1.Impact of Body Mass Index on Long-term Prognosis in Patients of Acute ST-segment Elevation Myocardial Infarction After Percutaneous Coronary Intervention
Huanhuan WANG ; Xueyan ZHAO ; Zhan GAO ; Shubin QIAO ; Yuejin YANG ; Runlin GAO ; Bo XU ; Jinqing YUAN
Chinese Circulation Journal 2017;32(4):348-352
Objective: To explore the impact of body mass index (BMI) on long-term prognosis in patients of acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods: A total of 1435 consecutive STEMI patients received PCI in our hospital from 2013-01 to 2013-12 were enrolled. Based BMI (kg/m2), the patients were divided into 3 groups: Normal weight group, the patients with 18.5≤BMI<24.0, n=365, Overweight group, 24.0≤BMI<28.0, n=718 and Obese group, BMI≥28.0, n=352. The impact of BMI on major adverse cardiovascular and cerebral events (MACCE) was observed; weather BMI had predictive value for all-cause mortality and cardiac death was analyzed. Results: All-cause mortality in Obese group was lower than Normal weight group (0.6% vs 3.0%), P=0.027; while the incidences of bleeding, stroke, in-stent thrombosis, blood revascularization, re-myocardial infarction and cardiac death were similar among 3 groups. Multivariate analysis revealed that obesity was an independent predictor for all-cause death (HR=0.201, 95% CI 0.043-0.943, P=0.042), BMI was not the independent predictor for cardiac death. Conclusion: For STEMI patients after PCI treatment, the individuals with obesity had the better prognosis than those with normal weight and overweight. Obesity was an independent predictor for all-cause death and obesity paradox was applicable in such population.
2.Effects of HIV infection on the disease progression of hepatitis C in patients with HIV/HCV coinfec-tion
Huanhuan SUN ; Guihai LIU ; Huanqin SUN ; Ning LIU ; Jie XU ; Na JIANG ; Guifang QIAO ; Ang LI ; Yonghong ZHANG
Chinese Journal of Microbiology and Immunology 2015;35(10):749-752
Objective To analyze the differentiation status of CTL and to evaluate its clinical val-ue in patients with HIV/HCV coinfection .Methods Twenty-eight patients with HIV/HCV coinfection and twelve patients with single HCV infection were enrolled in this study .The technique of Fibro-Scan was used to evaluate liver fibrosis .The viral load of HCV was detected by real-time quantitative PCR .Flow cytometry analysis was performed to measure the differentiation status of CTL .Results Both of the levels of alanine transaminase ( ALT) and alkaline phosphatase ( ALP) in patients with HIV/HCV coinfection were signifi-cantly higher than those in patients with single HCV infection [(53.7464±48.1180) U/L vs (27.4750± 13.9850) U/L, P=0.012;(24.5071±8.1940) g/L vs (16.9667±7.1890) g/L, P=0.009].The liver stiffness of patients with HIV/HCV coinfection was higher than that of patients with single HIV infection [(5.9500, 5.8250) Kpa vs (5.1500, 1.0500) Kpa, P=0.117].Compared with the patients with single HCV infection, the patients with HIV/HCV coinfection showed higher viral loads of HCV [( 6.4768, 5.3434) lg copy/ml vs (2.6815, 1.6990) lg copy/ml, P=0.012], but lower clearance rate of HCV [32.14%vs 75%, P=0.032].Compared with the patients with single HCV infection , the patients with HIV/HCV coinfection showed lower percentages of CD 27+CD28+CTL [(28.265±15.095)%vs (18.068±10.263)%, P=0.017), but higher percentages of CD27+/-CD28+CTL [(62.449 ±14.561)% vs (71.111±12.681)%, P=0.066].A trend toward negative correlation was observed between the percent -age of CD27+CD28+CTL and the degree of liver stiffness (r=-0.310, P=0.058).Conclusion HIV in-fection could accelerate the progression of liver disease in patients with HIV /HCV coinfection by affecting the differentiation of CTL .
3.Influence of HIV infection on hepatitis C progress in patients co-infected with HIV/HCV
Jinhua LIU ; Huanqin SUN ; Yan ZHAO ; Huanhuan SUN ; Guifang QIAO ; Jie XU ; Ning LIU ; Ling QIN ; Ang LI ; Na JIANG ; Yonghong ZHANG
Chinese Journal of Epidemiology 2015;(7):738-742
Objective To understand the influence of HIV infection on hepatitis C progress in patients co-infected with HIV and hepatitis C virus (HCV) and related immune mechanism. Methods Twenty eight patients co-infected with HIV/HCV and 12 patients with simplex HCV infection were enrolled. The liver function and hepatic fibrosis progress were evaluated by detecting peripheral blood and with Fibro-Scan. The viral load of HCV was detected by using real time quantitative PCR. And the percentage of Treg/CD4 +T lymphocyte cell was tested by using flow cytometry. Results The levels of ALT and ALP in HIV/HCV co-infection group were (76.16 ± 81.248)U/L,(24.507 1 ± 8.194)g/L respectively,higher than those of simplex HCV infection group [(27.475 0±13.985)U/L,(16.966 7±7.189)g/L],the differences were statistical significant. P value was 0.012 and 0.009 respectively. The liver fibrosis index in HIV/HCV co-infection group was 5.950 0-5.825 0 Kpa,higher than that in simplex HIV infection group(5.150 0-1.050 0 Kpa),and the difference was nearly statistical significant(P=0.077). The HCV viral load in HIV/HCV co-infection group was(6.476 8-5.343 4)lg copy/ml,higher than that in simplex HCV infection group[(1.699 0-2.681 5)lg copy/ml],and the rate of HCV clearance in HIV/HCV co-infection group was 32.14%, lower than that in simplex HCV infection group(75.00%). P value was 0.012 and 0.032 respectively. The percentage of Treg/CD4+T lymphocyte cell in HIV/HCV co-infection group was (7.460 0%-2.287 5%),higher than that in simplex HCV infection group (5.965 0%-2.105 0%),and the difference was significant (P=0.032). The percentage of Treg/CD4 + T lymphocyte cell was significantly related with HCV viral load(ρ=0.350,P=0.027),and HCV viral load was significantly related with the liver fibrosis index(ρ=0.487,P=0.001). Conclusion HIV infection could accelerate the progress of hepatitis C,and Treg cells were involved in this progress.
4. Impact of platelet distribution width on the extent and long-term outcome of patients with stable coronary artery disease post percutaneous coronary intervention
Ping JIANG ; Ying SONG ; Jingjing XU ; Yuanliang MA ; Xiaofang TANG ; Yi YAO ; Lin JIANG ; Huanhuan WANG ; Xue ZHANG ; Xiaolin DIAO ; Yuejin YANG ; Runlin GAO ; Shubin QIAO ; Bo XU ; Jinqing YUAN
Chinese Journal of Cardiology 2017;45(10):862-866
Objective:
To evaluate the relationship between platelet distribution width(PDW) and the extent of coronary artery disease and 2-year outcome in patients received percutaneous coronary artery intervention(PCI) because of stable coronary artery disease(SCAD).
Methods:
We consecutively enrolled 4 293 patients who received PCI because of SCAD in Fuwai Hospital from Jan 2013 to Dec 2013, patients were followed up for 2 years. Patients were divided into three groups according to tertiles values of PDW as follows: PDW≤11.4%(1 402 patients), 11.4%
5. Outcome of patients with coronary artery disease and left ventricular ejection fraction less than 50% undergoing percutaneous coronary intervention
Lin JIANG ; Ying SONG ; Jingjing XU ; Xiaofang TANG ; Huanhuan WANG ; Ping JIANG ; Lijian GAO ; Lei SONG ; Zhan GAO ; Jue CHEN ; Runlin GAO ; Shubin QIAO ; Yuejin YANG ; Bo XU ; Jinqing YUAN
Chinese Journal of Cardiology 2017;45(12):1058-1066
Objective:
To investigate the in-hospital and long-term outcomes of patients with left ventricular ejection fraction (LVEF) <50% undergoing percutaneous coronary intervention (PCI) .
Methods:
From January to December 2013, 10 445 consecutive patients who underwent PCI in Fuwai Hospital and the LVEF value was available were prospectively included. The patients were divided into LVEF≥50% group (9 896 cases) and LVEF
6. Impact of direct bilirubin on the long-term outcome of patients with acute coronary syndrome post percutaneous coronary intervention
Lianjun XU ; Ying SONG ; Jingjing XU ; Zhan GAO ; Xiaofang TANG ; Huanhuan WANG ; Ru LIU ; Ping JIANG ; Lin JIANG ; Yi YAO ; Lijian GAO ; Yin ZHANG ; Lei SONG ; Xueyan ZHAO ; Jue CHEN ; Runlin GAO ; Shubin QIAO ; Yuejin YANG ; Bo XU ; Jinqing YUAN
Chinese Journal of Cardiology 2018;46(5):352-358
Objective:
To investigate the impact of direct bilirubin on long-term prognosis of acute coronary syndrome (ACS) patients post percutaneous coronary intervention(PCI).
Methods:
As a prospective and observational cohort study, a total of 6 431 consecutive ACS patients underwent PCI from January to December 2013 in Fuwai hospital were included. Patients were divided into 3 groups according to tertiles values of direct bilirubin as follows: low direct bilirubin group(<2.2 μmol/L,
7. Relationship between thrombolysis in myocardial infarction risk index and the severity of coronary artery lesions and long-term outcome in acute myocardial infarction patients undergoing percutaneous coronary intervention
Yan CHEN ; Ying SONG ; Jingjing XU ; Xiaofang TANG ; Huanhuan WANG ; Ping JIANG ; Lin JIANG ; Ru LIU ; Xueyan ZHAO ; Lijian GAO ; Lei SONG ; Yin ZHANG ; Jue CHEN ; Zhan GAO ; Shubin QIAO ; Yuejin YANG ; Runlin GAO ; Bo XU ; Jinqing YUAN
Chinese Journal of Cardiology 2018;46(11):874-881
Objective:
To investigate the relationship between thrombolysis in myocardial infarction risk index(TRI) and the severity of coronary artery lesions and long-term outcome in acute myocardial infarction(AMI) patients undergoing percutaneous coronary intervention(PCI).
Methods:
A total of 1 663 consecutive AMI patients undergoing PCI between January and December 2013 in Fuwai hospital were prospectively included in this study. The severity of coronary artery lesions was evaluated using the SYNTAX score. Receiver operating characteristic(ROC) curve was used to analyze the optimal cut-off value of TRI on predicting all-cause mortality at 2 years after PCI.The patients were divided into 2 groups based on the optimal cut-off value of TRI:high TRI group (TRI ≥ 23.05, 465 cases) and low TRI group(TRI<23.05, 1 198 cases). Multivariate logistic regression analyses were used for determining the relationship between TRI and SYNTAX scores≥33. A multivariate Cox regression analyses was used to identify the influence factors of long-term outcome after PCI.
Results:
SYNTAX score was higher in high TRI group than in low TRI group (13.00(7.00, 20.50) vs.10.25(7.00, 17.00),
8. Impact of short-time anticoagulant therapy after selective percutaneous intervention on prognosis of patients with coronary artery disease
Ying SONG ; Xiaofang TANG ; Jingjing XU ; Huanhuan WANG ; Ru LIU ; Ping JIANG ; Lin JIANG ; Lijian GAO ; Yin ZHANG ; Lei SONG ; Lianjun XU ; Xueyan ZHAO ; Zhan GAO ; Jue CHEN ; Runlin GAO ; Shubin QIAO ; Yuejin YANG ; Bo XU ; Jinqing YUAN
Chinese Journal of Cardiology 2019;47(2):108-116
Objective:
To observe the safety and impact of short-term anticoagulant therapy on prognosis after selective percutaneous coronary intervention (PCI) in patients with coronary artery disease.
Methods:
From January 2013 to December 2013, 9 769 consecutive patients underwent selective PCI in Fuwai Hospital were retrospectively included in this study. Patients were divided into two groups, including non-post-PCI anticoagulant therapy group and low-dose and short-time post-PCI anticoagulant therapy group (enoxaparin 0.4 ml/12 h or fondaparinux 2.5 mg/day by subcutaneous injection for 2-3 days after PCI). All patients were evaluated at 30 days, 180 days and 12 months for major adverse coronary and cerebral events (MACCE) including all-cause death, myocardial infarction, revascularization and stroke as well as in-stent thrombosis and bleeding events. Data from 1 755 pairs of patients were analysis after propensity score matching. The clinical outcomes were compared between groups by using Kaplan-Meier survival analysis before and after propensity score matching. Multivariable Cox analysis was used to define the impact and determinants of post-PCI anticoagulation on clinical outcomes.
Results:
one thousand seven hundred and fifty-five (18.0%) patients didn′t receive post-PCI anticoagulation and 8 014 (82.0%) patients received post-PCI anticoagulation, 5 666 (58.0%) patients received enoxaparin and 2 348 (24.0%) patients received fondaparinux. Patients were younger and incidence of female patients was less, incidence of renal dysfunction and acute coronary syndrome were higher in low-dose and short-time post-PCI anticoagulant therapy group than in non-post-PCI anticoagulation group (all
9. Safety and efficacy of a novel abluminal groove-filled biodegradable polymer sirolimus-eluting stent for the treatment of de novo coronary lesions: 5-year results of the TARGET Ⅱ trial
Lianjun XU ; Zhan GAO ; Ying SONG ; Huanhuan WANG ; Jingjing XU ; Lijian GAO ; Yin ZHANG ; Lei SONG ; Xueyan ZHAO ; Jue CHEN ; Jinqing YUAN ; Shubin QIAO ; Yuejin YANG ; Bo XU ; Runlin GAO
Chinese Journal of Cardiology 2018;46(7):523-528
Objective:
This study sought to evaluate the safety and efficacy of FIREHAWK, a novel abluminal groove-filled biodegradable polymer sirolimus-eluting stent (SES) in patients with moderate-complex coronary lesions (including patients with small vessel disease, long lesion and multi vessel disease), and to validate the ability of the SYNTAX score (SS) to predict clinical outcomes in patients treated with FIREHAWK stent.
Methods:
TARGETⅡ was a prospective, multicenter, single-arm clinical trial, a total of 730 patients who underwent percutaneous coronary intervention (PCI) of de novo lesions in native coronary arteries in 24 medical centers in China from August 2011 to February 2012 were enrolled in this study. All patients were exclusively treated with the FIREHAWK stent. Clinical data including patients with diabetes, small vessel disease, long lesion and multi vessel disease were analyzed. The primary composite endpoint was the target lesion failure (TLF) of cardiac death, target vessel-related myocardial infarction (TV-MI), or target lesion revascularization (TLR). The secondary composite endpoint was patient-oriented endpoint (PoCE), a composite of all death, all myocardial in farction (MI), or any repeat revascularization; definite/probable stent thrombosis (ST) (including acute, late, and very late thrombosis) . SS was calculated in lesions with stenosis more than 50% with coronary artery diameter greater than 1.5 mm. Patients were grouped by tertiles of SS (≤7, >7 to ≤12, >12). Follow-up was performed up to 5 years.
Results:
A total of 730 patients were enrolled in the TARGET Ⅱ trial. The average SS was 10.9±6.9. 683 (93.6%) patients completed 5-year clinical follow-up. The 5-year incidence of TLF was 8.5%(58/683). The incidence of TLF components was as follows: cardiac death 2.0%(14/683), TV-MI 4.4%(30/683), TLR 3.4%(23/683). The incidence of PoCE was 16.4%(112/683). The incidence of definite/probable stent thrombosis was 0.7%(5/683).Multivariable Cox regression analysis showed that the diabetes subgroup (
10. Outcome analysis of patients undergoing percutaneous coronary intervention with or without prior coronary artery bypass grafting operation
Ying SONG ; Jingjing XU ; Xiaofang TANG ; Huanhuan WANG ; Ru LIU ; Ping JIANG ; Lin JIANG ; Lijian GAO ; Yin ZHANG ; Lei SONG ; Lianjun XU ; Xueyan ZHAO ; Zhan GAO ; Jue CHEN ; Runlin GAO ; Shubin QIAO ; Yuejin YANG ; Bo XU ; Jinqing YUAN
Chinese Journal of Cardiology 2017;45(7):559-565
Objective:
To investigate the impact of previous coronary artery bypass grafting(CABG) on long-term outcomes in patients undergoing percutaneous coronary intervention(PCI).
Methods:
A total of 10 724 consecutive coronary heart disease patients undergoing PCI between January and December 2013 in Fuwai hospital were prospectively included in this research. According to CABG history, the patients were divided into CABG group(437 cases) and without CABG group(10 287 cases). The patients were followed up for 2 years. Major adverse cardiovascular and cerebrovascular events(MACCE) including death, myocardial infarction, revascularization and stroke, and in-stent thrombosis following PCI were compared between the 2 groups. Multivariate Cox regression analysis was used to identify independent risk factors of poor prognosis.
Results:
Compared with without CABG group, CABG group were older((61±10)years vs.(58±10)years,