Atherosclerosis is one of the leading causes of ischemic cardiovascular disease worldwide. Recent studies indicated that vascular smooth muscle cells (VSMCs) play an indispensable role in the progression of atherosclerosis. Exosomes derived from mesenchymal stem cells (MSCs) have demonstrated promising clinical applications in the treatment of atherosclerosis. However, there are still challenges and limitations persist in targeted therapy. This study aims to develop a bionic nano-delivery system by fusing platelet membranes with exosomes (MSC-ExoP) and explore the anti-atherosclerosis effect of MSC-ExoP by improving the targeting efficiency and participating in regulating the pathophysiological processes associated with VSMCs. The morphology, particle size, stability, and fusion efficiency of MSC-ExoP were assessed using transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), immunofluorescence staining, and Western blotting, respectively. MSC-ExoP was administered intravenously into ApoE−/− mice via the tail vein. In vivo, immunofluorescence staining was used to assess the targeting efficacy of MSC-ExoP. The ORO staining, H E staining, Masson staining, aortic root immunofluorescence staining, and Western blot were utilized to evaluate the VSMC autophagy and anti-atherosclerosis effects of MSC-ExoP. In vitro, the autophagy activation of MSC-ExoP on VSMCs was further assessed by immunofluorescence staining and Western blotting. The effects of MSC-ExoP on VSMCs proliferation, migration, and foam cell formation were detected by EdU experiment, Transwell experiment, wound healing experiment, ORO staining, and BODIPY staining. The TEM revealed that MSC-ExoP retained a ring nanostructure, which was similar to MSC-Exo in morphology. NTA analysis indicated the MSC-ExoP exhibited a slight increase after cell membrane fusion. Besides, the stability analysis of exosomes and MSC-ExoP resulted in no significant changes in particle size. Western blot analysis confirmed that MSC-ExoP simultaneously expressed platelet-specific markers (GPVI, GPIbα, CD62P) and exosome-specific markers (CD81, TSG101, and Alix). In ApoE−/− mice, the immunofluorescence of aorta and its roots was significantly enhanced after injection of DiI-labeled MSC-ExoP, indicating enhanced targeting of MSC-Exo to atherosclerotic plaques by platelets. In vivo experiments demonstrated that MSC-ExoP could significantly suppress the progression of atherosclerosis and reduce the area of atherosclerotic plaques by reducing lipid deposition and necrotic nucleus area and increasing collagen content. In vitro experiments further revealed that the uptake of MSC-ExoP by foam cells significantly increased, and their proliferation, migration, and foam formation were inhibited by autophagy activation. This study demonstrated successful fusion of platelet membranes with exosomes derived from MSCs. MSC-ExoP could significantly improve the targeting efficiency of atherosclerosis and play an anti-atherosclerosis effect by activating VSMC autophagy.

High-density lipoprotein (HDL) plays a key role in reverse cholesterol transport (RCT), traditionally associated with cardiovascular protection. However, while low HDL-cholesterol (HDL-C) levels correlate with increased cardiovascular risk, therapeutic interventions raising HDL-C (e.g., niacin, fibrates) have failed to reduce cardiovascular events. Recent evidence reveals a U-shaped relationship between HDL-C and mortality, with both excessively high and low levels conferring risk-indicating functional impairment as the critical determinant. Consequently, focus has shifted from HDL-C quantification to functional assessment: (1) Cholesterol efflux capacity (CEC) exhibits a stronger inverse correlation with cardiovascular risk than HDL-C; (2) HDL particle number (HDL-P) outperforms HDL-C in predicting cardiovascular events; (3) HDL subclass heterogeneity (e.g., HDL2, HDL3), where composition and distribution determine the protective functions of HDL particles. This review synthesizes evidence demonstrating that comprehensively assessing HDL functionality-including quality metrics, particle concentration, and subclass distribution-provides superior cardiovascular risk assessment. Future research must prioritize restoring or enhancing HDL function rather than merely increasing its concentration.

BACKGROUND:Fasting blood glucose (FBG) is a significant risk factor for in-hospital mortality in acute coronary syndrome (ACS). This study examines the relationship between FBG levels and outcomes in ACS patients with different glycemic statuses. METHODS AND RESULTS:Data from 50,365 ACS patients in the CCC-ACS Project (2014-2019) were analyzed in a prospective cohort study. Patients were categorized into three groups based on diabetes history and HbA1c levels: Group A (good), Group B (intermediate), and Group C (poor) glycemic status. A non-linear relationship between FBG and mortality was found. The lowest mortality risks were associated with FBG levels of 4.96 mmol/L (Group A), 5.71 mmol/L (Group B), and 7.44 mmol/L (Group C). Elevated FBG levels were linked to increased mortality risk in all groups: Group A (OR: 1.17), Group B (OR: 1.14), and Group C (OR: 1.10), all p < 0.001. The model showed moderate accuracy (AUC: 0.78 for Groups A/B, 0.80 for Group C)·In Group A, each unit increase in FBG raised the mortality risk by 1.08 times compared to Group B (OR: 1.08, 95 % CI: 1.03-1.14, p = 0.002) and by 1.07 times compared to Group C (OR: 1.07, 95 % CI: 1.03-1.12, p = 0.002). CONCLUSIONS:In ACS patients, elevated FBG is an independent risk factor for in-hospital mortality, regardless of glycemic status. Different glycemic statuses have varied optimal glycemic targets. The effect of FBG on mortality differs across glycemic groups, with patients in good glycemic status facing the highest mortality risk as FBG increases.

INTRODUCTION:Recurrent in-stent restenosis (RISR) remains a major therapeutic challenge in patients undergoing percutaneous coronary intervention (PCI), with a high incidence of repeat revascularisation and increased mortality. Immune-mediated inflammation has been implicated in the pathogenesis of RISR. This trial aims to evaluate the clinical efficacy and safety of two anti-inflammatory strategies-low-dose colchicine and prednisone-on reducing ISR recurrence and cardiovascular events. METHODS AND ANALYSIS:This is a multicentre, prospective, randomised, open-label controlled trial enrolling 252 patients with RISR. Following successful PCI, patients are randomly assigned (1:1:1) to receive: (1) standard medical therapy (control group); (2) colchicine 0.5 mg/day (colchicine group) or (3) prednisone 0.5 mg/kg/day, tapered monthly to 5-10 mg/day over 12 months (prednisone group). All groups receive background standard therapy per guidelines. The primary endpoint is angiographically confirmed ISR of the target lesion at 12 months post PCI. Secondary endpoints include the incidence of major adverse cardiovascular and cerebrovascular events (cardiovascular death, myocardial infarction, stroke and target vessel revascularisation), target lesion revascularisation and revascularisation of non-target coronary lesions within 12 months. ETHICS AND DISSEMINATION:This trial has received ethical approval from the Ethics Committee of Fuwai Hospital (Chinese Academy of Medical Sciences and Peking Union Medical College), which acts as the central institutional review board. All participants will provide written informed consent. Study results will be disseminated via peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER:ClinicalTrials.gov, NCT06090890. Registered 15 October 2023, https://clinicaltrials.gov/study/NCT06090890.

Acute coronary syndrome (ACS) is a leading cause of heart failure (HF). However, the association between percutaneous coronary intervention (PCI) and in-hospital outcomes among ACS patients with varying degrees of left ventricular ejection fraction (LVEF) and HF remains unclear. This prospective nationwide registry study included 4,694 ACS patients with HF (ACS-HF) at admission. Patients were categorized into three subgroups according to LVEF and stratified by PCI receipt during hospitalization. The primary outcome was all-cause death, and the secondary outcome was major adverse cardiovascular and cerebrovascular events (MACCE). PCI was associated with a lower risk of in-hospital all-cause death (HR, 0.52; 95

Purpose:Accumulating evidence indicates that mesenchymal stem cells (MSCs)-derived exosomes hold significant potential for the treatment of atherosclerosis. However, large-scale production and organ-specific targeting of exosomes are still challenges for further clinical applications. This study aims to explore the targeted efficiency and therapeutic potential of biomimetic platelet membrane-coated exosome-mimetic nanovesicles (P-ENVs) in atherosclerosis. Methods:To produce exosome-mimetic nanovesicles (ENVs), MSCs were successively extruded through polycarbonate porous membranes. P-ENVs were engineered by fusing MSC-derived ENVs with platelet membranes and characterized using transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), and Western blot. The stability and safety of P-ENVs were also assessed. The targeted efficacy of P-ENVs was evaluated using an in vivo imaging system (IVIS) spectrum imaging system and immunofluorescence. Histological analyses, Oil Red O (ORO) staining, and Western blot were used to investigate the anti-atherosclerotic effectiveness of P-ENVs. Results:Both ENVs and P-ENVs exhibited similar characteristics to exosomes. Subsequent miRNA sequencing of P-ENVs revealed their potential to mitigate atherosclerosis by influencing biological processes related to cholesterol metabolism. In an ApoE-/- mice model, the intravenous administration of P-ENVs exhibited enhanced targeting of atherosclerotic plaques, resulting in a significant reduction in lipid deposition and necrotic core area. Our in vitro experiments showed that P-ENVs promoted cholesterol efflux and reduced total cholesterol content in foam cells. Further analysis revealed that P-ENVs attenuated intracellular cholesterol accumulation by upregulating the expression of the critical cholesterol transporters ABCA1 and ABCG1. Conclusion:This study highlighted the potential of P-ENVs as a novel nano-drug delivery platform for enhancing drug delivery efficiency while concurrently mitigating adverse reactions in atherosclerotic therapy.

Background : Tai Chi is an increasingly utilized aerobic rehabilitation exercise in the field of cardiovascular disease (CVD). However, there remains debate regarding its effects on physiological function and mental health in patients with coronary heart disease (CHD). This study aims to investigate the impact of Tai Chi -based rehabilitation exercises on physical and psychological health outcomes for CHD patients. Methods : By collecting data from 12 databases up to December 2022, we conducted a meta -analysis of randomized controlled trials (RCTs) to evaluate the effects of Tai Chi on the physical function and psychological health among CHD patients. Results : We analyzed twenty qualified studies involving 2095 patients. Meta -analyses revealed that compared with conventional therapy groups, those who participated in Tai Chi -based interventions demonstrated significant improvements in physical function as measured by sixminute walk test (6MWT) [mean difference (MD) = 56.40, 95% confidence interval (CI) (38.50, 74.29), p < 0.01], maximal oxygen consumption (VO 2 max) [standardized mean difference (SMD) = 0. 57, 95% CI (0.12, 1.03), p = 0.01], New York Heart Association (NYHA) class [relative risk (RR) = 1.34, 95% CI (1.18, 1.53), p < 0.01] and physical health components (PHC) [SMD = 1.23, 95% CI (0.76, 1.69), p < 0.01]. Additionally, Tai Chi participants showed greater improvement than control groups across various psychological parameters including anxiety scales [SMD = -0.80, 95% CI (-1.33, -0.28), p = 0.003], depression scales [SMD = -0.77, 95% CI (-1.32, -0.23), p = 0.005] and mental health components (MHC) [SMD = 1.27, 95% CI (0.76, -1.78), p < 0.01]. The GRADEpro (Grade Guideline Development Tool) indicated evidence levels ranging from very low to moderate. Conclusions : The present meta -analysis demonstrates that mind -body rehabilitation exercises based on Tai Chi can improve both physical and psychological health outcomes for CHD patients. These findings suggest that this exercise pattern may be a potential option for cardiovascular rehabilitation. PROSPERO Registration : The protocol for this systematic review and meta -analysis has been registered with PROSPERO International Prospective Systematic Reviews (No: CRD42022370021, http://www.crd.york.ac.uk/PROSPERO).

目的 探讨老年急性冠状动脉(冠脉)综合征患者贫血对预后的影响.方法 检索PubMed、Scopus、OVID、Cochrane library、Web of Science、Embase、中国知网、中国生物医学、万方、维普数据库中关于贫血与老年急性冠脉综合征预后影响的相关研究.检索时限为建库至2022年12月10日,由两名评审员按文献的纳入和排除标准独立完成文献筛选及数据提取,采用Stata 16.0软件进行统计分析.结果 在最初检索的1 399篇文献中,13篇9 540例患者符合纳入标准,平均年龄70.3岁,合并贫血2 872例(30.1％),非贫血患者6 668例.老年急性冠脉综合征贫血与非贫血患者比较,贫血增加患者的死亡风险(RR=2.28,95％CI:1.74～3.00),同时亦增加缺血(RR=1.36,95％CI:1.13～1.64)和出血事件(RR=2.18,95％CI:1.59～3.01)的发生风险(均 P＜0.05).结论 贫血增加老年急性冠脉综合征患者死亡风险,与不良预后相关.

心血管疾病是导致人类残疾和死亡的最重要病因,其中冠心病(冠状动脉粥样硬化性心脏病)威胁最大.伴随心脏康复在我国飞速发展,冠心病患者获益良多.情绪作为一种心理活动与病情的加重和缓解息息相关,对于冠心病患者而言,治疗期间的心理评估和干预是不可或缺的,由于对此认识不够深入,很多患者在康复期间出现情绪障碍,进而影响顺利康复.为提高医务人员以及患者等对心理干预的认识,本文将心理干预在冠心病患者心脏康复中的应用进展作一综述.

目的 探讨血流储备分数(FFR)在急性ST段抬高型心肌梗死(STEMI)合并多支病变患者急诊经皮冠状动脉介入(PCI)治疗中的应用价值.方法 入选2018年2月至2019年8月首都医科大学附属北京友谊医院平谷医院及首都医科大学附属北京安贞医院STEMI合并多支病变并已行梗死相关血管急诊PCI治疗患者101例.按随机数字表法将患者分为2组,一组以FFR为指导,根据FFR处理非梗死相关血管完成完全血运重建(完全血运重建组,48例);另一组以冠状动脉造影为指导,在急性期仅处理梗死相关血管(仅处理梗死相关血管组,53例).比较2组患者PCI相关指标和术后随访心脑血管事件发生情况.主要终点为随访12个月时全因死亡、非致死性心肌梗死、再次血运重建和脑血管事件.结果 完全血运重建组手术操作时间长于仅处理梗死相关血管组[(65±11)min比(59±8)min],支架总长短于仅处理梗死相关血管组[(31±10)mm比(36±10)mm],差异均有统计学意义(均P<0.05).完全血运重建组在FFR指导下行非梗死相关血管PCI处理26例(54.2％).完全血运重建组随访12个月时心绞痛、再次血运重建和主要终点事件发生率均低于仅处理梗死相关血管组[4.2％(2/48)比18.9％(10/53)、6.2％(3/48)比22.6％(12/53)、8.3％(4/48)比24.5％(13/53)],差异均有统计学意义(均P<0.05).结论 对于STEMI合并多支病变并已行梗死相关血管急诊PCI治疗患者,急性期在FFR指导下对非梗死相关血管进行完全血运重建,比仅进行梗死相关血管PCI降低了心脑血管事件的发生风险.

目的 探讨不同冠状动脉(冠脉)血运重建方式对80岁及以上高龄冠状动脉粥样硬化性心脏病(冠心病)患者长期心血管相关死亡率的影响.方法 连续入选2011年1月至2016年1月于首都医科大学附属北京安贞医院接受冠脉旁路移植(CABG)或经皮冠脉介入治疗(PCI)的≥80岁高龄冠心病患者351例.根据血运重建方式不同分为PCI组(n=254)和CABG组(n=97).比较两组高龄患者的长期心血管相关死亡率,并分析随访5年主要不良心血管事件(MACE)的预测因子.结果 两组患者的性别、年龄、吸烟、合并高血压、糖尿病、家族史、既往病史包括既往脑梗死、心肌梗死、心力衰竭,体质指数(BMI)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、内生肌酐清除率(Ccr)、糖化血红蛋白(HbA1c),术前心脏彩超的指标包括左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、二尖瓣中度以上反流和室壁瘤等差异均无统计学意义(P均>0.05).PCI组患者既往血运重建治疗比例显著高于CABG组,CABG组既往外周血管病比例显著高于PCI组(P均<0.05).在住院诊断分型方面,PCI组急性心肌梗死比例高于CABG组,而不稳定型心绞痛比例低于CABG组(P<0.05);冠脉解剖特征方面,CABG组左主干和多支病变比例显著高于PCI组,而PCI组单支和双支病变的比例显著高于CABG组(P均<0.05).5年随访结果显示,PCI组心血管死亡54例(21.3％),CABG组心血管死亡18例(18.6％),组间差异无统计学意义(χ2=0.315,P=0.575).Logistic回归分析结果显示,合并糖尿病(HR=0.056,95％CI:0.004～0.832,P=0.036)、既往血运重建治疗(HR=0.065,95％CI:0.005～0.837,P=0.036)和肌酐清除率(HR=1.130,95％CI:1.004～1.271,P=0.043)是≥80岁高龄冠心病患者术后随访5年MACE的独立预测因子.结论 不同冠脉血运重建方式对80岁及以上高龄冠心病患者长期心血管相关死亡率的影响无显著差异.

Hypertension represents one of the most common pre-existing conditions and comorbidities in Coronavirus disease 2019 (COVID-19) patients. To explore whether hypertension serves as a risk factor for disease severity, a multi-centre, retrospective study was conducted in COVID-19 patients. A total of 498 consecutively hospitalised patients with lab-confirmed COVID-19 in China were enrolled in this cohort. Using logistic regression, we assessed the association between hypertension and the likelihood of severe illness with adjustment for confounders. We observed that more than 16% of the enrolled patients exhibited pre-existing hypertension on admission. More severe COVID-19 cases occurred in individuals with hypertension than those without hypertension (21% vs. 10%, P = 0.007). Hypertension associated with the increased risk of severe illness, which was not modified by other demographic factors, such as age, sex, hospital geological location and blood pressure levels on admission. More attention and treatment should be offered to patients with underlying hypertension, who usually are older, have more comorbidities and more susceptible to cardiac complications.

目的 探讨术前SYNTAX积分与80岁及以上冠心病(冠状动脉粥样硬化性心脏病)患者行经皮冠状动脉介入(PCI)前后生活质量改善的相关性.方法 选择2015年1月至2016年12月在首都医科大学附属北京安贞医院住院并行PCI治疗的80岁及以上冠心病患者73例,在术前及PCI术后1年随访时采用西雅图心绞痛问卷(SAQ)对其进行生活质量评估.根据SYNTAX积分将患者分为低危组(51例,0～ 22分),中危组(14例,23～32分),高危组(8例,＞32分).分析术前SYNTAX积分与患者PCI治疗1年后SAQ量表各维度评分改善的相关性.结果 术前高危组患者SAQ量表心绞痛稳定状态维度评分明显低于低危组和中危组,低危组患者心绞痛发作频次(AF)维度评分明显高于中危组和高危组(均P ＜0.05).低危组术后1年SAQ量表AF维度评分改善程度明显低于中危组和高危组[(2±6)分比(15±25)、(19±12)分],差异有统计学意义(P＜0.05).多因素回归分析显示,SYNTAX积分与PCI术后1年SAQ量表的AF维度评分改善有关,SYNTAX积分每升高1分,AF维度评分改善0.409分(β=0.409,P＜0.05).结论 术前SYNTAX积分与80岁及以上冠心病患者PCI术后1年SAQ量表AF维度评分改善有一定的相关性.

Background: Myocardial injury is a life-threatening complication of coronavirus disease 2019 (COVID-19). Pre-existing health conditions and early morphological alterations may precipitate cardiac injury and dysfunction after contracting the virus. The current study aimed at assessing potential risk factors for COVID-19 cardiac complications in patients with pre-existing conditions and imaging predictors. Methods and Results: The multi-center, retrospective cohort study consecutively enrolled 400 patients with lab-confirmed COVID-19 in six Chinese hospitals remote to the Wuhan epicenter. Patients were diagnosed with or without the complication of myocardial injury by history and cardiac biomarker Troponin I/T (TnI/T) elevation above the 99th percentile upper reference limit. The majority of COVID-19 patients with myocardial injury exhibited pre-existing health conditions, such as hypertension, diabetes, hypercholesterolemia, and coronary disease. They had increased levels of the inflammatory cytokine interleukin-6 and more in-hospital adverse events (admission to an intensive care unit, invasive mechanical ventilation, or death). Chest CT scan on admission demonstrated that COVID-19 patients with myocardial injury had higher epicardial adipose tissue volume ([EATV] 139.1 (83.8–195.9) vs. 92.6 (76.2–134.4) cm 2 ; P = 0.036). The optimal EATV cut-off value (137.1 cm 2 ) served as a useful factor for assessing myocardial injury, which yielded sensitivity and specificity of 55.0% (95%CI, 32.0–76.2%) and 77.4% (95%CI, 71.6–82.3%) in adverse cardiac events, respectively. Multivariate logistic regression analysis showed that EATV over 137.1 cm 2 was a strong independent predictor for myocardial injury in patients with COVID-19 [OR 3.058, (95%CI, 1.032–9.063); P = 0.044]. Conclusions: Augmented EATV on admission chest CT scan, together with the pre-existing health conditions (hypertension, diabetes, and hyperlipidemia) and inflammatory cytokine production, is associated with increased myocardial injury and mortality in COVID-19 patients. Assessment of pre-existing conditions and chest CT scan EATV on admission may provide a threshold point potentially useful for predicting cardiovascular complications of COVID-19.

目的 观察甲泼尼龙和苯海拉明用于碘造影剂过敏史患者预防再次碘造影剂过敏的效果.方法 回顾性分析2013年8月至2017年9月中国医学科学院阜外医院明确为碘造影剂过敏需再次行经皮冠状动脉介入(PCI)术的患者168例,其中58例术前接受甲泼尼龙和苯海拉明防过敏处理(甲泼尼龙组),110例术前仅接受苯海拉明防过敏处理(苯海拉明组).2组在术前1h内分别给予甲泼尼龙80 mg静脉滴注+苯海拉明20 mg肌内注射、苯海拉明20 mg肌内注射,分别记录术前术后恶心、呕吐、皮肤表现、血压、心率、血指标、心电图等.结果 2组患者入院前碘造影剂过敏反应均主要表现为皮肤损害,包括红斑、丘疹、荨麻疹,2组间过敏反应发生情况差异均无统计学意义(均P＞0.05).2组患者首次过敏距此次PCI的时间差异无统计学意义[(223±125)d比(197±142)d,P＞0.05].2组患者PCI术中均换用不同于第一次过敏的造影剂,甲泼尼龙组只有1例(1.7％)患者在使用造影剂25 min时发生恶心呕吐;而苯海拉明组共有10例(9.1％)患者发生过敏,患者接触碘造影剂的时间为(15±6) min,包括局部皮肤反应5例(4.5％)、全身皮肤反应4例(3.6％)和血压下降1例(0.9％),苯海拉明组过敏反应发生率高于甲泼尼龙组(P=0.001).PCI术中2组患者大多选择碘克沙醇,占比分别为甲泼尼龙组52例(89.7％)和苯海拉明组98例(89.1％).结论 甲泼尼龙联合苯海拉明用于含碘造影剂过敏患者再次使用碘造影剂时预防过敏反应安全且效果显著.

•The pandemic of coronavirus disease 2019 (COVID-19) has emerged as a major health crisis, with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) having infected over a million people around the world within a few months of its identification as a human pathogen.•Initially, SARS-CoV-2 infects cells in the respiratory system and causes inflammation and cell death.•Subsequently, the virus spreads out and damages other vital organs and tissues, triggering a complicated spectrum of pathophysiological changes and symptoms, including cardiovascular complications.•Acting as the receptor for SARS-CoV entering mammalian cells, angiotensin converting enzyme-2 (ACE2) plays a pivotal role in the regulation of cardiovascular cell function.•Diverse clinical manifestations and laboratory abnormalities occur in patients with cardiovascular injury in COVID-19, characterizing the development of this complication, as well as providing clues to diagnosis and treatment.•This review provides a summary of the rapidly appearing laboratory and clinical evidence for the pathophysiology and therapeutic approaches to COVID-19 pulmonary and cardiovascular complications.

Objective To investigate the correlation between small dense low-density lipoprotein(sdLDL)and prognosis in patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI). Methods A total of 353 patients with AMI who had PCI in Beijing Anzhen Hospital, Capital Medical University were enrolled from January to August 2018. Clinical indicators and blood lipid biochemical indexes were collected. All patients were followed up for at least 1 year to observe the occurrence of major adverse cardiovascular events (MACE). Influencing factors of sdLDL and risk factors affecting the prognosis of AMI were analyzed. Results There were 71 cases(20. 1％) of MACE occurring during follow-up, including 4 cases of all-cause death, 58 cases of recurrent angina, 8 cases of target revascularization and 1 case of malignant arrhythmia. Analysis showed that sdLDL was associated with triacylglycerol ( r =0. 509 ) , total cholesterol ( r =0. 812 ) and body mass index ( r =0. 132). Multivariate Cox regression analysis suggested that sdLDL ( hazard ratio = 1. 900, 95％ confidence interval:1. 067-3. 383), lipoprotein A(hazard ratio=2. 825, 95％ confidence interval:1. 441-5. 540) and uric acid(hazard ratio=1. 003, 95％ confidence interval:1. 000-1. 005) were independent risk factors of MACE(all P<0. 05). Kaplan-Meier survival analysis found that patients with sdLDL≥0. 78 mmol/L had poor prognosis at 1 year follow-up(Log-Rank = 4.463, P = 0.035). Conclusion SdLDL is a risk factor of MACE after PCI treating AMI.

Objective:To study the effects of conservative treatment versus percutaneous interventional treatment(PCI)on symptoms and prognosis of chronic coronary syndrome patients aged over 75 years with fractional flow reserve(FFR)in the grey zone(0.75≤FFR≤0.80).Methods:A total of 96 coronary heart disease(CHD)patients aged over 75 years undergone FFR examination in our hospital from January 2011 to December 2017 were retrospectively selected.All patients showed stenosis of 50%-90% in at least one main coronary artery and had FFR values within the range of 0.75-0.80(0.75≤FFR≤0.80). According to the treatment, patients were divided into the optimized medication group(OMT group, n=35)and the PCI group(n=61). The degree of angina alleviation assessed by the Seattle Angina Questionnaire(SAQ)and the incidence of major adverse cardiovascular endpoints(death, myocardial infarction, stroke, and repeated revascularization)were recorded during the one-year follow-up after treatment.Results:There was no significant difference in baseline data including age, gender and comorbidities between the OMT and PCI groups( P>0.05). The incidence of previous myocardial infarction, and the basal level of low-density lipoprotein cholesterol(LDL-C)were higher in the PCI group than in the OMT group( P<0.05). One-year follow-up showed that there was no significant difference between the OMT and PCI groups in the score of SAQ(77.6 ± 19.5 vs. 83.1 ± 22.8, P>0.05)and the incidence of composite MACEs(11.4% or 4 / 35 vs. 9.8% or 6/61, P>0.05). However, the incidence of repeated target vessel revascularization was lower in the PCI group than in the OMT group(1.6% or 1 case vs. 5.8% or 2 cases, P<0.05). Conclusions:In elderly CHD patients aged over 75 years with FFR values between 0.75-0.8 in the grey zone, optimal medication treatment has similar effects as the PCI on symptom alleviation, and no significant increase in composite MACEs is found at one-year follow-up.

The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has become a major health crisis and a worldwide pandemic. COVID-19 is characterized by high infectivity, long incubation period, diverse clinical presentations, and strong transmission intensity. COVID-19 can cause myocardial injury as well as other cardiovascular complications, particularly in senior patients with pre-existing medical conditions. The current review summarizes the epidemiological characteristics, potential mechanisms, clinical manifestations, and recent progress in the management of COVID-19 cardiovascular complications.