OBJECTIVETo observe the changes of hospitalization rates and in-hospital mortality for coronary heart disease (CHD) in Beijing from 2007-2012.

METHODSPatients hospitalized for CHD in Beijing from 1 January 2007 to 31 December 2012 were identified from"The Cardiovascular Disease Surveillance System in Beijing". In total, 421 929 patients aged ≥25 years of permanent Beijing residents were admitted for CHD in Beijing during the 6 years. After excluding duplicate records and validation for the completeness and accuracy of the records, the hospitalization rates for CHD and in-hospital CHD mortality were analyzed. Trends in hospitalization rates and the in-hospital mortality for CHD were analyzed with Poisson regression models.

RESULTSThe age-standardized average hospitalization rate of CHD was 515.3 per 100 000 population in patients aged ≥25 years in Beijing. During the six years, an increasing trend was observed in the hospitalization rates for CHD after adjusting the age and gender (P<0.001). The age-standardized hospitalization rates of CHD increased by 43.0% in the past six years. The greatest increases of hospitalization rates were noted in both men and women between 45 to 54 years. The age-standardized in-hospital mortality decreased from 3.3% to 2.2% over the time (P<0.001), with a in-hospital mortality reduction for acute myocardial infarction from 11.3% to 8.5%.

CONCLUSIONSAn increasing trend in hospitalization rate was observed during 2007-2012 for Beijing residents aged ≥25 years, indicating an urgent need in CHD prevention in Beijing. The in-hospital mortality reduction during this period might reflect the improvement in the in-hospital treatment modalities of CHD.

Anterior Wall Myocardial Infarction ; Coronary Artery Disease ; Coronary Disease ; Hospital Mortality ; Hospitalization ; Hospitals ; Humans

To estimate the incidence rate of coronary heart disease in Korea, of all residents of the Taegu city aged 25 or above, those who had an acute MI or fatal coronary event between 1 July 1996 and 30 June 1997 were registered. Seven hundreds and eight patients were registered during the study period(685 were identified at hospital and 23 were autopsy cases). Age-standardized annual incidence rate of men in city area was 93 per 100,000(95% CI; 61-142) and 33(95% CI; 16-67) in women(100 in men and 20 in women aged 35-64). The incidence was rapidly increased after age 40 in men, however, in women after age 60. Twenty-eight-days case fatality rate was 45% in men and 47% in women. However, in the age group of 45-59 case fatality rate in women was two times higher than that in men. In conclusion, crude annual incidence rate of CHD in city area was 73 per 100,000 in men and 33 in women. The age-standardized annual incidence of CHD in men(93 per 100,000) was 3.2 times higher than that in women (33 per 100,000) in Korea.
Autopsy ; Coronary Disease* ; Daegu ; Female ; Humans ; Incidence* ; Korea ; Male ; Mortality

Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. Over the last decade coronary computed tomography angiography (CCTA) has gained wide acceptance as a reliable, cost-effective and non-invasive modality for diagnosis and prognostication of CAD. Use of CCTA is now expanding to characterization of plaque morphology and identification of vulnerable plaque. Additionally, CCTA is developing as a non-invasive modality to monitor plaque progression, which holds future potential in individualizing treatment. In this review, we discuss the role of CCTA in diagnosis and management of CAD. Additionally, we discuss the recent advancements and the potential clinical applications of CCTA in management of CAD.
Angiography ; Atherosclerosis ; Coronary Artery Disease ; Diagnosis ; Mortality ; Plaque, Atherosclerotic

Recently, the incidence of hypertension (HT) and coronary artery disease is increasing because of the change of diet and life pattern. But, coronary artery disease is relatively uncommon in young women of pregnant age. The trend towards delayed marriage and child-bearing may results in an increasing number of women with coronary heart disease. Myocardial infarction complicates approximately 1 in 20,000 pregnancies. Myocardial infarction in pregnancy carries substantial maternal and fetal risks. Overall maternal mortality rate is 21% to 35% and the fetal mortality rate is 13%. Importantly, the maternal mortality rate approaches 50% when women deliver within 2 weeks of the initial MI event. We experienced a case of pregnancy with acute myocardial infarction (AMI) and chronic HT. The patient had a myocardial attack at gestational age 36(+5) weeks and medical treatment was administered. Labor inuction was begun at gestational age 39+3 weeks and the patient delivered by spontaneous vaginal delivery. We report this case with a brief review of the concerned literatures.
Coronary Artery Disease ; Coronary Disease ; Diet ; Female ; Fetal Mortality ; Gestational Age ; Humans ; Hypertension ; Incidence ; Marriage ; Maternal Mortality ; Myocardial Infarction* ; Pregnancy*

OBJECTIVETo compare the impacts of percutaneous coronary intervention (PCI) and medical therapy on mortality in patients with stable coronary artery disease.

METHODSWe searched PubMed,Embase, Cochrane central register of controlled trials, Wanfang data and CNKI to find relevant randomized controlled trials on PCI versus medical therapy for treating patients with stable coronary artery disease, which were reported before December 2013. Publications were selected according to inclusion and exclusion standard. Meta-analyses was performed with the software of STATA 12.0.

RESULTSFive randomized controlled trials and 5 567 patients were enrolled for this analysis. Compared with medical therapy, PCI could not significantly decrease the long-term all-cause mortality (RR = 0.96, 95%CI 0.80-1.15), the cardiac death rate (RR = 1.02, 95%CI 0.77-1.36), the myocardial infarction rate (RR = 1.05, 95%CI 0.89-1.23), the acute coronary syndrome (RR = 0.70, 95%CI 0.27-1.82), the rate of freedom from angina (RR = 1.09, 95%CI 0.98-1.21), and the rate of stroke (RR = 1.27, 95%CI 0.75-2.15).However, the revascularization rate was significantly lower for patients in PCI group (RR = 0.60, 95%CI 0.42-0.86).

CONCLUSIONSLong-term mortality is similar for patients with stable coronary artery disease underwent PCI or medical therapy.

Angina Pectoris ; Coronary Artery Disease ; mortality ; therapy ; Coronary Disease ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Randomized Controlled Trials as Topic ; Stroke

BACKGROUND AND OBJECTIVES: The recovery of the normal heart rate immediately after exercise is a function of vagal reactivation. An attenuated heart rate recovery during the first minute after graded exercise is believed to be a marker of reduced parasympathetic activity and has been proven to be an independent predictor of overall mortality. However, the clinical significance of an abnormal heart rate recovery in coronary artery disease and the changes in the exercise parameters after coronary stenting have not been fully evaluated. Subjects and Methods: The study population included 53 patients with a significant coronary artery stenosis and 25 subjects with a normal coronary artery. All underwent a treadmill exercise test prior to coronary angiography. The differences in the heart rate recovery and the Duke treadmill score between two groups were investigated. After coronary stenting, changes in the exercise parameters were evaluated during the follow-up treadmill exercise test in 22 coronary artery disease patients. RESULTS: The frequencies of abnormal heart rate recovery (12% vs 38.3%, p=0.014) and a moderate to high risk Duke treadmill score (4% vs 21.3%, p=0.034) were significantly higher in the coronary artery disease group. The frequencies of these parameters were also significantly higher in the multivessel disease group than the single vessel disease group. After coronary stenting, most of the exercise parameters showed no significant changes but the Duke treadmill score improved significantly (p=0.038). CONCLUSION: The frequency of abnormal heart rate recovery was significantly higher in the coronary artery disease group. The Duke treadmill score was significantly improved and is thought to be a useful follow up parameter after coronary stenting.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Stenosis ; Coronary Vessels* ; Exercise Test ; Follow-Up Studies ; Heart Rate* ; Heart* ; Humans ; Mortality ; Stents*

BACKGROUND AND OBJECTIVES: The recent data has revealed that the first 1 minute and 2 minutes of heart rate recovery of patients who are being evaluated for chest pain and asymptomatic adults are associated with the overall mortality. However, the clinical significance of the heart rate recovery after exercise testing during the first 2 minutes for predicting the presence or severity of coronary artery disease and the correlation with the Duke treadmill score (DTS) have not been fully evaluated. SUBJECTS AND METHODS: The study population included 39 patients with significant coronary artery stenosis and 39 subjects with normal coronary arteries. All of them underwent a tread-mill exercise testing prior to coronary angiography. The differences in the heart rate recovery and the DTS between the two groups were investigated. The heart rate recovery and DTS between the multivessel disease group and single vessel disease group were also investigated. RESULTS: The heart rate recovery during the second minute (calculated by the heart rate at 1 minute-the heart rate at 2 minute) after exercise and the DTS were significantly lower in the coronary artery disease group. These parameters were also significantly lower in the multivessel disease group than those in the single vessel disease group. The heart rate recovery during the second minute and the DTS had positive linear correlation (R=0.281, p<0.05). CONCLUSION: In this study, the heart rate recovery during the second minute was considered to be an additional important variable to predict the presence and severity of coronary artery disease.
Adult ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Stenosis ; Coronary Vessels* ; Exercise Test* ; Heart Rate* ; Heart* ; Humans ; Mortality

Coronary artery disease (CAD) is the leading cause of mortality worldwide, and various cardiovascular imaging modalities have been introduced for the purpose of diagnosing and determining the severity of CAD. More recently, advances in computed tomography (CT) technology have contributed to the widespread clinical application of cardiac CT for accurate and noninvasive evaluation of CAD. In this review, we focus on imaging assessment of CAD based upon CT, which includes coronary artery calcium screening, coronary CT angiography, myocardial CT perfusion, and fractional flow reserve CT. Further, we provide a discussion regarding the potential implications, benefits and limitations, as well as the possible future directions according to each modality.
Angiography ; Calcium ; Coronary Artery Disease* ; Coronary Vessels* ; Mass Screening ; Mortality ; Perfusion

BACKGROUND AND OBJECTIVES: The red blood cell distribution width (RDW) has been found to be associated with cardiovascular morbidity and mortality. The objective of this study was to determine whether the RDW measures are associated with the coronary artery calcification score (CACS) in patients who did not present with obvious coronary heart disease (CHD). SUBJECTS AND METHODS: A total of 527 consecutive patients with a low to intermediate risk for CHD but without obvious disease were enrolled in this study. The study subjects underwent coronary computerized tomography angiography and CACS was calculated. The patients were divided into two groups based on CACS: Group I (CACS< or =100) and Group II (CACS>100). The two groups were compared in terms of classic CHD risk factors and haematological parameters, particularly the RDW. RESULTS: Group I patients were younger than Group II patients. The Framingham risk score (FRS) in patients of Group II was significantly higher than that in patients of Group I. Group II patients had significantly elevated levels of haemoglobin, RDW, neutrophil count, and neutrophil/lymphocyte ratio compared with Group I patients. CACS was correlated with age, RDW, and ejection fraction. In the multivariate analysis, age, RDW, and FRS were independent predictors of CACS. Using the receiver-operating characteristic curve analysis, a RDW value of 13.05% was identified as the best cut-off for predicting the severity of CACS (>100) (area under the curve=0.706). CONCLUSION: We found that the RDW is an independent predictor of the CACS, suggesting that it might be a useful marker for predicting CAD.
Angiography ; Coronary Disease ; Coronary Vessels* ; Erythrocytes* ; Humans ; Mortality ; Multivariate Analysis ; Neutrophils ; Risk Factors

Coronary artery disease is one of the principal causes of mortality worldwide. Andreas Gruntzig initially developed balloon angioplasty to treat the condition. Coronary stenting was first used in the mid-1980s to prevent abrupt vessel closure and restenosis. Stent material and design have received a great deal of attention over the past 30 years. Modern polymer stents feature antiproliferative coatings. Recently, a bioresorbable stent scaffold was introduced. This article focuses on the current status of coronary stents, especially with respect to certain aspects of clinical practice.
Angioplasty, Balloon ; Coronary Artery Disease ; Mortality ; Percutaneous Coronary Intervention ; Polymers ; Stents*