BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

OBJECTIVE:To observe therapeutic efficacy and safety of Shensong yangxin capsule combined with low-dose ami-odarone in the treatment of ventricular tachyarrhythmia. METHODS:In retrospective analysis,106 patients with ventricular tachyar-rhythmia were divided into control group and observation with 53 cases in each group according to drug use. Based on conventional treatment,control group was additionally given Amiodarone tablet (first week:0.2 g each time,3 times a day;second week:0.2 g each time,2 times a day;third week to the end of the treatment:0.2 g each time,1 times a day),orally. Observation group was given Amiodarone tablet (first week:0.2 g each time,twice a day;second week to the end of the treatment:0.2 g each time,1 times daily),orally +Shensong yangxin capsule 1.6 g,3 times a day,orally. Both groups were treated for 8 weeks. Clinical effica-cy,blood pressure,heart rate and electrocardiogram(PR period and QT period)and the cardiac cardioversion time were compared between 2 groups,and the occurrence of ADR was also recorded during treatment. RESULTS:After treatment,total response rate of observation group(94.34%)was higher than that of control group(81.13%),the incidence of ADR was lower than that of con-trol group (3.77% vs. 13.21%) and the cardiac cardioversion time was shorter than that of control group,with statistical signifi-cance(P<0.05). Before treatment,there was no statistical significance in heart rate between 2 groups;after treatment,heart rate of 2 groups were significantly lower than before,and observation group was significantly lower than control group,with statistical significance(P<0.05). There were no statistical significance in blood pressure、PR period and QT period between 2 groups before and after treatment (P>0.05). CONCLUSIONS:Based on conventional treatment, Shensong yangxin capsule combined with low-dose amiodarone have good therapeutic efficacy with rapid response for ventricular arrhythmia,it can significantly improve the heart rate of the patients,and the effect is faster with good safety .

40 patients,20 males and 20 females,with 52 miniscrews were included.The concentration of IL-1β,IL-6 and IL-8 in the gingival crevicular fluid around the miniscrews were measured.The results showed that the concentrations of IL-1β,IL-6 and IL-8 increased during orthodintic tooth movement(P ＜0.05),indicating that orthodontic force had an effect on the cytokines around the miniscrews,which may be related to orthodontic bone resorption.