88 results on '"Aoming Jin"'
Search Results
2. Endovascular therapy in acute ischaemic stroke with large infarction with matched or mismatched clinical-radiological severities: a post-hoc analysis of the ANGEL-ASPECT trialResearch in context
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Lina Zheng, Ximing Nie, Mengxing Wang, Xin Liu, Wanying Duan, Zhe Zhang, Jingyi Liu, Yufei Wei, Miao Wen, Zhonghua Yang, Thomas W. Leung, Gaoting Ma, Xiaochuan Huo, Yuesong Pan, Thanh N. Nguyen, Xinyi Leng, Zhongrong Miao, Liping Liu, Yongjun Wang, Yilong Wang, David S. Liebeskind, Zeguang Ren, Vitor Mendes Pereira, Xunming Ji, Qiang Dong, Anding Xu, Xinfeng Liu, Qingwu Yang, Jing Jing (Chair), Yingkui Zhang, Wei Wu, Dapeng Sun, Zhongqi Qi, Shuo Li, Zhenqiang Liu, Zequan Yu, Jingyu Zhang, Fangguang Chen, Kangyue Li, Kai Zhang, Mingkai Hu, Jianmin Liu (Chair), Chen Yao, Kangning Chen, Kun Fang (Chair), Bo Song, Yi Dong, Guangxiong Yuan, Hongxing Han, Wenhuo Chen, Ming Wei, Jiangang Zhang, Zhiming Zhou, Xiaoxi Yao, Guoqing Wang, Weigen Song, Xueli Cai, Guangxian Nan, Di Li, Yizhou Wang, Wentong Ling, Chuwei Cai, Changming Wen, En Wang, Liyong Zhang, Changchun Jiang, Yajie Liu, Geng Liao, Xiaohui Chen, Tianxiao Li, Shudong Liu, Jinglun Li, Yaxuan Sun, Na Xu, Zong’en Gao, Dongsheng Ju, Cunfeng Song, Jinggang Xuan, Feng Zhou, Qing Shi, Jun Luo, Yan Liu, Zaiyu Guo, Tong Li, Hongbo Zheng, Linzhi Dai, Junfeng Zhao, Liqiang Gui, Xiaokun Geng, Yufeng Tang, Congguo Yin, Hua Yang, Ruiyang An, Yuying Sun, Yanan Wu, Chunlai Yu, Shuangcheng Zheng, Aoming Jin, Xianglong Xiang, Hongyi Yan, Yuanling He, Chunyang Li, Weixia Kong, Yuhuan Chen, Chenhao Guo, Fengjie Ji, Pengshan Ji, Lei Liu, Xinghua Lu, Guangkuo Luo, Nanjing Wang, Yu Zhang, Bo Liu, Jian Yang, Jingjing Deng, Juan Wang, Wanru Wang, Hang Yu, Le Cui, Wenwen Liu, Ziyong Wang, Xia Zhao, Zhou Zhou, and Alvin Yi-Chou Wang
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Endovascular therapy ,Acute ischaemic stroke ,Large vessel occlusion ,Large infarct core ,Post hoc analysis ,Medicine (General) ,R5-920 - Abstract
Summary: Background: Endovascular therapy (EVT) was demonstrated effective in acute large vessel occlusion (LVO) with large infarction. Revealing subgroups of patients who would or would not benefit from EVT will further inform patient selection for EVT. Methods: This post-hoc analysis of the ANGEL-ASPECT trial, a randomised controlled trial of 456 adult patients with acute anterior-circulation LVO and large infarction, defined by ASPECTS 3–5 or infarct core volume 70–100 mL, enrolled from 46 centres across China, between October 2, 2020 and May 18, 2022. Patients were randomly assigned (1:1) to receiving EVT and medical management or medical management alone. One patient withdrew consent, 455 patients were included in this post-hoc analysis and categorised into 4 subgroups by lower or higher NIHSS (< or ≥16) and smaller or larger infarct core (< or ≥70 mL). Those with lower NIHSS & smaller core, and higher NIHSS & larger core were considered clinical-radiological matched subgroups; otherwise clinical-radiological mismatched subgroups. Primary outcome was 90-day modified Rankin Scale (mRS). ANGEL-ASPECT is registered with ClinicalTrials.gov, NCT04551664. Findings: Overall, 139 (30.5%) patients had lower NIHSS & smaller core, 106 (23.3%) higher NIHSS & larger core, 130 (28.6%) higher NIHSS & smaller core, and 80 (17.6%) lower NIHSS & larger core. There was significant ordinal shift in the 90-day mRS toward a better outcome with EVT in clinical-radiological matched subgroups: lower NIHSS & smaller core (generalised OR, 1.76; 95% CI, 1.18–2.62; p = 0.01) and higher NIHSS & larger core (1.64; 1.06–2.54; 0.01); but not in the two clinical-radiological mismatched subgroups. Interpretation: Our findings suggested that in patients with anterior-circulation LVO and large infarction, EVT was associated with improved 90-day functional outcomes in those with matched clinical and radiological severities, but not in those with mismatched clinical and radiological severities. Simultaneous consideration of stroke severity and infarct core volume may inform patient selection for EVT. Funding: Unrestricted grants from industry [Covidien Healthcare International Trading (Shanghai), Johnson & Johnson MedTech, Genesis MedTech (Shanghai), and Shanghai HeartCare Medical Technology].
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- 2024
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3. Adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke
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Qi Zhou, Hongyi Yan, Aoming Jin, Xia Meng, Jinxi Lin, Hao Li, Yongjun Wang, and Yuesong Pan
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Adipose tissue ,Insulin resistance ,Metabolism ,Risk ,Stroke ,Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Abstract Background Insulin resistance is linked to atherosclerotic cardiovascular diseases and stroke, whereas less is known about adipose tissue specific insulin resistance and outcomes after ischemic stroke. This study aimed to estimate the association between adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke. Methods Patients with ischemic stroke without a history of diabetes mellitus in the Third China National Stroke Registry were included. Adipose tissue specific insulin resistance index (Adipo-IR) was calculated by fasting serum insulin and free fatty acids and categorized into 5 groups according to the quintiles. Outcomes included stroke recurrence (ischemic or hemorrhagic), combined vascular events, all-cause death, and poor outcome (modified Rankin Scale, 3–6) at 12 months after stroke onset. We assessed the association between Adipo-IR and risk of prognosis by multivariable Cox/logistic regression models adjusted for potential covariates. Results Among 2,222 patients, 69.0% were men with a mean age of 62.5 years. At 12 months, 185 (8.3%) patients had recurrent stroke, 193 (8.7%) had combined vascular events, 58 (2.6%) died, and 250 (11.5%) had a poor outcome. Compared with patients with the lowest quintile, patients with the second, third, fourth, fifth quintiles of the Adipo-IR were associated with an increased risk of stroke recurrence (hazard ratio [HR], 1.77; 95% CI, 1.04–3.03; P = 0.04; HR, 2.19; 95% CI, 1.30–3.68; P = 0.003; HR, 1.84; 95% CI, 1.06–3.21; P = 0.03; HR, 2.11; 95% CI, 1.20–3.71; P = 0.01, respectively) and marginally associated with an increased risk of combined vascular events ( HR, 1.60; 95%CI, 0.97–2.64; P = 0.07; HR, 1.91; 95% CI, 1.17–3.13; P = 0.01; HR, 1.62; 95% CI, 0.96–2.75; P = 0.07; HR, 1.80; 95% CI, 1.05–3.09; P = 0.03, respectively) at 12 months after adjustment for potential covariates. Adipo-IR was not associated with mortality and poor outcome at 12 months. Conclusions These findings suggest that adipose tissue specific insulin resistance is independently associated with recurrent stroke and combined vascular events after acute ischemic stroke in nondiabetic patients.
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- 2023
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4. Association of metabolic dysfunction-associated fatty liver disease with systemic atherosclerosis: a community-based cross-sectional study
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Yanli Zhang, Zhang Xia, Xueli Cai, Xin Su, Aoming Jin, Lerong Mei, Jing Jing, Suying Wang, Xia Meng, Shan Li, Mengxing Wang, Tiemin Wei, Yongjun Wang, Yan He, and Yuesong Pan
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Fatty liver disease ,Metabolic dysfunction ,Atherosclerosis ,Polyvascular disease ,Diabetes mellitus ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Data are limited on the association of metabolic dysfunction-associated fatty liver disease (MAFLD) with systemic atherosclerosis. This study aimed to examine the relationship between MAFLD and the extent of atherosclerotic plaques and stenosis, and presence of polyvascular disease (PolyVD). Methods In this cross-sectional study, MAFLD was diagnosed based on the presence of metabolic dysfunction (MD) and fatty liver disease (FLD). MAFLD was divided into three subtypes: MAFLD with diabetes mellitus (DM), MAFLD with overweight or obesity (OW), as well as MAFLD with lean/normal weight and at least two metabolic abnormalities. Atherosclerosis was evaluated, with vascular magnetic resonance imaging for intracranial and extracranial arteries, thoracoabdominal computed tomography angiography for coronary, subclavian, aorta, renal, iliofemoral arteries, and ankle-brachial index for peripheral arteries. The extent of plaques and stenosis was defined according to the number of these eight vascular sites affected. PolyVD was defined as the presence of stenosis in at least two vascular sites. Results This study included 3047 participants, with the mean age of 61.2 ± 6.7 years and 46.6% of male (n = 1420). After adjusting for potential confounders, MAFLD was associated with higher extent of plaques (cOR, 2.14, 95% CI 1.85–2.48) and stenosis (cOR, 1.47, 95% CI 1.26–1.71), and higher odds of presence of PolyVD (OR, 1.55, 95% CI 1.24–1.94) as compared with Non-MAFLD. In addition, DM-MAFLD and OW-MAFLD were associated with the extent of atherosclerotic plaques and stenosis, and presence of PolyVD (All P
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- 2023
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5. Experience with 2 years’ intervention to progressively reduce salt supply to kitchens in elderly care facilities—challenges and further research: post hoc analysis of the DECIDE-Salt randomized clinical trial
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Yifang Yuan, Aoming Jin, Peifen Duan, La’e Cao, Hongxia Wang, Senke Hu, Jiayu Li, Xiangxian Feng, Qianku Qiao, Hui Zhang, Ruijuan Zhang, Huijuan Li, Pei Gao, Gaoqiang Xie, Jianhui Yuan, Lili Cheng, Sujuan Wang, Wenyi Niu, Paul Elliott, Runlin Gao, Darwin Labarthe, and Yangfeng Wu
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Randomized trial ,Sodium intake ,Salt reduction ,Blood pressure ,Cardiovascular disease ,Medicine - Abstract
Abstract Background Progressive reduction of sodium intake is an attractive approach for addressing excessive salt intake, but evidence for this strategy in real practice is limited. We aimed to determine the feasibility, effectiveness, and safety of a progressive sodium intake reduction intervention in real-world setting. Methods We randomized 48 residential elderly care facilities in China, with 1612 participants aged 55 years and older, to either progressive reduction (PR, 24 facilities) or no reduction (NR, 24 facilities) of the supply of study salt to the kitchens of these facilities for 2 years. The primary efficacy outcome was systolic blood pressure (SBP) at any scheduled follow-up visit. Secondary efficacy outcomes included diastolic blood pressure (DBP) at any scheduled follow-up visit, and major adverse cardiovascular events (comprising non-fatal stroke, non-fatal myocardial infarction, hospitalized non-fatal heart failure, or vascular death) and total mortality. The perception of food saltiness, the addition of out-of-study salt in meals, and 24-h urinary sodium excretion were used as process indicators. Results Pre-specified analysis per randomization found no effect of the intervention on the 2-year overall mean systolic and diastolic blood pressure (SBP, DBP) and any other outcomes. However, post hoc analysis showed that the intervention effect on blood pressure varied over multiple follow-up visits (p for interaction
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- 2023
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6. Blood Pressure Partially Mediated the Association of Insulin Resistance and Cerebral Small Vessel Disease: A Community‐Based Study
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Mengyuan Zhou, Lerong Mei, Jing Jing, Yingying Yang, Xueli Cai, Xia Meng, Aoming Jin, Jinxi Lin, Shan Li, Hao Li, Tiemin Wei, Yongjun Wang, Yilong Wang, and Yuesong Pan
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blood pressure ,insulin resistance ,mediation ,small vessel disease ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Insulin resistance as a significant vascular risk factor has been studied in relation to cerebral small vessel disease (SVD). Evidence suggests that insulin resistance might trigger high blood pressure (BP). Therefore, we aimed to investigate whether insulin resistance impacts SVD with a mediating effect of BP in nondiabetic subjects. Methods and Results PRECISE (Polyvascular Evaluation for Cognitive Impairment and Vascular Events) study participants underwent brain and vascular imaging techniques and metabolomic risk factors measurements. Insulin resistance was evaluated by the insulin sensitivity index and the Homeostatic Model Assessment for Insulin Resistance based on the standard oral glucose tolerance test. On average, 2752 nondiabetic subjects (47.1% men) aged 60.9 years were included. The multivariable logistic regression model and linear regression model tested the association of insulin resistance with BP components (including systolic BP [SBP], diastolic BP (DBP), and pulse pressure [PP]) and SVD, and of BP components with SVD. In the mediation analysis, SBP, DBP, and PP were found to partially mediate the detrimental effect of insulin resistance (assessed by the insulin sensitivity index) on lacunes (mediation percentage: SBP, 31.15%; DBP, 34.21%; PP, 10.43%), white matter hyperintensity (mediation percentage: SBP, 37.34%; DBP, 44.15%; PP, 9.80%), and SVD total burden (mediation percentage: SBP, 42.07%; DBP, 49.29%; PP, 11.71%) (all P
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- 2024
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7. Association of serum potassium level with dietary potassium intake in Chinese older adults: a multicentre, cross-sectional survey
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Yangfeng Wu, Xiangxian Feng, Hongxia Wang, Ming-hui Zhao, Aoming Jin, Ruijuan Zhang, Qianku Qiao, Runlin Gao, and Yifang Yuan
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Medicine - Abstract
Objectives Evidence linking dietary potassium and serum potassium is virtually scarce and inconclusive. The aim of the study was to investigate the association between serum potassium level and potassium intake measured by 24-hour urine. We also explored whether the association differed across health conditions.Design A cross-sectional study conducted from September 2017 to March 2018.Setting 48 residential elderly care facilities in northern China.Participants Participants aged 55 years and older and with both serum potassium and 24-hour urinary potassium measured were classified as having a low (apparently healthy), moderate (with ≥1 health condition but normal renal function) and high (with ≥1 health condition and abnormal renal function) risk of hyperkalaemia.Exposure Potassium intake is measured by 24-hour urinary potassium.Outcomes Serum potassium in association with potassium intake after adjustment for age, sex, region and accounting for the cluster effect.Results Of 962 eligible participants (mean age 69.1 years, 86.8% men), 17.3% were at low risk, 48.4% at moderate risk and 34.3% at high risk of hyperkalaemia. Serum potassium was weakly associated with 24-hour urinary potassium among individuals with moderate (adjusted β=0.0040/L; p=0.017) and high (adjusted β=0.0078/L; p=0.003) but not low (adjusted β=0.0018/L; p=0.311) risk of hyperkalaemia.Conclusions A weak association between dietary potassium intake and serum potassium level existed only among individuals with impaired renal function or other health conditions but not among apparently healthy individuals. The results imply that increasing dietary potassium intake may slightly increase the risk of hyperkalaemia but may also decrease the risk of hypokalaemia in unhealthy individuals, both of which have important health concerns.Trial registration number NCT03290716; Post-results.
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- 2023
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8. Association of insulin resistance with intra- and extra-cranial atherosclerotic burden in the nondiabetic community population
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Xueli Cai, Jingping Sun, Aoming Jin, Jing Jing, Suying Wang, Lerong Mei, Xia Meng, Shan Li, Tiemin Wei, Yongjun Wang, and Yuesong Pan
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Insulin resistance ,Intracranial plaques ,Extracranial plaques ,Atherosclerotic burden ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Aims: Few population-based studies have investigated the association between insulin resistance and atherosclerotic burden in intra- and extra-cranial arteries. The purpose of this study is to explore the relationship between insulin resistance and intra- and extra-cranial atherosclerotic burden in community-based nondiabetic participants. Methods: This is a cross-sectional analysis from a population-based prospective cohort-PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study in China. The homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity indices (ISI0–120) were stratified by the quartiles, respectively. The atherosclerotic presence of plaques and burden was evaluated by high-resolution MRI. Binary or ordinal logistic regression was performed to assess the association between HOMA-IR or ISI0–120 and the presence and burden of atherosclerosis. Results: Among the 2754 participants, the mean age was 60.9 ± 6.6 years, and 1296 (47.1%) were males. Compared with the lowest quartile of HOMR-IR, the highest quartile of HOMA-IR (indicating a higher level of insulin resistance) was associated with an increased presence of plaques (OR:1.54, 95% CI:1.14–2.08), and atherosclerotic burden (OR:1.53, 95%CI:1.14–2.07) in intracranial arteries. Meanwhile, we observed a similar relationship between HOMA-IR and the presence or burden in extracranial atherosclerosis. The first (indicating a higher level of insulin resistance) quartiles of ISI0–120 were associated with the intracranial plaques (Q1, OR:1.56, 95%CI:1.16–2.11) and atherosclerotic burden (Q1, OR:1.57, 95%CI:1.17–2.12), but not extracranial plaques or atherosclerotic burden, compared with the fourth quartile of ISI0–120. Conclusions: Insulin resistance was associated with an increased intra-and extra-cranial atherosclerotic burden in the nondiabetic elderly Chinese population.
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- 2023
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9. Association between triglyceride glucose index and atherosclerotic plaques and Burden: findings from a community-based study
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Mengxing Wang, Lerong Mei, Aoming Jin, Xueli Cai, Jing Jing, Suying Wang, Xia Meng, Shan Li, Tiemin Wei, Yongjun Wang, and Yuesong Pan
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Insulin resistance ,Triglyceride glucose index ,HOMA-IR ,Atherosclerosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Insulin resistance is an important cause of cardiovascular events and cerebral infarction development. We aimed to investigate the association of the triglyceride glucose (TyG) index with atherosclerotic burden and plaques in coronary, intra- and extracranial arteries in participants with non-diabetes, and compared the results with that of the homeostasis model assessment of insulin resistance (HOMA-IR). Methods Participants without diabetes in the PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study were included. We categorized participants by tertiles of the TyG index and the concordance/discordance of the TyG index and HOMA-IR. Discordance was defined as a TyG index equal to or greater than the median and HOMA-IR less than the median, or vice versa. The atherosclerosis plaques and burden in coronary, intra- and extracranial arteries were evaluated. The association of HOMA-IR and TyG index with the presence of atherosclerotic plaques and atherosclerotic burden was assessed by binary and ordinal logistic regression models, respectively. Results Among 2,719 included participants, the average age was 60.9 (± 6.6) years, and 53.0% were female. Both TyG index and HOMA-IR were associated with increased odds of coronary/intra- and extracranial atherosclerotic plaques and burden after adjustment for age, sex, currenting smoking and drinking (all P
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- 2022
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10. Effects of genetically determined mineral status on life expectancy: a Mendelian randomization study
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Hongjuan Fang, Weiqi Chen, Aoming Jin, Mengxing Wang, Hongyi Yan, Xianglong Xiang, Yuesong Pan, Rongman Jia, and Xiuyuan Hao
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Medicine - Published
- 2023
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11. Associations of deep medullary veins with vascular risk factors, laboratory indicators, and cerebral small vessel disease: A population‐based study
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Yu Tian, Shan Li, Yingying Yang, Xueli Cai, Jing Jing, Suying Wang, Xia Meng, Lerong Mei, Aoming Jin, Dongxiao Yao, Tiemin Wei, Yongjun Wang, Yuesong Pan, and Yilong Wang
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aging ,cerebral small vessel disease ,deep medullary veins ,enlarged perivascular spaces ,white matter hyperintensity ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Abstract Objective Deep medullary veins (DMVs) were not considered a typical marker of cerebral small vessel disease (CSVD) due to limited understanding of their involvement in pathology of CSVD. This study aimsto investigate potential vascular risk factors for DMVs and their associations with CSVD. Methods In total, 1909 community‐dwelling participants were included in this analysis. Demographic, clinical, laboratory, and imaging data were collected. DMV scores (0–18) werecalculated as the sum of bilateral frontal, parietal, and occipital regional scores using a semiquantitative visual scale (0–3). The presence, total burden, and imaging markers of CSVD were assessed. Linear regression analyses were conducted to explore potential vascular factors for DMV scores. Binary and ordinal logistic regression analyses were performed to investigate the associations of DMV scores with CSVD and its markers. Results Mean age was 61.8 (SD 6.5) years, and 1027 (53.8%) of participants were men. The median DMV scores were14 (IQR 12–16). DMV scores wererelated to age, male sex, body mass index, diastolic blood pressure, hypercholesterolaemia, atrial fibrillation, current drinking, total cholesterol, triglycerides, low‐density lipoprotein, hemoglobin A1c, leukocytes, lymphocytes, hemoglobin, and platelets (p
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- 2023
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12. Higher visceral adiposity index and lipid accumulation product in relation to increased risk of atherosclerotic burden in community-dwelling older adults
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Jingping Sun, Xia Meng, Huifen Huang, Jing Jing, Yuesong Pan, Lerong Mei, Aoming Jin, Yongjun Wang, Tiemin Wei, and Xueli Cai
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Visceral adiposity index ,Lipid accumulation product ,Coronary atherosclerosis ,Intracranial and extracranial atherosclerosis ,Medicine ,Biology (General) ,QH301-705.5 - Abstract
Background and aims: Visceral adiposity index (VAI) and lipid accumulation product (LAP), as anthropometric indices, have been applied to predict the risk of cardiovascular diseases (CVD). However, few studies investigated the correlation between these two indicators and cardio-cerebro-vascular atherosclerosis in community populations. Our study was to explore the association of VAI and LAP with coronary, intracranial and extracranial atherosclerosis in a community-based asymptomatic middle-aged and older population. Methods: Participants without a history of CVD in the study of PRECISE (Polyvascular Evaluation for Cognitive Impairment and Vascular Events) were included. The sex-special indicators of VAI and LAP were calculated and stratified by the tertiles. The presence of plaque and coronary segmental stenosis score (SSS) were assessed by coronary computed tomography (CTA), as well as intracranial and extracranial atherosclerotic burden were evaluated by high-resolution magnetic resonance imaging (HR-MRI), respectively. Binary or ordinal logistic regression was conducted to assess the association between each of the indexes and the presence and burden of atherosclerosis. Results: A total of 2875 subjects were included in the final analysis. The mean age was 60.9 ± 6.6 years and 1329 (46.2 %) participants were males. Compared with the first tertile of VAI, the higher tertile was associated with the presence of plaques (T3 vs T1, OR, 1.49, 95%CI, 1.12–1.98, for males; OR, 1.64, 95%CI, 1.24–2.17, for females) and atherosclerotic burden (T3 vs T1, adjusted cOR, 1.63, 95%CI, 1.24–2.14, for males; adjusted cOR, 1.70, 95%CI, 1.29–2.24, for females) in major coronary arteries. A similar association was found for LAP. VAI level has presented an association with the extracranial atherosclerotic plaques (T3 vs T1, OR, 1.34, 95%CI, 1.02–1.77) and burden (T3 vs T1, adjusted cOR 1.32, 95 % CI 1.00–1.73) only in females. Whereas, for intracranial atherosclerosis, the results failed to show any statistically significant association. Conclusions: Among community-dwelling asymptomatic older adults, VAI and LAP were associated with the presence and burden of coronary atherosclerotic plaques, while VAI presented a weaker significant association with extracranial atherosclerosis in females.
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- 2023
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13. Association of inflammatory markers with cerebral small vessel disease in community-based population
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Lingling Jiang, Xueli Cai, Dongxiao Yao, Jing Jing, Lerong Mei, Yingying Yang, Shan Li, Aoming Jin, Xia Meng, Hao Li, Tiemin Wei, Yongjun Wang, Yuesong Pan, and Yilong Wang
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Cerebral small vessel disease ,Inflammation ,Neutrophil count ,Neutrophil–lymphocyte ratio ,Systemic immune-inflammation index ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Background This study investigated the relationships of neutrophil count (NC), neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) with cerebral small vessel disease (CSVD). Methods A total of 3052 community-dwelling residents from the Poly-vasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study were involved in this cross-sectional study. CSVD burden and imaging markers, including white matter hyperintensity (WMH), lacunes, cerebral microbleeds (CMBs) and enlarged perivascular spaces in basal ganglia (BG-EPVS), were assessed according to total CSVD burden score. The associations of NC, NLR and SII with CSVD and imaging markers were evaluated using logistic regression models. Furthermore, two-sample Mendelian randomization (MR) analysis was performed to investigate the genetically predicted effect of NC on CSVD. The prognostic performances of NC, NLR and SII for the presence of CSVD were assessed. Results At baseline, the mean age was 61.2 ± 6.7 years, and 53.5% of the participants were female. Higher NC was suggestively associated with increased total CSVD burden and modified total CSVD burden (Q4 vs. Q1: common odds ratio (cOR) 1.33, 95% CI 1.05–1.70; cOR 1.28, 95% CI 1.02–1.60) and marginally correlated with the presence of CSVD (OR 1.29, 95% CI 1.00–1.66). Furthermore, elevated NC was linked to a higher risk of lacune (OR 2.13, 95% CI 1.25–3.62) and moderate-to-severe BG-EPVS (OR 1.67, 95% CI 1.14–2.44). A greater NLR was related to moderate-to-severe BG-EPVS (OR 1.68, 95% CI 1.16–2.45). Individuals with a higher SII had an increased risk of modified WMH burden (OR 1.35, 95% CI 1.08–1.69) and moderate-to-severe BG-EPVS (OR 1.70, 95% CI 1.20–2.41). MR analysis showed that genetically predicted higher NC was associated with an increased risk of lacunar stroke (OR 1.20, 95% CI 1.04–1.39) and small vessel stroke (OR 1.21, 95% CI 1.06–1.38). The addition of NC to the basic model with traditional risk factors improved the predictive ability for the presence of CSVD, as validated by the net reclassification index and integrated discrimination index (all p
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- 2022
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14. Elevated Homocysteine Intensify the Effect of Lipoprotein(a) on Stroke Recurrence
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Zhiyuan Feng, Jie Xu, Aoming Jin, Aichun Cheng, Jing Xue, Xia Meng, and Yongjun Wang
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acute ischemic stroke ,homocysteine ,interaction effect ,lipoprotein(a) ,stroke recurrence ,transient ischemic attack ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2023
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15. Elevated lipoprotein(a) and lipoprotein-associated phospholipase A2 are associated with unfavorable functional outcomes in patients with ischemic stroke
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Xue Jiang, Jie Xu, Xiwa Hao, Jing Xue, Ke Li, Aoming Jin, Jinxi Lin, Xia Meng, Lemin Zheng, and Yongjun Wang
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Lipoprotein(a) ,Lipoprotein-associated phospholipase A2 ,Inflammation ,Functional outcomes ,Ischemic stroke ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Background The association of lipoprotein(a) [Lp(a)] and stroke functional outcomes was conflicting. The aim of the study was to clarify whether high Lp(a) is associated with unfavorable functional outcomes in patients with ischemic stroke. Methods A total of 9709 individuals from the third China National Stroke Registry cohort were recruited. Plasma level of Lp(a) at admission was measured with enzyme-linked immunosorbent assay. The cut-off was set at the median for Lp(a). Functional outcome was assessed using the modified Rankin scale (mRS) at 3 months and 1 year after ischemic stroke. The association between Lp(a) and functional outcomes was evaluated using a logistic regression model. Results The median age was 63.0 years, and 31.1% participants were women. Patients in higher Lp(a) group had higher incidences of unfavorable functional outcomes at 3 months. In logistic regression model, elevated Lp(a) levels were associated with unfavorable functional outcomes at 3 months (Q4 vs. Q1: odds ratio 1.33, 95% confidence interval 1.11–1.61). Subgroup analysis showed that in the lower Lp-PLA2 group, Lp(a) level was not associated with functional outcomes, but in the higher Lp-PLA2 group, Lp(a) level was significantly associated with functional outcomes. After grouped by different levels of Lp(a) and Lp-PLA2, the Lp(a) high/ Lp-PLA2 high group showed the highest incidence of unfavorable functional outcomes at 3 months and 1 year. Conclusions Elevated Lp(a) level is associated with unfavorable functional outcomes in patients with ischemic stroke. The increment in both Lp(a) and Lp-PLA2 are associated with unfavorable functional outcomes at 3 months and 1 year after ischemic stroke.
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- 2021
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16. Prevalence and distribution of lacunar stroke in China: a cross-sectional study using self-reported survey data
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Yilong Wang, Bin Jiang, Wenzhi Wang, Aoming Jin, Dongling Sun, Haixin Sun, Xiaojuan Ru, and Shangrong Han
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Medicine - Abstract
Objectives To report the prevalence and distribution of lacunar stroke in different regions of China, as well as the demographical characteristics of symptomatic and asymptomatic lacunar stroke.Design Cross-sectional study.Setting Data were derived from NESS-China Study that was conducted in 157 sites covering all 31 provinces, including 64 urban and 93 rural areas in mainland China between 1 September 2013 and 31 December 2013. Lacunar stroke was defined as being previously diagnosed according to the participants’ medical history. Patients were further divided into symptomatic or asymptomatic groups, depending on whether they were initially diagnosed with neurological symptoms.Participants 458 833 participants aged ≥20 years were enrolled in this study.Results A total of 7520 participants (1.63%) were diagnosed with lacunar stroke. The peak rate of diagnosis was between the ages of 70 and 79 years in both men and women. Geographically, the age-standardised and sex-standardised prevalence was highest in Northeast China (2495.3/100 000 persons) and lowest in Southeast China (599.7/100 000 persons), showing a geographical disparity. Over 90% of patients with lacunar stroke were diagnosed in secondary or tertiary hospitals. Patients with symptomatic lacunar stroke had significantly different demographic characteristics in age, sex and geographical regions compared with those who were asymptomatic.Conclusions In this study, the prevalence and distribution of lacunar stroke were reported at population level across China. Special attention and prevention should be given to the age, sex and geographical groups that are vulnerable to lacunar stroke.
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- 2022
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17. Residual Risk of Trimethylamine‐N‐Oxide and Choline for Stroke Recurrence in Patients With Intensive Secondary Therapy
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Jing Xue, Jie Xu, Mingming Zhao, Aoming Jin, Aichun Cheng, Xue Jiang, Ke Li, Jinxi Lin, Xia Meng, Hao Li, Lemin Zheng, and Yongjun Wang
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(above vs. below the median) ,choline ,ischemic stroke ,residual risk ,stroke recurrence ,trimethylamine N‐oxide ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Trimethylamine N‐oxide (TMAO) contributes to cardiovascular disease through its prothrombotic, proatherothrombotic, and proinflammatory effects. We aimed to evaluate whether residual risk of recurrent stroke of TMAO and its precursor choline remain among patients who received dual‐antiplatelet therapy and intensive lipid‐lowering therapy and with a low inflammation level (high‐sensitivity C‐reactive protein
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- 2022
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18. Association between diabetes duration and 1‐year prognosis of stroke: A national registry study
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Yanli Zhang, Aoming Jin, Xia Meng, Mengxing Wang, Hao Li, Yuesong Pan, and Yongjun Wang
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clinical outcome ,diabetes duration ,prognosis ,stroke recurrence ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Abstract Background and purpose Diabetes mellitus is a strong independent risk factor for stroke recurrence. However, the association between diabetes duration and the prognosis of stroke remains uncertain. We aimed to characterize whether an association exists between diabetes duration and stroke outcomes in patients with ischemic stroke or transient ischemic attack (TIA). Methods Between 2015 and 2018, 14,674 patients with ischemic stroke or TIA within 7 days and older than 18 years from the Third China National Stroke Registry (CNSR‐III) were included in this analysis. Diabetes duration at baseline was collected by face‐to‐face interviews and further categorized into groups of without diabetes, diabetes
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- 2022
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19. Differential Effects of Genetically Determined Cholesterol Efflux Capacity on Coronary Artery Disease and Ischemic Stroke
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Aoming Jin, Mengxing Wang, Weiqi Chen, Hongyi Yan, Xianglong Xiang, and Yuesong Pan
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cholesterol efflux capacity ,Mendelian randomization ,coronary artery disease ,stroke ,genetics ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundObservational studies indicated that cholesterol efflux capacity (CEC) of high-density lipoprotein (HDL) is inversely associated with cardiovascular events, independently of the HDL cholesterol concentration. The aim of the study is to examine the casual relevance of CEC for coronary artery disease (CAD) and myocardial infarction (MI), and compare it with that for ischemic stroke and its subtypes using a Mendelian randomization approach.MethodsWe performed a 2-sample Mendelian randomization to estimate the casual relationship of CEC with the risk of CAD, MI, and ischemic stroke. A CEC-related genetic variant (rs141622900) and other five genetic variants were used as the instrumental variables. Association of genetic variants with CAD were estimated in a GWAS involving 60,801 CAD cases and 123,504 controls. They were then compared with the associations of these variants with ischemic stroke and its subtypes (large vessel, small vessel, and cardioembolic) involving 40,585 ischemic stroke cases and 406,111 controls.ResultsUsing the SNP of rs141622900 as the instrument, a 1-SD increase in CEC was associated with 45% lower risk for CAD (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.44–0.69, p < 0.001) and 33% lower risk for MI (odds ratio [OR] 0.67, 95% CI 0.52–0.87, p = 0.002). By contrast, the causal effect of CEC was much weaker for ischemic stroke (odds ratio [OR] 0.79, 95% CI 0.64–0.97, p = 0.02; p for heterogeneity = 0.03) and, in particular, for cardioembolic stroke (p for heterogeneity = 0.006) when compared with that for CAD. Results using five genetic variants as the instrument also indicated consistently weaker effects on ischemic stroke than on CAD.ConclusionGenetic predicted higher CEC may be associated with decreased risk of CAD. However, the casual association of CEC with ischemic stroke and specific subtypes would need to be validated in further Mendelian randomization studies.
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- 2022
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20. Heterogeneity of White Matter Hyperintensities in Cognitively Impaired Patients With Cerebral Small Vessel Disease
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Tingting Wang, Aoming Jin, Ying Fu, Zaiqiang Zhang, Shaowu Li, David Wang, and Yilong Wang
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white matter hyperintensities ,cognitive impairment ,cerebral small vessel disease ,heterogeneity ,ultrasmall superparamagnetic iron oxide (USPIO) ,Immunologic diseases. Allergy ,RC581-607 - Abstract
ObjectiveSimilar white matter hyperintensities (WMH) might have different impact on the cognitive outcomes in patients with cerebral small vessel disease (CSVD). This study is to assess the possible factors related to the heterogeneity of WMH in cognitively impaired patients with CVSD.MethodsWe analyzed data from a cohort of patients with CVSD who were recruited consecutively from the Beijing Tiantan Hospital from 2015 to 2020. WMH, lacunes, enlarged perivascular space (ePVS), microbleeds and lacunar infarcts were rated on brain MRI. A score of
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- 2021
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21. Effect of salt reduction interventions in lowering blood pressure in Chinese populations: a systematic review and meta-analysis of randomised controlled trials
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Wuxiang Xie and Aoming Jin
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Medicine - Abstract
Rationale and objectiveSalt reduction remains a global challenge and different salt reduction strategies have been studied in China. This study is to systematically evaluate evidence from randomised controlled trials (RCT) in China and inform the effective salt reduction strategies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, Cochrane Central Register of Controlled Trials, Wanfang Data and the China National Knowledge Infrastructure databases through October 2019.Eligibility criteriaRCTs conducted in China with at least 4 weeks’ duration of study and blood pressure (BP) reported.Data extraction and synthesisData were screened, extracted and appraised by two independent reviewers. The quality of study was assessed using a modified Cochrane Collaboration’s risk of bias tool. The primary outcome was the difference in BP change from baseline to the end of study between interventions and control. The effects were pooled using a random effects model and associated factors were explored by a meta-regression.ResultsWe identified 24 studies involving 10 448 participants, including 8 studies on health education (4583 participants), 2 studies on salt restriction diet (162 participants), 1 study on salt restriction spoon (50 participants) and 13 studies on salt substitute (5653 participants). Six studies on salt substitute and three studies on health education were identified with high quality. Pooled results from the six studies showed that salt substitutes significantly reduced systolic BP (−5.7 mm Hg; 95% CI −8.5 to −2.8) and diastolic BP (−2.0 mm Hg; 95% CI −3.5 to −0.4). The School-EduSalt study showed that the school-based health education significantly reduced systolic BP among parents (−2.3 mm Hg; 95% CI −4.5 to −0.04).ConclusionsAmong four salt reduction strategies studied in China with RCT design, only salt substitute was proved effective in lowering BP by the pooled effect from multiple studies with high quality. More well-designed studies are warranted for other strategies.
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- 2020
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22. Incidence, temporal trend and factors associated with ventilator-associated pneumonia in mainland China: a systematic review and meta-analysis
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Chengyi Ding, Yuelun Zhang, Zhirong Yang, Jing Wang, Aoming Jin, Weiwei Wang, Ru Chen, and Siyan Zhan
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Ventilator-associated pneumonia ,Incidence ,Risk factors ,Meta-analysis ,China ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Data to date is far from sufficient to describe the recent epidemiology of ventilator-associated pneumonia (VAP) in mainland China. This study aimed to estimate the overall incidence of VAP, with a special focus on its temporal trend and associated factors. Methods Meta-analyses of 195 studies published from 2010 to 2015 were conducted, followed by subgroup analyses by methodological quality, pre-defined setting characteristics and attributes of populations. Results The overall cumulative VAP incidence in mainland China was 23.8% (95% confidence interval (CI) 20.6–27.2%), with the results showing high heterogeneity. The pooled incidence densities were 24.14 (95% CI 21.19–27.51) episodes and 22.83 (95% CI 19.88–26.23) patients per 1000 ventilator-days. A decline in the cumulative incidence was observed from 2006 (49.5%, 95% CI 40.0–59.0%) to 2014 (19.6%, 95% CI 10.4–31.0%); differences in the incidence rates were also documented according to Chinese provinces and diagnostic criteria (p
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- 2017
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23. High-Level PM2.5/PM10 Exposure Is Associated With Alterations in the Human Pharyngeal Microbiota Composition
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Tian Qin, Furong Zhang, Haijian Zhou, Hongyu Ren, Yinju Du, Shengnan Liang, Fei Wang, Lihong Cheng, Xuguang Xie, Aoming Jin, Yangfeng Wu, Jinxing Zhao, and Jianguo Xu
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PM2.5/PM10 ,pharynx ,microbiome composition ,smoking ,respiratory pathogen ,Microbiology ,QR1-502 - Abstract
Previous studies showed that high concentration of particulate matter (PM) 2.5 and PM10 carried a large number of bacterial and archaeal species, including pathogens and opportunistic pathogens. In this study, pharyngeal swabs from 83 subjects working in an open air farmer’s market were sampled before and after exposure to smog with PM2.5 and PM10 levels up to 200 and 300 μg/m3, respectively. Their microbiota were investigated using high-throughput sequencing targeting the V3–V4 regions of the 16S rRNA gene. The genus level phylotypes was increased from 649 to 767 in the post-smog pharyngeal microbiota, of which 142 were new and detected only in the post-smog microbiota. The 142 new genera were traced to sources such as soil, marine, feces, sewage sludge, freshwater, hot springs, and saline lakes. The abundance of the genera Streptococcus, Haemophilus, Moraxella, and Staphylococcus increased in the post-smog pharyngeal microbiota. All six alpha diversity indices and principal component analysis showed that the taxonomic composition of the post-smog pharyngeal microbiota was significantly different to that of the pre-smog pharyngeal microbiota. Redundancy analysis showed that the influences of PM2.5/PM10 exposure and smoking on the taxonomic composition of the pharyngeal microbiota were statistically significant (p < 0.001). Two days of exposure to high concentrations of PM2.5/PM10 changed the pharyngeal microbiota profiles, which may lead to an increase in respiratory diseases. Wearing masks could reduce the effect of high-level PM2.5/PM10 exposure on the pharyngeal microbiota.
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- 2019
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24. Facteurs prédicteurs de la mortalité après thrombolyse intraveineuse avec Tenecteplase chez les patients ayant un accident vasculaire cérébral
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Mbarek, Lamia, primary, Aoming, Jin, additional, Yuesong, Pan, additional, Yong, Jiang, additional, and Yongjun, Wang, additional
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- 2024
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25. Colchicine in patients with acute ischaemic stroke or transient ischaemic attack (CHANCE-3): multicentre, double blind, randomised, placebo controlled trial.
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Jiejie Li, Xia Meng, Fu-Dong Shi, Jing Jing, Hong-Qiu Gu, Aoming Jin, Yong Jiang, Hao Li, Claiborne Johnston, S., Hankey, Graeme J., Easton, J. Donald, Liguo Chang, Penglai Shi, Lihua Wang, Xianbo Zhuang, Haitao Li, Yingzhuo Zang, Jianling Zhang, Zengqiang Sun, and Dongqi Liu
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PATIENT safety ,ACUTE diseases ,BLIND experiment ,STATISTICAL sampling ,COLCHICINE ,TREATMENT effectiveness ,RANDOMIZED controlled trials ,HOSPITALS ,DESCRIPTIVE statistics ,CONTROL groups ,PRE-tests & post-tests ,ISCHEMIC stroke ,DRUG efficacy ,RESEARCH ,DISEASE relapse ,COMPARATIVE studies ,CONFIDENCE intervals ,TRANSIENT ischemic attack ,C-reactive protein ,EVALUATION ,DISEASE risk factors - Published
- 2024
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26. Cost-effectiveness of endovascular therapy for acute ischemic stroke with large infarct in China.
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Yuesong Pan, Xiaochuan Huo, Aoming Jin, Thanh N. Nguyen, Gaoting Ma, Xu Tong, Xuelei Zhang, Feng Gao, Ning Ma, Dapeng Mo, Zeguang Ren, Yongjun Wang, and Zhongrong Miao
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MIDDLE-income countries ,STATISTICAL models ,QUALITY-adjusted life years ,COST effectiveness ,RESEARCH funding ,PROBABILITY theory ,ENDOVASCULAR surgery ,DESCRIPTIVE statistics ,ISCHEMIC stroke ,DECISION trees ,LOW-income countries - Abstract
Background Endovascular therapy administered within 24 hours has been shown to improve outcomes for patients with acute ischemic stroke with large infarction, but the data on its cost-effectiveness are limited. Objective To evaluate the cost-effectiveness of endovascular therapy for acute ischemic stroke with large infarction in China, the largest low- and middle-income country. Methods A short-term decision tree model and a long-term Markov model were used to analyze the cost-effectiveness of endovascular therapy for patients with acute ischemic stroke with large infarction. Outcomes, transition probability, and cost data were obtained from a recent clinical trial and published literature. The benefit of endovascular therapy was assessed by the cost per quality-adjusted life-years (QALYs) gained in the short and long term. Deterministic one-way and probabilistic sensitivity analyses were performed to assess the robustness of the results. Results Compared with medical management alone, endovascular therapy for acute ischemic stroke with large infarction was found to be cost-effective from the fourth year onward and during a lifetime. In the long term, endovascular therapy yielded a lifetime gain of 1.33 QALYs at an additional cost of ¥73 900 (US$ 11 400), resulting in an incremental cost of ¥55 500 (US$ 8530) per QALY gained. Probabilistic sensitivity analysis showed that endovascular therapy was cost-effective in 99.5% of the simulation runs at a willingness-to-pay threshold of ¥243 000 (3 x gross domestic product per capita of China in 2021) per QALY gained. Conclusions Endovascular therapy for acute ischemic stroke with large infarction could be cost-effective in China. [ABSTRACT FROM AUTHOR]
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- 2024
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27. Indobufen versus aspirin in patients with acute ischaemic stroke in China (INSURE): a randomised, double-blind, double-dummy, active control, non-inferiority trial
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Yuesong Pan, Xia Meng, Baoshi Yuan, S Claiborne Johnston, Hao Li, Philip M Bath, Qiang Dong, Anding Xu, Jing Jing, Jinxi Lin, Yong Jiang, Xuewei Xie, Aoming Jin, Yue Suo, Hongqin Yang, Yefang Feng, Yanhua Zhou, Qing Liu, Xueli Li, Bin Liu, Hui Zhu, Jinguo Zhao, Xuerong Huang, Haitao Li, Yunyun Xiong, Zixiao Li, Yilong Wang, Xingquan Zhao, Liping Liu, Yongjun Wang, Yanxia Wang, Cunrui Wang, Yazhou Han, Ming Yu, Guoping Zou, Aisheng Wu, Guiru Zhang, Ping Zhang, Mingzong Yan, Jia Zhang, Jingyan Zhao, Huitian Zhang, Qinde Qi, Jianling Zhang, Zhishan Zhu, Wenfeng Fan, Liguo Chang, Lan Tan, Liang Zhao, Yanzhong Xue, Peiru Liu, Xiaohua Ju, Zuowen Zhang, Linwen Li, Feng Wei, Lixia Yang, Xuemei Li, Zhixiong Zheng, Hui Liang, Yan Wei, Ming Zhang, Ting Wang, Jianbo Yang, Panbing Huang, Guojun Tan, Yongming Chen, Jin Zhou, Zhongping An, Chunlei Li, Guohua Chen, Runxiu Zhu, Xin Sun, Yong Liu, Mei Zhang, Yanguang Zhuo, Fanwen Meng, Kebo Li, Wei Zhang, Xiangting Chai, Ke Deng, Jianhua Li, Zhiyou Cai, Hailian Jin, Bo Li, Xiaomei Zhang, Beihai Ge, Wei Hu, Zhen Jiao, Lianmei Zhong, Lijie Ren, Xinyi Li, Songdi Wu, Yinguo Wan, Jinghua Zhang, Xiaoyan Ma, Jizheng Hu, Ge Zhang, Chunling Zheng, Jun Xu, YuAn Zou, Zhihui Duan, Changxin Li, Qingxiu Zhang, Xiaoming Song, Zhengchang Jia, Chun Wang, Peining Shao, Jijun Teng, Hua Bao, Yangkun Chen, Yunfei Wei, Xu Zhang, Xisi Meng, Guangning Li, Pengke Pan, Aixia Zhuang, Xiaofei Chen, Jun Tang, Hongwei An, Shihao You, Yanyan Tang, Guilian Zhang, Hongyan Li, Miao Guo, Chunlei Yu, Ying Li, Haichao Liu, Pengfei Liang, Guangming Kang, Huijie Sun, Yu Che, Juan Tang, Dandan Li, Xiaopeng Feng, Yu Geng, Huibing Wang, Ping Shen, Huaiping Zhu, Farong Li, Lifang Zhang, Minghua Cao, Yong You, Guiyun Cui, Jun Gu, Xiangfeng Zhang, Xiaojun Liu, Houqin Chen, Yuehua Zhang, Hongnian Zhao, Ke Liang, Rui Zhi, Ling Ma, Yuanhua Wu, Yalan Geng, Ping Sun, Bing Zhong, Dongxue Li, Jingya Jiao, Yanlei Hao, Guozhong Li, Shaohua Su, Weiping Ju, Lianqiu Min, Liyan Guo, Yafei Shangguan, Yingdong Tai, Ying Xing, Hongshan Chang, Wenya Chen, Hongtao Tang, Shuchun Huang, Jingxian Fang, Donghui Yu, Hailong Zhao, Lei Xu, Aimei Wu, Hebin Wan, Hongliang Wang, Zhihui Shen, Qing Zhang, and Qian Wang
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Neurology (clinical) - Published
- 2023
28. Adherence to a healthy lifestyle and brain structural imaging markers
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Yuesong Pan, Jie Shen, Xueli Cai, Hui Chen, Geng Zong, Wanlin Zhu, Jing Jing, Tao Liu, Aoming Jin, Yilong Wang, Xia Meng, Changzheng Yuan, and Yongjun Wang
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Epidemiology - Published
- 2023
29. Safety and Efficacy of Reteplase Versus Alteplase for Acute Ischemic Stroke: A Phase 2 Randomized Controlled Trial.
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Shuya Li, Xuechun Wang, Aoming Jin, Gaifen Liu, Hongqiu Gu, Hao Li, Campbell, Bruce C. V., Fisher, Marc, Yi Yang, Yan Wei, Junhai Wang, Yilong Wang, Xingquan Zhao, Liping Liu, Zixiao Li, Xia Meng, and Yongjun Wang
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- 2024
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30. Mediation of Systemic Inflammation on Insulin Resistance and Prognosis of Nondiabetic Patients With Ischemic Stroke
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Aoming Jin, Shukun Wang, Jiejie Li, Mengxing Wang, Jinxi Lin, Hao Li, Xia Meng, Yongjun Wang, and Yuesong Pan
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Advanced and Specialized Nursing ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Background: Insulin resistance is associated with stroke recurrence and poor functional outcomes of nondiabetic patients with ischemic stroke. The study aimed to investigate whether the association between insulin resistance and the prognosis of nondiabetic patients with ischemic stroke was mediated by systematic inflammation. Methods: Patients with ischemic stroke but without a history of diabetes who were enrolled in CNSR-III (Third China National Stroke Registry) were included in the study and followed up for 1 year after stroke onset. Insulin resistance was determined by using the homeostasis model assessment for insulin resistance (HOMA-IR) method. hs-CRP (high-sensitivity C-reactive protein) and Lp-PLA 2 (lipoprotein-associated phospholipase A 2 ) activity were measured at baseline. The primary outcome was stroke recurrence, and other outcomes included composite vascular events, mortality, and poor functional outcome (modified Rankin Scale score, 3–6). Multivariable Cox or logistic regression analyses were performed to estimate the association between HOMA-IR and the study outcomes. A mediation analysis was performed to examine the relationship between insulin resistance and the study outcomes mediated by systemic inflammation. Results: Among a total of 3808 nondiabetic patients with ischemic stroke who were included in the study, the median HOMA-IR was 1.79 (interquartile range, 1.05–2.97). After adjustments for potential confounders, higher HOMA-IR quartiles were associated with higher risks of stroke recurrence, ischemic stroke, and composite vascular events, especially in the large artery atherosclerosis subtype. hs-CRP partially mediated the association between the HOMA-IR index and the prognosis of ischemic stroke (mediation proportion, 5.9% for stroke recurrence and 7.5% for composite vascular events). No evidence of Lp-PLA 2 activity mediating the association of insulin resistance with stroke outcomes was observed. Conclusions: Our study found that insulin resistance was associated with poor clinical outcomes in nondiabetic patients with ischemic stroke, which was partially mediated by hs-CRP with a modest amount.
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- 2023
31. Predictive Value of the ABCD3-I for Short- and Long-Term Stroke after TIA with or without sICAS
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Yilong Wang, Yuesong Pan, Aoming Jin, Yong Jiang, Xuewei Xie, Xia Meng, Zixiao Li, Yongjun Wang, Pan Chen, Jing Jing, Liping Liu, Hao Li, and Xingquan Zhao
- Subjects
medicine.medical_specialty ,business.industry ,Proportional hazards model ,Biochemistry (medical) ,Hazard ratio ,Area under the curve ,medicine.disease ,Risk Assessment ,Predictive value ,Outcome parameter ,Stroke ,Stenosis ,Ischemic Attack, Transient ,Risk Factors ,Internal medicine ,Internal Medicine ,Cardiology ,Humans ,Medicine ,In patient ,Registries ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims We aimed to validate the predictive value of the ABCD3-I score for short-term and long-term stroke risk after transient ischemic attack (TIA) and to evaluate the influence of symptomatic intracranial artery stenosis (sICAS) on the performance of ABCD3-I. Methods We recruited TIA patients from the Third China National Stroke Registry study. Outcome parameters were stroke events during the 14-day, 3-month, 6-month, and 12-month points. The area under the curve (AUC) was calculated as a measure of predictive ability. A multivariable-adjusted Cox proportional hazards model was used to assess the hazard ratio of risk factors for stroke. Results Among 986 patients, 3.9%, 5.1%, 6.5 %, and 8.2% of participants experienced a stroke event during the 14-day, 3-month, 6-month, and 12-month points post TIA, respectively. The AUCs of ABCD3-I score for the prediction of stroke were 0.786, 0.732, 0.715, and 0.699 at the 14-day, 3-month, 6-month, and 12-month points, respectively. The AUCs were 0.774, 0.690, 0.617, and 0.611 in patients with sICAS, 0.789, 0.748, and 0.758 and 0.734 in those without sICAS. P values of the interaction between ABCD3-I categories and sICAS were 0.0618 for 14-day, 0.0098 for 3-month, 0.0318 for 6-month, and 0.0294 for 12-month. Conclusions ABCD3-I score performed well in predicting short-term risk of a stroke after an index TIA in patients with or without sICAS. However, the predictive power decayed with the prolonged period, and the decayed extent was more pronounced among those with sICAS. The assessment of sICAS is a non-ignorable item when using the ABCD3-I score for long-term stroke risk prediction in patients with TIA.
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- 2022
32. Thyroid Function in Causal Relation to MRI Markers of Cerebral Small Vessel Disease: A Mendelian Randomization Analysis
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Yu Tian, Dongxiao Yao, Aoming Jin, Mengxing Wang, Yuesong Pan, Yongjun Wang, and Yilong Wang
- Subjects
Endocrinology ,Endocrinology, Diabetes and Metabolism ,Biochemistry (medical) ,Clinical Biochemistry ,Biochemistry - Abstract
Context Observational studies have provided insufficient information on the association between thyroid function and the risk of cerebral small vessel disease (CSVD); moreover, the causality of this link is still unclear. Objective This study aims to investigate whether genetically predicted variation within thyroid function is causally associated with the risk of CSVD using 2-sample Mendelian randomization (MR) analysis. Methods In this 2-sample MR study with genome-wide association variants, we estimated the causal effects of genetically predicted thyrotropin (thyroid-stimulating hormone, TSH; n = 54 288), free thyroxine (FT4; n = 49 269), hypothyroidism (n = 51 823), and hyperthyroidism (n = 51 823) on 3 neuroimaging markers of CSVD, including white matter hyperintensity (WMH; n = 42 310), mean diffusivity (MD; n = 17 467), and fractional anisotropy (FA, n = 17 663). The primary analysis was conducted by the inverse variance–weighted MR method, followed by sensitivity analyses using MR-PRESSO, MR-Egger, weighted median, and weighted mode methods. Results Genetically increased TSH was associated with increased MD (β = .311, 95% CI 0.0763, 0.548, P = .01). Genetically increased FT4 was associated with increased FA (β = .540, 95% CI 0.222, 0.858, P < .001). Sensitivity analyses using different MR methods showed similar directions but lower precision. No significant associations of hypothyroidism or hyperthyroidism with WMH, MD, or FA were found (all P > .05). Conclusion This study indicated that genetically predicted increased TSH was associated with increased MD, as well as increased FT4 with increased FA, implying the causal effect of thyroid dysfunction on white matter microstructural injury. There were no significant causal relationships of hypothyroidism or hyperthyroidism with CSVD. Further investigations should verify these findings and clarify the underlying pathophysiological mechanisms.
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- 2023
33. Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities: a cluster-randomized trial
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Yifang Yuan, Aoming Jin, Bruce Neal, Xiangxian Feng, Qianku Qiao, Hongxia Wang, Ruijuan Zhang, Jiayu Li, Peifen Duan, La’e Cao, Hui Zhang, Senke Hu, Huijuan Li, Pei Gao, Gaoqiang Xie, Jianhui Yuan, Lili Cheng, Sujuan Wang, Haijun Zhang, Wenyi Niu, Hai Fang, Minghui Zhao, Runlin Gao, Junshi Chen, Paul Elliott, Darwin Labarthe, and Yangfeng Wu
- Subjects
General Medicine ,General Biochemistry, Genetics and Molecular Biology - Abstract
There is a paucity of high-quality evidence on the effectiveness and safety of salt reduction strategies, particularly for older people, who have the most to benefit but are at higher risk of adverse effects. Here, we conducted a clinical trial in which 48 residential elderly care facilities in China (1,612 participants including 1,230 men and 382 women, 55 years or older) were cluster-randomized using a 2 × 2 factorial design to provision of salt substitute (62.5% NaCl and 25% KCl) versus usual salt and to a progressively restricted versus usual supply of salt or salt substitute for 2 years. Salt substitute compared with usual salt lowered systolic blood pressure (-7.1 mmHg, 95% confidence interval (CI) -10.5 to -3.8), meeting the primary outcome of the trial, whereas restricted supply compared with usual supply of salt or salt substitute had no effect on systolic blood pressure. Salt substitute also lowered diastolic blood pressure (-1.9 mmHg, 95% CI -3.6 to -0.2) and resulted in fewer cardiovascular events (hazard ratio (HR) 0.60, 95% CI 0.38-0.96), but had no effect on total mortality (HR 0.84, 95% CI 0.63-1.13). From a safety standpoint, salt substitute increased mean serum potassium and led to more frequent biochemical hyperkalemia, but was not associated with adverse clinical outcomes. In contrast, salt restriction had no effect on any study outcome. The results of this trial indicate that use of salt substitute, but not efforts to restrict salt supply, may achieve blood pressure lowering and deliver health benefits to residents of elderly care facilities in China. Clinicaltrials.gov registration: NCT03290716.
- Published
- 2023
34. Author response for 'Associations of deep medullary veins with vascular risk factors, laboratory indicators, and cerebral small vessel disease: A population‐based study'
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null Yu Tian, null Shan Li, null Yingying Yang, null Xueli Cai, null Jing Jing, null Suying Wang, null Xia Meng, null Lerong Mei, null Aoming Jin, null Dongxiao Yao, null Tiemin Wei, null Yongjun Wang, null Yuesong Pan, and null Yilong Wang
- Published
- 2023
35. Elevated Homocysteine Intensify the Effect of Lipoprotein(a) on Stroke Recurrence
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Zhiyuan Feng, Jie Xu, Aoming Jin, Aichun Cheng, Jing Xue, Xia Meng, and Yongjun Wang
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Cardiology and Cardiovascular Medicine - Published
- 2022
36. Adherence to a healthy lifestyle and brain structural imaging markers
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Yuesong Pan, Jie Shen, Xueli Cai, Hui Chen, Geng Zong, Wanlin Zhu, Jing Jing, Tao Liu, Aoming Jin, Yilong Wang, Xia Meng, Changzheng Yuan, and Yongjun Wang
- Abstract
ObjectiveTo investigate the association of adherence to a healthy lifestyle with a panel of brain structural markers in middle-aged and older adults.DesignCross-sectional and prospective study design.SettingPolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study in China and UK Biobank (UKB).Participants2,413 participants in PRECISE and 19,822 participants in UKB.ExposuresA healthy lifestyle score (0-5) was constructed based on five modifiable lifestyle factors: healthy diet, physically active, non-current-smoking, non-alcohol consumption (in PRECISE)/moderate alcohol consumption (in UKB), and healthy body weight.Main OutcomesValidated multimodal neuroimaging markers were derived from brain magnetic resonance imaging (MRI).ResultsIn the cross-sectional analysis of PRECISE, participants who adopted four or five low-risk lifestyle factors had larger total brain volume (TBV; β= 0.12, 95%CI: - 0.02, 0.26; p-trend = 0.048) and gray matter volume (GMV; β= 0.16, 95%CI: 0.01, 0.30; p-trend = 0.047), smaller white matter hyperintensity volume (WMHV; β= -0.35, 95%CI: -0.50, -0.20; p-trend p-trend = 0.03), compared to those with zero or one low-risk factors. Meanwhile, in the prospective analysis in UKB (with a median of 7.7 years’ follow-up), similar associations were observed between the number of low-risk lifestyle factors (4-5 vs 0-1) and TBV (β= 0.22, 95%CI: 0.16, 0.28; p-trend p-trend < 0.001), white matter volume (WMV; β= 0.08, 95%CI: 0.01, 0.15; p-trend = 0.001), hippocampus volume (β= 0.15, 95%CI: 0.08, 0.22; p-trend = p-trend < 0.001). Those with four or five low-risk lifestyle factors showed approximately 2.0-5.8 years of delay in aging of brain structure.ConclusionAdherence to a healthier lifestyle was associated with a lower degree of neurodegeneration-related brain structural markers in middle-aged and older adults.What is already known on this topicPrevious research has linked specific modifiable lifestyle factors to age-related cognitive decline in adults.Little is known about the potential role of an overall healthy lifestyle in brain structure.What this study addsIn the cross-sectional analysis of 2,413 participants in China and the prospective analysis of 19,822 participants in UK, participants who adopted 4-5 low-risk lifestyle factors had larger total brain volume and gray matter volume and lower white matter hyperintensity volume, compared to those with 0-1 factors.The association estimates were equivalent to approximately 2.0-5.8 years of delay in aging of brain structure.Adherence to a healthier lifestyle was associated with a lower degree of neurodegeneration-related brain structural markers in middle-aged and older adults.
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- 2022
37. Association of Serum Cystatin C With Cerebral Small Vessel Disease in Community-Based Population
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Dongxiao Yao, Shan Li, Jing Jing, Xueli Cai, Aoming Jin, Yingying Yang, Suying Wang, Xia Meng, Jinxi Lin, Lerong Mei, Hao Li, Tiemin Wei, Yongjun Wang, Yuesong Pan, and Yilong Wang
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Advanced and Specialized Nursing ,Male ,Middle Aged ,Magnetic Resonance Imaging ,Cohort Studies ,Cross-Sectional Studies ,Cerebral Small Vessel Diseases ,Humans ,Female ,Neurology (clinical) ,Cystatin C ,Cardiology and Cardiovascular Medicine ,Aged ,Cerebral Hemorrhage - Abstract
Background: The aim of this study was to investigate the relationship between serum cystatin C levels and the presence and severity of cerebral small vessel disease (CSVD). Methods: Community-dwelling residents in the Lishui city in China from the cross-sectional survey of the PRECISE (Poly-Vascular Evaluation for Cognitive Impairment and Vascular Events) cohort study were included in present study from 2017 to 2019. Total CSVD burden and modified total CSVD burden score, as well as the markers of CSVD on magnetic resonance imaging, including white matter hyperintensity, lacunes, cerebral microbleeds, and perivascular spaces, were assessed at baseline survey. Participants were divided into 4 groups according to the quartiles of cystatin C. The association of serum cystatin C with total CSVD burden and imaging markers was analyzed using ordinal or binary logistic regression models. Furthermore, 2-sample Mendelian randomization analysis was performed to investigate the genetically predicted effect of cystatin C on CSVD. Results: A total of 3061 participants were included in this study. The mean age of the participants was 61.2±6.7 years, and 1637 (53.5%) were women. Higher level of cystatin C was associated with an increased total CSVD burden and modified total CSVD burden (Q4 versus Q1: common odds ratio [OR], 1.30 [95% CI, 1.03–1.64] and 1.32 [95% CI, 1.01–1.73]) after adjustment for covariates. Further, compared with the first quartile of cystatin C, subjects in the last quartile had higher risk of lacunes (OR, 1.99 [95% CI, 1.05–3.76]), modified white matter hyperintensity burden (common OR, 1.42 [95% CI, 1.07–1.90]), and moderate-to-severe perivascular spaces (OR, 2.15 [95% CI, 1.29–3.59]) but not cerebral microbleeds. The Mendelian randomization analysis showed that a genetically predicted higher cystatin C level was associated with increased risk of lacunar stroke (OR, 1.16 [95% CI, 1.06–1.27]). Conclusions: In this community-based study, we found a possible association between cystatin C and CSVD, especially for lacunes, that was independent of estimated glomerular filtration rate.
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- 2022
38. Impaired glymphatic system as evidenced by low diffusivity along perivascular spaces is associated with cerebral small vessel disease: a population-based study
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Yu Tian, Xueli Cai, Yijun Zhou, Aoming Jin, Suying Wang, Yingying Yang, Lerong Mei, Jing Jing, Shan Li, Xia Meng, Tiemin Wei, Tao Liu, Yongjun Wang, Yuesong Pan, and Yilong Wang
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Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
ObjectiveThis study aims to investigate the associations of glymphatic system with the presence, severity and neuroimaging phenotypes of cerebral small vessel disease (CSVD) in a community-based population.MethodThis report included 2219 community-dwelling people aged 50–75 years who participated in the PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events cohort. The diffusivity along perivascular spaces based on diffusion tensor imaging (DTI-ALPS index) was measured to assess glymphatic pathway. The presence and severity of CSVD were estimated using a CSVD score (points from 0 to 4) and a modified CSVD score (points from 0 to 4), which were driven by 4 neuroimaging features of CSVD, including white matter hyperintensity (WMH), enlarged perivascular spaces (EPVS), lacunes, cerebral microbleeds. Brain atrophy (BA) was also evaluated. Binary or ordinal logistic regression analyses were carried out to investigate the relationships of DTI-ALPS index with CSVD.ResultThe mean age was 61.3 (SD 6.6) years, and 1019 (45.9%) participants were men. The average DTI-ALPS index was 1.67±0.14. Individuals in the first quartile (Q1) of the DTI-ALPS index had higher risks of the presence of CSVD (OR 1.77, 95% CI 1.33 to 2.35, pConclusionA lower DTI-ALPS index underlay the presence, severity and typical neuroimaging markers of CSVD, implying that glymphatic impairment may interact with CSVD-related pathology in the general ageing population.Trial registration numberNCT03178448.
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- 2023
39. Author response for 'Association between diabetes duration and 1‐year prognosis of stroke: A national registry study'
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null Yanli Zhang, null Aoming Jin, null Xia Meng, null Mengxing Wang, null Hao Li, null Yuesong Pan, and null Yongjun Wang
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- 2022
40. A score to predict the stroke recurrence of patients with embolic stroke of undetermined source
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Jing Jing, Xiaomeng Yang, Yueyang Wu, Xia Meng, Zixiao Li, Yong Jiang, Yuesong Pan, Aoming Jin, Xingquan Zhao, Yilong Wang, Hao Li, and Yongjun Wang
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Stroke ,Embolic Stroke ,Neurology ,Infarction ,Risk Factors ,Recurrence ,Humans ,Neurology (clinical) ,Prospective Studies ,Risk Assessment - Abstract
We aimed to develop a score and validate it in a prospective cohort to identify the patients with ESUS at high risk for stroke recurrence.We assessed the stroke recurrence in ESUS patients of the Third China National Stroke Registry. We performed multivariable logistic regression analysis to identify predictors of stroke recurrence in the derivation cohort. Based on the coefficient of each covariate of the fitted multivariable model, we generated an integer-based point scoring system. We validated the score in the validation cohort assessing its discrimination and calibration.2415 patients were included: 1611 in the derivation and 804 in the validation sample. We developed a scoring system (0-15 points) by assigning 2 points for hypertension, 3 points for diabetes mellitus, 4 points for multiple stage infarction, 2 points for watershed involved infarction, 1 points for left atrial diameter index (per increasing 2.5 mm/m2) and 3 points for without statin at discharge. The rate of stroke recurrence was 5.9% per year (95% CI 4.2-7.6%) in patients with low risk(a score of 0-5), 9.4% (7.3-11.5%) in patients with intermediate risk (6-10), and 26.8% (16.5-37.1%) in patients with high risk (11-15). The AUC (area under curve of receiver operator characteristic curve) of the score in the derivation cohort and validation cohort was, respectively, 0.60 (0.55-0.65) and 0.63 (0.56-0.70). The score was well calibrated both in the derivation cohort (p = 0.36) and validation cohort (p = 0.26) with the Hosmer-Lemeshow test.The developed score can improve risk stratification after ESUS in secondary care settings.
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- 2022
41. The Associations of Heart Rate Variability with Stroke Outcomes: Mediating Effects of Inflammatory Markers
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Mengxing Wang, Changhong Li, Wangli Xu, Aoming Jin, Xia Meng, Jiejie Li, Jinxi Lin, Hao Li, Yuesong Pan, and Yongjun Wang
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circulatory and respiratory physiology - Abstract
BackgroundHeart rate variability (HRV), as a sensitive index of autonomic nervous system (ANS) function, was supposed to be associated with risk of recurrent stroke and functional disability, and negatively related with inflammatory marker levels. Some studies showed that significant changes in HRV metrics might precede the development of asymptomatic or inflammatory flare. This study aimed to validate the association of HRV with stroke outcomes and inflammation, and further to investigate whether inflammatory markers were mediators of the association between HRV and stroke outcome.MethodsPatients were derived from the Third China National Stroke Registry from August 2015 to March 2018. HRV and inflammatory markers was measured at baseline. The primary outcome (ischemic stroke) and secondary outcomes (new stroke, composite vascular events, all-cause death and disability) were assessed at 1-year follow-up after stroke symptom onset. Mediation analysis was performed to estimate the mediation effect of inflammatory markers between HRV and stroke outcomes.ResultsA total of 4,592 patients were included in this analysis. The standard deviation of N-N intervals (SDNN) of HRV was negatively associated with inflammatory markers, including high-sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6). The adjusted hazard ratio/odds ratio for the fourth vs. the first quartile of SDNN for Primary and all secondary outcomes were significant (PConclusionsSDNN was an independent predictor for stroke outcomes and had a negative relationship with inflammatory markers. Inflammatory markers may partially mediate the relationship between heart rate variability and stroke outcomes at one year. However, the specific role of inflammation in HRV and stroke outcomes needs to be verified by more studies, and our results might provide clues for future studies.
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- 2022
42. Effect of Lipoprotein(a) on Stroke Recurrence Attenuates at Low LDL-C (Low-Density Lipoprotein) and Inflammation Levels
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Jie Xu, Xiwa Hao, Rui Zhan, Xue Jiang, Aoming Jin, Jing Xue, Aichun Cheng, Jiewen Liu, Jinxi Lin, Xia Meng, Hao Li, Lemin Zheng, and Yongjun Wang
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Advanced and Specialized Nursing ,Inflammation ,Interleukin-6 ,Cholesterol, LDL ,Stroke ,C-Reactive Protein ,Ischemic Attack, Transient ,Risk Factors ,Humans ,Neurology (clinical) ,Prospective Studies ,Cardiology and Cardiovascular Medicine ,Biomarkers ,Ischemic Stroke ,Lipoprotein(a) - Abstract
Background: Lp(a) (lipoprotein(a)) contributes to cardiovascular disease mainly through proatherogenic and proinflammatory effects. Here, we aimed to evaluate whether a residual stroke risk of Lp(a) would remain when the LDL-C (low-density lipoprotein cholesterol) and inflammatory levels are maintained low. Methods: This prospective cohort study included 9899 patients with ischemic stroke or transient ischemic attack from the Third China National Stroke Registry who had measurements of plasma Lp(a) and were followed up for 1 year. Cutoffs were set at the 50 mg/dL for Lp(a). LDL-C was corrected for Lp(a)-derived cholesterol (LDL-Cc [LDL-C corrected]) and cutoffs were set at 55 and 70 mg/dL.The threshold values of IL-6 (interleukin 6) and hsCRP (high-sensitive C-reactive protein) were the median 2.65 ng/L and 2 mg/L. Multivariable-adjusted hazard ratio (HR) were calculated using Cox regression models for each category to investigate the associations of Lp(a) with stroke recurrence within 1 year. Results: Among all patients, those with Lp(a) ≥50 mg/dL were at higher stroke recurrence risk than those with Lp(a) Conclusions: Increased Lp(a) was significantly associated with stroke recurrence risk in patients with ischemic stroke/transient ischemic attack. However, at low LDL-Cc or IL-6 levels, the elevated Lp(a) -associated stroke recurrence risk was attenuated in a secondary prevention setting.
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- 2022
43. Differential associations of lipoprotein(a) level with cerebral large artery and small vessel diseases
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Yuesong Pan, Xueli Cai, Jing Jing, Suying Wang, Xia Meng, Lerong Mei, Yingying Yang, Aoming Jin, Yao DongXiao, Shan Li, Hao Li, Tiemin Wei, Yongjun Wang, and Yilong Wang
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Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Background and purposeCerebral large artery and small vessel diseases are related to different pathogenetic mechanisms and have different risk factor profile. Lipoprotein(a) (Lp(a)) was shown to promote atherosclerosis but data was limited on its association with cerebral small vessel diseases (cSVD). The objective of this study was to assess the associations of Lp(a) level with the two types of cerebrovascular diseases.MethodsCommunity-dwelling subjects aged 50–75 years from the baseline survey of The PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events study were included. Lp(a) concentrations was measured and categorised into three groups according to the tertiles. Eligible participants were scanned by a 3.0T MRI scanner and assessed for intracranial atherosclerosis and cSVD burden based on four imaging markers.ResultsThis study included 3059 subjects. The average age of the participants was 61.2±6.7 years, and 53.5% (1636) were female. Compared with the first tertile, subjects with the second and third tertiles of Lp(a) concentrations were associated with an increased odds of presence of intracranial plaque (18.7% vs 15.4%, adj.OR 1.37, 95% CI 1.08 to 1.75; 18.9% vs 15.4%, adj.OR 1.34, 95% CI 1.05 to 1.72). Similar associations were observed for intracranial atherosclerotic burden. Whereas, subjects with the third tertile of Lp(a) level had a decreased odds of presence of cSVD (25.9% vs 31.7%, adj.OR 0.74, 95% CI 0.60 to 0.92) and lower cSVD burden (adj.cOR 0.76, 95% CI 0.62 to 0.94).ConclusionsIn this study, Lp(a) concentrations were positively associated with presence and burden of intracranial atherosclerosis, but was inversely associated with cSVD.Trial registration numberNCT03178448.
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- 2022
44. Residual Risk and Its Risk Factors for Ischemic Stroke with Adherence to Guideline-Based Secondary Stroke Prevention
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Zixiao Li, Xia Meng, Hao Li, Jinxi Lin, Yongjun Wang, Yilong Wang, Jing Jing, Yuesong Pan, Jiejie Li, and Aoming Jin
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medicine.medical_specialty ,Statin ,business.industry ,medicine.drug_class ,Secondary prevention ,Hazard ratio ,Guideline ,medicine.disease ,Confidence interval ,Stroke ,Residual risk ,Stenosis ,Risk factors ,Internal medicine ,Antithrombotic ,Medicine ,Original Article ,cardiovascular diseases ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,Outcome - Abstract
Background and Purpose Despite administration of evidence-based therapies, residual risk of stroke recurrence persists. This study aimed to evaluate the residual risk of recurrent stroke in acute ischemic stroke or transient ischemic attack (TIA) with adherence to guideline-based secondary stroke prevention and identify the risk factors of the residual risk.Methods Patients with acute ischemic stroke or TIA within 7 hours were enrolled from 169 hospitals in Third China National Stroke Registry (CNSR-III) in China. Adherence to guideline-based secondary stroke prevention was defined as persistently receiving all of the five secondary prevention medications (antithrombotic, antidiabetic and antihypertensive agents, statin and anticoagulants) during hospitalization, at discharge, at 3, 6, and 12 months if eligible. The primary outcome was a new stroke at 12 months.Results Among 9,022 included patients (median age 63.0 years and 31.7% female), 3,146 (34.9%) were identified as adherence to guideline-based secondary prevention. Of all, 864 (9.6%) patients had recurrent stroke at 12 months, and the residual risk in patients with adherence to guidelinebased secondary prevention was 8.3%. Compared with those without adherence, patients with adherence to guideline-based secondary prevention had lower rate of recurrent stroke (hazard ratio, 0.85; 95% confidence interval, 0.74 to 0.99; P=0.04) at 12 months. Female, history of stroke, interleukin-6 ≥5.63 ng/L, and relevant intracranial artery stenosis were independent risk factors of the residual risk.Conclusions There was still a substantial residual risk of 12-month recurrent stroke even in patients with persistent adherence to guideline-based secondary stroke prevention. Future research should focus on efforts to reduce the residual risk.
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- 2021
45. Pronostic vital d’accident vasculaire ischémique chez les sujets jeunes à court terme
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Mbarek, Lamia, Aoming, Jin, Yuesong, Pan, Yong, Jiang, and Yongjun, Wang
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- 2024
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46. Abstract WP194: Ldlc Levels, Lipid Lowering Treatment And Recurrent Stroke In Minor Ischemic Stroke Or Tia
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Wangqin, Runqi, primary, Pan, Yuesong, additional, Xian, Ying, additional, Laskowitz, Daniel T, additional, Wang, Yongjun, additional, Meng, Xia, additional, Jiejie, Li, additional, Jinxi, Lin, additional, Aoming, Jin, additional, and Hao, Li, additional
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- 2022
- Full Text
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47. Validation of the Canadian TIA Score to Predict Subsequent Stroke Risk in Chinese TIA Patients
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Chengyuan Yang, Aoming Jin, Jinxi Lin, Yongjun Wang, Jie Xu, and Xia Meng
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Neurology ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Background and Objectives: The Canadian TIA Score has been verified as a good predictive tool for subsequent stroke risk in Caucasian patients; however, it had insufficient external verification of other races. We aimed to validate the Canadian TIA Score in Chinese patients and compared it with ABCD2 for subsequent stroke risk after transient ischemic attack (TIA). Methods: The Third China National Stroke Registry (CNSR-III) was a nationwide, multicenter prospective registry recruiting consecutive patients with acute ischemic stroke or TIA within 7 days of the onset from August 2015 to March 2018. The Canadian TIA Score was verified in patients diagnosed with TIA from the CNSR-III (N = 1,184). The outcomes were subsequent stroke at 7 days, 14 days/discharge, 3 months, and 1 year. Outcomes were recorded by face-to-face assessment or telephone interview. The prognostic performance of the scoring system was assessed by the area under the receiver operator characteristic curve (AUC). Results: Of 1,184 TIA patients (mean [IQR] age, 61.00 [53.00–69.00] years; 413 women [34.88%]), there were 40 patients (3.38%) having subsequent stroke within 7 days, 45 (3·80%) within 14 days/hospitalization, 66 (5·57%) within 3 months, and 100 (8·45%) within 1 year. The Canadian TIA Score (AUC 0 63–0·68) seemed to be a better prognostic score of stroke risk than the ABCD2 score (AUC 0·61–0·62), although no significant differences were noted. In the subgroup of atypical TIA, the Canadian TIA Score showed significantly stronger predictivity than the ABCD2 score within 7 days (0.80 [0.62–0.98] vs. 0.52 [0.30–0.73]; difference in AUC, 0.28 [0.03–0.53]; p, 0.026), and marginal significantly stronger predictivity within 1 year (0.71 [0.61–0.80] vs. 0.58 [0.48–0.68]; difference in AUC, 0.12 [−0.01 to 0.25]; p, 0.06). Conclusion: The Canadian TIA Score might be a better prognostic score than the ABCD2 score for post-TIA stroke risk, especially in patients with atypical TIA.
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- 2021
48. Synergetic Effect of Lipoprotein(a) and Lipoprotein-Associated Phospholipase A2 on Functional Outcomes in Patients with Ischemic Stroke
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Xiwa Hao, Jing Xue, Yongjun Wang, Xia Meng, Lemin Zheng, Jie Xu, Jinxi Lin, Ke Li, Aoming Jin, and Xue Jiang
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Text mining ,biology ,business.industry ,Lipoprotein-associated phospholipase A2 ,Ischemic stroke ,biology.protein ,Medicine ,In patient ,Lipoprotein(a) ,Bioinformatics ,business - Abstract
Background:The relationship of lipoprotein(a) [Lp(a)] and stroke functional outcomes was conflicting. The relationship of Lp(a) and Lp-PLA2 levels to functional outcomes is unclear. The aim was to clarify whether high Lp(a) is associated with poor functional outcomes and examine the relationship of Lp(a) and Lp-PLA2 to functional outcomes in patients with ischemic stroke.Methods:A total of 10,422 individuals from the third China National Stroke Registry cohort were recruited. Plasma level of Lp(a) at admission was measured with enzyme-linked immunosorbent assay. The cut-off was set at the median for Lp(a). Functional outcome was assessed using the modified Rankin scale (mRS) at 3 months after stroke. The association between Lp(a) and stroke functional outcomes was evaluated using a multivariate Cox regression model.Results:The median age was 63.0 years, and 31.6% participants were women. Patients in higher Lp(a) group had higher incidences of poor functional outcome at 3 months (P2 level with Lp(a) level on functional outcomes (p=0.008). After stratification by Lp(a) and Lp-PLA2, the Lp(a) high/ Lp-PLA2 high group showed the highest incidence of poor functional outcomes at 3 months.Conclusions:Elevated Lp(a) level is associated with poor functional outcomes in patients with ischemic stroke. Lp(a) has a synergetic effect with Lp-PLA2 on functional outcomes after ischemic stroke.
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- 2021
49. LDL-C levels, lipid-lowering treatment and recurrent stroke in minor ischaemic stroke or TIA
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Yuesong Pan, Runqi Wangqin, Hao Li, Aoming Jin, Jiejie Li, Jinxi Lin, Xia Meng, Ying Xian, Daniel T Laskowitz, and Yongjun Wang
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Stroke ,Ischemic Attack, Transient ,Humans ,Neurology (clinical) ,Cerebral Infarction ,Cholesterol, LDL ,Cardiology and Cardiovascular Medicine ,Brain Ischemia ,Clopidogrel ,Ischemic Stroke - Abstract
Background and purposeDyslipidaemia is a major risk factor for ischaemic stroke and transient ischaemic attack (TIA). This study aimed to investigate the association between baseline low-density lipoprotein cholesterol (LDL-C) level, lipid-lowering treatment and short-term risk of new stroke in patients with a minor ischaemic stroke or TIA.MethodsWe derived data from the Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events trial. Patients with a minor stroke or TIA were categorised by LDL-C level at baseline (ResultsAmong 3027 patients, 2154 (71.2%) patients had an initial LDL-C ≥2.6 mmol/L, of which 1267 (41.9%) received lipid-lowering treatment. Elevated LDL-C level was associated with a higher risk of new ischaemic stroke at 3 months in patients without lipid-lowering treatment (adj.HR=1.35, 95% CI: 1.19 to 1.53), but not in those with lipid-lowering treatment (adj.HR=0.99, 95% CI: 0.82 to 1.19) (p for interaction=0.007). Patients with LDL-C ≥2.6 mmol/L had a numerically higher risk of ischaemic stroke (11.8% vs 8.0%, adj.HR=1.37, 95% CI: 0.96 to 1.96) in those without lipid-lowering treatment. For patients with LDL-C ≥2.6 mmol/L, lipid-lowering treatment was associated with reduced risk of ischaemic stroke at 3 months (7.9% vs 11.8%; adj.HR=0.54, 95% CI: 0.39 to 0.75).ConclusionsElevated untreated baseline LDL-C level was associated with an increased short-term risk of ischaemic stroke among patients presenting with minor ischaemic stroke or TIA. There was potential benefit of lipid-lowering treatment in minor stroke or TIA patients with LDL-C ≥2.6 mmol/L.Trial registration numberNCT00979589.
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- 2021
50. Time Course for Benefit and Risk With Ticagrelor and Aspirin in Individuals With Acute Ischemic Stroke or Transient Ischemic Attack Who Carry CYP2C19 Loss-of-Function Alleles
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Yuesong Pan, Xia Meng, Aoming Jin, S. Claiborne Johnston, Hao Li, Philip M. Bath, Xuewei Xie, Jing Jing, Jinxi Lin, Yilong Wang, Xingquan Zhao, Zixiao Li, Yong Jiang, Liping Liu, Hongqin Yang, Jiwei Cheng, Zhimin Wang, and Yongjun Wang
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Male ,Ticagrelor ,Aspirin ,Hemorrhage ,Middle Aged ,Clopidogrel ,Cytochrome P-450 CYP2C19 ,Stroke ,Treatment Outcome ,Ischemic Attack, Transient ,Humans ,Drug Therapy, Combination ,Female ,Neurology (clinical) ,Alleles ,Platelet Aggregation Inhibitors ,Aged ,Ischemic Stroke - Abstract
Dual antiplatelet therapy (DAPT) with ticagrelor and aspirin has been found to be effective for secondary prevention after minor ischemic stroke or transient ischemic attack (TIA) in individuals who carry CYP2C19 loss-of-function (LOF) alleles; however, uncertainties remain about the time course of benefit and risk with ticagrelor and aspirin in these patients.To obtain time-course estimates of efficacy and risk with ticagrelor and aspirin after minor stroke or TIA in individuals with CYP2C19 LOF alleles.The Ticagrelor or Clopidogrel With Aspirin in High-risk Patients With Acute Nondisabling Cerebrovascular Events II (CHANCE-2) randomized clinical trial enrolled patients 40 years and older from 202 hospitals in China with acute minor stroke or TIA who carried CYP2C19 LOF alleles between September 23, 2019, and March 22, 2021, and were followed up for 90 days. All 6412 patients enrolled in the CHANCE-2 trial were included in this secondary analysis. Data were analyzed in October 2021.Ticagrelor (180 mg on day 1 followed by 90 mg twice daily on days 2-90) or clopidogrel (300 mg on day 1 followed by 75 mg daily on days 2-90). All patients received aspirin (75-300 mg on day 1 followed by 75 mg daily for 21 days).The efficacy outcome was major ischemic event, defined as the composite of ischemic stroke or nonhemorrhagic death. Safety outcomes included moderate to severe bleeding and any bleeding.A total of 6412 patients were included (3205 in the ticagrelor and aspirin group and 3207 in the clopidogrel and aspirin group). The median (IQR) age was 65 (57-71) years, and 4242 patients (66%) were men. The reduction of major ischemic events with ticagrelor and aspirin predominately occurred in the first week (absolute risk reduction, 1.34%; 95% CI, 0.29 to 2.39) and attenuated but remained in the next 3 weeks (absolute risk reduction in the second week, 0.11%; 95% CI, -0.24 to 0.45; absolute risk reduction in the third week, 0.14%; 95% CI, -0.11 to 0.38; absolute risk reduction in the fourth week, 0.04%; 95% CI, -0.18 to 0.25). The risk of moderate to severe bleeding was consistently low in the ticagrelor and aspirin group. The absolute increase in any bleeding seen in the first week (0.87%; 95% CI, 0.25 to 1.50) remained in the next 3 weeks (absolute increase in the second week, 1.21%; 95% CI, 0.75 to 1.68; absolute increase in the third week, 0.33%; 95% CI, -0.05 to 0.72; absolute increase in the fourth week, 0.23%; 95% CI, -0.03 to 0.49).Among patients with minor stroke or TIA who carried CYP2C19 LOF alleles, benefit with ticagrelor and aspirin was present predominately in the first week, with additional small benefit accruing in the next 2 weeks.
- Published
- 2022
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