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

Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.