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9. Interpretation of Report on Cardiovascular Health and Diseases in China 2022

Author

MA Liyuan, WANG Zengwu, FAN Jing, HU Shengshou

Subjects
cardiovascular disease, epidemiology, health influencing factors, risk factors, prevalence, mortality, community-based prevention and control, rehabilitation, basic research, medical device development, fees, medical, Medicine
Abstract

Due to the acceleration of population aging and the prevalence of unhealthy lifestyles, the huge population with cardiovascular disease (CVD) risk factors, the burden of CVD continues to increase in China. CVD is still the leading cause of death among urban and rural residents in China. In 2020, CVD accounted for 48.00% and 45.86% of the causes of death in rural and urban areas, respectively, and two out of every five deaths were due to CVD. It is estimated that the number of current CVD patients in China is 330 million, including 13 million cases of stroke, 11.39 million cases of coronary heart disease, 8.9 million cases of heart failure, 5 million cases of pulmonary heart disease, 4.87 million cases of atrial fibrillation, 2.5 million cases of rheumatic heart disease, 2 million cases of congenital heart disease, 45.3 million cases of peripheral artery disease, and 245 million cases of hypertension. The total hospitalization costs were 270.901 billion yuan for CVD in China in 2020. The prevention and treatment of CVD in China still has a long way to go. In general, we should not only do a good job in secondary prevention and treatment of CVD, but also further strengthen the upstream treatment of modifiable risk factors such as hypertension, hyperglycemia and hyperlipidemia starting with both preventive treatment and treatment diseases. In addition, attention should be paid to the allocation and prioritization of health care and public health resources, so as to reach the inflection point of CVD prevention and treatment as early as possible.

Published
2023
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37. A comparison of bilateral and unilateral cerebral perfusion for total arch replacement surgery for non-marfan, type A aortic dissection.

Author

Jiang, Qin, Huang, Keli, Wang, Deliang, Xia, Jiaqi, Yu, Tao, and Hu, Shengshou

Subjects
CONSENSUS (Social sciences), RNA-binding proteins, T-test (Statistics), RESEARCH funding, AXILLARY artery, AORTIC dissection, COMPUTED tomography, NEUROPHYSIOLOGY, TREATMENT effectiveness, RETROSPECTIVE studies, DESCRIPTIVE statistics, MANN Whitney U Test, MAGNETIC resonance imaging, SURGICAL complications, LONGITUDINAL method, ODDS ratio, KAPLAN-Meier estimator, INTRAOPERATIVE monitoring, NERVOUS system, MEDICAL records, ACQUISITION of data, CEREBRAL circulation, PERFUSION, COMPARATIVE studies, CONFIDENCE intervals, DATA analysis software, CYTOKINES, THORACIC aorta, PERIOPERATIVE care, INTERLEUKINS, DISEASE complications
Abstract

Objectives: Acknowledging lacking of consensus exist in total aortic arch (TAA) surgery for acute type A aortic dissection (AAD), this study aimed to investigate the neurologic injury rate between bilateral and unilateral cerebrum perfusion on the specific population. Methods: A total of 595 AAD patients other than Marfan syndrome receiving TAA surgery since March 2013 to March 2022 were included. Among them, 276 received unilateral cerebral perfusion (via right axillary artery, RCP) and 319 for bilateral cerebral perfusion (BCP). The primary outcome was neurologic injury rate. Secondary outcomes were 30-day mortality, serum inflammation response (high sensitivity C reaction protein, hs-CRP; Interleukin-6, IL-6; cold-inducible RNA binding protein, CIRBP) and neuroprotection (RNA-binding motif 3, RBM3) indexes. Results: The BCP group reported a significantly lower permanent neurologic deficits [odds ratio: 0.481, Confidence interval (CI): 0.296–0.782, p = 0.003] and 30-day mortality (odds ratio: 0.353, CI: 0.194–0.640, p < 0.001) than those received RCP treatment. There were also lower inflammation cytokines (hr-CRP: 114 ± 17 vs. 101 ± 16 mg/L; IL-6: 130 [103,170] vs. 81 [69,99] pg/ml; CIRBP: 1076 [889, 1296] vs. 854 [774, 991] pg/ml, all p < 0.001), but a higher neuroprotective cytokine (RBM3: 4381 ± 1362 vs 2445 ± 1008 pg/mL, p < 0.001) at 24 h after procedure in BCP group. Meanwhile, BCP resulted in a significantly lower Acute Physiology, Age and Chronic Health Evaluation (APACHE) Ⅱscore (18 ± 6 vs 17 ± 6, p < 0.001) and short stay in intensive care unit (4 [3,5] vs. 3 [2,3] days, p < 0.001) and hospital (16 ± 4 vs 14 ± 3 days, p < 0.001). Conclusions: This present study indicated that BCP compared with RCP was associated with lower permanent neurologic deficits and 30-day mortality in AAD patients other than Marfan syndrome receiving TAA surgery. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Quality of primary health care in China: challenges and recommendations

Author

Li, Xi, Krumholz, Harlan M, Yip, Winnie, Cheng, Kar Keung, De Maeseneer, Jan, Meng, Qingyue, Mossialos, Elias, Li, Chuang, Lu, Jiapeng, Su, Meng, Zhang, Qiuli, Xu, Dong Roman, Li, Liming, Normand, Sharon-Lise T, Peto, Richard, Li, Jing, Wang, Zengwu, Yan, Hongbing, Gao, Runlin, Chunharas, Somsak, Gao, Xin, Guerra, Raniero, Ji, Huijie, Ke, Yang, Pan, Zhigang, Wu, Xianping, Xiao, Shuiyuan, Xie, Xinying, Zhang, Yujuan, Zhu, Jun, Zhu, Shanzhu, and Hu, Shengshou

Published
2020
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44. The China Patient-Centred Evaluative Assessment of Cardiac Events (China PEACE)-Prospective Study of 3-Vessel Disease: rationale and design

Author

Rao, Chenfei, Bongiovanni, Tasce, Li, Xi, Gao, Huawei, Zhang, Heng, Li, Jing, Zhao, Yan, Yuan, Xin, Hua, Kun, Hu, Shengshou, Krumholz, Harlan M, Jiang, Lixin, and Zheng, Zhe

Subjects
Cardiovascular, Patient Safety, Prevention, Heart Disease, Clinical Research, Heart Disease - Coronary Heart Disease, Atherosclerosis, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Good Health and Well Being, China, Coronary Artery Bypass, Coronary Artery Disease, Drug-Eluting Stents, Guideline Adherence, Humans, Patient-Centered Care, Percutaneous Coronary Intervention, Practice Guidelines as Topic, Prospective Studies, Quality Improvement, Quality of Life, Treatment Outcome, China PEACE Collaborative Group, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences
Abstract

IntroductionComplex coronary artery disease (left main and three-vessel disease) carries high risks of adverse events and cost burden. However, in China, little is known about which patients are directed toward which treatment strategies and what outcomes are being achieved.Methods and analysisUsing the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) research network, this prospective study of three-Vessel Disease, the China PEACE-3VD study, has a plan to consecutively register over 4000 patients with a diagnosis of 3VD and/or left-main disease by elective coronary angiography at 24 large cardiovascular centres in China. We centrally conducted medical record abstraction and SYNTAX Score calculation for all registered patients. The sites invited patients to the prospective cohort, and conducted 1-year follow-up on major events, including cardiac events, symptoms, secondary prevention and quality of life. The estimated entire sample size of eligible patients of 4000 was determined based on both feasibility and consideration of adequate statistical precision for describing the treatment decisions, guidelines adherence and appropriateness of treatment for patients with complex coronary artery diseases. The study is designed to investigate patient, clinician and hospital factors associated with each treatment strategy (percutaneous coronary intervention, coronary artery bypass grafting or medical therapy) as well as appropriateness of treatment choice, current guideline compliance and patient-reported outcomes for patients with complex coronary artery disease in large cardiovascular centres in China, as a foundation for enhanced knowledge in the field and to assist quality improvement initiatives.Ethics and disseminationThe study protocol was approved by the ethics committee at the China National Center for Cardiovascular Diseases. Findings will be shared with participating hospitals, policymakers and the academic community, to promote quality monitoring, quality improvement and the efficient allocation, and use of coronary revascularisation procedures in China.Trial registration numberNCT01625312; Pre-results.

Published
2016

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