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Coronary Artery Disease: HELP
Articles by Yue-Jie Zhou
Based on 14 articles published since 2008
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Between 2008 and 2019, Yue Zhou wrote the following 14 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Review Prevalence and Prognosis of Nonobstructive Coronary Artery Disease in Patients Undergoing Coronary Angiography or Coronary Computed Tomography Angiography: A Meta-Analysis. 2017

Wang, Zhi Jian / Zhang, Lin Lin / Elmariah, Sammy / Han, Hong Ya / Zhou, Yu Jie. ·Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-Related Cardiovascular Disease, Ministry of Education, Beijing, China. · Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston. · Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-Related Cardiovascular Disease, Ministry of Education, Beijing, China. Electronic address: azzyj12@163.com. ·Mayo Clin Proc · Pubmed #28259226.

ABSTRACT: OBJECTIVE: To evaluate the prevalence, clinical characteristics, and risk of cardiac events in patients with nonobstructive coronary artery disease (CAD). PATIENTS AND METHODS: We searched PubMed, EMBASE, and the Cochrane Library from January 1, 1990, to November 31, 2015. Studies were included if they reported prevalence or prognosis of patients with nonobstructive CAD (≤50% stenosis) among patients with known or suspected CAD. Patients with nonobstructive CAD were further grouped as those with no angiographic CAD (0% or ≤20%) and those with mild CAD (>0% or >20% to ≤50%). Data were pooled using random effects modeling, and annualized event rates were assessed. RESULTS: Fifty-four studies with 1,395,190 participants were included. The prevalence of patients with nonobstructive CAD was 67% (95% CI, 63%-71%) among patients with stable angina and 13% (95% CI, 11%-16%) among patients with non-ST-segment elevation acute coronary syndrome. The prevalence varied depending on sex, clinical setting, and risk profile of the population investigated. The risk of hard cardiac events (cardiac death or myocardial infarction) in patients with mild CAD was lower than that in patients with obstructive CAD (risk ratio, 0.28; 95% CI, 0.20-0.38) but higher than that in those with no angiographic CAD (risk ratio, 1.85; 95% CI, 1.52-2.26). The annualized event rates of hard cardiac events in patients with no angiographic CAD, mild CAD, and obstructive CAD were 0.3% (95% CI, 0.1%-0.4%), 0.7% (95% CI, 0.5%-1.0%), and 2.7% (95% CI, 1.7%-3.7%), respectively, among patients with stable angina and 1.2% (95% CI, 0.02%-2.3%), 4.1% (95% CI, 3.3%-4.9%), and 17.0% (95% CI, 8.4%-25.7%) among patients with non-ST-segment elevation acute coronary syndrome. The correlation between CAD severity and prognosis is consistent regardless of clinical presentation of all-cause death, myocardial infarction, total cardiovascular events, and revascularization. CONCLUSION: Nonobstructive CAD is associated with a favorable prognosis compared with obstructive CAD, but it is not benign. The high prevalence and impaired prognosis of this population warrants further efforts to improve the risk stratification and management of patients with nonobstructive CAD.

2 Review Meta-Analysis of Radial Versus Femoral Artery Approach for Coronary Procedures in Patients With Previous Coronary Artery Bypass Grafting. 2016

Rigattieri, Stefano / Sciahbasi, Alessandro / Brilakis, Emmanouil S / Burzotta, Francesco / Rathore, Sudhir / Pugliese, Francesco R / Fedele, Silvio / Ziakas, Antonios G / Zhou, Yu J / Guzman, Luis A / Anderson, Richard A. ·Emergency Department, Sandro Pertini Hospital, Rome, Italy. Electronic address: stefanorigattieri@yahoo.it. · Emergency Department, Sandro Pertini Hospital, Rome, Italy. · VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, Texas. · Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy. · Department of Cardiology, Frimley Park Hospital NHS Foundation Trust, London, United Kingdom. · Department of Cardiology, AHEPA Hospital, Thessaloniki, Greece. · Department of Cardiology, An Zhen Hospital, Capital Medical University, Beijing, China. · University of Florida College of Medicine, Jacksonville, Florida. · University Hospital of Wales, Cardiff, United Kingdom. ·Am J Cardiol · Pubmed #26892452.

ABSTRACT: Cardiac catheterization through the radial artery approach (RA) has been shown to significantly reduce access-site complications compared with the femoral artery approach (FA) in many clinical settings. However, in the subset of patients with previous coronary artery bypass grafting (CABG), optimal vascular access site for coronary angiography and intervention is still a matter of debate. We aimed to perform a systematic review and meta-analysis of available studies comparing RA with FA in patients with previous CABG. Data were extracted by two independent reviewers; weighted mean differences and 95% confidence interval (CI) were calculated for continuous outcomes, whereas odds ratio (OR) and 95% CI were calculated for dichotomous outcomes. Summary statistics were calculated by random-effects model using Review Manager 5.3 software. The meta-analysis included 1 randomized and 8 nonrandomized studies, with a total of 2,763 patients. Compared with FA, RA required similar procedural time (mean difference 3.24 minutes, 95% CI -1.76 to 8.25, p = 0.20), fluoroscopy time (mean difference 0.62 minutes, 95% CI -0.83 to 2.07, p = 0.40), and contrast volume (mean difference -2.58 ml, 95% CI -18.36 to 13.20, p = 0.75) and was associated with similar rate of procedural failure (OR 1.32, 95% CI 0.63 to 2.80, p = 0.46), higher rate of crossover to another vascular access (OR 7.0, 95% CI 2.74 to 17.87, p <0.0001), and lower risk of access-site complications (OR 0.46, 95%CI 0.26 to 0.80, p = 0.006). In conclusion, the present meta-analysis suggests that in patients with previous CABG undergoing coronary procedures, RA, compared with FA, is associated with increased crossover rate but may reduce access-site complications.

3 Review Association of body mass index with mortality and cardiovascular events for patients with coronary artery disease: a systematic review and meta-analysis. 2015

Wang, Zhi Jian / Zhou, Yu Jie / Galper, Benjamin Z / Gao, Fei / Yeh, Robert W / Mauri, Laura. ·Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China Brigham and Women's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA. · Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. · Brigham and Women's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA. · Harvard Medical School, Boston, Massachusetts, USA Massachusetts General Hospital, Boston, Massachusetts, USA Harvard Clinical Research Institute, Boston, Massachusetts, USA. · Brigham and Women's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA Harvard Clinical Research Institute, Boston, Massachusetts, USA. ·Heart · Pubmed #26025084.

ABSTRACT: OBJECTIVES: The association between obesity and prognosis in patients with coronary artery disease (CAD) remains uncertain. We undertook a meta-analysis for the effects of body mass index (BMI) on mortality and cardiovascular events in these patients. METHODS: We identified studies that provided risk estimates for mortality or cardiovascular events on the basis of BMI in patients with CAD. Summary estimates of relative risks were obtained for five BMI groups: underweight, normal-weight, overweight, obese and grade II/III obese. Mortality was analysed separately as short-term (<6 months) and long-term (≥6 months). RESULTS: Data from 89 studies with 1 300 794 patients were included. Mean follow-up of long-term estimates was 3.2 years. Using normal-weight as the reference, underweight was associated with higher risk of short-term mortality (2.24 (1.85 to 2.72)) and long-term mortality (1.70 (1.56 to 1.86)), overweight and obesity were both associated with lower risk of short-term mortality (0.69 (0.64 to 0.75); 0.68 (0.61 to 0.75)) and long-term mortality (0.78 (0.74 to 0.82); 0.79 (0.73 to 0.85)), but the long-term benefit of obesity disappeared after 5 years of follow-up (0.99 (0.91 to 1.08)). Grade II/III obesity was associated with lower risk of mortality in the short term (0.76 (0.62 to 0.91)) but higher risk after 5 years of follow-up (1.25 (1.14 to 1.38)). The similar J-shaped pattern was also seen for cardiovascular mortality and across different treatment strategies. Meta-regression found an attenuation of the inverse association between BMI and risk of mortality over longer follow-up. CONCLUSIONS: Our data support a J-shaped relationship between mortality and BMI in patients with CAD. The limitation of current literature warrants better design of future studies.

4 Review Meta-analysis of percutaneous coronary intervention versus coronary artery bypass graft surgery in patients with diabetes and left main and/or multivessel coronary artery disease. 2013

Gao, Fei / Zhou, Yu Jie / Shen, Hua / Wang, Zhi Jian / Yang, Shi Wei / Liu, Xiao Li. ·Department of Cardiology, An Zhen Hospital, Capital Medical University, Anzhenli Avenue, Chao Yang District, Beijing, 100029, China. ·Acta Diabetol · Pubmed #22907763.

ABSTRACT: The optimal coronary revascularization strategy for patients with diabetes and left main and/or multivessel disease is undetermined. The aim of our study was to evaluate percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in those patients. We identified 13 articles, published before October 2011, enrolling 6992 patients, whose follow-up period ranged from 1 to 5 years. Patients with PCI had a significant reduction in cerebral vascular attack (CVA) (OR, 0.29; 95 % CI, 0.16-0.51; p < 0.0001, I (2) = 0 %) as compared with CABG, whereas there was a fourfold increased risk of repeat revascularization associated with PCI even using drug-eluting stent (OR, 4.44; 95 % CI, 3.42-5.78; Χ(2) = 4.92, p < 0.00001, I (2) = 0 %). The overall mortality (OR, 0.97; 95 % CI, 0.81-1.15; p = 0.70, I (2) = 0 %) was comparable between the PCI and CABG. However, in subgroup analysis, the composite outcome (death/myocardial infarction/CVA) was significantly reduced in favor of DES implantation (OR, 0.79; 95 % CI, 0.63-0.99; Χ(2) = 1.07, p = 0.04, I (2) = 0 %). Our study confirmed the cerebral vascular benefits of PCI by significantly reducing CVA risks, and the composite outcome was better in patients undergoing PCI with drug-eluting stent, despite a higher repeat revascularization rate. It poses imperative demands for future prospective randomized studies to define the optimal strategy in patients with diabetes and left main and/or multivessel disease.

5 Article Combined surgical treatment of esophageal cancer and coronary heart diseases in elderly patients. 2018

Zhang, Weiran / Liu, Ban / Zhou, Yue / Wang, Feng / Gu, Chang / Wang, Qi / Wang, Xiaofang / Zhang, Yangyang. ·Department of Cardiothoracic Surgery, BenQ Hospital, Affiliated Hospital of Nanjing Medical University, Nanjing, China. · Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China. · Department of Cardiothoracic Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, China. · Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China. · Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China. · The Clinical Medical Department of Nanjing Medical University, Nanjing, China. · Department of Cardiovascular Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China. · Department of Cardiovascular Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China. zhangyangyang_wy@vip.sina.com. ·World J Surg Oncol · Pubmed #30355357.

ABSTRACT: OBJECTIVE: The co-incidence of esophageal cancer and coronary heart disease (CHD) is increasing in elderly patients. This study was carried out to analyze the efficiency and safety of simultaneous esophagectomy and cardiac surgery in a selected group of elderly patients. METHODS: Prospective database for coexistency of severe CHD and esophageal or esophageal-gastric junction cancer was firstly reviewed. Twenty-two patients undergoing combined surgical interventions, including first beating-heart coronary artery bypass grafting (off-pump CABG) and then esophagectomy, were involved as group A. Then, 44 patients undergoing isolated esophagectomy were selected as group B using the propensity score matching method. Data including clinic pathological characteristics and postoperative outcomes were investigated. Kaplan-Meier analysis was used. RESULTS: The surgical procedure was performed through left lateral thoracotomy in all patients, except one patient in group A who received median sternotomy and left lateral thoracotomy. The operation time and blood loss were both more in group A, as a result of two operations performed at one session. Patients in both groups were followed up from 1.3 to 78.3 months. No significant between-group was found in overall survival or relapse-free survival. CONCLUSION: The risk of simultaneous esophagectomy and cardiac surgery is not high. Despite certain differences in clinical indicators between groups, the safety of simultaneous procedures in group A is evident. TRIAL REGISTRATION: ChiCTR 1800014498 . Registered 17 January 2018.

6 Article Circulating microRNAs correlated with the level of coronary artery calcification in symptomatic patients. 2015

Liu, Wei / Ling, Shukuan / Sun, Weijia / Liu, Tong / Li, Yuheng / Zhong, Guohui / Zhao, Dingsheng / Zhang, Pengfei / Song, Jinping / Jin, Xiaoyan / Xu, Zi / Song, Hailin / Li, Qi / Liu, Shujuan / Chai, Meng / Dai, Qinyi / He, Yi / Fan, Zhanming / Zhou, Yu Jie / Li, Yingxian. ·Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China. · State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, Beijing, China. · Department of Radiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China. ·Sci Rep · Pubmed #26537670.

ABSTRACT: The purpose of this study was to find the circulating microRNAs (miRNAs) co-related with the severity of coronary artery calcification (CAC), and testify whether the selected miRNAs could reflect the obstructive coronary artery disease in symptomatic patients. Patients with chest pain and moderated risk for coronary artery disease (CAD) were characterized with coronary artery calcium score (CACS) from cardiac computed tomography (CT). We analyzed plasma miRNA levels of clinical matched 11 CAC (CACS > 100) and 6 non-CAC (CACS = 0) subjects by microarray profile. Microarray analysis identified 34 differentially expressed miRNAs between CAC and non CAC groups. Eight miRNAs (miR-223, miR-3135b, miR-133a-3p, miR-2861, miR-134, miR-191-3p, miR-3679-5p, miR-1229 in CAC patients) were significantly increased in CAC plasma in an independent clinical matched cohort. Four miRNAs (miR-2861, 134, 1229 and 3135b) were correlated with the degree of CAC. Validation test in angiographic cohort showed that miR-134, miR-3135b and miR-2861 were significantly changed in patients with obstructive CAD . We identified three significantly upregulated circulating miRNAs (miR-134, miR-3135b and 2861) correlated with CAC while detected obstructive coronary disease in symptomatic patients.

7 Article Rationale and design of the RT-AF study: Combination of rivaroxaban and ticagrelor in patients with atrial fibrillation and coronary artery disease undergoing percutaneous coronary intervention. 2015

Gao, Fei / Shen, Hua / Wang, Zhi Jian / Yang, Shi Wei / Liu, Xiao Li / Zhou, Yu Jie. ·Department of Cardiology, An Zhen Hospital, Capital Medical University, Beijing, China. · Department of Cardiology, An Zhen Hospital, Capital Medical University, Beijing, China. Electronic address: azzyj12@163.com. ·Contemp Clin Trials · Pubmed #26003433.

ABSTRACT: OBJECTIVE: Optimal antithrombotic strategy for patients with concomitant coronary artery disease and atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) is still controversial, and the role of novel antithrombotic agents has nerve been tested. Therefore, the aim of this study is to evaluate and overall safety and efficacy profile of the combination of rivaroxaban and ticagrelor in this particular population. DESIGN: The RT-AF study is an open-label, randomized, active-controlled, multicenter clinical trial with up to 420 subjects enrolled in 5 centers. Eligible patients, who have a history or new onset paroxysmal, persistent, or permanent non-valvular AF, referred to the study centers with indications for PCI will be randomly assigned to receive triple therapy (including warfarin, clopidogrel and aspirin) or dual therapy (rivaroxaban and ticagrelor). All subjects will have clinical follow-up at discharge, at 30 days, 6 months and 12 months. The primary end point is major or clinically relevant non-major bleeding events at 12 months. The major secondary end point is the composite efficacy outcome of death, myocardial infarction, stent thrombosis and ischemic stroke. CONCLUSION: The study will be sufficiently powered to provide data primarily regarding the safety of dual therapy with rivaroxaban and ticagrelor over the traditional triple therapy in patients with AF undergoing PCI at 12 months. It will also provide important information regarding the efficacy of the two different antithrombotic regimens. (ClinicalTrials.gov identifier: NCT02334254).

8 Article The effect of intravenous vitamin C infusion on periprocedural myocardial injury for patients undergoing elective percutaneous coronary intervention. 2014

Wang, Zhi Jian / Hu, Wen Kun / Liu, Yu Yang / Shi, Dong Mei / Cheng, Wan Jun / Guo, Yong He / Yang, Qing / Zhao, Ying Xin / Zhou, Yu Jie. ·Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. · Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. Electronic address: zyingxinmi@163.com. ·Can J Cardiol · Pubmed #24365194.

ABSTRACT: BACKGROUND: This small study has determined the effect of vitamin C on myocardial reperfusion in patients undergoing elective percutaneous coronary intervention (PCI). This study was to explore whether antioxidant vitamin C infusion before the procedure is able to affect the incidence of periprocedural myocardial injury (PMI) in patients undergoing PCI. METHODS: In this prospective single-centre randomized study, 532 patients were randomized into 2 groups: the vitamin C group, which received a 3-g vitamin C infusion within 6 hours before PCI, and a control group, which received normal saline. The primary end point was the troponin I-defined PMI, and the second end point was the creatine kinase (CK)-MB-defined PMI. Separate analyses using both end points were performed. PMI was defined as an elevation of cardiac biomarker values (CK-MB or troponin I) > 5 times the upper limit of normal (ULN), alone or associated with chest pain or ST-segment or T-wave changes. RESULTS: After PCI, the incidence of PMI was reduced, whether defined by troponin or by CK-MB, compared with the control group (troponin I, 10.9% vs 18.4%; P = 0.016; CK-MB, 4.2% vs 8.6%; P = 0.035). Logistic multivariate analysis showed that preprocedure use of vitamin C is an independent predictor of PMI either defined by troponin I (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.33-0.97; P = 0.037) or by CK-MB (OR, 0.37; 95% CI, 0.14-0.99; P = 0.048). CONCLUSIONS: In patients undergoing elective PCI, preprocedure intravenous treatment with vitamin C is associated with less myocardial injury.

9 Article Remote ischemic preconditioning reduces myocardial injury in patients undergoing coronary stent implantation. 2013

Luo, Sheng Jie / Zhou, Yu Jie / Shi, Dong Mei / Ge, Hai Long / Wang, Jian Long / Liu, Rui Fang. ·Department of Cardiology, An Zhen Hospital, Capital Medical University, Beijing, China. ·Can J Cardiol · Pubmed #23414904.

ABSTRACT: BACKGROUND: Myocardial necrosis occurs frequently in elective percutaneous coronary intervention (PCI) and is associated with subsequent major adverse cardiovascular events (MACEs). This study assessed the protective effect of remote ischemic preconditioning (RIPC) in patients undergoing successful drug-eluting stent implantation with normal baseline troponin values. METHODS: We analyzed 205 participants with normal baseline troponin values undergoing successful coronary stent implantation. Subjects were randomized to 2 groups: The RIPC group (n = 101), whose members received RIPC (created by three 5-minute inflations of a pneumatic medical tourniquet cuff to 200 mm Hg around the upper arm, interspersed with 5-minute intervals of reperfusion) < 2 hours before the PCI procedure, and the control group (n = 104). RESULTS: The primary outcomes were high sensitive cardiac troponin I (hscTnI) levels and incidence of myocardial infarction (MI 4a, defined as hscTnI > 0.20 ng/mL) at 16 hours after the PCI procedure. The median hscTnI at 16 hours after PCI was lower in the RIPC group compared with the unpreconditioned, control group (0.11 vs 0.21 ng/mL; P < 0.01). The incidence of MI 4a was lower in the RIPC group compared with the control group (39% vs 54%, P < 0.05). Index of renal function showed no difference between the 2 groups at 16 hours after PCI (P > 0.05). CONCLUSION: RIPC reduced post-PCI TnI release and incidence of MI 4a in patients undergoing elective coronary stent implantation.

10 Article Sex difference in the effect of obesity on prognosis for patients undergoing percutaneous coronary intervention. 2012

Wang, Zhi Jian / Zhao, Ying Xin / Liu, Yu Yang / Shi, Dong Mei / Gao, Fei / Liu, Xiao Li / Yu, Miao / Zhou, Yu Jie. ·Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. ·Coron Artery Dis · Pubmed #22828723.

ABSTRACT: OBJECTIVES: To examine whether obesity has a similar effect on long-term prognosis between men and women undergoing a percutaneous coronary intervention (PCI). METHODS: We separately examined 3926 men and 2157 women undergoing PCI with drug-eluting stents between January 2004 and December 2006. All the patients were categorized according to BMI: normal weight (<25 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (≥30 kg/m(2)). The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of cardiac death and nonfatal myocardial infarction. The median follow-up was 26 months. RESULTS: The MACE rate was significantly higher in obese than in normal-weight and overweight patients among men (6.8 vs. 3.5 vs. 4.2%; P=0.001) but not among women (5.1 vs. 4.4 vs. 4.1%; P=0.684). Further categorization of BMI showed a linear association between the risk of MACE and BMI in men, with a graded increase in obesity grade I (30-34.9 kg/m(2)) and grade II/III (≥35 kg/m(2)) groups compared with normal-weight individuals [hazard ratio (HR) 1.94; 95% confidence interval (CI) 1.22-3.06; P=0.005 for obesity grade I and HR 2.62; 95% CI 1.50-4.56; P=0.001 for obesity grade II/III]. In women, the risk of MACE showed no difference in obesity grade I group, whereas there was a significant increase in the obesity grade II/III group compared with normal-weight patients (HR 2.15; 95% CI 1.10-4.18; P=0.025). CONCLUSION: In patients undergoing PCI, BMI is associated with a risk of MACE in both men and women. However, BMI exerts relatively less effect on women than on men.

11 Article Effect of obesity on repeat revascularization in patients undergoing percutaneous coronary intervention with drug-eluting stents. 2012

Wang, Zhi Jian / Zhou, Yu Jie / Zhao, Ying Xin / Liu, Yu Yang / Shi, Dong Mei / Liu, Xiao Li / Yu, Miao / Gao, Fei. ·Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. ·Obesity (Silver Spring) · Pubmed #21720423.

ABSTRACT: Obesity is a major risk factor for developing coronary artery disease. The impact of obesity on prognosis among those with established coronary disease is less clear. The objective of this study was to evaluate the effect of obesity on repeat revascularization in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). We examined 6,083 patients who were divided into three groups according to BMI: normal (BMI 18.5-24.9 kg/m(2), n = 1,592); overweight (BMI 25-29.9 kg/m(2), n = 3,026) and obese (BMI >30 kg/m(2), n = 1,465). The follow-up focused on clinical-driven repeat revascularization, including target lesion revascularization (TLR) and nonTLR. Median follow-up was 26 months (interquartile range 20-32). There was no significant difference in the incidence of TLR among normal, overweight, and obese patients (6.3% vs. 6.1% vs. 7.1%; P = 0.423). In contrast, the incidence of nonTLR was significantly higher in obese patients compared with normal and overweight (8.4% vs. 6.0% vs. 5.8%, P = 0.003). Multivariate analysis showed that obesity was an independent predictor of nonTLR during follow-up (hazard ratio = 1.39; 95% confidence interval = 1.06-1.83; P = 0.019), along with diabetes and hypercholesterolemia. Concomitant use of statins was independently associated with decreased risk of nonTLR (hazard ratio = 0.75; 95% confidence interval = 0.62-0.92; P = 0.005). In conclusion, among patients undergoing PCI with DES, obesity was not associated with TLR, but was associated with a higher risk of nonTLR.

12 Article [Metabolic syndrome may be better at predicting the prognosis of coronary artery disease than other traditional cardiovascular risk factors]. 2010

Hu, Rong / Ma, Chang-Sheng / Nie, Shao-Ping / Lü, Qiang / Kang, Jun-Ping / Du, Xin / Liu, Xiao-Hui / Chen, Fang / Zhou, Yue-Jie / Lü, Shu-Zheng. ·Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, 100029, China. ·Zhonghua Yi Xue Za Zhi · Pubmed #20973234.

ABSTRACT: OBJECTIVE: The prevalence of cardiovascular risk factors is growing. People with metabolic syndrome (MS) plus five cardiovascular risk factors are at a higher risk of developing coronary artery disease (CAD). The effect of metabolic syndrome on outcomes in patients with preexisting CAD has not been well studied. The present study was conducted to assess the prevalence, characteristics and long-term prognosis of CAD with metabolic syndrome and to determine which factor is the most influential prognostic factor of CAD. METHODS: The DESIRE (drug-eluting stent impact on revascularization) registry represented a database of 2368 CAD patients between July 2003 and September 2004. The median long-term follow-up was 3.5 years (293 -1855 days). Metabolic syndrome was based on the modified version of Adult Treatment Panel (ATP) III Definition of Metabolic Syndrome in 2005 using body mass index (BMI) instead of waist circumference. We tested the utility of MS and its components to predict the incidence of major adverse cardiac and cerebral events (MACCE) in a large cohort of patients undergoing revascularization. RESULTS: The presence of MACCE was predicted only by MS (OR = 1.319, 95% CI 1.020 - 1.706, P = 0.035) but not other cardiovascular risk factors, such as advance age, male, smoking, high LDL cholesterol and CAD family history. MS was present in 45.6% (high fasting glucose 44.5%; high triglyceride 45.0%; low HDL 50.8%; high blood pressure 61.4%; high BMI 60.7%). CONCLUSION: Among the traditional cardiovascular risk factors, only metabolic syndrome has a primary predictive ability for MACCE in CAD patients.

13 Article Comparison of different antithrombotic regimens for patients with atrial fibrillation undergoing drug-eluting stent implantation. 2010

Gao, Fei / Zhou, Yu Jie / Wang, Zhi Jian / Shen, Hua / Liu, Xiao Li / Nie, Bin / Yan, Zhen Xian / Yang, Shi Wei / Jia, De An / Yu, Miao. ·Department of Cardiology, An Zhen Hospital, Capital Medical University, Beijing, China. ·Circ J · Pubmed #20208381.

ABSTRACT: BACKGROUND: The optimal antithrombotic strategy for patients with atrial fibrillation (AF) undergoing drug-eluting stent (DES) implantation is unknown. METHODS AND RESULTS: The 622 consecutive AF patients undergoing DES implantation were prospectively enrolled. Among them, 142 patients (TT group) continued triple antithrombotic therapy comprising aspirin, clopidogrel and warfarin after discharge; 355 patients (DT group) had dual antiplatelet therapy; 125 patients (WS group) were discharged with warfarin and a single antiplatelet agent. Target INR was set as 1.8-2.5 and was regularly monitored after discharge. The TT group had a significant reduction in stroke and major adverse cardiac and cerebral events (MACCE) (8.8% vs 20.1% vs 14.9%, P=0.010) as compared with either the DT or WS group. In the Cox regression analysis, administration with warfarin (hazard ratio (HR) 0.49; 95% confidence interval (CI) 0.31-0.77; P=0.002) and baseline CHADS(2) score >or=2 (HR 2.09; 95%CI 1.27-3.45; P=0.004) were independent predictors of MACCE. Importantly, the incidence of major bleeding was comparable among 3 groups (2.9% vs 1.8% vs 2.5%, P=0.725), although the overall bleeding rate was increased in the TT group. Kaplan-Meier analysis indicated that the TT group was associated with the best net clinical outcome. CONCLUSIONS: The cardiovascular benefits of triple antithrombotic therapy were confirmed by reducing the MACCE rate, and its major bleeding risk might be acceptable if the INR is closely monitored.

14 Article Comparison of drug-eluting stents and coronary artery bypass grafting for the treatment of multivessel coronary artery disease in patients with chronic kidney disease. 2009

Wang, Zhi Jian / Zhou, Yu Jie / Liu, Yu Yang / Shi, Dong Mei / Zhao, Ying Xin / Guo, Yong He / Cheng, Wan Jun / Yu, Miao. ·Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. ·Circ J · Pubmed #19443956.

ABSTRACT: BACKGROUND: Chronic kidney disease (CKD) is a strong predictor of mortality after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), but the relative efficacy of the 2 revascularization strategies in this context remains unknown. METHODS AND RESULTS: The 1,069 patients with CKD undergoing revascularization for multivessel coronary disease were evaluated. Of them, 532 patients were treated for 2-vessel disease (97 CABG, 435 PCI) and 537 for 3-vessel disease (248 CABG, 289 PCI). CKD was defined as estimated glomerular filtration rate <60 ml/min. No differences between the PCI and CABG groups in the 2-vessel population were observed in the composite of death, myocardial infarction (MI) or cerebrovascular events (10.6% vs 8.2%, P=0.493) and repeat revascularization (6.7% vs 3.1%, P=0.181) during the 2-year follow-up. In the 3-vessel population, patients undergoing PCI showed similar rate for the composite endpoint (6.7% vs 3.1%, P=0.181), but had a higher incidence of repeat revascularization (12.5% vs 4.4%, P=0.001) compared with the CABG group. After multivariate adjustment, revascularization strategy was not an independent predictor of the composite endpoint. CONCLUSIONS: Compared with PCI with a drug-eluting stent, CABG showed a similar incidence of death, MI or cerebrovascular events in patients with multivessel disease and CKD, but was associated with decreased repeat revascularization in the 3-vessel population.