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Objective. It is not clear which Traditional Chinese Medicine- (TCM-) related elements affect primary IgA nephropathy (IgAN) progression. Here, we explored the risk factors, based on TCM syndrome elements, related to the prognosis of primary IgAN patients. Methods. We analyzed patients with newly diagnosed, biopsy-proven IgAN at a single institution from December 2013 to September 2021. Basic clinical and pathological characteristics were assessed at the time of renal biopsy. The study endpoint was end-stage renal disease (ESRD: eGFR <15 ml/min per 1.73 m2, dialysis, or kidney transplantation) and/or eGFR decreased by >30% from baseline. Kaplan‒Meier survival analysis was used to explore the role of TCM syndrome elements in IgAN progression. Multivariate Cox regression analysis with adjustment for traditional risk factors was performed to explore TCM syndrome elements that may influence patient prognosis. The factors correlated with TCM syndrome elements in IgAN patients were further evaluated by logistic regression analysis. Results. During a median follow-up of 22.0 months, 53 (12.5%) of the 423 included IgAN patients reached the study endpoint. The main IgAN disease location elements were the kidney, liver, and spleen. The main IgAN disease nature elements were Yin-deficiency and Qi-deficiency, dampness, Yang-deficiency, phlegm, and Blood-deficiency. Kaplan‒Meier analysis identified three disease locations (liver, spleen, and kidney) and four disease natures (Qi-deficiency, Yang-deficiency, phlegm, and dampness) as elements associated with poor renal survival in IgAN patients. In multivariate Cox regression analysis, baseline Yang-deficiency was an independent risk predictor of poor prognosis in primary IgAN patients (hazard ratio 2.338; 95% confidence interval [CI]: 1.208–4.525; P = 0.012) after adjustment for traditional risk factors. Furthermore, logistic regression analysis identified being female (odds ratio [OR] 2.518; 95% CI: 1.538–4.122; P < 0.001), older age (OR 1.043; 95% CI: 1.022–1.065; P < 0.001), low hemoglobin levels (OR 0.984; 95% CI: 0.971–0.996; P = 0.013), and cellular/fibrocellular crescents (OR 1.706; 95% CI: 1.068–2.728; P = 0.026) as factors affecting Yang-deficiency in IgAN patients. Conclusions. Yang-deficiency independently predicts the risk of poor prognosis in primary IgAN patients. Being female, older age, low hemoglobin levels, and cellular/fibrocellular crescents were independently associated with Yang-deficiency in IgAN patients. [ABSTRACT FROM AUTHOR]

Background. Coronary heart disease (CHD) is caused by the blockage or spasm of coronary arteries. Evidence shows that liver disease is related to CHD. However, the correlation between the Model for End-Stage Liver Disease (MELD) score and outcomes in patients after percutaneous coronary intervention (PCI) was unclear. Method. A retrospective cohort study involved 5373 patients with coronary heart disease after PCI was conducted from January 2008 to December 2016. Participants were classified to four groups according to the MELD score by quartiles. The primary endpoint was long-term mortality including all-case mortality (ACM) and cardiac mortality (CM). Secondary endpoints included bleeding events, readmission, major adverse cardiovascular events (MACE), major adverse cardiovascular, and cerebrovascular events (MACCE). The longest follow-up time was almost 10 years. Results. There were significant differences in the incidences of ACM (p = 0.038) and CM (p = 0.027) among the four MELD groups, but there was no significant difference in MACEs (p = 0.496), MACCEs (p = 0.234), readmission (p = 0.684), and bleeding events (p = 0.232). After adjusting the age, gender, smoking, drinking status, and diabetes by a multivariable Cox regression analysis, MELD remains independently associated with ACM (HR:1.57, 95%CI 1.052–2.354, p = 0.027) and CM (HR:1.434, 95% CI 1.003–2.050, p = 0.048). Conclusion. This study indicated that the MELD score had a strong prediction for long-term mortality in CHD patients who underwent PCI. [ABSTRACT FROM AUTHOR]

Background. The relationship between heart rate in CAD patients who underwent percutaneous coronary intervention (PCI) and had long-term outcomes over up to 10 years of follow-up has not been investigated. Methods. All patients were from the CORFCHD-PCI, a retrospective cohort study that included a total of 6050 CAD patients who underwent PCI from January 2008 to December 2016. One patient was excluded due to a lack of heart rate data. Ultimately, 6049 patients were enrolled. The primary outcome was long-term mortality after PCI. Results. Patients were divided into 5 groups according to heart rate quintiles: 1st quintile (heart rate <66 beats/min; n=1123), 2nd quintile (heart rate ≥66 beats/min to 72 beats/min; n=1010), 3rd quintile (heart rate ≥72 beats/min to 78 beats/min; n=1442), 4th quintile (heart rate ≥78 beats/min to 84 beats/min; n=1211), and 5th quintile (heart rate ≥84 beats/min; n=1263). After multivariate Cox regression analyses, the respective risks of ACM, CM, and MACEs were increased 79.1% (hazard risk (HR) = 1.791, 95% CI: 1.207–2.657, P=0.004), 56.9% (HR = 1.569, 95% CI: 1.019–2.416, P=0.041), and 25.5% (HR = 1.255, 95% CI: 0.990–1.590, P=0.060) in the 4th quintile and 98.7% (HR = 1.987, 95% CI: 1.344–2.937, P=0.001), 98.8% (HR = 1.988, 95% CI: 1.310–3.016, P<0.001), and 0.36.1% (HR = 1.361, 95% CI: 1.071–1.730, P=0.012) in the 5th quintile compared with those in the 1st quintile. Patients with a heart rate of ≥80 beats/min had 89.4%, 115.2%, and 39.1% increased risk of ACM, CM, and MACEs, respectively, compared to those patients with a heart rate of <80 beats/min. Conclusion. The present study indicated that the resting heart rate is an independent predictor of adverse long-term outcomes in CAD patients who underwent PCI. [ABSTRACT FROM AUTHOR]

Background. In-stent restenosis (ISR) remains a common problem following percutaneous coronary intervention (PCI). However, the best treatment strategy remains uncertain. There is some controversy over the efficacy of drug-eluting balloons (DEBs) and second-generation drug-eluting stents (DESs) for treating ISR. Methods. A meta-analysis was used to compare the efficacy of the DEB and second-generation DES in the treatment of ISR. The primary endpoint is the incidence of target lesion revascularization (TLR). The secondary endpoint is the occurrence of target vessel revascularization (TVR), myocardial infarction (MI), all-cause death (ACM), cardiac death (CD), major adverse cardiac events (MACEs), minimum luminal diameter (MLD), late luminal loss (LLL), binary restenosis (BR), and percent diameter stenosis (DS%). Results. A total of 12 studies (4 randomized controlled trials and 8 observational studies) including 2020 patients with a follow-up of 6–25 months were included in the present study. There was a significant difference in the MLD between the two groups during follow-up (P=0.007, RR = 0.23, and 95% CI: 0.06–0.4 mm). There was no significant difference in LLL, BR, or DS% and the overall incidence of MACEs between the two groups. Subgroup analysis showed no significant difference in the incidence of primary and secondary endpoints when considering RCTs or observational studies only. Conclusions. The efficacy of the DEB and second-generation DES in the treatment of ISR is comparable. However, our results need further verification through multicenter randomized controlled trials. [ABSTRACT FROM AUTHOR]