linked immunosorbent assay( ELISA)in 49 central obesity participants without coronary heart disease and 67 central obesity participants with coronary heart disease,as well as 56 normal healthy individuals as control group. In addition,glucose and lipid metabolism parameter and morphological characters were assessed. Finally multivariate logistic regression analysis was used to explore the risk fact for coronary heart disease in central obesity. Results The serum plasma omentin-1 level of central obesity participants without coronary heart disease group was (45. 63 ± 9. 66)μg/L,much higher than those of people in and central obesity participants with coronary group ((30. 67 ± 6. 78 )μg/L,P ﹤0. 01 ),while lower than control group(( 53. 12 ± 7. 97 )μg/L,P ﹤ 0. 01 ) . Multivariate logistic regression analysis revealed that,age was independent risk factor of coronary heart disease in central obesity(OR=1. 176,95%CI:1. 012-1. 330,P=0. 041),while plasma omentin-1 and high density lipoprotein cholesterol were independent protective factors(OR=0. 576,95%CI:0. 254-0. 898,P=0. 000;OR=0. 466,95%CI:0. 242 -0. 690,P =000). Conclusion Detection of plasma omentin-1 level may play an important role in early diagnosis and prevention of coronary heart disease in central obesity.
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Objective To study the significance of plasma homocysteine(Hcy),high sensitivity C-reactive protein(hs-CRP)and cardiac treponin T(cTnT)changes in the patients with coronary heart diseases(CHD).Methods From August 2012 to November 2013,240 patients with CHD in our hospital were collected as the CHD group and 250 individuals of healthy physical examination served as the control group.Serum Hcy,hs-CRP and cTnT were detected by using the enzymatic cycle assay,immune scatter turbi-dimetry and electrochemiluminescence assay respectively.The data were statistically analyzed by the SPSS software.Results The serum levels of Hcy,hs-CRP and cTnT in the CHD group were (24.89±17.78)μmol/L,(17.43±35.89)mg/L and (0.76±2.36) ng/mL respectively,which were significantly higher than those in the control group(P <0.001).Moreover,the positive rate of Hcy in the CHD group was the highest (81 .25%),followed by hs-CRP(64.58%)and cTnT (58.75%).Conclusion Hcy,hs-CRP and cTnT played important roles in the development and progression of CHD,so reducing Hcy level may be an important pathway for preventing and treating CHD.
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Objective To investigate the relationship between elderly male patients with coronary heart diseases (CHD) and endogenous androgen level and other related factors.Methods 28 male patients with acute coronary syndrome (ACS) were chosen as research group,28 male patients with stable angina pectoris (SAP) were chosen as observation group,and 28 healthy male people were selected as control group.All of three groups were checked by carotid artery Doppler ultrasonography and the peripheral blood concentration of testosterone (T),TC,LDL-C,Glu,CRP were measured,BMI was calculated in all three groups.Results Peripheral blood concentration of T,TC,LDL-C,Glu in ACS group and SAP group were significantly higher than those of the control group(P ＜0.05).IMT and number,quality of plaque in patients with ACS and SAP were significantly different compared with the control group (P ＜ 0.05).T,Tc,LDL-C,CRP,BMI,IMT,unstable plaque were significantly different between ACS group and SAP group(P ＜ 0.05).Glu had no statistical difference between ACS group and SAP group (P ＞ 0.05).Conclusion Peripheral blood concentration of T was negatively correlated with arterosclerosis,unstable plaque,Tc,LDL-C,BMI in old male CHD patients
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ObjectiveTo explore the influence of fluvastatin on the levels of IL-6,MMP-1 and APN in patients with coronary heart diseases.Methods60 patients with coronary heart diseases were randomly divided into 2groups:40mg group and 80mg group treated by fluvastatin and 30 healthy persons were selected as control group,serum levels of IL-6,MMP-1 and APN were measured before and after treatmead.ResultsSerum levels of IL-6,MMP-1 were significantly increasd in the coronary heart diseases group (t =4.896,4.231,all P ＜ 0.05 ).Serum level of APN was significantly decreasd in the coronary heart diseases group( t =4.352,P ＜ 0.05 ).The serum levels of IL-6and M MP-1 were significantly decreasd after therapy (4.156,4.121、4.553,all P ＜ 0.05 ).The decrease of serum levels of IL-6,MMP-1 in 80mg group was more significant than those of 40mg group( t =3.786,3.690,4.10,all P ＜0.05).ConclusionSerum concentrations of IL-6 and MMP-1 increase,but APN decrease in patients with coronary heart diseases.Serum concentrations of IL-6,MMP-1 and APN had relationships with coronary plaque extent.Fluvastatin could decrease serum levels of IL-6 and MMP-1,increase serum level of APN in patients with coronary heart diseases,and have a beneficial effect on steadying the plaque.
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BACKGROUND: Small dense low density lipoprotein (sdLDL) has recently emerged as an important risk factor of coronary heart disease. METHODS: The mean LDL particle size was measured in 203 patients with type 2 diabetes mellitus (T2DM) and 212 matched subjects without diabetes using polyacrylamide tube gel electrophoresis. Major vascular complications were defined as stroke, angiographically-documented coronary artery disease or a myocardial infarction. Peripheral vascular stenosis, carotid artery stenosis (> or =50% in diameter) or carotid artery plaque were considered minor vascular complications. Overall vascular complications included both major and minor vascular complications. RESULTS: Diabetic patients had significantly smaller mean-LDL particle size (26.32 nm vs. 26.49 nm) and a higher percentage of sdLDL to total LDL compared to those of subjects without diabetes (21.39% vs. 6.34%). The independent predictors of sdLDL in this study were serum triglyceride level and body mass index (odds ratio [OR], 1.020 with P<0.001 and OR 1.152 with P<0.027, respectively). However, no significant correlations were found between sdLDL and major vascular complications (P=0.342), minor vascular complications (P=0.573) or overall vascular complications (P=0.262) in diabetic subjects. CONCLUSION: Diabetic patients had a smaller mean-LDL particle size and higher proportion of sdLDL compared to those of subjects without diabetes. Obese diabetic patients with hypertriglyceridemia have an increased risk for atherogenic small dense LDL. However, we could not verify an association between LDL particle size and vascular complications in this study.
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Humanos , Resinas Acrílicas , Índice de Massa Corporal , Estenose das Carótidas , Constrição Patológica , Doença da Artéria Coronariana , Doença das Coronárias , Diabetes Mellitus , Diabetes Mellitus Tipo 2 , Eletroforese , Coração , Hipertrigliceridemia , Lipoproteínas , Infarto do Miocárdio , Tamanho da Partícula , Fatores de Risco , Acidente Vascular CerebralRESUMO
The role of apolipoprotein E (apo E) in lipid metabolism and cholesterol transport is well established. About 14 per cent of the variation in plasma cholesterol levels is attributed to polymorphisms in apo E gene (APOapo E). E consists of three common alleles, designated as ε2, ε3 and ε4 which code for E2, E3 and E4 proteins respectively resulting in three homozygous (E2/E2, E3/E3, E4/E4) and three heterozygous (E3/E2, E4/E2 and E4/E3) phenotypes. Different populations studied worldwide inherit variable frequencies of the E alleles and genotypes, with the most frequent allele being ε3.The ε4 allele has been consistently shown to be associated with Alzheimer’s disease, coronary heart disease and cerebrovascular disorders. In this review, we have discussed the role of apo E polymorphisms in cerebrovascular and coronary heart diseases. The status of apo E polymorphisms and their disease associations in Asian Indians besides, other populations has also been discussed. Further, studies elucidating the pathophysiology of apo E deficiency conducted in knock-out mice have been reviewed.
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Alelos , Doença de Alzheimer/genética , Animais , Apolipoproteínas E/deficiência , Apolipoproteínas E/genética , Apolipoproteínas E/metabolismo , Sistema Nervoso Central/metabolismo , Transtornos Cerebrovasculares/genética , Colesterol/metabolismo , Doença das Coronárias/genética , Humanos , Índia , Lipídeos/sangue , Proteína-1 Relacionada a Receptor de Lipoproteína de Baixa Densidade/metabolismo , Camundongos , Camundongos Knockout , Polimorfismo Genético/genéticaRESUMO
Objective To investigate the effect of atorvastatin on endothelial dilated function in the patients with coronary heart disease (CHD). Methods The dilatation of brachial arteries during reactive hyperemia and after sublingual administraction of glyceryl trinitrate (GTN) were measured by using B-mode ultrasonography in 120 patients. The endothelial dilatation changes 10～12 weeks after treatment of atorvastatin were observed. Results The content of TC, LDL-C and the incidences of hypertension and diabetes mellitus were higher in CHD group than those in the control group. The flow-mediated dilatation and GTN-induced dilatation of brachial arteries in patients with CHD were significantly reduced as composed with those in control group(P