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

CD70/CD27 pathway plays an important role in human immune regulation.The role of CD70/CD27 pathway in immune regulation is mainly to promote the activation and proliferation of T cells,induce the differentiation and formation of effector T cells and memory T cells,and interfere with regulatory T cells.In addition,the high level of CD70 expression in some tumor cells provides a new way for tumor immunotherapy.

Objective:To explore the relationship between type I hypersensitivity reaction and the mechanism of the viral hepatitis B through the research of interleukin(IL-13 ) and prostaglandin(PGE1) levels in serum of patients with viral hepatitis B, and therefore, to provide new theory for the perfection of the immunological mechanism of hepatitis B, especially acute hepatitis B.Methods:Serum IL-13 and PGE1 levels were measured in 50 patients with viral hepatitis B and 35 normal cases using double antibody sandwich ELISA method. AST and ALT levels were studied using omni automatic biochemistry analyzer and those correlation with IL-13 and PGE1 were observed.Results:①The IL-13 and PGE1 levels of 10 acute hepatitis B were significantly higher than those of the normal cases; ②The IL-13 and PGE1 levels of 35 chronic hepatitis B were also significantly higher than those of the normal cases; ③The levels of IL-13 and PGE1 were significantly positively correlated with serum ALT and AST.Conclusion:IL-13 and PGE1 levels in patients with acute hepatitis B are most remarkably increased, and correlate with the damage of liver.