China cardiovascular diseases report 2018: an updated summary
Rapid socioeconomic progress has greatly affected the lifestyle in China. Consequently, owing to lifestyle changes,urbanization, and accelerated population aging, the risk of cardiovascular diseases (CVD) has increased. The incidence of CVD has been increasing continuously and this upward trend is projected to continue in the next decade. The growing burden of CVD has become a major public health issue. Accordingly, since 2005, the National Center for Cardiovascular Diseases of China has directed experts in cardiology, neurology, nephrology, diabetes, epidemiology, community healthcare, health economics, biostatistics, and other related fields to prepare the annual Report on Cardiovascular Diseases in China.
Heart failure in the elderly
Heart failure (HF) is a clinical syndrome caused by structural and/or functional cardiac abnormalities, resulting in a reduced cardiac output and/or elevated intracardiac filling pressures at rest or during stress. HF is a major public health problem with high prevalence and incidence, involving both high morbidity and mortality, but also high economic costs. The incidence of HF progressively increases with age, reaching around 20% among people over 75 years old. Indeed, HF represents the leading cause of hospitalization in patients older than 65 years in Western countries. Hence, some authors even consider HF a geriatric syndrome, entailing worse prognosis and high residual disability, and often associating some complex comorbidities, common in older population, that may further complicate the course of the disease. On the other hand, however, clinical course and prognosis may be often difficult to predict. In this article, main pathophysiological issues related to the aging heart are addressed, together with key aspects related to both diagnosis and prognosis in elderly patients with HF. Besides, main geriatric conditions, common in the elderly population, are reviewed, highlighting the importance of a comprehensive and multidisciplinary approach.
sDR5-Fc inhibits macrophage M1 polarization by blocking the glycolysis
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2021, 18(11): 857-866.
doi: 10.11909/j.issn.1671-5411.2021.11.004
2021, 18(11): 867-876.
doi: 10.11909/j.issn.1671-5411.2021.11.002
2021, 18(11): 877-885.
doi: 10.11909/j.issn.1671-5411.2021.11.001
2021, 18(11): 886-896.
doi: 10.11909/j.issn.1671-5411.2021.11.003
2021, 18(11): 908-951.
doi: 10.11909/j.issn.1671-5411.2021.11.010
2021, 18(11): 957-967.
doi: 10.11909/j.issn.1671-5411.2021.11.007
2021, 18(11): 968-972.
doi: 10.11909/j.issn.1671-5411.2021.11.009
2021, 18(11): 973-974.
doi: 10.11909/j.issn.1671-5411.2021.11.008
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, Available online ,
doi: 10.11909/j.issn.1671-5411.2021.12.001
Abstract:
BACKGROUND Lipoprotein(a) [Lp(a)] has been closely related to coronary atherosclerosis and might affect perivascular inflammation due to its proinflammatory properties. However, there are limited data about Lp(a) and related perivascular inflammation on coronary atheroma progression. Therefore, this study aimed to investigate the associations between Lp(a) and the perivascular fat attenuation index (FAI) with coronary atheroma progression detected by coronary computed tomography angiography (CCTA). METHODS Patients who underwent serial CCTA examinations without a history of revascularization and with available data for Lp(a) within one month before or after baseline and follow-up CCTA imaging scans were considered to be included. CCTA quantitative analyses were performed to obtain the total plaque volume (TPV) and the perivascular FAI. Coronary plaque progression (PP) was defined as a ≥ 10% increase in the change of the TPV at the patient level or the presence of new-onset coronary atheroma lesions. The associations between Lp(a) or the perivascular FAI with PP were examined by multivariate logistic regression. RESULTS A total of 116 patients were ultimately enrolled in the present study with a mean CCTA interscan interval of 30.80 ± 13.50 months. Among the 116 patients (mean age: 53.49 ± 10.21 years, males: 83.6%), 32 patients presented PP during the follow-up interval. Lp(a) levels were significantly higher among PP patients than those among non-PP patients at both baseline [15.80 (9.09−33.60) mg/dL vs. 10.50 (4.75−19.71) mg/dL, P = 0.029] and follow-up [20.60 (10.45−34.55) mg/dL vs. 8.77 (5.00−18.78) mg/dL, P = 0.004]. However, there were no differences in the perivascular FAI between PP group and non-PP group at either baseline or follow-up. Multivariate logistic regression analysis showed that elevated baseline Lp(a) level (OR = 1.031, 95% CI: 1.005−1.058, P = 0.019) was an independent risk factor for PP after adjustment for other conventional variables. CONCLUSIONS Lp(a) was independently associated with coronary atheroma progression beyond low-density lipoprotein cholesterol and other conventional risk factors. Further studies are warranted to identify the inflammation effect exhibited as the perivascular FAI on coronary atheroma progression.
, Available online ,
doi: 10.11909/j.issn.1671-5411.2021.12.003
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BACKGROUND Cystatin C (CysC) is a cysteine protease inhibitor involved in proteins catabolism and plays an essential role in human vascular pathophysiology. CysC may also increase the risk of aortic stenosis (AS), but limited studies have reported on this association. This study aimed to investigate if elevated serum CysC levels are associated with hemodynamically significant AS. METHODS Serum CysC levels were estimated in 4,791 participants, samples were collected in 1990−1992. The study population was divided into quintile groups. Follow-up continued in 2011–2013 when participants returned for echocardiography examination. Incidence of aortic valve disease (AVD) was ascertained by Doppler echocardiography through the end of 2013. AVD defined in hemodynamic progression was assessed and classified as aortic sclerosis, mild stenosis, and moderate-to-severe stenosis. RESULTS Overall, a total of 4,791 participants (mean age: 54.8 ± 5.0 years, females: 57.6%, blacks: 8.2%) were included in this study. During a follow-up of 21 years, we identified 736 cases (15.4%) of aortic sclerosis, 194 cases (4.0%) of mild stenosis, and 42 cases (0.7%) of moderate-to-severe stenosis. Compared with serum CysC levels within individual quintile groups, the odds ratio (OR) was per standard deviation associated with an increased incidence of AVD (OR = 1.15, 95% CI: 1.05−1.26, P = 0.002). CONCLUSIONS In this large population-based study, an increased serum CysC levels is independently associated with the incidence of hemodynamically significant AS. However, this association appears not to extend to patients with extremely high serum CysC levels and necessitate further investigation.
, Available online ,
doi: 10.11909/j.issn.1671-5411.2021.12.005
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BACKGROUD Acute heart failure with preserved ejection fraction (HFpEF) is a common but poorly studied cause of hospital admissions among nonagenarians. This study aimed to evaluate predictors of thirty-day readmission, in-hospital mortality, length of stay, and hospital charges in nonagenarians hospitalized with acute HFpEF. METHODS Patients hospitalized between January 2016 and December 2018 with a primary diagnosis of diastolic heart failure were identified using ICD-10 within the Nationwide Readmission Database. We excluded patients who died in index admission, and discharged in December each year to allow thirty-day follow-up. Univariate regression was performed on each variable. Variables with P-value < 0.2 were included in the multivariate regression model. RESULTS From a total of 45,393 index admissions, 43,646 patients (96.2%) survived to discharge. A total of 7,437 patients (15.6%) had a thirty-day readmission. Mean cost of readmission was 43,265 United States dollars (USD) per patient. Significant predictors of thirty-day readmission were chronic kidney disease stage III or higher [adjusted odds ratio (aOR) = 1.20, 95% CI: 1.07−1.34, P = 0.002] and diabetes mellitus (aOR = 1.18, 95% CI: 1.07−1.29, P = 0.001). Meanwhile, female (aOR = 0.90, 95% CI: 0.82−0.99, P = 0.028) and palliative care encounter (aOR = 0.27, 95% CI: 0.21−0.34, P < 0.001) were associated with lower odds of readmission. Cardiac arrhythmia (aOR = 1.46, 95% CI: 1.11−1.93, P = 0.007) and aortic stenosis (aOR = 1.36, 95% CI: 1.05−1.76, P = 0.020) were amongst predictors of in-hospital mortality. CONCLUSIONS In nonagenarians hospitalized with acute HFpEF, thirty-day readmission is common and costly. Chronic comorbidities predict poor outcomes. Further strategies need to be developed to improve the quality of care and prevent the poor outcome in nonagenarians.
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We would delightedly report that the 2020 SCI impact factor of Journal of Geriatric Cardiology（JGC，ISSN 1671-5411/ CN 11-5329/R） has increased from 2.491 to 3.327, according to the 2020 Journal Citation Reports (InCites, Clarivate Analytics), ranking 33/53 and 65/142 in the fields of Geriatrics & Gerontology and Cardiac & Cardiovascular Systems, respectively.
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doi: 10.11909/j.issn.1671-5411.2020.01.001
