173 results on '"Shu Bin, Qiao"'
Search Results
2. Clinical characteristics of early and late drug-eluting stent in-stent restenosis and mid-term prognosis after repeated percutaneous coronary intervention
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Jian-Feng Zheng, Ting-Ting Guo, Yuan Tian, Yong Wang, Xiao-Ying Hu, Yue Chang, Hong Qiu, Ke-Fei Dou, Yi-Da Tang, Jin-Qing Yuan, Yong-Jian Wu, Hong-Bing Yan, Shu-Bin Qiao, Bo Xu, Yue-Jin Yang, Run-Lin Gao, Yan-Jie Yin, and Xiu-Yuan Hao
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Medicine - Abstract
Abstract. Background:. The mechanism and characteristics of early and late drug-eluting stent in-stent restenosis (DES-ISR) have not been fully clarified. Whether there are different outcomes among those patients being irrespective of their repeated treatments remain a knowledge gap. Methods:. A total of 250 patients who underwent initial stent implantation in our hospital, and then were readmitted to receive treatment for the reason of recurrent significant DES-ISR in 2016 were involved. The patients were categorized as early ISR (
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- 2020
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3. Impacts of smoking status on the clinical outcomes of coronary non-target lesions in patients with coronary heart disease: a single-center angiographic study
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Hao-Bo Xu, Juan Wang, Ji-Lin Chen, Chao Guo, Jian-Song Yuan, Xin Duan, Feng-Huan Hu, Wei-Xian Yang, Xiao-Liang Luo, Rong Liu, Jin-Gang Cui, Sheng-Wen Liu, Xiao-Jin Gao, Yu-Shi Chun, Shu-Bin Qiao, and Xiu-Yuan Hao and Xin Chen
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Medicine - Abstract
Abstract. Background. Coronary atherosclerotic plaque could go through rapid progression and induce adverse cardiac events. This study aimed to evaluate the impacts of smoking status on clinical outcomes of coronary non-target lesions. Methods. Consecutive patients with coronary heart disease who underwent two serial coronary angiographies were included. All coronary non-target lesions were recorded at first coronary angiography and analyzed using quantitative coronary angiography at both procedures. Patients were grouped into non-smokers, quitters, and smokers according to their smoking status. Clinical outcomes including rapid lesion progression, lesion re-vascularization, and myocardial infarction were recorded at second coronary angiography. Multivariable Cox regression analysis was used to investigate the association between smoking status and clinical outcomes. Results. A total of 1255 patients and 1670 lesions were included. Smokers were younger and more likely to be male compared with non-smokers. Increase in percent diameter stenosis was significantly lower (2.7 [0.6, 7.1] % vs. 3.5 [0.9, 8.9]%) and 3.4 [1.1, 7.7]%, P = 0.020) in quitters than those in smokers and non-smokers. Quitters tended to have a decreased incidence of rapid lesions progression (15.8% [76/482] vs. 21.6% [74/342] and 20.6% [89/431], P = 0.062), lesion re-vascularization (13.1% [63/482] vs. 15.5% [53/432] and 15.5% [67/431], P = 0.448), lesion-related myocardial infarction (0.8% [4/482] vs. 2.6% [9/342] and 1.4% [6/431], P = 0.110) and all-cause myocardial infarction (1.9% [9/482] vs. 4.1% [14/342] and 2.3% [10/431], P = 0.128) compared with smokers and non-smokers. In multivariable analysis, smoking status was not an independent predictor for rapid lesion progression, lesion re-vascularization, and lesion-related myocardial infarction except that a higher risk of all-cause myocardial infarction was observed in smokers than non-smokers (hazards ratio: 3.00, 95% confidence interval: 1.04–8.62, P = 0.042). Conclusion. Smoking cessation mitigates the increase in percent diameter stenosis of coronary non-target lesions, meanwhile, smokers are associated with increased risk for all-cause myocardial infarction compared with non-smokers.
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- 2020
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4. Assessing the association of appropriateness of coronary revascularization and 1-year clinical outcomes for patients with stable coronary artery disease in China
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Shen Lin, Heng Zhang, Chen-Fei Rao, Si-Peng Chen, Shu-Bin Qiao, Hong-Bing Yan, Ke-Fei Dou, Yong-Jian Wu, Yi-Da Tang, Xin-Chun Yang, Zhu-Jun Shen, Jian Liu, Zhe Zheng, Ning-Ning Wang, and Beijing Coronary Angiography Registry Collaborative Group
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Medicine - Abstract
Abstract. Background:. The Chinese appropriate use criteria (AUC) for coronary revascularization was released in 2016 to improve the use of coronary revascularization. This study aimed to evaluate the association between the appropriateness of coronary revascularization based on the Chinese AUC and 1-year outcomes in stable coronary artery disease (CAD) patients. Methods. : We conducted a prospective, multi-center cohort study of stable CAD patients with coronary lesion stenosis ≥50%. After the classification of appropriateness based on Chinese AUC, patients were categorized into the coronary revascularization group or the medical therapy group based on treatment received. The primary outcome was a composite of death, myocardial infarction, stroke, repeated revascularization, and ischemic symptoms with hospital admission. Results:. From August 2016 to August 2017, 6085 patients were consecutively enrolled. Coronary revascularization was associated with a lower adjusted hazard of 1-year major adverse cardiovascular and cerebrovascular events (MACCEs; hazard ratio [HR]: 0.62; 95% confidence interval [CI]: 0.45–0.86; P = 0.004) than medical therapy in patients with appropriate indications (n = 1617). No significant benefit in 1-year MACCEs was found after revascularization compared to after medical therapy in patients with uncertain indications (n = 2658, HR: 0.81; 95% CI: 0.52–1.25; P = 0.338) and inappropriate indications (n = 1810, HR: 0.80; 95% CI: 0.51–1.23; P = 0.308). Conclusions:. In patients with appropriate indications according to Chinese AUC, coronary revascularization was associated with significantly lower risk of MACCEs at 1 year. No benefit was found in coronary revascularization in patients with inappropriate indications. Our findings provide evidence for using Chinese AUC to guide clinical decision-making. Clinical trial registration:. NCT02880605. https://www.clinicaltrials.gov.
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- 2020
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5. Does Prior Stroke Predict Long-Term Recurrent Stroke After Percutaneous Coronary Intervention? Five-Year Results From a Large Cohort Study
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Jing-jing Xu, Si-da Jia, Pei Zhu, Lin Jiang, Ping Jiang, Ying Song, Xue-yan Zhao, Jian-xin Li, Jue Chen, Yue-jin Yang, Run-lin Gao, Shu-bin Qiao, Bo Xu, and Jin-qing Yuan
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prior stroke ,coronary heart disease ,PCI—percutaneous coronary intervention ,predictor ,long-term outcome ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Background: We found a positive correlation between the prior stroke history and recurrent stroke in patients who underwent percutaneous coronary intervention (PCI) in our previous study, which indicated the close interaction of stroke and cardiovascular diseases. However, it is unclear whether prior stroke is still associated with worse prognosis at a longer follow-up period.Methods: A total of 10,724 coronary heart disease (CHD) patients who received PCI from January to December 2013 were prospectively enrolled and were subsequently divided into the prior stroke (n = 1,150) and non-prior stroke (n = 9,574) groups according to their history. Baseline characteristics and 5-year outcomes were recorded.Results: Patients with prior stroke had more clinical risk factors, as well as more extensive coronary artery lesions. Although in-hospital outcomes were similar between patients from the two groups, the 5-year follow-up result revealed that patients with prior stroke experienced higher incidence of stroke, major adverse cardiac and cerebrovascular events (MACCEs), all-cause death, and cardiac death (7.0 vs. 3.0%, p < 0.001; 25.9 vs. 20.3%, p < 0.001; 5.3 vs. 3.5%, p = 0.002; 3.1 vs. 2.1%, p = 0.032, respectively). After the propensity score matching, the 5-year stroke rate was still higher in the prior stroke group (6.8 vs. 3.4%, p = 0.001). The multivariable regression analysis also identified the prior stroke as a risk predictor of the 5-year stroke (HR = 2.011, 95% CI: 1.322–3.059, p = 0.001).Conclusions: Coronary heart disease patients with prior stroke who received PCI had a higher incidence of 5-year long-term adverse cardiovascular and cerebrovascular events, especially recurrent stroke. Prior stroke was a strong risk predictor of future stroke events.
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- 2021
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6. The prognostic value of collateral circulation in coronary chronic total occlusion underwent percutaneous coronary intervention.
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Xiao-Ying HU, Wei-Xian YANG, Chang-Dong GUAN, Li-Hua XIE, Ke-Fei DOU, Yong-Jian WU, Jin-Qing YUAN, Jie QIAN, Yue-Jin YANG, Shu-Bin QIAO, and Lei SONG
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PEARSON correlation (Statistics) ,CORONARY disease ,T-test (Statistics) ,FISHER exact test ,LOGISTIC regression analysis ,DESCRIPTIVE statistics ,CHI-squared test ,MULTIVARIATE analysis ,CHRONIC total occlusion ,ODDS ratio ,KAPLAN-Meier estimator ,LOG-rank test ,PERCUTANEOUS coronary intervention ,COLLATERAL circulation ,COMPARATIVE studies ,CORONARY angiography ,CONFIDENCE intervals ,DATA analysis software ,PROPORTIONAL hazards models - Abstract
BACKGROUND The prognostic value of coronary collateral circulation (CC) in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is underdetermined. The purpose of the study was to assess the prognostic value of current two CC grading systems and their association with long-term outcomes in patients with CTO underwent PCI. METHODS We consecutively enrolled patients with single-vessel CTO underwent PCI between January 2010 and December 2013. All patients were categorized into well-developed or poor-developed collaterals group according to angiographic Werner's CC (grade 2 vs. grade 0-1) or Rentrop (grade 3 vs. grade 0-2) grading system. The primary endpoint was 5-year cardiac death. RESULTS Of 2452 enrolled patients, the overall technical success rate was 74.1%. Well-developed collaterals were present in 686 patients (28.0%) defined by Werner's CC grade 2, and in 1145 patients (46.7%) by Rentrop grade 3. According to Werner's CC grading system, patients with well-developed collaterals had a lower rate of 5-year cardiac death compared with those with poordeveloped collaterals (1.6% vs. 3.3%, P = 0.02), those with suboptimal recanalization was associated with higher rate of 5-year cardiac death compared with optimal recanalization (4.7% vs. 0.8%, P = 0.01) and failure patients (4.7% vs. 1.6%, P = 0.12). However, the similar effect was not shown in Rentrop grading system. CONCLUSIONS In patients with the single-vessel CTO underwent PCI, well-developed collaterals by Werner's CC definition were associated with lower rate of 5-year cardiac death. Werner's CC grading system had a greater prognostic value than Rentrop grading system in patients with CTO underwent PCI. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Diagnostic performance of intravascular ultrasound-based fractional flow reserve in evaluating of intermediate left main stenosis.
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Yong-Gang SUI, Cheng YANG, Chang-Dong GUAN, Yan-Lu XU, Na-Qiong WU, Wei-Xian YANG, Yong-Jian WU, Ke-Fei DOU, Yue-Jin YANG, Shu-Bin QIAO, Wei YU, Bo XU, Sheng-Xian TU, and Jie QIAN
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RESEARCH funding ,CORONARY circulation ,DESCRIPTIVE statistics ,LONGITUDINAL method ,PERCUTANEOUS coronary intervention ,INTRAVASCULAR space ,CONFIDENCE intervals ,CORONARY artery stenosis ,SENSITIVITY & specificity (Statistics) - Abstract
BACKGROUND The recently introduced ultrasonic flow ratio (UFR), is a novel fast computational method to derive fractional flow reserve (FFR) from intravascular ultrasound (IVUS) images. In the present study, we evaluate the diagnostic performance of UFR in patients with intermediate left main (LM) stenosis. METHODS This is a prospective, single center study enrolling consecutive patients with presence of intermediated LM lesions (diameter stenosis of 30%-80% by visual estimation) underwent IVUS and FFR measurement. An independent core laboratory assessed offline UFR and IVUS-derived minimal lumen area (MLA) in a blinded fashion. RESULTS Both UFR and FFR were successfully achieved in 41 LM patients (mean age, 62.0 ± 9.9 years, 46.3% diabetes). An acceptable correlation between UFR and FFR was identified (r = 0.688, P < 0.0001), with an absolute numerical difference of 0.03 (standard difference: 0.01). The area under the curve (AUC) in diagnosis of physiologically significant coronary stenosis for UFR was 0.94 (95% CI: 0.87-1.01), which was significantly higher than angiographic identified stenosis > 50% (AUC = 0.66, P < 0.001) and numerically higher than IVUS-derived MLA (AUC = 0.82; P = 0.09). Patient level diagnostic accuracy, sensitivity and specificity for UFR to identify FFR = 0.80 was 82.9% (95% CI: 70.2-95.7), 93.1% (95% CI: 82.2-100.0), 58.3% (95% CI: 26.3-90.4), respectively. CONCLUSION In patients with intermediate LM diseases, UFR was proved to be associated with acceptable correlation and high accuracy with pressure wire-based FFR as standard reference. The present study supports the use of UFR for functional evaluation of intermediate LM stenosis. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Relationship between fibrinogen levels and cardiovascular events in patients receiving percutaneous coronary intervention: a large single-center study
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Ping Jiang, Zhan Gao, Wei Zhao, Ying Song, Xiao-Fang Tang, Jing-Jing Xu, Huan-Huan Wang, Lin Jiang, Jue Chen, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, Jin-Qing Yuan, and Li-Min Chen
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Medicine - Abstract
Abstract. Background:. It is currently unclear if fibrinogen is a risk factor for adverse events in patients receiving percutaneous coronary intervention (PCI) or merely serves as a marker of pre-existing comorbidities and other causal factors. We therefore investigated the association between fibrinogen levels and 2-year all-cause mortality, and compared the additional predictive value of adding fibrinogen to a basic model including traditional risk factors in patients receiving contemporary PCI. Methods:. A total of 6293 patients undergoing PCI with measured baseline fibrinogen levels were enrolled from January to December 2013 in Fuwai Hospital. Patients were divided into three groups according to tertiles of baseline fibrinogen levels: low fibrinogen,
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- 2019
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9. Biodegradable polymer drug-eluting stents versus second-generation drug-eluting stents in patients with and without diabetes mellitus: a single-center study
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Xiao-Fang Tang, Yuan-Liang Ma, Ying Song, Jing-Jing Xu, Yi Yao, Chen He, Huan-Huan Wang, Ping Jiang, Lin Jiang, Ru Liu, Zhan Gao, Xue-yan Zhao, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, and Jin-Qing Yuan
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Diabetes mellitus ,Second-generation drug-eluting stent ,Biodegradable polymer drug-eluting stent ,Target lesion revascularization ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background To improve outcomes in patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention remain an unmet clinical need. The study aimed to evaluate the efficacy and safety of G2-DESs and BP-DESs in patients with and without DM in a single center in China. Methods A total of 7666 consecutive patients who exclusively had G2-DES or BP-DES implantation throughout 2013 in our center were studied. The primary efficacy endpoint was any target lesion revascularization (TLR), whereas the primary safety endpoint was a composite of death or myocardial infarction (MI) at 2-year follow-up. Results G2-DESs had a similar occurrence of death, non-fatal MI, TLR, stroke, and stent thrombosis compared with BP-DESs in patients with DM (all P > 0.05). The incidence of TVR and TLR was lower for G2-DESs than for BP-DESs in patients without DM (3.2% vs. 5.1%, P = 0.002; 2.2% vs. 4.5%, P 0.05). Conclusions G2-DESs have better efficacy, represented by a reduced risk of TLR, and similar safety compared with BP-DESs in patients without DM. G2-DESs have similar efficacy and safety compared with BP-DESs in patients with DM at 2-year follow-up.
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- 2018
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10. Relationship between High Level of Estimated Glomerular Filtration Rate and Contrast-Induced Acute Kidney Injury in Patients who Underwent an Emergency Percutaneous Coronary Intervention
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Ying Yuan, Hong Qiu, Xiao-Ying Hu, Tong Luo, Xiao-Jin Gao, Xue-Yan Zhao, Jun Zhang, Yuan Wu, Shu-Bin Qiao, Yue-Jin Yang, and Run-Lin Gao
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Contrast-Induced Acute Kidney Injury ,Emergency Percutaneous Coronary Intervention ,Estimated Glomerular Filtration Rate ,Medicine - Abstract
Background: Mounts of studies have shown that low estimated glomerular filtration rate (eGFR) is associated with increased risk of adverse outcomes in patients with coronary artery disease. However, high level of eGFR was less reported. In the study, we aimed to explore the relationship between the baseline eGFR, especially the high level, and contrast-induced acute kidney injury (CI-AKI) in a Chinese population who underwent an emergency percutaneous coronary intervention (PCI). Methods: Patients who underwent an emergency PCI from 2013 to 2015 were enrolled and divided into five groups as eGFR decreasing. Baseline characteristics were collected and analyzed. The rates of CI-AKI and the composite endpoint (including nonfatal myocardial infarction, revascularization, stroke, and all-cause death) at 6- and 12-month follow-up were compared. Logistic analysis for CI-AKI was performed. Results: A total of 1061 patients were included and the overall CI-AKI rate was 22.7% (241/1061). The separate rates were 77.8% (7/9) in Group 1 (eGFR ≥120 ml·min−1·1.73 m−2), 26.0% (118/454) in Group 2 (120 ml·min−1·1.73 m−2> eGFR ≥90 ml·min−1·1.73m−2), 18.3% (86/469) in Group 3 (90 ml·min−1·1.73 m−2> eGFR ≥60 ml·min−1·1.73 m−2), 21.8% (26/119) in Group 4 (60 ml·min−1·1.73 m−2> eGFR ≥30 ml·min−1·1.73 m−2), and 40.0% (4/10) in Group 5 (eGFR
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- 2018
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11. Comparison of Efficacy and Safety between First- and Second-Generation Drug-Eluting Stents in Patients with Acute Coronary Syndrome
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Yuan-Liang Ma, Xiao-Fang Tang, Yi Yao, Na Xu, Ying Song, Ping Jiang, Jing-Jing Xu, Huan-Huan Wang, Lin Jiang, Ru Liu, Xue-Yan Zhao, Jue Chen, Zhan Gao, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, and Jin-Qing Yuan
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Acute Coronary Syndrome ,First-Generation Drug-Eluting Stent ,Percutaneous Coronary Intervention ,Second-Generation Drug-Eluting Stent ,Stent Thrombosis ,Medicine - Abstract
Background: It remains undetermined whether second-generation drug-eluting stents (G2-DESs) outperform first-generation DESs (G1-DESs) in patients with acute coronary syndrome (ACS). We aimed to compare the efficacy and safety of G1-DES and G2-DES in ACS patients in a high-volume cardiovascular center. Methods: In 2013, 10,724 consecutive patients underwent percutaneous coronary intervention in our institution. We included 4037 patients with ACS who underwent exclusively G1-DES or G2-DES implantation (n = 364 and n = 3673, respectively). We used propensity score matching to minimize the imbalance between the G1-DES and G2-DES groups and followed patients for 2 years. The efficacy endpoints were major adverse cardiac events (MACEs) and its components including target vessel-related myocardial infarction (TV-MI), target vessel revascularization/target lesion revascularization (TVR/TLR), and cardiac death. The safety endpoint was stent thrombosis. Continuous variables were compared by Mann-Whitney U-test, and categorical variables were compared using Pearson's Chi-square or Fisher's exact test. Kaplan-Meier curves were constructed to compare the event-free survival rates, and multivariate Cox proportional hazards regression analysis was used to assess whether stent type was an independent risk factor for the efficacy and safety endpoints. Results: At the 2-year follow-up, the results for MACE and it components, as well as stent thrombosis, were similar for G1-DES and G2-DES (MACE, 5.2% vs. 4.3%, χ2 = 0.514, P = 0.474; TV-MI, 0.8% vs. 0.4%, P = 0.407; TVR, 4.9% vs. 3.7%, χ2 = 0.939, P = 0.333; TLR, 3.8% vs. 2.5%, χ2 = 1.610, P = 0.205; cardiac death, 0.3% vs. 0.5%, P = 0.670; and stent thrombosis, 0.5% vs. 0.4%, P > 0.999). Kaplan-Meier analysis indicated similar event-free survival rates between G1-DES and G2-DES after propensity score matching (all: log-rank P > 0.05). Multivariate analysis demonstrated that stent type was not an independent risk factor for the efficacy and safety endpoints (MACE, hazard ratio [HR] = 0.805, 95% confidence interval [CI]: 0.455–1.424, P = 0.456; TV-MI, HR = 0.500, 95% CI: 0.101–2.475, P = 0.395; TVR, HR = 0.732, 95% CI: 0.403–1.330, P = 0.306; TLR, HR = 0.629, 95% CI: 0.313–1.264, P = 0.193; cardiac death, HR = 1.991, 95% CI: 0.223–17.814, P = 0.538; and stent thrombosis, HR = 0.746, 95% CI: 0.125–4.467, P = 0.749). Conclusion: G1-DES and G2-DES have similar efficacy and safety profiles in ACS patients at the 2-year follow-up.
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- 2018
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12. Validation of Predictive Value of Patterns of Nonadherence to Antiplatelet Regimen in Stented Patients Thrombotic Risk Score in Chinese Population Undergoing Percutaneous Coronary Intervention: A Prospective Observational Study
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Xue-Yan Zhao, Jian-Xin Li, Xiao-Fang Tang, Jing-Jing Xu, Ying Song, Lin Jiang, Jue Chen, Lei Song, Li-Jian Gao, Zhan Gao, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, and Jin-Qing Yuan
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Coronary Thrombosis ,Percutaneous Coronary Intervention ,Prognosis ,Risk Assessment ,Medicine - Abstract
Background: The patterns of nonadherence to antiplatelet regimen in stented patients (PARIS) thrombotic risk score are a novel score for predicting the risk of coronary thrombotic events (CTEs) after percutaneous coronary intervention (PCI) with drug-eluting stents. However, the prognostic value of this score has not been fully evaluated in non-Euro-American PCI populations. Methods: We performed a prospective, observational study of 10,724 patients who underwent PCI in Fuwai hospital, China and evaluated the PARIS thrombotic risk score's predictive value of CTEs in the PCI population. The area under the receiver operating characteristic curve (AUROC) was used to assess the predictive value of the PARIS score for CTE. Results: Among 9782 patients without in-hospital events, a total of 95 CTEs occurred during the 2-year follow-up. The PARIS score was significantly higher in patients with CTEs (3.38 ± 2.04) compared with patients without events (2.53 ± 1.70, P < 0.001). According to the risk stratification of the PARIS thrombotic score, the risk of CTEs in the high-risk group was 3.14 times higher than that in the low-risk group (hazard ratio [HR], 3.14; 95% confidence interval [CI], 1.92–5.13; P < 0.001). However, the risk of CTEs in the intermediate-risk and low-risk groups was not significant (HR, 1.39; 95% CI, [0.86–2.24]; P = 0.184). The PARIS score showed prognostic value in evaluating CTEs in the overall population (AUROC, 0.621; 95% CI, 0.561–0.681), the acute coronary syndrome (ACS) population (AUROC, 0.617; 95% CI, 0.534–0.700; P = 0.003), and the non-ACS population (AUROC, 0.647; 95% CI, 0.558–0.736; P = 0.001). Conclusions: In a real-world Chinese population, the PARIS thrombotic risk score shows a modest prognostic value for CTEs in patients after PCI. This score also has a predictive value for CTEs in the ACS and non-ACS subgroup populations.
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- 2018
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13. Evaluation of CRUSADE and ACUITY-HORIZONS Scores for Predicting Long-term Out-of-Hospital Bleeding after Percutaneous Coronary Interventions
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Xue-Yan Zhao, Jian-Xin Li, Xiao-Fang Tang, Ying Xian, Jing-Jing Xu, Ying Song, Lin Jiang, Lian-Jun Xu, Jue Chen, Yin Zhang, Lei Song, Li-Jian Gao, Zhan Gao, Jun Zhang, Yuan Wu, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, and Jin-Qing Yuan
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Bleeding Score ,Dual Antiplatelet Therapy ,Major Bleeding ,Percutaneous Coronary Intervention ,Prognosis ,Medicine - Abstract
Background: There is scanty evidence concerning the ability of Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) and Acute Catheterization and Urgent Intervention Triage Strategy and Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (ACUITY-HORIZONS) scores to predict out-of-hospital bleeding risk after percutaneous coronary interventions (PCIs) with drug-eluting stents (DES) in patients receiving dual antiplatelet therapy. We aimed to assess and compare the long-term prognostic value of these scores regarding out-of-hospital bleeding risk in such patients. Methods: We performed a prospective observational study of 10,724 patients undergoing PCI between January and December 2013 in Fuwai Hospital, China. All patients were followed up for 2 years and evaluated through the Fuwai Hospital Follow-up Center. Major bleeding was defined as Types 2, 3, and 5 according to Bleeding Academic Research Consortium Definition criteria. Results: During a 2-year follow-up, 245 of 9782 patients (2.5%) had major bleeding (MB). CRUSADE (21.00 [12.00, 29.75] vs. 18.00 [11.00, 26.00], P < 0.001) and ACUITY-HORIZONS (9.00 [3.00, 14.00] vs. 6.00 [3.00, 12.00], P < 0.001) risk scores were both significantly higher in the MB than non-MB groups. Both scores showed a moderate predictive value for MB in the whole study cohort (area under the receiver-operating characteristics curve [AUROC], 0.565; 95% confidence interval [CI], 0.529–0.601, P = 0.001; AUROC, 0.566; 95% CI, 0.529–0.603, P < 0.001, respectively) and in the acute coronary syndrome (ACS) subgroup (AUROC: 0.579, 95% CI: 0.531–0.627, P = 0.001; AUROC, 0.591; 95% CI, 0.544–0.638, P < 0.001, respectively). However, neither score was a significant predictor in the non-ACS subgroup (P > 0.05). The value of CRUSADE and ACUITY-HORIZONS scores did not differ significantly (P > 0.05) in the whole cohort, ACS subgroup, or non-ACS subgroup. Conclusions: CRUSADE and ACUITY-HORIZONS scores showed statistically significant but relatively limited long-term prognostic value for out-of-hospital MB after PCI with DES in a cohort of Chinese patients. The value of CRUSADE and ACUITY-HORIZONS scores did not differ significantly (P > 0.05) in the whole cohort, ACS subgroup, or non-ACS subgroup.
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- 2018
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14. Evaluation of the Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients Bleeding Score for Predicting the Long-term Out-of-hospital Bleeding Risk in Chinese Patients after Percutaneous Coronary Intervention
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Xue-Yan Zhao, Jian-Xin Li, Xiao-Fang Tang, Jing-Jing Xu, Ying Song, Lin Jiang, Jue Chen, Lei Song, Li-Jian Gao, Zhan Gao, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, and Jin-Qing Yuan
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Bleeding ,Percutaneous Coronary Intervention ,Prognosis ,Medicine - Abstract
Background: The Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients (PARIS) bleeding score is a novel score for predicting the out-of-hospital bleeding risk after percutaneous coronary intervention (PCI). However, whether this score has the same value in non-European and American populations is unclear. This study aimed to assess the PARIS bleeding score's predictive value of bleeding in patients after PCI in the Chinese population. Methods: We performed a prospective, observational study of 10,724 patients who underwent PCI from January to December 2013, in Fuwai Hospital, China. We defined the primary end point as major bleeding (MB) according to Bleeding Academic Research Consortium definition criteria including Type 2, 3, or 5. The predictive value of the PARIS bleeding score was assessed with the area under the receiver operating characteristic (AUROC) curve. Results: Of 9782 patients, 245 (2.50%) MB events occurred during the 2 years of follow-up. The PARIS bleeding score was significantly higher in the MB group than that of non-MB group (4.00 [3.00, 5.00] vs. 3.00 [2.00, 5.00], Z = 3.71, P < 0.001). According to risk stratification of the PARIS bleeding score, the bleeding risk in the intermediate- and high-risk groups was 1.50 times (hazard ratio [HR]: 1.50; 95% confidence interval [CI]: 1.160–1.950; P = 0.002) and 2.27 times higher (HR: 2.27; 95% CI: 1.320–3.900; P = 0.003) than that in the low-risk group. The PARIS bleeding score showed a moderate predictive value for MB in the overall population (AUROC: 0.568, 95% CI: 0.532–0.605; P < 0.001) and acute coronary syndrome (ACS) subgroup (AUROC: 0.578, 95% CI: 0.530–0.626; P = 0.001) and tended to be predictive in the non-ACS subgroup (AUROC: 0.556, 95% CI: 0.501–0.611; P = 0.054). Conclusion: The PARIS bleeding score shows good clinical value for risk stratification and has a significant, but relatively limited, prognostic value for out-of-hospital bleeding in the Chinese population after PCI.
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- 2018
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15. Impact of Residual SYNTAX Score and Its Derived Indexes on Clinical Outcomes after Percutaneous Coronary Intervention: Data from a Large Single Center
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Ying Song, Zhan Gao, Xiao-Fang Tang, Ping Jiang, Jing-Jing Xu, Yi Yao, Jian-Xin Li, Xue-Yan Zhao, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, and Jin-Qing Yuan
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Clinical Outcome ,Percutaneous Coronary Intervention ,Risk Assessment ,Risk Stratification ,Medicine - Abstract
Background: Residual SYNTAX score (rSS) and its derived indexes including SYNTAX revascularization index (SRI) and clinical rSS had been developed to quantify and describe the extent of incomplete revascularization. This study was conducted to explore the utility of the three scores among real-world patients after percutaneous coronary intervention (PCI). Methods: From January 2013 to December 2013, patients underwent PCI treatment at Fuwai Hospital were included. The primary endpoints were all-cause death and major adverse cardiovascular and cerebrovascular events. The secondary endpoints were myocardial infarction, revascularization, stroke, and stent thrombosis. Kaplan-Meier methodology was used to determine the outcomes. Cox multivariable regression was to test the associations between scores and all-cause mortality. Results: A total of 10,344 patients were finally analyzed in this study. Kaplan-Meier survival analysis indicated that greater residual coronary lesions quantified by rSS and its derived indexes were associated with increased risk of adverse cardiovascular events. However, after multivariate analysis, only clinical rSS was an independent predictor of 2-year all-cause death (hazard ratio: 1.02, 95% confidence interval: 1.01–1.03, P < 0.01). By receiver operating characteristic (ROC) curve analysis, clinical rSS had superior predictability of 2-year all-cause death than rSS and SRI (area under ROC curve [AUC]: 0.59 vs. 0.56 vs. 0.56, all P < 0.01), whereas rSS was superior in predicting repeat revascularization than clinical rSS and SRI (AUC: 0.62 vs. 0.61 vs. 0.61; all P < 0.01). When comparing the predictive capability of rSS ≥8 with SRI
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- 2018
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16. Impact of Proton-pump Inhibitors on the Pharmacodynamic Effect and Clinical Outcomes in Patients Receiving Dual Antiplatelet Therapy after Percutaneous Coronary Intervention: A Propensity Score Analysis
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Pei Zhu, Zhan Gao, Xiao-Fang Tang, Jing-Jing Xu, Yin Zhang, Li-Jian Gao, Jue Chen, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, and Jin-Qing Yuan
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Clopidogrel ,Drug Interactions ,Percutaneous Coronary Intervention ,Proton-pump Inhibitors ,Medicine - Abstract
Background: Prior studies have reported controversial conclusions regarding the risk of adverse cardiovascular events in patients using proton-pump inhibitors (PPIs) combined with clopidogrel therapy, causing much uncertainty in clinical practice. We sought to evaluate the safety of PPIs use among high-risk cardiovascular patients who underwent percutaneous coronary intervention (PCI) in a long-term follow-up study. Methods: A total of 7868 consecutive patients who had undergone PCI and received dual antiplatelet therapy (DAPT) at a single center from January 2013 to December 2013 were enrolled. Adenosine diphosphate (ADP)-induced platelet aggregation inhibition was measured by modified thromboelastography (mTEG) in 5042 patients. Propensity score matching (PSM) was applied to control differing baseline factors. Cox proportional hazards regression was used to evaluate the 2-year major adverse cardiovascular and cerebrovascular events (MACCEs), as well as individual events, including all-cause death, myocardial infarction, unplanned target vessel revascularization, stent thrombosis, and stroke. Results: Among the whole cohort, 27.2% were prescribed PPIs. The ADP-induced platelet aggregation inhibition by mTEG was significantly lower in PPI users than that in non-PPI users (42.0 ± 30.9% vs. 46.4 ± 31.4%, t = 4.435, P < 0.001). Concomitant PPI use was not associated with increased MACCE through 2-year follow-up (12.7% vs. 12.5%, χ2 = 0.086, P = 0.769). Other endpoints showed no significant differences after multivariate adjustment, regardless of PSM. Conclusion: In this large cohort of real-world patients, the combination of PPIs with DAPT was not associated with increased risk of MACCE in patients who underwent PCI at up to 2 years of follow-up.
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- 2017
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17. Risk Factors of Contrast-induced Acute Kidney Injury in Patients Undergoing Emergency Percutaneous Coronary Intervention
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Ying Yuan, Hong Qiu, Xiao-Ying Hu, Tong Luo, Xiao-Jin Gao, Xue-Yan Zhao, Jun Zhang, Yuan Wu, Hong-Bing Yan, Shu-Bin Qiao, Yue-Jin Yang, and Run-Lin Gao
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Contrast-induced Acute Kidney Injury ,Emergency Percutaneous Coronary Intervention ,Risk Factors ,Medicine - Abstract
Background: Previous studies of contrast-induced acute kidney injury (CI-AKI) were mostly based on selective percutaneous coronary intervention (PCI) cases, and risk factors of CI-AKI after emergency PCI are unclear. The aim of this study was to explore the risk factors of CI-AKI in a Chinese population undergoing emergency PCI. Methods: A total of 1061 consecutive patients undergoing emergency PCI during January 2013 and June 2015 were enrolled and divided into CI-AKI and non-CI-AKI group. Univariable and multivariable analyses were used to identify the risk factors of CI-AKI in emergency PCI patients. CI-AKI was defined as an increase in serum creatinine ≥25% or ≥0.5 mg/dl (44.2 μmol/L) above baseline within 3 days after exposure to contrast medium. Results: The incidence of CI-AKI in patients undergoing emergency PCI was 22.7% (241/1061). Logistic multivariable analysis showed that body surface area (BSA) (odds ratio [OR] 0.213, 95% confidence interval [CI]: 0.075–0.607, P= 0.004), history of myocardial infarction (MI) (OR 1.642, 95% CI: 1.079–2.499, P= 0.021), left ventricular ejection fraction (LVEF) (OR 0.969, 95% CI: 0.944–0.994, P= 0.015), hemoglobin (Hb) (OR 0.988, 95% CI: 0.976–1.000, P= 0.045), estimated glomerular filtration rate (OR 1.027, 95% CI: 1.018–1.037, P < 0.001), left anterior descending (LAD) stented (OR 1.464, 95% CI: 1.000–2.145, P= 0.050), aspirin (OR 0.097, 95%CI: 0.009–0.987, P= 0.049), and diuretics use (OR 1.850, 95% CI: 1.233–2.777, P= 0.003) were independent predictors of CI-AKI in patients undergoing emergency PCI. Conclusion: History of MI, low BSA, LVEF and Hb level, LAD stented, and diuretics use are associated with increased risk of CI-AKI in patients undergoing emergency PCI.
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- 2017
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18. Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease: A Single-center Retrospective Study
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Ru Liu, Fei Xiong, Yuan Wen, Yuan-Liang Ma, Yi Yao, Zhan Gao, Bo Xu, Yue-Jin Yang, Shu-Bin Qiao, Run-Lin Gao, and Jin-Qing Yuan
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Drug-eluting Stents ,Percutaneous Coronary Intervention ,Stable Coronary Artery Disease ,Medicine - Abstract
Background: Lots of trials demonstrate that second-generation drug-eluting stents (G2-DES), with their improved properties, offer significantly superior efficacy and safety profiles compared to first generation DES (G1-DES) for patients with coronary artery disease (CAD) receiving percutaneous coronary intervention (PCI). This study aimed to verify the advantage of G2-DES over G1-DES in Chinese patients with stable CAD (SCAD). Methods: For this retrospective observational analysis, 2709 SCAD patients with either G1-DES (n = 863) or G2-DES (n = 1846) were enrolled consecutively throughout 2013. Propensity score matching (PSM) was applied to control differing baseline factors. Two-year outcomes, including major adverse coronary events as well as individual events, including target vessel-related myocardial infarction, target lesion revascularization (TLR), target vessel revascularization, and cardiogenic death were evaluated. Results: The incidence of revascularization between G1- and G2-DES showed a trend of significant difference with a threshold P - value (8.6% vs. 6.7%, χ2 = 2.995, P = 0.084). G2-DES significantly improved TLR-free survival compared to G1-DES (96.6% vs. 97.9%, P = 0.049) and revascularization-free survival curve showed a trend of improvement of G2-DES (92.0% vs. 93.8%, P = 0.082). These differences diminished after PSM. Multivariate Cox proportional hazard regression analysis showed a trend for G1-associated increase in revascularization (hazard ratio: 1.28, 95% confidence interval: 0.95–1.72, P = 0.099) while no significance was found after PSM. Other endpoints showed no significant differences after multivariate adjustment regardless of PSM. Conclusions: G1-DES showed the same safety as G2-DES in this large Chinese cohort of real-world patients. However, G2-DES improved TLR-free survival of SCAD patients 2 years after PCI. The advantage was influenced by baseline clinical factors. G1-DES was associated with a trend of increase in revascularization risk and was not an independent predictor of worse medium-term prognosis compared with G2-DES.
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- 2017
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19. A retrospective study of an invasive versus conservative strategy in patients aged ≥80 years with acute ST-segment elevation myocardial infarction
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Yong-Gang Sui, Si-Yong Teng, Jie Qian, Yuan Wu, Ke-Fei Dou, Yi-Da Tang, Shu-Bin Qiao, and Yong-Jian Wu
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Medicine (General) ,R5-920 - Abstract
Objective To investigate what is the most appropriate strategy for patients with ST-segment elevation myocardial infarction (STEMI) aged ≥80 years in China. Methods This cohort study retrospectively enrolled patients with STEMI aged ≥80 years old and grouped them according to the treatment strategy that was used: a conservative treatment strategy or an invasive treatment strategy. Factors associated with whether to perform an invasive intervention, in-hospital death and a good prognosis were investigated using logistic regression analyses. Results A total of 232 patients were enrolled: conservative treatment group ( n = 93) and invasive treatment group ( n = 139). Patients in the invasive treatment group had a better prognosis and lower incidence of adverse events compared with the conservative treatment group. Advanced age, creatinine level and a higher Killip class were inversely correlated with whether to perform an invasive intervention, while the use of beta-receptor-blocking agents was a favourable factor for invasive treatment. Hypertension and a higher Killip class were risk factors for in-hospital death, while the use of beta-receptor-blocking agents and diuretics decreased the risk of in-hospital death. Conclusions An invasive treatment strategy was superior to a conservative treatment strategy in patients with STEMI aged ≥80 years.
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- 2019
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20. Prolonged dual antiplatelet therapy after drug-eluting stent implantation improves long-term prognosis for acute coronary syndrome: five-year results from a large cohort study
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Jin-qing Yuan, Run-lin Gao, Bo Xu, Shu-bin Qiao, Yue-jin Yang, Jian-xin Li, Xue-yan Zhao, Yi Yao, De-shan Yuan, Pei Zhu, Ying Song, Lin Jiang, Si-da Jia, and Jing-jing Xu
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Emergency Medicine ,Original Article - Abstract
BACKGROUND: To investigate the most appropriate dual antiplatelet therapy (DAPT) duration for patients with acute coronary syndrome (ACS) after drug-eluting stent (DES) implantation in the largest cardiovascular center of China. METHODS: We enrolled 5,187 consecutive patients with ACS who received DES from January to December 2013. Patients were divided into four groups based on DAPT duration: standard DAPT group (11–13 months, n=1,568) and prolonged DAPT groups (13–18 months [n=308], 18–24 months [n=2,125], and >24 months [n=1,186]). Baseline characteristics and 5-year clinical outcomes were recorded. RESULTS: Baseline characteristics were similar across the four groups. Among the four groups, those with prolonged DAPT (18–24 months) had the lowest incidence of major adverse cardiovascular and cerebrovascular events (MACCEs) (14.1% vs. 11.7% vs. 9.6% vs. 24.2%, P
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- 2023
21. Clinical and Angiographic Predictors of Major Side Branch Occlusion after Main Vessel Stenting in Coronary Bifurcation Lesions
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Dong Zhang, Bo Xu, Dong Yin, Yi-Ping Li, Yuan He, Shi-Jie You, Shu-Bin Qiao, Yong-Jian Wu, Hong-Bing Yan, Yue-Jin Yang, Run-Lin Gao, and Ke-Fei Dou
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Coronary Bifurcation Lesions ,Major Side Branch Occlusion ,Percutaneous Coronary Intervention ,Medicine - Abstract
Background: Major side branch (SB) occlusion is one of the most serious complications during percutaneous coronary intervention (PCI) for bifurcation lesions. We aimed to characterize the incidence and predictors of major SB occlusion during coronary bifurcation intervention. Methods: We selected consecutive patients undergoing PCI (using one stent or provisional two stent strategy) for bifurcation lesions with major SB. All clinical characteristics, coronary angiography findings, PCI procedural factors and quantitative coronary angiographic analysis data were collected. Multivariate logistic regression analysis was performed to identify independent predictors of SB occlusion. SB occlusion after main vessel (MV) stenting was defined as no blood flow or any thrombolysis in myocardial infarction (TIMI) flow grade decrease in SB after MV stenting. Results: Among all 652 bifurcation lesions, 32 (4.91%) SBs occluded. No blood flow occurred in 18 lesions and TIMI flow grade decreasing occurred in 14 lesions. In multivariate analysis, diameter ratio between MV/SB (odds ratio [OR]: 7.71, 95% confidence interval [CI]: 1.53-38.85, P = 0.01), bifurcation angle (OR: 1.03, 95% CI: 1.02-1.05, P < 0.01), diameter stenosis of SB before MV stenting (OR: 1.05, 95% CI: 1.03-1.07, P < 0.01), TIMI flow grade of SB before MV stenting (OR: 3.59, 95% CI: 1.48-8.72, P < 0.01) and left ventricular eject fraction (LVEF) (OR: 1.06, 95% CI: 1.02-1.11, P < 0.01) were independent predictors of SB occlusion. Conclusions: Among clinical and angiographic findings, diameter ratio between MV/SB, bifurcation angle, diameter stenosis of SB before MV stenting, TIMI flow grade of SB before MV stenting and LVEF were predictive of major SB occlusion after MV stenting.
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- 2015
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22. Impact of Body Mass Index on the Clinical Outcomes after Percutaneous Coronary Intervention in Patients ≥75 Years Old
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Pei-Yuan He, Yue-Jin Yang, Shu-Bin Qiao, Bo Xu, Min Yao, Yong-Jian Wu, Yuan Wu, Jin-Qing Yuan, Jue Chen, Hai-Bo Liu, Jun Dai, Wei Li, Yi-Da Tang, Jin-Gang Yang, and Run-Lin Gao
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Aged ,Angioplasty ,Body Mass Index ,Outcomes ,Medicine - Abstract
Background: The impact of body mass index (BMI) on the clinical outcomes after percutaneous coronary intervention (PCI) in patients ≥75 years old remained unclear. Methods: A total of 1098 elderly patients undergoing PCI with stent implantation were recruited. Patients were divided into four groups by the value of BMI: Underweight (≤20.0 kg/m 2 ), normal weight (20.0-24.9 kg/m 2 ), overweight (25.0-29.9 kg/m 2 ) and obese (≥30.0 kg/m 2 ). Major clinical outcomes after PCI were compared between the groups. The primary endpoint was defined as in-hospital major adverse cardiovascular events (MACEs), which included death, myocardial infarction (MI) and target vessel revascularization. The secondary endpoint was defined as 1 year death. Logistic regression analysis was performed to adjust for the potential confounders. Results: Totally, 1077 elderly patients with available BMIs were included in the analysis. Patients of underweight, normal weight, overweight and obese accounted for 5.6%, 45.4%, 41.5% and 7.5% of the population, respectively. Underweight patients were more likely to attract ST-segment elevation MI, and get accompanied with anemia or renal dysfunction. Meanwhile, they were less likely to achieve thrombolysis in MI 3 grade flow after PCI, and receive beta-blocker, angiotensin converting enzyme inhibitor or angiotensin receptor blocker after discharge. In underweight, normal weight, overweight and obese patients, in-hospital MACE were 1.7%, 2.7%, 3.8%, and 3.7% respectively (P = 0.68), and 1 year mortality rates were 5.0%, 3.9%, 5.1% and 3.7% (P = 0.80), without significant difference between the groups. Multivariate regression analysis showed that the value of BMI was not associated with in-hospital MACE in patients at 75 years old. Conclusions: The BMI "obese paradox" was not found in patients ≥75 years old. It was suggested that BMI may not be a sensitive predictor of adverse cardiovascular events in elderly patients.
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- 2015
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23. Effect of Final Kissing Balloon Dilatation after One-stent Technique at Left-main Bifurcation: A Single Center Data
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Zhan Gao, Bo Xu, Yue-Jin Yang, Shu-Bin Qiao, Yong-Jian Wu, Tao Chen, Liang Xu, Jin-Qing Yuan, Jue Chen, Xue-Wen Qin, Min Yao, Hai-Bo Liu, Shi-Jie You, Ye-Lin Zhao, Hong-Bing Yan, Ji-Lin Chen, and Run-Lin Gao
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Angioplasty ,Balloon ,Bifurcation ,Percutaneous Coronary Angioplasty ,Unprotected Left-main ,Medicine - Abstract
Background: Whether final kissing balloon (FKB) dilatation after one-stent implantation at left-main (LM) bifurcation site remains unclear. Therefore, this large sample and long-term follow-up study comparatively assessed the impact of FKB in patients with unprotected LM disease treated with one-stent strategy. Methods: Total 1528 consecutive patients underwent LM percutaneous coronary intervention in one center from January 2004 to December 2010 were enrolled; among them, 790 patients treated with one drug-eluting stent crossover LM to left anterior descending (LAD) with FKB (n = 230) or no FKB (n = 560) were comparatively analyzed. Primary outcome was the rate of major adverse cardiovascular events, defined as a composite of death, myocardial infarction (MI) and target vessel revascularization (TVR). Results: Overall, The prevalence of true bifurcation lesions, which included Medina classification (1,1,1), (1,0,1), or (0,1,1), was similar between-groups (non-FKB: 37.0% vs. FKB: 39.6%, P = 0.49). At mean 4 years follow-up, rates of major adverse cardiovascular events (non-FKB: 10.0% vs. FKB: 7.8%, P = 0.33), death, MI and TVR were not significantly different between-groups. In multivariate propensity-matched regression analysis, FKB was not an independent predictor of adverse outcomes. Conclusions: For patients treated with one-stent crossover LM to LAD, clinical outcomes appear similar between FKB and non-FKB strategy.
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- 2015
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24. Comparing of Light Transmittance Aggregometry and Modified Thrombelastograph in Predicting Clinical Outcomes in Chinese Patients Undergoing Coronary Stenting with Clopidogrel
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Xiao-Fang Tang, Ya-Ling Han, Jia-Hui Zhang, Jing Wang, Yin Zhang, Bo Xu, Zhan Gao, Shu-Bin Qiao, Jue Chen, Yuan Wu, Ji-Lin Chen, Run-Lin Gao, Yue-Jin Yang, and Jin-Qing Yuan
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Clopidogrel ,High On-treatment Platelet Reactivity ,Light Transmittance Aggregometry ,Thrombelastography ,Medicine - Abstract
Background: Several platelet function tests are currently used to measure responsiveness to antiplatelet therapy. This study was to compare two tests, light transmittance aggregometry (LTA) and modified thrombelastography (mTEG), for predicting clinical outcomes in Chinese patients after percutaneous coronary intervention (PCI). Methods: Prospective, observational, single-center study of 789 Chinese patients undergoing PCI was enrolled. This study was investigated the correlations between the two tests and performed receiver operating characteristic curve (ROC) analysis for major adverse cardiovascular events (MACEs) at 1-year follow-up. Results: MACEs occurred in 32 patients (4.1%). Correlations were well between the two tests in the adenosine diphosphate induced platelet reactivity (Spearman r = 0.733, P < 0.001). ROC-curve analysis demonstrated that LTA (area under the curve [AUC]: 0.677; 95% confidence interval [CI]: 0.643-0.710; P = 0.0009), and mTEG (AUC: 0.684; 95% CI: 0.650-0.716; P = 0.0001) had moderate ability to discriminate between patients with and without MACE. MACE occurred more frequently in patients with high on-treatment platelet reactivity (HPR) when assessed by LTA (7.4% vs. 2.7%; P < 0.001), and by TEG (6.7% vs. 2.6%; P < 0.001). Kaplan-Meier analysis demonstrated that HPR based on the LTA and mTEG was associated with almost 3-fold increased risk of MACE at 1-year follow-up. Conclusions: The correlation between LTA and mTEG is relatively high in Chinese patients. HPR measured by LTA and mTEG were significantly associated with MACE in Chinese patients undergoing PCI.
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- 2015
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25. A Comparison of the Transradial and Transfemoral Approaches for the Angiography and Intervention in Patients with a History of Coronary Artery Bypass Surgery: In-hospital and 1-year Follow-up Results
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Pei-Yuan He, Yue-Jin Yang, Shu-Bin Qiao, Bo Xu, Min Yao, Yong-Jian Wu, Jin-Qing Yuan, Jue Chen, Hai-Bo Liu, Jun Dai, Xin-Ran Tang, Yang Wang, Wei Li, and Run-Lin Gao
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Coronary Angioplasty ,Coronary Artery Bypass Surgery ,Transfemoral ,Transradial ,Medicine - Abstract
Background: Percutaneous coronary intervention (PCI) through transradial approach (TRA) has shown to be safe and effective as transfemoral approach (TFA) among unselected patients. However, very few studies have compared the outcomes between TRA and TFA specifically in patients with a history of coronary artery bypass grafting surgery (CABG). Methods: A total of 404 post-CABG patients who had undergone angiography or PCI were included in the study. The primary endpoint was defined as angiographic success and procedure success. The secondary endpoint was defined as in-hospital net adverse clinical events (NACEs), which included all cause of death, myocardial infarction (MI), stroke, repeat revascularization, and major bleeding. Patients were followed-up for 1-year. Major adverse cardiovascular events (MACEs), which included death, MI, and repeat revascularization, at 1-year follow-up were also compared. Results: The angiographic success was reached by 97.4% in the TRA group compared with 100% in the TFA group (P = 0.02). The procedure success was achieved in 99.1% in the TRA group and 97.9% in the TFA group (P = 0.68). The incidence rates of in-hospital NACE (2.7% vs. 2.7%, P = 1.00) and 1-year MACE (11.5% vs. 12.0%, P = 0.88) were similar between TRA and TFA. Meanwhile, TRA was associated with a lower rate of Bleeding Academic Research Consortium ≥2 bleeding (P = 0.02). In patients undergoing graft PCI, the procedure success was similar between TRA and TFA (100.0% vs. 98.7%, P = 1.00). The procedure time (25.0 min vs. 27.5 min, P = 0.53) was also similar. No significant difference was detected between TRA and TFA in terms of in-hospital NACE (0 vs. 0, P = 1.00) and 1-year MACE (21.4% vs. 10.3%, P = 0.19). Conclusions: Compared with TFA, TRA had lower angiographic success but had a similar procedure success in post-CABG patients. TRA was also associated with decreased bleeding and shortened hospital stay.
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- 2015
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26. Effects of chronic obstructive pulmonary disease on long-term prognosis of patients with coronary heart disease post-percutaneous coronary intervention
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Yi, Yao, Pei, Zhu, Na, Xu, Lin, Jiang, Xiao-Fang, Tang, Ying, Song, Xue-Yan, Zhao, Shu-Bin, Qiao, Yue-Jin, Yang, Jin-Qing, Yuan, and Run-Lin, Gao
- Abstract
Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases are often comorbid conditions, their co-occurrence yields worse outcomes than either condition alone. This study aimed to investigate COPD impacts on the five-year prognosis of patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).Patients with CHD who underwent PCI in 2013 were recruited, and divided into COPD group and non-COPD group. Adverse events occurring among those groups were recorded during the five-year follow-up period after PCI, including all-cause death and cardiogenic death, myocardial infarction, repeated revascularization, as well as stroke and bleeding events. Major adverse cardiac and cerebral events were a composite of all-cause death, myocardial infarction, repeated revascularization and stroke.A total of 9843 patients were consecutively enrolled, of which 229 patients (2.3%) had COPD. Compared to non-COPD patients, COPD patients were older, along with poorer estimated glomerular filtration rate and lower left ventricular ejection fraction. Five-year follow-up results showed that incidences of all-cause death and cardiogenic death, as well as major adverse cardiac and cerebral events, for the COPD group were significantly higher than for non-COPD group (10.5%COPD is an independent predictive factor for clinical mortality, in which CHD patients with COPD are associated with worse prognosis than CHD patients with non-COPD.
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- 2022
27. Association between left ventricular reverse remodeling and long-term outcomes after alcohol septal ablation for hypertrophic obstructive cardiomyopathy
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Fu-Jian Duan, You-Zhou Chen, Jian-Song Yuan, Yan Zhang, and Shu-Bin Qiao
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There is a paucity of data regarding the effect of left ventricular (LV) reverse remodeling (r-LVR) on diastolic function and outcomes after alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM). The aim of this study was to identify the impact of r-LVR on the outcome and the predictors of such changes after ASA. Eighty-seven patients (57.5% men) were enrolled and underwent both echocardiography and cardiovascular magnetic resonance (CMR) imaging at baseline and 27 months after the procedure. The study population was divided into two groups by the degree of r-LVR. Compared to the greater r-LVR group, the lesser r-LVR group had a significantly larger LV mass (LVM) and lower diastolic function parameters at baseline. The greater r-LVR group had significantly greater LVM regression and improvement of diastolic function after ASA. Kaplan‒Meier analysis showed significantly worse composite events in the lesser r-LVR group after ASA (P = 0.016). After adjusting for multiple clinical variables, r-LVR was associated with an improved E/e' (β = 0.390, p 0.001) and reduced events (hazard ratio: 0.795; 95% confidence interval (CI), 0.644-0.983; p = 0.034). Preablation LVM was associated with a decreased probability of r-LVR (β = -0.228, p = 0.021) and diastolic function improvement (β= -0.245, p = 0.006). r-LVR was associated with long-term outcome benefit in patients with HOCM. Preablation LVM prevented LV from favoring reverse remodeling and thus may be a potential parameter for risk stratification and prognosis after ASA treatment.
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- 2022
28. Elevated plasma miRNA-122, -140-3p, -720, -2861, and -3149 during early period of acute coronary syndrome are derived from peripheral blood mononuclear cells.
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Xiang-Dong Li, Yue-Jin Yang, Lai-Yuan Wang, Shu-Bin Qiao, Xiang-Feng Lu, Yong-Jian Wu, Bo Xu, Hong-Fan Li, and Dong-Feng Gu
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Medicine ,Science - Abstract
Our previous study has found that circulating microRNA (miRNA, or miR) -122, -140-3p, -720, -2861, and -3149 are significantly elevated during early stage of acute coronary syndrome (ACS). This study was conducted to determine the origin of these elevated plasma miRNAs in ACS.qRT-PCR was performed to detect the expression profiles of these 5 miRNAs in liver, spleen, lung, kidney, brain, skeletal muscles, and heart. To determine their origins, these miRNAs were detected in myocardium of acute myocardial infarction (AMI), and as well in platelets and peripheral blood mononuclear cells (PBMCs, including monocytes, circulating endothelial cells (CECs) and lymphocytes) of the AMI pigs and ACS patients.MiR-122 was specifically expressed in liver, and miR-140-3p, -720, -2861, and -3149 were highly expressed in heart. Compared with the sham pigs, miR-122 was highly expressed in the border zone of the ischemic myocardium in the AMI pigs without ventricular fibrillation (P < 0.01), miR-122 and -720 were decreased in platelets of the AMI pigs, and miR-122, -140-3p, -720, -2861, and -3149 were increased in PBMCs of the AMI pigs (all P < 0.05). Compared with the non-ACS patients, platelets miR-720 was decreased and PBMCs miR-122, -140-3p, -720, -2861, and -3149 were increased in the ACS patients (all P < 0.01). Furthermore, PBMCs miR-122, -720, and -3149 were increased in the AMI patients compared with the unstable angina (UA) patients (all P < 0.05). Further origin identification revealed that the expression levels of miR-122 in CECs and lymphocytes, miR-140-3p and -2861 in monocytes and CECs, miR-720 in monocytes, and miR-3149 in CECs were greatly up-regulated in the ACS patients compared with the non-ACS patients, and were higher as well in the AMI patients than that in the UA patients except for the miR-122 in CECs (all P < 0.05).The elevated plasma miR-122, -140-3p, -720, -2861, and -3149 in the ACS patients were mainly originated from CECs and monocytes.
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- 2017
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29. Prolonged dual antiplatelet therapy after drug-eluting stent implantation improves long-term prognosis for acute coronary syndrome: five-year results from a large cohort study.
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Jing-jing Xu, Si-da Jia, Lin Jiang, Ying Song, Pei Zhu, De-shan Yuan, Yi Yao, Xue-yan Zhao, Jian-xin Li, Yue-jin Yang, Shu-bin Qiao, Bo Xu, Run-lin Gao, and Jin-qing Yuan
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ACUTE coronary syndrome ,PLATELET aggregation inhibitors ,COHORT analysis ,MYOCARDIAL infarction - Abstract
BACKGROUND: To investigate the most appropriate dual antiplatelet therapy (DAPT) duration for patients with acute coronary syndrome (ACS) after drug-eluting stent (DES) implantation in the largest cardiovascular center of China. METHODS: We enrolled 5,187 consecutive patients with ACS who received DES from January to December 2013. Patients were divided into four groups based on DAPT duration: standard DAPT group (11-13 months, n=1,568) and prolonged DAPT groups (13-18 months [n=308], 18-24 months [n=2,125], and >24 months [n=1,186]). Baseline characteristics and 5-year clinical outcomes were recorded. RESULTS: Baseline characteristics were similar across the four groups. Among the four groups, those with prolonged DAPT (18-24 months) had the lowest incidence of major adverse cardiovascular and cerebrovascular events (MACCEs) (14.1% vs. 11.7% vs. 9.6% vs. 24.2%, P<0.001), all-cause death (4.8% vs. 3.9% vs. 2.1% vs. 2.6%, P<0.001), cardiac death (3.1% vs. 2.6% vs. 1.4% vs. 1.9%, P=0.004), and myocardial infarction (MI) (3.8% vs. 4.2% vs. 2.5% vs. 5.8%, P<0.001). The incidence of bleeding was not different among the four groups (9.9% vs. 9.4% vs. 11.0% vs. 9.4%, P=0.449). Cox multivariable analysis showed that prolonged DAPT (18-24 months) was an independent protective factor for MACCEs (hazard ratio [HR] 0.802, 95% confidence interval [CI] 0.729-0.882, P<0.001), all-cause death (HR 0.660, 95% CI 0.547-0.795, P<0.001), cardiac death (HR 0.663, 95% CI 0.526-0.835, P<0.001), MI (HR 0.796, 95% CI 0.662-0.957, P=0.015), and target vessel revascularization (HR 0.867, 95% CI 0.755-0.996, P=0.044). Subgroup analysis for high bleeding risk showed that prolonged DAPT remained an independent protective factor for all-cause death and MACCEs. CONCLUSION: For patients with ACS after DES, appropriately prolonging the DAPT duration may be associated with a reduced risk of adverse ischemic events without increasing the bleeding risk. [ABSTRACT FROM AUTHOR]
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- 2023
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30. Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China
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Chen Jin, Wei Li, Shu‐Bin Qiao, Jin‐Gang Yang, Yang Wang, Pei‐Yuan He, Xin‐Ran Tang, Qiu‐Ting Dong, Xiang‐Dong Li, Hong‐Bing Yan, Yong‐Jian Wu, Ji‐Lin Chen, Run‐Lin Gao, Jin‐Qing Yuan, Ke‐Fei Dou, Bo Xu, Wei Zhao, Xue Zhang, Ying Xian, and Yue‐Jin Yang
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coronary artery disease ,cost ,health services research ,interventional cardiology ,outcomes research ,percutaneous coronary intervention ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundTransradial percutaneous coronary intervention (PCI) has been increasingly adopted in clinical practice, given its potential advantages over transfemoral intervention; however, the impact of different access strategies on costs and clinical outcomes remains poorly defined, especially in the developing world. Methods and ResultsUsing data from a consecutive cohort of 5306 patients undergoing PCI in China in 2010, we compared total hospital costs and in‐hospital outcomes for transradial intervention (TRI) and transfemoral intervention. Patients receiving TRI (n=4696, 88.5%) were slightly younger (mean age 57.4 versus 59.5 years), less often women (21.6% versus 33.1%), more likely to undergo PCI for single‐vessel disease, and less likely to undergo PCI for triple‐vessel or left main diseases. The unadjusted total hospital costs were 57 900 Chinese yuan (¥57 900; equivalent to 9190 US dollars [$9190]) for TRI and ¥67 418 ($10,701) for transfemoral intervention. After adjusting for all observed patient and procedural characteristics using the propensity score inverse probability weighting method, TRI was associated with a lower total cost (adjusted difference ¥8081 [$1283]). More than 80% of the cost difference was related to lower PCI‐related costs (adjusted difference −¥5162 [−$819]), which were likely driven by exclusive use of vascular closure devices in transfemoral intervention, and lower hospitalization costs (−¥1399 [−$222]). Patients receiving TRI had shorter length of stay and were less likely to experience major adverse cardiac events or post‐PCI bleeding. These differences were consistent among clinically relevant subgroups with acute myocardial infarction, acute coronary syndrome, and stable angina. ConclusionsAmong patients undergoing PCI, TRI was associated with lower cost and favorable clinical outcomes compared with transfemoral intervention.
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- 2016
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31. Profile and outcomes of patients with mediastinal hematoma after cardiac catheterization: A retrospective analysis
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Xiao‐Liang Luo, Wei‐Xian Yang, Jun Zhang, Jian‐Song Yuan, Jun‐Yi Wan, and Shu‐Bin Qiao
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Cardiac Catheterization ,Chest Pain ,Hematoma ,Treatment Outcome ,Aspirin ,Mediastinal Diseases ,Humans ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Cardiology and Cardiovascular Medicine ,Retrospective Studies - Abstract
To provide a comprehensive introduction of mediastinal hematoma.Mediastinal hematoma is a rare complication that is usually not considered in the differential diagnosis of chest pain after cardiac catheterization.From January 1, 2006, to December 31, 2013, at Fuwai Hospital, 126,265 patients underwent coronary angiography (CAG); 121,215 of them underwent CAG via the radial artery. Ultimately, 10 patients with mediastinal hematoma due to cardiac catheterization were included. Patients' clinical characteristics, diagnosis, treatment, and prognosis were retrospectively analyzed.The incidences of mediastinal hematoma in cardiac catheterization and transradial cardiac catheterization were 0.79‱ and 0.74‱, respectively. A super slide hydrophilic guidewire was used in all 10 patients with mediastinal hematoma. These patients felt chest pain and dyspnea during/after the procedure, and computed tomography (CT) was used to diagnose mediastinal hematoma. Among them, two patients had a neck hematoma. The post-procedural hemoglobin level decreased substantially in all patients. Antiplatelet therapy was discontinued for 8-20 days in three patients without stents implanted, and then only oral aspirin was prescribed. Aspirin was transiently discontinued for 2 days in one patient undergoing percutaneous coronary intervention. The others continued taking dual antiplatelet drugs. Two patients received blood transfusion. There was no case of stent thrombosis, and surgery was not indicated for any patient. No complication was observed after discharge during the 9.0 ± 2.5-year follow-up.CT should be performed as early as possible in patients with suspected mediastinal hematoma. The prognosis of mediastinal hematoma is usually good with early diagnosis and suitable therapy.
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- 2021
32. [Two types of exercise-induced abnormal blood pressure response in hypertrophic cardiomyopathy]
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Xiao-Ying, Hu, Xing-Guo, Sun, Shu-Bin, Qiao, Xiao-Jin, Gao, Xiao-Liang, Luo, Fang, Liu, Ye, Zhang, Lu, Hao, Ya, Song, Ying-Zhe, Chen, Ji-Nan, Wang, Wen-Qi, Tai, Chao, Shi, Fan, Xu, Wen-Xuan, Zhai, Jie, Yang, and Tian-Jing, Zhang
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Exercise Test ,Humans ,Blood Pressure ,Stroke Volume ,Cardiomyopathy, Hypertrophic ,Ventricular Function, Left - Published
- 2021
33. Comparison of outcomes for percutaneous coronary intervention in men and women with unprotected left main disease
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Sheng-Wen, Liu, Chang-Dong, Guan, Feng-Huan, Hu, Jue, Chen, Ke-Fei, Dou, Wei-Xian, Yang, Yong-Jian, Wu, Yue-Jin, Yang, Bo, Xu, and Shu-Bin, Qiao
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cardiovascular diseases ,Research Article - Abstract
BACKGROUND Percutaneous coronary intervention (PCI) in patients with unprotected left main coronary artery disease (ULMCAD) is increasing strategy in coronary artery patients. However, there is a lack of knowledge on the impact of sex on outcomes of patients undergoing ULMCAD PCI. METHODS From January 2004 to December 2015, there were 3,960 patients undergoing ULMCAD PCI at our institution, including 3,121 (78.8%) men and 839 (21.2%) women. The clinical outcome included the incidence of major adverse cardiac events (MACE) (the composite of all-cause death, myocardial infarction (MI), and revascularization), all-cause death, MI, revascularization at three years follow-up. RESULTS Compared with men, women had not significantly different MACE (14.7% vs. 14.6%, P = 0.89, all-cause death (3.5% vs. 3.7%, P = 0.76), MI (5.0% vs. 4.3%, P = 0.38), revascularization (9.1% vs. 8.9%, P = 0.86), respectively. After adjustment, rates of MACE (HR = 1.49; 95% CI: 1.24−1.81;P < 0.0001) and all-cause death (HR = 1.65; 95% CI: 1.09−2.48; P = 0.017) occurred more frequently in male patients, as well as revascularization (HR = 1.46; 95% CI: 1.16−1.85;P = 0.001). CONCLUSION In this analysis, compared to men, women undergoing ULMCAD PCI have better outcomes of MACE, all-cause death, and revascularization.
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- 2021
34. Does Percutaneous Coronary Intervention on Off Days have an Effect on Long-term Prognosis in Patients with Coronary Artery Disease in China?
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Ru, Liu, Li Jian, Gao, Ou, Xu, Ce, Zhang, Si Da, Jia, Shu Bin, Qiao, Yue Jin, Yang, Run Lin, Gao, Bo, Xu, and Jin Qing, Yuan
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Male ,China ,Percutaneous Coronary Intervention ,Time Factors ,Humans ,Female ,Coronary Artery Disease ,Middle Aged ,Prognosis ,Aged ,Holidays - Published
- 2020
35. The Impact of Smoking Status on the Long-Term Prognosis of Male Patients Underwent Percutaneous Coronary Intervention of Left Main Coronary Artery
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XU Hao-bo, Shu-bin Qiao, Xu Bo, Wang Xin-yu, Guan Chang-dong, Yuan Jiansong, Yang Weixian, Teng Hao-bo, Guo Chao, Wang Juan, and Chun Yu-shi
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medicine.medical_specialty ,medicine.anatomical_structure ,Male patient ,business.industry ,medicine.medical_treatment ,Internal medicine ,medicine ,Cardiology ,Percutaneous coronary intervention ,Smoking status ,business ,Artery ,Term (time) - Abstract
Objective: To evaluate the impact of smoking status on the long-term prognosis of male patients with left main coronary artery lesions who received percutaneous coronary intervention. Methods: A retrospective analysis was conducted. A total of 3122 male patients with left main lesions who received percutaneous coronary intervention in our hospital were categorized by smoking status at admission: 1207 in the non-smokers group, 1339 in the current smokers group, and 576 in the ex-smokers group. The patients were followed up for 3 years. The main study endpoints were major cardiovascular adverse events (composite endpoints of all-cause death, all myocardial infarctions and revascularization) and target lesion failure (composite endpoints of cardiogenic death, target vessel-related myocardial infarction, target vessel-related blood flow reconstruction). Results: The patients in the current smokers group was younger than the non-smokers group and the ex-smokers group (pConclusion: For male patients with the left main coronary artery lesions receiving PCI, smoking has no impact on the long-term MACE or target lesion failure, current smoking is an independent protective factor for target vessel related myocardial infarction.
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- 2020
36. Atorvastatin enhance efficacy of mesenchymal stem cells treatment for swine myocardial infarction via activation of nitric oxide synthase.
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Lei Song, Yue-Jin Yang, Qiu-Ting Dong, Hai-Yan Qian, Run-Lin Gao, Shu-Bin Qiao, Rui Shen, Zuo-Xiang He, Min-Jie Lu, Shi-Hua Zhao, Yong-Jian Geng, and Bernard J Gersh
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Medicine ,Science - Abstract
BACKGROUND: In a swine model of acute myocardial infarction (AMI), Statins can enhance the therapeutic efficacy of mesenchymal stem cell (MSCs) transplantation. However, the mechanisms remain unclear. This study aims at assessing whether atorvastatin (Ator) facilitates the effects of MSCs through activation of nitric oxide synthase (NOS), especially endothelial nitric oxide synthase (eNOS), which is known to protect against ischemic injury. METHODS AND RESULTS: 42 miniswines were randomized into six groups (n = 7/group): Sham operation; AMI control; Ator only; MSC only, Ator+MSCs and Ator+MSCs+NG-nitrol-L-arginine (L-NNA), an inhibitor of NOS. In an open-heart surgery, swine coronary artery ligation and reperfusion model were established, and autologous bone-marrow MSCs were injected intramyocardium. Four weeks after transplantation, compared with the control group, Ator+MSCs animals exhibited decreased defect areas of both "perfusion" defined by Single-Photon Emission Computed Tomography (-6.2±1.8% vs. 2.0±5.1%, P = 0.0001) and "metabolism" defined by Positron Emission Tomography (-3.00±1.41% vs. 4.20±4.09%, P = 0.0004); Ejection fraction by Magnetic Resonance Imaging increased substantially (14.22±12.8% vs. 1.64±2.64%, P = 0.019). In addition, indices of inflammation, fibrosis, and apoptosis were reduced and survivals of MSCs or MSC-derived cells were increased in Ator+MSCs animals. In Ator or MSCs alone group, perfusion, metabolism, inflammation, fibrosis or apoptosis were reduced but there were no benefits in terms of heart function and cell survival. Furthermore, the above benefits of Ator+MSCs treatment could be partially blocked by L-NNA. CONCLUSIONS: Atorvastatin facilitates survival of implanted MSCs, improves function and morphology of infarcted hearts, mediated by activation of eNOS and alleviated by NOS inhibitor. The data reveal the cellular and molecular mechanism for anti-AMI therapy with a combination of statin and stem cells.
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- 2013
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37. Effects of chronic obstructive pulmonary disease on long-term prognosis of patients with coronary heart disease postpercutaneous coronary intervention.
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YAO, Pei ZHU, Na XU, Lin JIANG, Xiao-Fang TANG, Ying SONG, Xue-Yan ZHAO, Shu-Bin QIAO, Yue-Jin YANG, Jin-Qing YUAN, and Run-Lin GAO
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MYOCARDIAL infarction risk factors ,HEMORRHAGE risk factors ,STROKE risk factors ,CAUSES of death ,GLOMERULAR filtration rate ,PERCUTANEOUS coronary intervention ,VENTRICULAR ejection fraction ,CONFIDENCE intervals ,HEMOGLOBINS ,SCIENTIFIC observation ,TIME ,AGE distribution ,MULTIPLE regression analysis ,CALCIUM antagonists ,CORONARY disease ,DISEASE incidence ,RETROSPECTIVE studies ,TREATMENT effectiveness ,RISK assessment ,COMPARATIVE studies ,HOSPITAL mortality ,T-test (Statistics) ,PEARSON correlation (Statistics) ,OBSTRUCTIVE lung diseases ,RESEARCH funding ,MYOCARDIAL revascularization ,REOPERATION ,CHI-squared test ,DESCRIPTIVE statistics ,PLATELET count ,KAPLAN-Meier estimator ,DATA analysis software ,ODDS ratio ,COMORBIDITY ,LONGITUDINAL method ,PROPORTIONAL hazards models ,DISEASE complications ,EVALUATION - Abstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases are often comorbid conditions, their co-occurrence yields worse outcomes than either condition alone. This study aimed to investigate COPD impacts on the five-year prognosis of patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). METHODS: Patients with CHD who underwent PCI in 2013 were recruited, and divided into COPD group and non-COPD group. Adverse events occurring among those groups were recorded during the five-year follow-up period after PCI, including all-cause death and cardiogenic death, myocardial infarction, repeated revascularization, as well as stroke and bleeding events. Major adverse cardiac and cerebral events were a composite of all-cause death, myocardial infarction, repeated revascularization and stroke. RESULTS: A total of 9843 patients were consecutively enrolled, of which 229 patients (2.3%) had COPD. Compared to non-COPD patients, COPD patients were older, along with poorer estimated glomerular filtration rate and lower left ventricular ejection fraction. Five-year follow-up results showed that incidences of all-cause death and cardiogenic death, as well as major adverse cardiac and cerebral events, for the COPD group were significantly higher than for non-COPD group (10.5% vs. 3.9%, 7.4% vs. 2.3%, and 30.1% vs. 22.6%, respectively). COPD was found under multivariate Cox regression analysis, adjusted for confounding factors, to be an independent predictor of all-cause death [odds ratio (OR) = 1.76, 95% CI: 1.15-2.70, P = 0.009] and cardiogenic death (OR = 2.02, 95% CI: 1.21-3.39, P = 0.007). CONCLUSIONS: COPD is an independent predictive factor for clinical mortality, in which CHD patients with COPD are associated with worse prognosis than CHD patients with non-COPD. [ABSTRACT FROM AUTHOR]
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- 2022
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38. Cross‑sectional study of retroperitoneal hematoma after invasive intervention in a Chinese population: Prevalence, characteristics, management and outcomes
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Ke Fei Dou, Yi Da Tang, Jie Qian, Si‑Yong Teng, Yong‑Gang Sui, Yong Jian Wu, Yuan Wu, and Shu Bin Qiao
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0301 basic medicine ,retroperitoneal hematoma ,Cancer Research ,medicine.medical_specialty ,Blood transfusion ,Cross-sectional study ,medicine.medical_treatment ,Psychological intervention ,03 medical and health sciences ,0302 clinical medicine ,Immunology and Microbiology (miscellaneous) ,Intervention (counseling) ,Internal medicine ,invasive intervention ,Medicine ,clinical characteristics ,business.industry ,Incidence (epidemiology) ,percutaneous coronary intervention ,Percutaneous coronary intervention ,Articles ,General Medicine ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Inguinal ligament ,business ,Complication - Abstract
The present study aimed to explore the clinical characteristics and management of retroperitoneal hematoma (RPH) after invasive intervention during a 12-year period in China. A retrospective review of patients with RPH after various invasive interventions was conducted at the China National Center for Cardiovascular Diseases. A total of 42 patients with a mean age of 63.1±2.5 years were continuously recruited in the study between January 2007 and September 2018. The incidence, manifestations and management of RPH were analyzed. A total of 20 patients had punctures in the femoral arterial access under the inguinal ligament and 5 patients had punctures above the inguinal ligament. The majority of RPH occurred within 24 h after intervention, while some occurred after postoperative 24 h. Pain was the most common symptom in patients with RPH. All patients who underwent intervention presented a reduction in hemoglobin (HB) concentration. The overall incidence of nosocomial infection was 38.1% and mortality was 7.1%. The findings demonstrated that RPH is a rare complication after invasive intervention of cardiovascular diseases with non-specific clinical manifestations. The reduction of HB concentration was a vital manifestation for RPH. Most RPH cases could be treated by conservative treatment and blood transfusion. A puncture in the femoral arterial access under the inguinal ligament may result in RPH.
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- 2020
39. Transplantation efficacy of autologous bone marrow mesenchymal stem cells combined with atorvastatin for acute myocardial infarction (TEAM-AMI): rationale and design of a randomized, double-blind, placebo-controlled, multi-center, Phase II TEAM-AMI trial
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Bo Xu, Yuan Wu, Xi-Feng Jiang, Runlin Gao, Wen-Yang Jiang, Rui Shen, Shihua Zhao, Yuejin Yang, Wen-Xiu Leng, Yang Wang, Xiangfeng Lu, Yong-Jian Geng, Minjie Lu, Shu-Bin Qiao, Jun Zhang, Wei Li, Rui-Jie Tang, Jian-Wen Li, Hai-Yan Qian, Pei-Sen Huang, Jun Xu, Yu-Yan Xiong, Xiangdong Li, Gui-Hao Chen, Wei Fang, Chen Jin, Chen Xi, Jun-Yan Xu, Jie Qian, Chun-Cheng Ma, Weichun Wu, Yi Xu, Cun-Rong Huang, and Meng-Jin Hu
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Embryology ,medicine.medical_specialty ,Atorvastatin ,medicine.medical_treatment ,Biomedical Engineering ,Myocardial Infarction ,030204 cardiovascular system & hematology ,Placebo ,Transplantation, Autologous ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Internal medicine ,Clinical endpoint ,Medicine ,Humans ,Myocardial infarction ,030304 developmental biology ,Bone Marrow Transplantation ,0303 health sciences ,Ejection fraction ,business.industry ,Mesenchymal Stem Cells ,Stem-cell therapy ,medicine.disease ,Prognosis ,Combined Modality Therapy ,Clinical trial ,Transplantation ,Research Design ,Acute Disease ,Cardiology ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,medicine.drug ,Follow-Up Studies - Abstract
Aim: To determine the efficacy and safety of intracoronary infusion of autologous bone marrow mesenchymal stem cells (MSCINJ) in combination with intensive atorvastatin (ATV) treatment for patients with anterior ST-segment elevation myocardial infarction-elevation myocardial infarction. Patients & methods: The trial enrolls a total of 100 patients with anterior ST-elevation myocardial infarction. The subjects are randomly assigned (1:1:1:1) to receive routine ATV (20 mg/d) with placebo or MSCsINJ and intensive ATV (80 mg/d) with placebo or MSCsINJ. The primary end point is the absolute change of left ventricular ejection fraction within 12 months. The secondary end points include parameters in cardiac function, remodeling and regeneration, quality of life, biomarkers and clinical outcomes. Results & conclusion: The trial will implicate the essential of cardiac micro-environment improvement (‘fertilizing’) for cell-based therapy. Clinical Trial Registration: NCT03047772.
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- 2019
40. The relationship between β
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Xin, Duan, Rong, Liu, Xiao-Liang, Luo, Xiao-Jin, Gao, Feng-Huan, Hu, Chao, Guo, Juan, Wang, Xiao-Ying, Hu, Yu-Shi, Chun, Jian-Song, Yuan, Jin-Gang, Cui, Wei-Xian, Yang, and Shu-Bin, Qiao
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Male ,Adrenergic Agents ,Atrial Fibrillation ,Humans ,Female ,Heart Atria ,Cardiomyopathy, Hypertrophic ,Middle Aged ,Receptors, Adrenergic, beta-1 ,Cardiomyopathies ,Receptors, Muscarinic ,Autoantibodies - Abstract
What is the central question of this study? The concentrations of βIncreasing attention is being given to the role of immunological mechanisms in the development of heart failure. The purpose of this study was to investigate the concentration of serum β
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- 2019
41. Analysis of anomalous origin of coronary arteries by coronary angiography in Chinese patients with coronary artery disease
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Yong Jian Wu, Hong Bing Yan, Hang Lu, Ke Fei Dou, Bo Xu, Yue Jin Yang, Liang Xu, Yuan Tian, Shu Bin Qiao, Jue Chen, Run Lin Gao, Hong Qiu, Chao Wei Mu, Wei Xian Yang, Yi Da Tang, Ying Yuan, Jin Qing Yuan, and Hai-Bo Liu
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Male ,China ,medicine.medical_specialty ,Coronary Vessel Anomalies ,Comorbidity ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Left coronary artery ,Asian People ,Predictive Value of Tests ,medicine.artery ,Internal medicine ,Prevalence ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Clinical significance ,Cardiac imaging ,Aged ,Retrospective Studies ,Dextrocardia ,business.industry ,Incidence ,Middle Aged ,medicine.disease ,Coronary arteries ,medicine.anatomical_structure ,Right coronary artery ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
With the development of coronary angiography for the diagnosis of coronary artery disease, its clinical significance in detecting coronary artery anomalies and evaluating the seriousness is attracting more attention. In the study we aimed to assess the prevalence of anomalous origin of coronary arteries in a Chinese population who underwent coronary angiography for coronary artery disease, and explore any patterns in the common variants and typical anomalies, especially the potentially serious ones. Patients who underwent coronary angiography from January 2013 to December 2016 in Fuwai Hospital were included. Baseline characteristics and angiographic data were collected, the incidence of anomalous origin of coronary arteries was calculated, and the typical patterns were analyzed. Comparisons between the present results and those of existing reports were also conducted. A total of 110,158 patients were included in the study, among which 0.76% (835 cases) had anomalous origin of coronary arteries. Among the anomalies, the incidences of anomalous origin of the right coronary artery (RCA), the left coronary artery (LCA), both the RCA and LCA, single coronary artery (SCA) and dextrocardia were 76.76% (641 cases), 14.61% (122 cases), 1.80% (15 cases), 4.67% (39 cases) and 2.16% (18 cases), respectively. Moreover, 47.54% (397 cases) of the anomalies were shown to be potentially serious, and an RCA arising from the left sinus of Valsalva (LSV) was the most common subtype (39.28%, 328 cases). Although anomalous origin of coronary arteries is not quite common, more clinical attention should be paid to this condition due to the potential risk of serious sequelae.
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- 2018
42. Comparison of long-term clinical outcome after successful implantation of FIREBIRD and CYPHER sirolimus-eluting stents in daily clinical practice: analysis of a large single-center registry
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Bo, XU, Ke-fei, DOU, Yue-jin, YANG, Ji-lin, CHEN, Shu-bin, QIAO, Yang, WANG, Jian-jun, LI, Xue-wen, QIN, Min, YAO, Hai-bo, LIU, Yong-jian, WU, Jue, CHEN, Jin-qing, YUAN, Shi-jie, YOU, Wei, LI, and Run-lin, GAO
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- 2011
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43. Efficacy and safety of Firebird sirolimus-eluting stent in treatment of complex coronary lesions in Chinese patients: one-year clinical and eight-month angiographic outcomes from the FIREMAN registry
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Yan, LI, Cheng-xiang, LI, Hai-chang, WANG, Bo, XU, Wei-yi, FANG, Jun-bo, GE, Wei-min, WANG, Shu-bin, QIAO, Jack-P, CHEN, Wen-kuang, SHEN, Hong, JIANG, Hong-liang, CONG, Xiao-qun, PU, Yong-wen, QIN, Hui-gen, JIN, Yu, CAO, He, HUANG, and Investigators, FIREMAN
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- 2011
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44. Role of plasma C-reactive protein in predicting in-stent restenosis in patients with stable angina after coronary stenting
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Yan-lu, XU, Jian-jun, LI, Bo, XU, Cheng-gang, ZHU, Yue-jin, YANG, Ji-lin, CHEN, Shu-bin, QIAO, Jin-qing, YUAN, Xue-wen, QIN, Wei-hua, MA, Min, YAO, Hai-bo, LIU, Yong-jian, WU, Jue, CHEN, Shi-jie, YOU, Jun, DAI, Ran, XIA, and Run-lin, GAO
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- 2011
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45. 中国老年患者经桡动脉与股动脉介入治疗比较
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Chen Jin, null 金辰, null 徐奕, null 乔树宾, null 唐欣然, null 吴永健, null 颜红兵, null 窦克非, null 徐波, null 杨进刚, null 杨跃进, Yi Xu, Shu-bin Qiao, Xin-ran Tang, Yong-jian Wu, Hong-bing Yan, Ke-fei Dou, Bo Xu, Jin-gang Yang, and Yue-jin Yang
- Subjects
medicine.medical_specialty ,Acute coronary syndrome ,business.industry ,Incidence (epidemiology) ,medicine.medical_treatment ,Percutaneous coronary intervention ,General Medicine ,Odds ratio ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Statistical significance ,Conventional PCI ,Cardiology ,Retrospective analysis ,Medicine ,030212 general & internal medicine ,Myocardial infarction ,business - Abstract
Objective To compare hospital costs and clinical outcomes between transradial intervention (TRI) and transfemoral intervention (TFI) in elderly patients aged over 65 years. Methods We identified 1229 patients aged over 65 years who underwent percutaneous coronary intervention (PCI) in Fuwai Hospital, Beijing, China, between January 1 and December 31, 2010. Total hospital costs and in-hospital outcomes were compared between TRI and TFI. An inverse probability weighting (IPW) model was introduced to control potential biases. Results Patients who underwent TRI were younger, less often female, more likely to receive PCI for single-vessel lesions, and less likely to undergo the procedure for ostial lesions. TRI was associated with a cost saving of CNY7495 (95%CI: CNY4419-10 420). Such differences were mainly driven by lower PCI-related costs. TRI patients had shorter length of stay (1.9 days, 95%CI: 1.1-2.7 days), shorter post-procedural stay (0.7 days, 95%CI: 0.3-1.1 days), and fewer major adverse cardiac events (adjusted odds ratio = 0.47, 95%CI: 0.31-0.73). There was no statistical significance in the incidence of post-PCI bleeding between TRI and TFI (P>0.05). Such differences remained consistent in clinically relevant subgroups of acute myocardial infarction, acute coronary syndrome, and stable angina. Conclusion The use of TRI in patients aged over 65 years was associated with significantly reduced hospital costs and more favorable clinical outcomes.
- Published
- 2017
46. Risk or Beneficial Factors Associated with Unplanned Revascularization Risk Following Percutaneous Coronary Intervention: A Large Single-Center Data
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Ru, Liu, Zhan, Gao, Li Jian, Gao, Xue Yan, Zhao, Jue, Chen, Shu Bin, Qiao, Yue Jin, Yang, Run Lin, Gao, Bo, Xu, and Jin Qing, Yuan
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Adult ,Male ,China ,Percutaneous Coronary Intervention ,Treatment Outcome ,Risk Factors ,Myocardial Revascularization ,Humans ,Female ,Coronary Artery Disease ,Middle Aged ,Aged - Abstract
To analyze factors associated with unplanned revascularization (UR) risk in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI).A total of 10,640 cases with CAD who underwent PCI were analyzed. Multivariate COX regressions and competing risk regressions were applied.The patients who underwent UR following PCI in 30 days, 1, and 2 years accounted for 0.3%, 6.5%, and 8.7%, respectively. After multivariate adjustment, the number of target lesions [hazard ratio (Specific factors were positively or negatively associated with short- and medium-long-term UR following PCI.
- Published
- 2019
47. The effectiveness and safety of the RESTORE
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Yi-Da, Tang, Shu-Bin, Qiao, Xi, Su, Yun-Dai, Chen, Ze-Ning, Jin, Hui, Chen, Biao, Xu, Xiang-Qing, Kong, Wen-Yue, Pang, Yong, Liu, Zai-Xin, Yu, Xue, Li, Hui, Li, Yan-Yan, Zhao, Wei, Li, Jian, Tian, Chang-Dong, Guan, Bo, Xu, and Run-Lin, Gao
- Subjects
Study Protocol ,Drug eluting balloon ,Percutaneous coronary intervention ,Small vessel disease - Abstract
Objective Small coronary vessel disease (disease affecting coronary vessels with main branch diameters of ≤ 2.75 mm) is a common and intractable problem in percutaneous coronary intervention (PCI). This study was designed to test the theory that the effectiveness and safety of drug-eluting balloons for the treatment of de novo lesions in small coronary vessels are non-inferior to those of drug-eluting stents. Methods We designed a prospective, multicenter, randomized, controlled clinical trial aiming to assess the effectiveness and safety of the RESTORE® (Cardionovum, Bonn, Germany) drug-eluting balloon (DEB) versus the RESOLUTE® (Medtronic, USA) drug-eluting stent (DES) in the treatment of small coronary vessel disease. This trial started in August 2016. A total of 230 patients with a reference vessel diameter (RVD) ≥ 2.25 mm and ≤ 2.75 mm were randomly assigned to treatment with a DEB or a DES at a 1:1 ratio. The study was also designed to enroll 30 patients with an RVD ≥ 2.00 mm and ≤ 2.25 mm in the tiny vessel cohort. Results The key baseline data include demographic characteristics, relative medical history, baseline angiographic values and baseline procedural characteristics. The primary endpoint is in-segment diameter stenosis at nine months after the index procedure. Secondary endpoints include acute success, all-cause death, myocardial infarction, target vessel revascularization, target lesion revascularization and stent thrombosis. Conclusions The study will evaluate the clinical efficacy, angiographic outcomes, and safety of DEBs compared to DESs in the treatment of de novo coronary artery lesions in small vessels.
- Published
- 2018
48. Prognostic Value of NT-proBNP in Stable Coronary Artery Disease in Chinese Patients after Percutaneous Coronary Intervention in the Drug-eluting Stent Era
- Author
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Xue Yan, Zhao, Jian Xin, Li, Xiao Fang, Tang, Jing Jing, Xu, Ying, Song, Lin, Jiang, Jue, Chen, Lei, Song, Li Jian, Gao, Zhan, Gao, Shu Bin, Qiao, Yue Jin, Yang, Run Lin, Gao, Bo, Xu, and Jin Qing, Yuan
- Subjects
Male ,China ,Drug-Eluting Stents ,Coronary Artery Disease ,Kaplan-Meier Estimate ,Middle Aged ,Prognosis ,Peptide Fragments ,Percutaneous Coronary Intervention ,Asian People ,ROC Curve ,Natriuretic Peptide, Brain ,Humans ,Female ,Aged - Abstract
The predictive value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with stable coronary artery disease (SCAD) in the drug-eluting stent era is not yet clear. We aimed to evaluate the prognostic value of NT-proBNP in SCAD patients after percutaneous coronary intervention (PCI).We examined 4,293 consecutive SCAD patients who underwent PCI between January 2013 and December 2013 in Fuwai Hospital, China. The primary endpoint was all-cause death. NT-proBNP levels were measured before PCI using Elisa kits (Biomedica, Austria). The indication for PCI was based on the degree of coronary stenosis and evidence of ischemia.Among 3,187 SCAD patients with NT-proBNP data, after a 2-year follow-up, NT-proBNP levels were predictive for all-cause death in the SCAD population [area under the receiver operating characteristic curve, 0.768; 95% confidence interval (CI), 0.687-0.849; P0.001]. At the optimum cutoff point of 732 pg/mL, the sensitivity and specificity of death was 75.0% and 72.3%, respectively. In a multivariable Cox regression model, the death hazard ratio was 6.43 (95% CI, 2.99-13.82; P0.001) for patients with NT-proBNP levels ⪖ 732 pg/mL, compared with732 pg/mL.NT-proBNP is a strong predictor of 2-year death with SCAD after PCI in the drug-eluting stent era.
- Published
- 2018
49. Transradial Versus Transfemoral Approach for Percutaneous Coronary Intervention in Elderly Patients in China: A Retrospective Analysis
- Author
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Chen, Jin, Yi, Xu, Shu-Bin, Qiao, Xin-Ran, Tang, Yong-Jian, Wu, Hong-Bing, Yan, Ke-Fei, Dou, Bo, Xu, Jin-Gang, Yang, and Yue-Jin, Yang
- Subjects
Male ,China ,Percutaneous Coronary Intervention ,Sex Factors ,Age Factors ,Myocardial Infarction ,Humans ,Female ,Hospital Costs ,Aged ,Retrospective Studies - Abstract
Objective To compare hospital costs and clinical outcomes between transradial intervention (TRI) and transfemoral intervention (TFI) in elderly patients aged over 65 years. Methods We identified 1229 patients aged over 65 years who underwent percutaneous coronary intervention (PCI) in Fuwai Hospital, Beijing, China, between January 1 and December 31, 2010. Total hospital costs and in-hospital outcomes were compared between TRI and TFI. An inverse probability weighting (IPW) model was introduced to control potential biases. Results Patients who underwent TRI were younger, less often female, more likely to receive PCI for single-vessel lesions, and less likely to undergo the procedure for ostial lesions. TRI was associated with a cost saving of CNY7495 (95%CI: CNY4419-10 420). Such differences were mainly driven by lower PCI-related costs. TRI patients had shorter length of stay (1.9 days, 95%CI: 1.1-2.7 days), shorter post-procedural stay (0.7 days, 95%CI: 0.3-1.1 days), and fewer major adverse cardiac events (adjusted odds ratio = 0.47, 95%CI: 0.31-0.73). There was no statistical significance in the incidence of post-PCI bleeding between TRI and TFI (P0.05). Such differences remained consistent in clinically relevant subgroups of acute myocardial infarction, acute coronary syndrome, and stable angina. Conclusion The use of TRI in patients aged over 65 years was associated with significantly reduced hospital costs and more favorable clinical outcomes.
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- 2017
50. Evaluation of left ventricular myocardial perfusion and function using gated SPECT in patients with hypertrophic obstruction cardiomyopathy following percutaneous transluminal septal myocardial ablation
- Author
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Ling Zhang, Zuo-Xiang He, Yue-Qin Tian, Rong Liu, Shu-Bin Qiao, and Xiao-Xin Sun
- Subjects
Ablation Techniques ,Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Gated SPECT ,Cardiomyopathy ,Ventricular Dysfunction, Left ,Young Adult ,Myocardial perfusion imaging ,Internal medicine ,Spect imaging ,Heart Septum ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Interventricular septum ,Aged ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Myocardial Perfusion Imaging ,General Medicine ,Cardiomyopathy, Hypertrophic ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Cardiology ,Female ,Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography ,business ,Perfusion ,Emission computed tomography - Abstract
OBJECTIVE This study was designed to evaluate the left ventricular myocardial perfusion and function in hypertrophic obstruction cardiomyopathy patients following percutaneous transluminal septal myocardial ablation (PTSMA) using rest single-photon emission computed tomography (SPECT) myocardial perfusion imaging. PATIENTS AND METHODS Thirty-five patients (24 men and 11 women, 48±11 years old) with hypertrophic obstruction cardiomyopathy underwent rest-gated Tc-MIBI SPECT imaging 4±10 days before (baseline) and 4.7±1.0 days (short-term) and 15.5±8.2 months (mid-term) after PTSMA. Semiquantitative and QGS quantitative evaluations of perfusion and function were carried out in 17 left ventricular segments. RESULTS Myocardial perfusion of the septum following PTSMA was significantly reduced compared with baseline in all patients (P
- Published
- 2014
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