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It is particularly important to establish more effective and safer antiplatelet treatment strategies according to age. The present subanalysis of the PATH-PCI trial was to determine the safety and efficacy of any dual-antiplatelet therapy (DAPT) strategy in different age groups. We randomized 2285 chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI) into a standard group or a personalized group from December 2016 to February 2018. The personalized group received personalized antiplatelet therapy (PAT) based on a novel platelet function test (PFT). The standard group received standard antiplatelet therapy (SAT). Then, all patients were divided according to age (under the age of 65 years and aged 65 years or over) to investigate the association and interaction of age on clinical outcomes at 180 days. In the patients under the age of 65 years, the incidence of NACEs was decreased in the personalized group compared to the standard group (5.1% vs. 8.8%, HR: 0.603, 95% CI: 0.409–0.888, P =.010). The rates of MACCEs (3.3% vs. 7.7%, HR: 0.450, 95% CI: 0.285–0.712, P =.001), MACEs (2.2% vs. 5.4%, HR: 0.423, 95% CI: 0.243–0.738, P =.002) also decreased. We did not find a significant difference in bleeding between the groups. In the patients aged 65 years or over, no difference in the primary endpoint was found (4.9% vs. 4.2%, P =.702), and comparable rates of survival were observed with the two strategies (all Ps > 0.05). The present study shows that PAT according to PFT was comparable to SAT at the 180-day follow-up for both ischemic and bleeding endpoints in CCS patients aged 65 years or over who underwent PCI. In patients under the age of 65 years, PAT can reduce ischemic events but does not increase bleeding, and it is an effective and safe treatment strategy. It may be necessary for young CCS patients after PCI to undergo PAT early after PCI. What is the context? The PATH-PCI trial reported that personalized antiplatelet therapy (PAT) based on a novel platelet function test (PFT) can greatly reduce the incidence of ischemic events. Antiplatelet strategies may have very different effects on clinical outcomes in patients in China who are undergoing PCI at different ages. What is new? PL-12 is a new point-of-care platelet function analyzer that is used to test the platelet maximum aggregation rate (MAR). We explored the efficacy and safety of different antiplatelet strategies in chronic coronary syndrome (CCS) patients in different age groups. What is the impact? PAT according to PFT was comparable to standard antiplatelet therapy (SAT) at the 180-day follow-up for both ischemic and bleeding endpoints in CCS patients aged 65 years or over who underwent PCI. In patients under the age of 65 years, PAT can reduce ischemic events but not increase bleeding. PAT may be an effective and safe treatment strategy in CCS patients under the age of 65 years who underwent PCI. Abbreviation: PCI: percutaneous coronary intervention; CCS: chronic coronary syndrome; DAPT: dual antiplatelet therapy; PAT: personalized antiplatelet therapy; SAT: standard antiplatelet therapy; PFT: platelet function test; NACEs: net adverse clinical events; MACCEs: major adverse cardiac and cerebrovascular events; MACEs: major adverse cardiovascular events [ABSTRACT FROM AUTHOR]

Recent studies suggest that decreased estimated glomerular filtration rate (eGFR) and uric acid (UA) may be independent risk factors for arterial stiffness (AS). As serum UA level is linked to renal function, we hypothesize that decreased eGFR may be not an independent risk factor of AS, but may be related to UA level. In this study, we aimed to validate this hypothesis in a large community-based Chinese population. A total of 13,899 people were selected from the Cardiovascular Risk Survey (CRS) from October 2007 to March 2010. Pulse wave velocity (PWV) was calculated using the established methods. The relationships between eGFR, fasting blood glucose (FBG), UA and PWV were analyzed with multivariate linear regression. We found that PWV was significantly correlated to FBG ( r = 0.173, p < 0.001) and UA ( r = 0.177, p < 0.001), and inversely correlated to eGFR ( r = − 0.161, p < 0.001). A multivariable regression analysis revealed that FBG (β = 0.056, p < 0.001) and UA (β = 0.039, p < 0.001), but not eGFR (β = − 0.011, p = 0.062) were significantly related to elevation of PWV. In women, eGFR was not an independent risk factor of AS with progressively decreasing renal function (all p > 0.05). However, in men, eGFR was associated with PWV in subjects with eGFR < 60 ml/min/1.73 m2. Our results suggest that decreased eGFR is not independently associated with AS in Chinese women. [ABSTRACT FROM AUTHOR]

Objective. Recent study suggested that the genetic polymorphisms of serum amyloid A protein (SAA) were linked to cardiovascular disease (CVD). However, the relationship between genetic polymorphisms of SAA and ankle-to-brachial index (ABI) in healthy subjects has not been studied. We investigated the role of the SAA1 gene polymorphisms with ABI. Methods and results. All participants were selected from a cohort of healthy subjects participating in the Cardiovascular Risk Survey (CRS) study. Four single-nucleotide polymorphisms (SNPs; rs12218, rs4638289, rs7131332 and rs11603089) were genotyped by use of polymerase chain reaction--restriction fragment length polymorphism (PCR-RFLP) method. There was significant difference between CC genotype and CT genotype [(1.066 ±± 0.113) vs (1.119 ±± 0.096), p == 0.008], CC genotype and TT genotype [(1.066 ±± 0.113) vs (1.127 ±± 0.095), p == 0.002] of rs12218 in ABI, and these differences remained significant after adjustment for the sex, age, blood pressure, BMI, alcohol intake, smoking and high-density lipoprotein (HDL) [(1.073 ±± 0.018) vs (1.122 ±± 0.007), p == 0.012; (1.073 ±± 0.018) vs (1.124 ±± 0.006), p == 0.009), respectively]. These relationships were not found in rs874957, rs7950019 and rs11603089 before and after multivariate adjustment. Conclusions. CC genotype of rs12218 in the SAA1 gene was associated with decreased ABI in Chinese Han subjects, which indicated that the carriers of CC genotype of rs12218 have high risk of peripheral arterial disease. [ABSTRACT FROM AUTHOR]