Since 1990,China has made considerable progress in resolving the problem of "treatment difficulty" of cardiovascular diseases (CVD). The prevalent unhealthy lifestyle among Chinese residents has exposed a massive proportion of the population to CVD risk factors,and this situation is further worsened due to the accelerated aging population in China. CVD remains one of the greatest threats to the health of Chinese residents. In terms of the proportions of disease mortality among urban and rural residents in China,CVD has persistently ranked first. In 2021,CVD accounted for 48.98％ and 47.35％ of deaths in rural and urban areas,respectively. Two out of every five deaths can be attributed to CVD. To implement a national policy "focusing on the primary health institute and emphasizing prevention" and truly achieve a shift of CVD prevention and treatment from hospitals to communities,the National Center for Cardiovascular Diseases has organized experts from relevant fields across China to compile the "Report on Cardiovascular Health and Diseases in China" annually since 2005. The 2024 report is established based on representative,published,and high-quality big-data research results from cross-sectional and cohort population epidemiological surveys,randomized controlled clinical trials,large sample registry studies,and typical community prevention and treatment cases,along with data from some projects undertaken by the National Center for Cardiovascular Diseases. These firsthand data not only enrich the content of the current report but also provide a more timely and comprehensive reflection of the status of CVD prevention and treatment in China.

Since 1990,significant progress has been achieved on solving the problem of"treatment difficulty"of cardiovascular diseases(CVD)in China.There are huge population with CVD risk factors due to the prevalent unhealthy lifestyle among Chinese residents,this situation is further worsened due to accelerated aging of the population in China.CVD remains one of the greatest threats to the health of Chinese residents.In terms of proportions of disease mortality among urban and rural residents in China,CVD still ranks the first.In 2021,CVD accounted for 48.98%and 47.35%of deaths in rural and urban areas,respectively.Two out of every five deaths are due to CVD.In order to implement the national policy of"focusing on the primary health institute and emphasizing prevention"and truly achieve the shift of the CVD prevention and treatment from hospitals to communities,the National Center for Cardiovascular Diseases has organized experts from relevant fields across the country to compile the"Report on Cardiovascular Health and Diseases in China"annually since 2005.This year's report is established based on representative,published,and high-quality big-data research results from cross-sectional and cohort population epidemiological surveys,randomized controlled clinical studies,large sample registry studies,and typical community prevention and treatment cases,present report also includes data from some of the projects undertaken by the National Center for Cardiovascular Diseases.These first hand data not only enrich the content of the current report but also provide a more timely and comprehensive reflection of the status of CVD prevention and treatment in China.

Objective To determine whether the single nucleotide polymorphism (SNPs) on chromosome 9p21 and 1p13 were associated with acute myocardial infarction (AMI) in a Chinese population, and to compare the allelic frequencies of risk SNP between populations living in north east China, north China, and south east China. Methods We conducted a case control study. Cases were those developed initial AMI (n=1148) between 1999 and 2003; controls (n=1185) were randomly selected age and sex matched non cardiovascular disease patients or normal controls. Twenty SNPs sites in 6 domains (9p21,1p13, 1p32, 1q41,10q11 and 19p13) were studied using the Illumina GoldenGate technology and the Bead Studio software package. SAS /genetics, SAS /STAT and Haploview were used for result analysis and for completing the drawing. Results Four SNPs in 9p21 and 2SNPs in 1p13 were associated with AMI risk in Chinese population (Global P value formul tiple logistic regression, <0.0001), with rs10757274 showing the strongest association with AMI (P=0.006).GG carriers off our SNPs (rs10757274,rs2383206,rs10757278 and rs1333049) in 9p21 were associated with higher risk of AMI (OR=1.40, 95% CI: 1.10-1.79; OR=1.33,95% CI:1.04-1.69; OR=1.35, 95% CI:1.07-1. 72; OR=1.34,95% CI:1.06-1.71).The present study failed to find a significant association of 9 SNPs in 1p32,1q41,10q11,and 19p13 regions with AMI. In the control or cases groups, G allele frequencies of rs646776 in populations living in north and north east China were significantly higher than those living in south China (P<0.05).Conclusion SNP rs10757274 is the susceptible locus of AMI in Chinese population.

Objective To analyze the midterm outcome of patients with congenital aortic stenosis undergoing percutaneous balloon aortic valvuloplasty (PBAV) by single echocardiographic guidance. Methods The clinical data of 12 patients with congenital aortic stenosis who underwent PBAV by single echocardiographic guidance at Fuwai Hospital from January 2016 to November 2017 were retrospectively analyzed. There were 7 males and 5 females with an average age of 18.27±15.30 years. The preoperative peak pressure gradient was 61.8–110.0 (80.30±24.50) mm Hg, and 50% of patients had aortic regurgitation. Results All patients successfully underwent PBAV. Aortic annulus diameter was 18.65±3.17 mm and balloon diameter was 17.62±3.77 mm, with balloon diameter to annulus diameter ratio of 0.92±0.07. The peak transaortic gradient was 16-51 (36.72±12.33) mm Hg immediately after procedure, which was significantly different from the preoperation (P=0.000). During the follow-up period, the peak transaortic gradient was 21-58 (37.06±13.52) mm Hg, and there was no significant difference between the follow-up and immediate postoperation (P=0.310). Immediately after procedure and during follow-up, 58% of patients had aortic regurgitation, which was not statistically different from the preoperation (P=0.682). Conclusion Systematic use of Doppler echocardiographic guidance for PBAV is feasible, and that it is associated with a high success rate and a very low complication rate.

In the late-breaking trials session of the American Heart Association’s Scientific Sessions 2021, which took place in November 2021, six clinical trials in cardiac surgery published their primary results. This review will look into three of them including the management of patients with moderate or less-than-moderate tricuspid regurgitation at the time of surgery for degenerative mitral regurgitation, timing of ticagrelor cessation before coronary artery bypass grafting, and long-term outcomes of ticagrelor-based antiplatelet therapy for secondary prevention of coronary artery bypass grafting.

OBJECTIVETo assess the role of direct thrombin inhibitor argatroban in the renal replacement therapy.

METHODSElectronic databases including Cochrane library, PubMed, EMBASE, Highwire, MEDLINE, CBM, CNKI, and CSJD were searched using keywords including "Argatroban", "hemodialysis", "renal function", "renal failure", and "renal replacement therapy". A meta-analysis of all randomized controlled trials(RCTs)comparing argatroban with controls in renal replacement therapy was performed. Both the study selection and the meta-analysis were conducted according to the Cochrane Handbook for systematic reviews. Data were extracted from these trials and analyzed by RevMan 5.0 software.

RESULTSCompared with the control group, argatroban in renal replacement therapy showed no significant difference in mortality(RR=0.97, 95%CI: 0.48-1.97, P=0.93)and bleeding rate(RR=0.71, 95%CI: 0.37-1.34, P=0.29). Argatroban significantly decreased the incidence of new thrombosis in renal replacement therapy for patients with heparin-induced Thrombocytopenia(RR=0.40, 95%CI: 0.21-0.75, P=0.004). Also, argatroban significantly decreased the clotting events in extracorporeal circuit during the renal replacement therapy(RR=0.06, 95%CI: 0.01-0.23, P<0.0001). CONCLUSION Argatroban applied in renal replacement therapy can decrease the incidences of new thrombosis and clotting events in extracorporeal circuit and meanwhile will not increase the mortality and bleeding.

Antithrombins ; therapeutic use ; Hemorrhage ; epidemiology ; Humans ; Incidence ; Pipecolic Acids ; therapeutic use ; Renal Dialysis ; Renal Insufficiency ; Renal Replacement Therapy ; methods ; Thrombosis ; drug therapy

Objective To explore the application and influencing factors of early clopidogrel use in patients with acute myocardial infarction (AMI) in the central-rural region of China in 2006 and 2011. Methods A representative sample of patients in central-rural region of China admitted to hospital for AMI was created from a two-stage random sampling. In the first phase,a simple random-sampling procedure was used to identify participating hospitals. In the second stage,we selected patients admitted to each participating hospitals for AMI with a systematic sampling approach. Then we obtained clinical information via central medical record abstraction for each patient. For analysis of early clopidogrel therapy (within 24 hours of admission) status,we used multilevel Logistical regression models with the use of generalized estimating equations. Results We identified 1464 patients eligible for early clopidogrel therapy. From 2006 to 2011,the early application rate of clopidogrel increased significantly,from 3.98% to 48.72% (P<0.0001). Logistic regression analysis showed that patients with hypertension were more likely to receive early clopidogrel(OR=1.65,95% CI=1.21-2.26,P=0.001),smokers were associated with greater likelihood to receive early clopidogrel(OR=1.87,95% CI=1.19-2.95,P=0.007),and patients with chest discomfort during hospitalization indicated association with higher likelihood of early clopidogrel use within 24 hours of admission (OR=2.17,95% CI=1.35-3.49,P=0.001). Conclusions Early clopidogrel use in AMI patients has been improved from 2006 to 2011. However,tremendous gap still exists between guidelines and clinical practice. Quality improvement initiatives are in urgent need to support further improvements in early clopidogrel use for AMI patients.

Facing the increasing cardiovascular disease burden and prevailing population risk factors, the cardiovascular surgery in China was also encountering challenges including imbalances in discipline development, significant divergencies in healthcare quality, lacking of clinical guidelines and domestic critical evidence. The concept of quality control and improvement has been practiced and tested in many disease specialties. Quality improvement programs are urgently needed in China to promote the universal cardiovascular surgery healthcare quality.

The cardiovascular surgery in China has reached a stable platform, with notable progress been achieved in the past several decades. However, significant divergency regarding the healthcare quality was also observed, which requiring effective intervention to start the transition from the focus on "quantity" to the pursuit of "quality". Quality improvement program, including the establishment of a national cardiovascular surgery database, the conformation of a standard key quality evaluation indicator system, and the conduction of quality intervention and improvement initiatives, are promising to consolidate and expand the advantages of cardiac surgery and lead to better patient outcomes.

Cardiovascular Agents ; economics ; therapeutic use ; Cardiovascular Diseases ; congenital ; epidemiology ; etiology ; China ; epidemiology ; Dyslipidemias ; complications ; Humans ; Motor Activity ; Nutritional Status ; Overweight ; Prevalence ; Renal Insufficiency, Chronic ; complications ; Risk Factors ; Smoking ; adverse effects ; Time Factors