著者

Xue Feng Yishuo Xu Ming Zeng Yuhan Qin Ziqian Weng Yanli Sun Zhanqun Gao Luping He Chen Zhao Ning Wang Dirui Zhang Chao Wang Yini Wang Lulu Li Chao Fang Jiannan Dai Haibo Jia Bo Yu

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0200, (Released:2023-07-04)

参考文献数

32

被引用文献数

2

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Background: Microvascular reperfusion following percutaneous coronary intervention (PCI) is associated with the prognosis of patients with ST-segment elevation myocardial infarction (STEMI). We investigated how plaque characteristics detected by optical coherence tomography (OCT) in STEMI patients affect the status of the microcirculation during PCI.Methods and Results: This retrospective, single-center study was a post hoc analysis basedon the multicenter SALVAGE randomized control trial (NCT03581513) that enrolled 629 STEMI patients, and finally we enrolled 235 patients who underwent PCI and pre-intervention OCT. Microvascular perfusion was evaluated using the Thrombolysis in Myocardial Infarction (TIMI) myocardial perfusion frame count (TMPFC). Patients were divided into 3 groups based on the change in TMPFC from before to after PCI: improving TMPFC (n=11; 4.7%), stable TMPFC (n=182; 77.4%), and worsening TMPFC group (n=42; 17.9%). The proportion of patients with a microcirculation dysfunction before reperfusion was 11.9%, which increased significantly by (P=0.079) 8.5% to 20.4% after reperfusion. Compared with plaque characteristics in the stable and worsening TMPFC groups, the improving TMPFC group had fewer thrombi (90.7% and 90.5% vs. 89.4%, respectively; P=0.018), a lower proportion of plaque rupture (66.5% and 66.3% vs. 54.5%, respectively; P=0.029), and a lower proportion of lipid-rich plaques (89.6% and 88.1% vs. 63.6%, respectively; P=0.036).Conclusions: PCI may not always achieve complete myocardial reperfusion. Thrombi, plaque rupture, and lipid-rich plaques detected by OCT can indicate microcirculation dysfunction during the reperfusion period.

著者

Chao Wang Heng Jiang Yi Zhu Yingying Guo Yong Gan Qingfeng Tian Yiling Lou Shiyi Cao Zuxun Lu

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.9, pp.415-422, 2022-09-05 (Released:2022-09-05)

参考文献数

52

被引用文献数

1 2

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Background: Increasing number of studies have suggested the time to first cigarette after waking (TTFC) have significant positive effect on respiratory diseases. However, few of them focused on the Chinese population. This study aims to estimate the impact of TTFC on the prevalence of chronic respiratory diseases (CRD) in Chinese elderly and explore the association in different sub-populations.Methods: Cross-sectional data of demographic characteristics, living environment, smoking-related variables, and CRD were drawn from the Chinese Longitudinal Healthy Longevity Survey in 2018. Multivariate stepwise logistic regression analyses were conducted to examine the association of the TTFC with the prevalence of CRD.Results: This study includes 13,208 subjects aged 52 years and older, with a mean age of 85.3 years. Of them, 3,779 participants were ex- or current smokers (44.9% had the TTFC ≤30 minutes, 55.1% >30 minutes) and 1,492 had suffered from CRD. Compared with non-smokers, participants with TTFC ≤30 minutes seemed to have higher prevalence of CRD (OR 1.97; 95% CI, 1.65–2.35) than those with TTFC >30 minutes (OR 1.70; 95% CI, 1.44–2.00), although the difference was statistically insignificant (Pinteraction = 0.12). Compared with TTFC >30 minutes, TTFC ≤30 minutes could drive a higher prevalence of CRD among female participants, those aged 90 years and older, urban residents, and ex-smokers (Pinteraction < 0.05).Conclusion: Shorter TTFC relates to higher prevalences of CRD in Chinese older females, those aged 90 years and older, urban residents, and ex-smokers. Delaying TTFC might partially reduce its detrimental impact on respiratory disease in these specific subpopulations.

著者

Yan Hao Yu-lin Yang Yong-chao Wang Jian Li

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.22-052, (Released:2022-07-14)

参考文献数

22

被引用文献数

13

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Proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors significantly reduce low-density lipoprotein cholesterol (LDL-C) and improve the prognosis of patients with acute coronary syndrome (ACS). However, the feasibility and safety of early application of PCSK9 inhibitors on the basis of statins combined with ezetimibe to strengthen lipid lowering in extremely high-risk coronary heart disease populations are still unknown.This study was a prospective, randomized controlled study. A total of 136 patients with extremely high-risk ACS with LDL-C ≥ 3.0 mmol/L after percutaneous coronary intervention (PCI) treatment were randomly assigned 1:1 to the control group (atorvastatin 40 mg/day and ezetimibe 10 mg/day) or the evolocumab group (evolocumab 140 mg every 2 weeks combined with atorvastatin 40 mg/day and ezetimibe 10 mg/day). We compared the blood lipid profiles, major adverse cardiovascular events (MACEs), and adverse reactions. MACEs included cardiogenic death, nonfatal myocardial infarction, nonfatal stroke, and readmission due to angina. Adverse reactions included allergies, myalgia, poor blood glucose control, and liver damage.Within 1 month, the average level of LDL-C in the evolocumab group decreased from 3.54 to 0.57 mmol/L and that in the control group decreased from 3.52 to 1.26 mmol/L. The LDL-C compliance (< 1.0 mmol/L) rate was significantly increased in the evolocumab group compared with the control group (82.35% versus 22.06%, P < 0.01). The average level of lipoprotein (a) (Lp (a)) in the control group increased by 9.94 ± 51.93% from baseline after treatment, but evolocumab reduced the Lp (a) level (−38.84 ± 32.40%). Additionally, evolocumab further reduced the levels of apolipoprotein B/A1 (−70.56 ± 22.38% versus −51.29 ± 18.14%), cholesterol (−54.76 ± 18.10% versus −41.16 ± 18.14%), and apolipoprotein B (−66.47 ± 26.89% versus −46.78 ± 24.12%) compared with those in the control group, all P < 0.01. The blood lipid levels of both control and evolocumab groups stabilized after 1 month. During the 3-month follow-up, the incidence of MACEs after PCI was lower in the evolocumab group than in the control group (8.82% versus 24.59%, P = 0.015), and evolocumab combined with statins and ezetimibe did not increase the occurrence of adverse reactions (13.24% versus 11.48%, P = 0.762).In patients with extremely high-risk ACS with high levels of LDL-C, adding evolocumab to their treatment regimen as early as possible may enhance lipid lowering, increase the patient's LDL-C compliance rate in the short term, and improve cardiovascular prognosis but will not increase adverse reactions.

著者

Chao WANG Liguang WU Haikun ZHAO Qingyuan LIU Ji WANG

出版者

Meteorological Society of Japan

雑誌

気象集誌. 第2輯 (ISSN:00261165)

巻号頁・発行日

vol.99, no.6, pp.1413-1422, 2021 (Released:2021-12-16)

参考文献数

46

被引用文献数

2

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Translation speed is an important factor determining locally accumulated disasters induced by tropical cyclones (TCs). We found that the basin wide TC translation speed over the western North Pacific (WNP) in the late season (October–December) experienced an abrupt decrease in the early 1980s. However, this slowdown cannot be explained by the previously proposed deceleration in large-scale steering. In this study, we demonstrated that this slowdown results from the decreased proportion of subtropical TC track frequency in the early 1980s. Because late-season large-scale steering flow in the subtropical WNP is much greater than that in the tropical WNP, TCs influencing the subtropical WNP generally hold greater translation speed than that of TCs staying in the tropical WNP. Thus, a decrease in the ratio of subtropical TC track frequency can lead to a notable decrease in the basin wide TC translation speed. The decreased ratio of subtropical TC track frequency results from the strengthened southwestward steering and the reduced ratio of TC genesis in the tropical eastern WNP, which is linked to a WNP anticyclonic circulation that appears to be driven by the Atlantic Multi-decadal Oscillation. The result introduces the crucial role of TC track shift in the basin wide TC translation speed and has important implications for understanding the effects of climate change on TC translation speed.