OBJECTIVE To observe the clinical efficacy of evolocumab combined with atorvastatin in the treatment of patients with borderline coronary heart disease （CHD）. METHODS In this retrospective cohort study， 342 hospitalized patients diagnosed with borderline CHD were enrolled in the First Affiliated Hospital of Nanyang Medical College from August 2021 to June 2024， and divided into control group （treated with atorvastatin， 190 cases） and trial group （treated with evolocumab combined with atorvastatin， 152 cases） according to therapeutic regimen. Blood lipid indexes， high-sensitivity C-reactive protein （hs-CRP） and intravascular ultrasound of the coronary artery at baseline and after 1 year of treatment， and incidence of cardiovascular adverse events were compared after propensity score matching. RESULTS A total of 295 patients （158 in control group and 137 in trial group） were finally included in the analysis. One year after the treatment， compared with control group， total cholesterol， triglycerides， low-density lipoprotein cholesterol and hs-CRP levels were decreased significantly in trial group （ P ＜0.05）， whereas high-density lipoprotein cholesterol level was increased significantly （ P ＜0.05）. The lumen diameter， lumen area， and the minimum lumen area were significantly increased （ P ＜0.05）， while plaque area and plaque burden were significantly decreased （ P ＜0.05）. Overall incidence of adverse events in trial group was significantly lower than that in control group （ P ＜0.05）. CONCLUSIONS Evolocumab combined with atorvastatin can significantly improve coronary luminal narrowing and reduce plaque burden， as well as reduce the incidence of cardiovascular adverse events in patients with borderline CHD.

OBJECTIVE To explore the application effect of ticagrelor combined with aspirin antiplatelet therapy in high-risk non-disabling ischemic cerebrovascular events （HR-NICE）. METHODS A total of 232 patients with HR-NICE treated at the First Affiliated Hospital of Nanyang Medical College from January 1， 2023 to January 1， 2025 were retrospectively selected. According to different antiplatelet regimens， the patients were divided into three groups： group A （78 cases） received clopidogrel 300 mg as a loading dose on the first day， followed by clopidogrel 75 mg， qd combined with aspirin 100 mg， qd； group B （69 cases） received ticagrelor 120 mg as a loading dose on the first day， followed by ticagrelor 60 mg， bid combined with aspirin 100 mg， qd； group C （85 cases） received ticagrelor 180 mg as a loading dose on the first day， followed by ticagrelor 90 mg， bid combined with aspirin 100 mg， qd. All groups received dual-antiplatelet therapy for 21 days and were then switched to aspirin monotherapy. The primary outcome [incidence of early neurological deterioration （END）] and secondary outcomes， including incidence of ischemic events within 90 days post-discharge， favorable prognosis at 30/90 days， and incidence of bleeding events within 90 days， were compared among the three groups. Logistic regression was used to analyze the relationship between different antiplatelet regimens and END. Interaction terms between treatment regimen and demographic and clinical baseline characteristics were further included to evaluate the interaction effect between treatment regimen and END risk in different subgroups. Propensity score matching （PSM） was performed for sensitivity analysis. RESULTS For the primary outcome， the incidence of END in group C was significantly lower than that in group A （ P ＜0.05）. For secondary outcomes， there were no statistically significant differences among the three groups in the incidence of ischemic events within 90 days post-discharge， favorable prognosis at 30/90 days （ P ＞0.05）. The incidence of minor bleeding events in groups B and C was significantly higher than that in group A （ P ＜0.05）， while no significant differences were observed among the three groups in moderate or severe bleeding events （ P ＞0.05）. Interaction analysis showed that ischemic cerebrovascular disease， Age-Blood Pressure-Clinical Feature-Duration-Diabetes Score （ABCD2）， REACH risk score， and Essen Stroke Risk Score （ESSEN） had significant interactions with treatment regimen （ P ＜0.05）. Among patients with ischemic cerebrovascular disease， ABCD2≥6 points， REACH risk score≥6 points， or ESSEN≥3 points， regimens B or C were associated with a lower risk of END compared with regimen A. The PSM results were generally consistent with the analysis before matching. CONCLUSIONS Ticagrelor， especially the 90 mg bid regimen， plus aspirin， was associated with a lower risk of END in patients with HR-NICE， but increased the risk of minor bleeding events. Patients with ischemic cerebrovascular disease and higher ABCD2， REACH risk score， or ESSEN may be potential beneficiaries of this combination regimen.

Objective To observe the efficacy of ivabradine combined with levosimendan in patients with acute myocardial infarction complicated with heart failure.Methods A total of 78 patients with acute myocardial infarction complicated with heart failure admitted to the hospital from May 1,2020 to December 31,2022 were selected and divided into control group(n = 39)and study group(n = 39)by random number table method.In addition to basic treatment,the control group received levosimendan,and the study group ivabradine and levosi-mendan.The treatment period of both groups was 4 weeks.Compare two groups of patients'vital signs,clinical curative effect and heart function index,serological indexes,inflammatory factors and security.Results Compared with before treatment,the systolic blood pressure,diastolic blood pressure and heart rate of the two groups were decreased after treatment(P<0.05),and the systolic blood pressure,heart rate,diastolic blood pressure and heart rate of the study group were significantly decreased compared with the control group(P<0.05).Compared with the control group,the total effective rate of the study group was significantly higher(P<0.05).Compared with before treatment,the levels of CO and LVEF were increased(P<0.05),while the levels of LVEDV and LVESV were decreased(P<0.05).Compared with the control group,the levels of CO and LVEF in the study group were higher(P<0.05),and the levels of LVEDV and LVESV in the study group were lower(P<0.05).Compared with before treatment,the levels of cTnI,sST2 and NT-proBNP in both groups were decreased after treatment(P<0.05),and the serum levels of cTnI,sST2 and NT-proBNP in the study group were significantly decreased compared with the control group(P<0.05).Tumor necrosis factor α(TNF-α),myeloperoxidase(MPO)and highly sensitive C-reactive protein(hs-CRP)were all decreased after treatment in the two groups(P<0.05),and those in the study group were much lower(P<0.05)No difference between the incidence of adverse reactions to the total contrast the two groups(P>0.05).Conclusion Levosimendan combined with ivabadinehave a definite effect on patients with acute myocardial infarction complicated with heart failure for the improved cardiac function,reduced inflammation,regulated serum sST2,cTnI,and NT-proBNP level.It is also safe and reliable

Objective To explore the biological function of intercellular adhesion molecule-1 (ICAM-1) gene in coronary heart disease (CHD) and to establish a primary regulatory network mediated by ICAM-1 gene. Methods The databases were searched from January 1st 2006 to December 31st 2018, including Wanfang, CNKI, VIP, Google scholar and PubMed databases for published researches on clinical study of CHD gene ICAM-1. The experimental group was CHD patients, and the control group was healthy people. Meta-analysis was employed to analyze the relationship between ICAM-1 gene and CHD. Gene Ontology (GO) and KEGG Pathway database were employed to conduct function annotation and pathway analysis. Results A total of 8 papers were enrolled into this analysis, Meta-analysis showed that the level of ICAM-1 in the experimental group was significantly higher than that in the control group [mean difference (MD) = 15.29, 95% confidence interval (95%CI) = 10.95-19.62, P < 0.000 01], surface ICAM-1 was significantly related with CHD. The GO analysis results showed that ICAM-1 molecular function mainly involved virus receptor activity, receptor activity, transmembrane signal receptor activity, protein binding, etc.; cell components mainly involve plasma membrane integral components, immune synapses, plasma membrane, etc.; biological processes mainly involve the positive regulation of cell adhesion, leukocyte adhesion, leukocyte migration and leukocyte adhesion, etc. A primary CHD regulatory network mediated by ICAM-1 gene was established based on KEGG Pathway database, and ICAM-1 was mainly expressed in endothelial cells, and further regulated the occurrence and development of CHD by promoting the proliferation of leukocytes. Conclusions ICAM-1 may regulate the occurrence and development of CHD by regulating the related biological processes of leukocytes. The successful establishment of the ICAM-1 mediated CHD regulatory network can lay a theoretical foundation for further exploring the specific regulatory role of ICAM-1 and other related genes in CHD occurrence.