miRNA, circRNA, and lncRNA play crucial roles in the pathogenesis and progression of myocardial ischemia-reperfusion injury (MI/RI). This study aims to provide valuable insights into miRNA, circRNA, lncRNA, and MI/RI from a bibliometric standpoint, with the goal of fostering further advancements in this area. The relevant literature in the field of miRNA, circRNA, lncRNA, and MI/RI was retrieved from the Science Citation Index Expanded (SCI-E) database within Web of Science. The “Analyze Results” and “Citation Report” functions in WOS were utilized to compile the annual publication and citation counts in this field. Microsoft Office Excel 2019 was used to organize and visualize the data. Furthermore, bibliometric and visualization analyses of countries/regions, institutions, authors, keywords, and references were conducted using the bibliometric visualization software CiteSpace. A total of 858 publications were included for further analysis in this field. The literature was published across 297 journals, with Molecular Medicine Reports contributing the highest number of publications. Researchers from 45 countries participated in studies within this field, with those from China contributing the most publications. The research hotspots in this field primarily focus on three areas: the role of miRNA, circRNA, and lncRNA in the pathogenesis of MI/RI, their potential as therapeutic targets, and their role as biomarkers. Among these, circular RNA, therapy target, inflammatory response, and cardiomyocyte ferroptosis are likely to emerge as emerging trends in this field. The overall development of research in this field is on the rise. The compilation of research hotspots and emerging trends in this area may provide researchers with more references and assistance in selecting research directions, ultimately benefiting MI/RI patients.

Background: The incidence of unstable angina (UA), a type of cardiovascular disease (CVD), has increased in recent years. Meanwhile, timely percutaneous coronary intervention (PCI) or percutaneous transluminal coronary angioplasty (PTCA) procedures are crucial for patients with UA who also have diabetes mellitus (DM). Additionally, exploring other factors that may influence the prognosis of these patients could provide long-term benefits. The systemic immune-inflammation index (SII), a novel marker for assessing inflammation levels, has been shown to correlate with the long-term prognosis of various diseases. Thus, this study aimed to investigate the predictive value of the SII for the long-term prognosis of patients with UA and DM after revascularization. Methods: A total of 937 UA patients who underwent revascularization, of which 359 also had DM, were included in this study. Patients were divided into two groups: the low SII group (<622.675 × 109/L; n = 219, 61.0%) and the high SII group (≥622.675 × 109/L; n = 140, 39.0%). The primary outcome was the frequency of major adverse cardiovascular and cerebrovascular events (MACCEs). The secondary outcome was the incidence of all-cause death. Results: Of the 359 patients who visited our institution between January 2018 and January 2020, 23 patients (10.5%) in the low SII group experienced MACCEs, whereas 34 cases (24.3%) in the high SII group experienced MACCEs, showing a statistically significant difference (p < 0.001). After conducting univariate and multivariate regression analyses on the endpoint events, we identified several risk factors for MACCEs. These risk factors included high SII levels, a history of myocardial infarction (MI), prior PCI or coronary artery bypass grafting (CABG), elevated brain natriuretic peptide (BNP), and the lack of angiotensin-converting enzyme inhibitors (ACEI) or statin use. Upon adjusting for covariates including age, sex, body mass index (BMI), BNP, smoking, hypertension, PCI or CABG history, MI history, statin use, ACEI use, and the presence of three-vessel coronary disease, only high SII levels remained a risk factor for MACCEs (HR: 0.155, 95% CI: 0.063–0.382; p = 0.001). However, high SII levels were not identified as a risk factor for other individual endpoint events, including non-fatal stroke, cardiovascular death, non-fatal MI, or cardiac rehospitalization. Conclusion: Elevated SII levels following percutaneous intervention are associated with poor outcomes in patients with UA and DM. Therefore, regular monitoring and controlling inflammation levels may help improve long-term outcomes.

Background and AimsThe role of fractional flow reserve (FFR) in coronary intermediate lesions has been widely recommended by guidelines. The effect of uric acid (UA) on cardiovascular events is also well known. However, the relationship between UA and long-term cardiovascular outcomes in patients who received FFR with intermediate lesions remains unknown.Methods and ResultsWe retrospectively included 428 patients who underwent both coronary angiography (CAG) and FFR. Participants were stratified into two groups based on the median UA. The primary endpoint was the composite of major adverse cardiovascular and cerebrovascular events (MACCEs), including repeat revascularization, nonfatal stroke, nonfatal myocardial infarction, and all-cause death. A Cox proportional hazards model was utilized to analyze the association between UA and the prevalence of MACCEs. During a median follow-up of 5.8 years, a higher MACCEs rate occurred in the high UA group compared to the low UA group (16.8% vs. 5.1%, p log-rank<0.01). Elevated UA was independently linked to a higher incidence of MACCEs, whether UA was treated as a categorical or continuous variable (hazard ratio [HR] 2.76, 95% confidence interval [CI] 1.27 - 6.03 or HR 1.01, 95% CI 1.01 - 1.02). The restricted cubic spline (RCS) analysis illustrated that the HR for MACCEs increased with increasing UA.ConclusionThe present study demonstrates that UA is associated with MACCEs risk and suggests that UA is a reliable predictor of long-term cardiovascular events in coronary intermediate stenosis patients.

The mechanisms through which aging increases heart injury remain partially understood. Protein phosphorylation plays a critical regulatory role in cell survival and death. Using an unbiased phosphoproteomics approach, we aimed to identify the proteins whose phosphorylation could be causatively related to aging-related cardiomyocyte apoptosis and elucidate the underlying mechanisms. Comparative phosphoproteomics was conducted on cardiac tissues obtained from young (8 weeks) and aged (24 months) mice. Our findings revealed that the Mammalian Target of Rapamycin phosphorylation at T1262 (mTORT1262) was reduced in the aging heart. Immunohistochemical and Western blot analyses confirmed these findings in aging myocardia and D-galactose-induced senescent AC16 cardiomyocytes. In hypoxia/reoxygenation cardiomyocytes, mTORT1262 phosphorylation deficiency (mTORT1262A, lentivirus-mediated transfection) inhibited AKT1, suppressed NF-κB, activated FOXO1/3a signaling, and ultimately exacerbated apoptosis. Conversely, mTORT1262 pseudophosphorylation (mTORT1262E) exhibited opposite effects. Through bioinformatics and CO-IP, purinergic receptor P2X4 (P2X4R) was found to be the possible receptor responsible for mTORT1262 phosphorylation. Knockdown of P2X4R increased apoptosis, whereas its overexpression decreased it. In senescent cardiomyocytes, P2X4R expression and mTORT1262 and AKT1S473 phosphorylation were reduced, NF-κB signaling was suppressed, and FOXO1/3a signaling was activated. We demonstrated that P2X4R downregulation and the subsequent reduction of mTORT1262 phosphorylation is a novel mechanism contributing to cardiomyocyte apoptosis in aging hearts. The P2X4R-mTOR-AKT1 signaling pathway represents a potential therapeutic target against accelerated cardiac injury in aging.

Abstract Background Guidelines on coronary intermediate lesions strongly recommend deferred revascularization after detecting a normal fractional flow reserve (FFR). Researches about triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) on cardiovascular diseases has also been well conducted. However, the association of TG/HDL-C and long-term adverse clinical outcomes remains unknown for patients deferred revascularization following FFR. Methods This study retrospectively included 374 coronary artery disease (CAD) patients with non-significant coronary lesions diagnosed by coronary angiography (CAG) and FFR. The main outcome measure was the combination of major adverse cardiovascular and cerebrovascular events (MACCEs). All patients were categorized into three subgroups in terms of TG/HDL-C tertiles (T1 < 0.96, 0.96 ≤ T2 < 1.58, T3 ≥ 1.58). Three different Cox regression models were utilized to reveal the association between TG/HDL-C and prevalence of MACCEs. Results 47 MACCEs were recorded throughout a median monitoring period of 6.6 years. The Kaplan-Meier survival curves showed a higher MACCEs rate occurred in the higher TG/HDL-C group (5.6% vs. 12.9% vs. 19.4%, log-rank P < 0.01). After adjustment, patients in T3 suffered a 2.6-fold risk compared to the T1 group (T3 vs. T1: HR 2.55, 95% CI 1.05–6.21, P = 0.038; T2 vs. T1: HR 1.71, 95% CI 0.65–4.49, P = 0.075; P for trend = 0.001). The restricted cubic spline (RCS) analysis demonstrated that the HR for MACCEs rose as TG/HDL-C increased. Both the receiver operating characteristic (ROC) and time-dependent ROC proved the excellent predictive ability of TG/HDL-C. Conclusion The study illustrates that TG/HDL-C correlates with the risk of MACCEs in CAD patients deferred revascularization following FFR. TG/HDL-C could serve as a dependable predictor of cardiovascular events over the long term in this population.

Objective To determine the association of D-dimer to albumin ratio (DAR) with major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in ischaemic heart failure patients with diabetes mellitus.Design A retrospective observational cohort study.Setting Single centre in Beijing, China, conducted at one of the largest cardiology centres in China.Participants From June 2017 to June 2019, 3707 patients with heart failure and concomitant multiple vessel disease undergoing elective PCI were screened. A total 1021 of patients were enrolled after exclusion and the follow-up period was up to 36 months.Primary and secondary outcome measures The MACE was the primary measured outcome. The secondary outcomes were all-cause mortality, non-fatal myocardial infarction and any revascularisation.Methods These participants were grouped according to DAR tertiles. The cumulative incidence functions, Cox regression, restricted cubic spline and receiver operating characteristic curves were used to determine the association between DAR and outcomes. The subgroup analysis was also performed.Results After follow-up, MACE occurred in 404 (39.6%) participants. The cumulative hazards curve manifested significant differences in MACE, all-cause mortality and any revascularisation (log-rank test: all p<0.001). In adjusted models, DAR was an independent risk factor of MACE (tertile 2: HR 1.82, 95% CI 1.37 to 2.42; tertile 3: HR 1.74, 95% CI 1.28 to 2.36) and all-cause mortality (tertile 2: HR 2.04, 95% CI 1.35 to 3.11; tertile 3: HR 1.89, 95% CI 1.20 to 2.98). The optimal cut-off of DAR was 1.2. In the stratified analysis, sex, age, hypertension, hypercholesterolaemia, total revascularisation and any interfered vessel did not affect the independent predictive ability.Conclusion Higher DAR was independently associated with MACE and all-cause mortality after PCI in ischaemic heart failure patients with diabetes mellitus.

Triglyceride-glucose index (TyG index) is a reliable surrogate marker of insulin resistance, associated with morbidity and prognosis of cardiovascular disease. However, its predictive value for cardiovascular events in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO) after percutaneous coronary intervention (PCI) has not been studied. Here, we retrospectively enrolled 681 patients with T2DM and CTO after PCI. Patients were divided into two groups based on a median TyG index of 9.02. The TyG index was calculated as ln [fasting triglyceride (mg/dL) x fasting glucose (mg/dL)/2]. The primary observational end point was the composite of overall death, nonfatal myocardial infarction, and unplanned revascularization. The Multivariate Cox hazards regression analysis showed that the TyG index was significantly correlated with the primary end point (hazard ratio = 1.699, 95% confidence interval 1.254-2.303, p = 0.001). The addition of TyG to a baseline risk model had an incremental effect on the predictive value for the primary end point (area under the curve: TyG index vs baseline model, 0.693 vs 0.663, comparison p = 0.040; integrated discrimination improvement = 0.049, p = 0.020). The TyG index might be a predictor of adverse cardiovascular events. Moreover, adding the TyG index into a baseline risk model had a cumulative effect on the predictive potential for the primary end point.

Abstract Background The prevalence of ischaemic heart failure (HF) continues to increase. Diabetes mellitus (DM) concomitant with ischaemic HF increases the risk of major adverse cardiovascular events (MACEs). As a promising predictor for cardiovascular diseases, the predictive value of the monocyte to high-density lipoprotein cholesterol ratio (MHR) for MACE in the ischaemic HF with DM cohort has never been investigated before. Objective We aimed to investigate the MHR as a predictor for MACE in ischaemic HF patients with DM who underwent percutaneous coronary intervention (PCI). Methods This observational study enrolled 1049 patients with ischaemic HF and DM undergoing PCI from June 2017 to June 2019. The baseline data were collected. MACEs, including all-cause mortality, nonfatal myocardial infarction, and any revascularization, were recorded within the 36-month follow-up. The characteristics and incidence of MACE were analysed in four groups stratified by the quartiles of MHR. The hazard ratio for MACE was analysed with Cox regression models. The incidence of MACE in the four groups was evaluated by Kaplan‒Meier survival analysis. Restricted cubic spline analysis was performed to determine the nonlinear correlation between the MHR and MACE. Results After the 36-month follow-up, 407 patients (38.8%) experienced MACEs. The incidence of MACE was significantly higher among patients in the upper MHR quartile than among those in the lower MHR quartiles (23.4% vs. 36.0% vs. 41.4% and 54.6%; P < 0.001, respectively), which was consistent with the Kaplan‒Meier survival analyses (P < 0.0001). A multivariate Cox regression model showed that the MHR was an independent risk factor for MACE after variables were adjusted (adjusted HR: 2.11; 95% CI 1.47–3.03; P < 0.001). Its predictive effects on MACE showed no interaction with hypercholesterolemia (P > 0.05). Conclusion The MHR was a significant and independent predictor of MACEs in ischaemic HF patients with DM undergoing PCI.

BackgroundRetrograde approach technique has been challenging in percutaneous coronary interventional treatment of chronic total occlusion (CTO) coronary disease. The present study endeavors to determine a novel Chinese scoring system for predicting successful collateral channels traverse via retrograde approach.MethodsThe demographic characteristics and angiographic characteristics of 309 CTO patient were analyzed by univariable and multivariable analysis for selecting potential predictors. And the nomogram was used to establish the scoring system. Then it was evaluated by the internal and external validation.ResultsThe predictors of Age, Connections between collateral channels and recipient vessels, and Channel Tortuosity (ACT) were identified with univariable and multivariable analysis and employed to the ACT score system. With acceptable calibrations, the area under curve of the scoring system and the external validation were 0.826 and 0.816 respectively. Based on score, the predictors were divided into three risk categories and it showed a consistent prediction power in the validation cohort.ConclusionsThe novel Chinese ACT score is a reliable tool for predicting successful retrograde collateral traverse.

Previous studies have shown that aging promotes myocardial apoptosis. However, the detailed mechanisms remain unclear. Our recent studies revealed that aging not only activates apoptosis, but also activates some anti-apoptotic factors. By quantitative phosphoproteomics, here we demonstrated that aging increases cytochrome c (Cytc) phosphorylation at threonine 50 (T50), a post-translational modification with unknown functional impact. With point mutation and lentivirus transfection, cardiomyocytes were divided into four groups: empty vector group, WT (wild type), T50E (as a phosphomimic variant), and T50A (non-phosphorylatable). TUNEL staining and flow cytometry were used to determine the apoptosis ratio in different groups after hypoxic/reoxygenated (H/R) treatment. The results showed that T50-phosphorylated Cytc suppressed myocardial apoptosis induced by H/R. Furthermore, Western Blot and ELISA measurements revealed that Cytc T50 phosphorylation inhibited caspase-9 and caspase-3 activity without altering caspase-8, BCL-2, BCL-XL, and Bax expression. In our study, we demonstrated that aging increases phosphorylation Cytc at T50 and this aging-increasing phosphorylation site can suppress H/R-induced apoptosis.

BACKGROUND:Acute myocardial infarction (AMI) is the main cause of death and disability in cardiovascular and cerebrovascular diseases. Both the Global Registry of Acute Coronary Events (Grace) score and high-sensitivity C-reactive protein (hs-CRP) were associated with prognosis in patients with AMI. However, whether the addition of the hs-CRP to Grace risk score could improve the predictive power of Grace risk score on the prognosis of patients with AMI is unclear. HYPOTHESIS:We hypothesized that the inclusion of hs-CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in-hospital outcomes. METHODS:We retrospectively enrolled 1804 patients with AMI in the final analysis. Patients were divided into four groups by hs-CRP quartiles. The relation between hs-CRP and Grace risk score was analyzed by Spearman rank correlation. Logistic regression was used to identify independent risk factors. The predictive value of hs-CRP add to Grace risk score was evaluated by C-statistic, net reclassification improvement (NRI), integrated differentiation improvement (IDI), calibration plot, and decision curve analysis. RESULTS:The hs-CRP and Grace risk score had a significantly positive correlation (r = .191, p < .001). hs-CRP combined with Grace risk score could improve the ability of Grace risk score alone to correctly redistinguish the occurrence of in-hospital outcome (C-statistic = 0.819, p < .001; NRI = 0.05956, p = .007; IDI = 0.0757, p < .001). CONCLUSION:Admission hs-CRP level was a significant independent risk factor for in-hospital outcomes in patients with AMI. The inclusion of hs-CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in-hospital outcomes.

Objective. The study aimed to investigate the incidence and influencing factors of heart failure after 5 years of percutaneous coronary intervention (PCI) for first acute myocardial infarction. Methods. A total of 1235 patients, diagnosed as acute myocardial infarction and treated with PCI in Beijing Anzhen Hospital, Capital Medical University, from January 1, 2014, to December 31, 2014, were enrolled. Based on the exclusion criteria, 671 patients were followed up to obtain echocardiographic results 5 years after the onset of myocardial infarction (from January 1, 2019, to December 31, 2019). Of 671 patients, 62 were lost to follow-up. Finally, 609 patients were recruited in this study. According to the results of the echocardiographic examination, patients were divided into a heart failure group (n = 97) (LVEF < 50%) and a nonheart failure group (n = 512) (LVEF ≥ 50%). The clinical characteristics were compared between the two groups, and the influencing factors of heart failure after 5 years of PCI in patients with acute myocardial infarction were analyzed using logistic regression and receiver-operating characteristic (ROC) analyses. Results. Of 609 patients, 97 had heart failure within 5 years after PCI for first myocardial infarction, with an incidence of 15.9%. Multivariate regression analysis finally examined the predictors related to the occurrence of heart failure, including age (aOR, 1.008; 95% confidence interval (CI), 1.054–1.123; P ≤ 0.001), peak troponin I level (aOR, 1.020; 95% CI, 1.006–1.034; P = 0.004), left ventricular ejection fraction (LVEF) (during admission) (aOR, 0.908; 95% CI, 0.862–0.956; P ≤ 0.001), and left ventricular end-diastolic dimension (LVEDD) (at admission) (aOR, 1.136; 95% CI, 1.016–1.271; P = 0.025). Conclusion. In this study, the incidence of heart failure (LVEF < 50%) in patients with acute myocardial infarction who underwent PCI was 15.9% at a five-year follow up. Age, peak troponin I level, and LVEDD (at admission) were risk factors for heart failure, while LVEF (at admission) of patients during hospitalization was a protective factor for heart failure.

BackgroundPrevious studies have confirmed the predicted value of serum glycated albumin (GA) in atherosclerotic cardiovascular disease. However, the relationship between GA and the development of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation has not been verified in patients with acute coronary syndrome (ACS).Materials and methodsIn this study, 797 patients diagnosed with ACS who underwent re-coronary angiography more than 6 months after the first successful DES-based percutaneous coronary intervention (PCI) were eventually included. Patients were categorized into two groups based on the median GA levels of 14.94%. Moreover, multivariate logistic regression analysis models and the net reclassification improvement and integrated differentiation improvement risk models were constructed to assess the relationship between the GA and DES-ISR in patients with ACS.ResultsThe GA was significantly associated with an increased risk of DES-ISR, upon adjusting for confounding factors (as nominal variate: OR 1.868, 95% CI 1.191–2.932, P = 0.007; as continuous variate: OR 1.109, 95% CI 1.040–1.183, P = 0.002). The addition of GA to a baseline risk model had an incremental effect on the predictive value for DES-ISR (AUC: GA vs. baseline model, 0.714 vs. 0.692, comparison P = 0.017; category-free net reclassification improvement (NRI) 0.080, P = 0.035; integrated discrimination improvement (IDI) 0.023, P < 0.001).ConclusionGA level was significantly associated with a high risk of DES-ISR in patients with ACS treated with PCI. Moreover, the addition of the GA to a baseline risk model has an incremental effect on the predictive potential for DES-ISR.

Background . Intermediate coronary stenosis (ICS) is defined as a visually estimated percentage of diameter stenosis ranging between 40% and 70% by conventional coronary angiography (CAG). Whether to perform percutaneous coronary intervention (PCI) for these lesions is a challenge in clinical practice. The fractional flow reserve (FFR) can guide treatment by determining the functional significance of ICS. Studies have shown that some clinical indicators can be used to predict FFR. However, there is little research on this in the Chinese population. Methods . We retrospectively analyzed 690 patients who underwent FFR measurements to determine the functional significance of a single ICS. Patients were divided into 2 groups: FFR ≤0.8 ( n  = 280) and FFR >0.8 ( n  = 410). We compared the clinical factors between the two groups and performed multivariate logistic regression analyses to explore the risk factors. In addition, receiver-operating characteristic (ROC) curves were constructed for FFR ≤0.8 diagnoses. Results . The mean UHR (uric acid to high-density lipoprotein cholesterol ratio) level was significantly higher in the FFR ≤0.8 group ( p < 0.001). UHR corrects negatively with FFR ( r  = −0.44, p < 0.001). High-level UHR was an independent risk factor for the FFR ≤0.8 (OR = 7.17, 95% CI 4.17–12.34). The area under the curve (AUC) of the UHR diagnostic capacity for the FFR ≤0.8 is 0.77, with 77.3% sensitivity and 68.2% specificity. Conclusion . UHR levels were significantly increased in patients with hemodynamically significant coronary lesions. UHR is a novel predictor of functionally significant lesions in patients with a single-vessel disease of ICS.

目的 采用慢性完全闭塞病变学术联盟(CTO-ARC)专家共识定义,按照CTO-ARC围术期心肌梗死(PMI)标准,评价慢性完全闭塞(CTO)病变行经皮冠状动脉介入治疗(PCI)PMI的发生率,并对相关危险因素进行分析.方法 根据CTO-ARC标准,回顾性分析首都医科大学附属北京安贞医院冠心病中心自2019年1—6月所有通过PCI成功完成血运重建的CTO病变患者的临床基线特征、造影结果以及手术操作特点,应用多因素Logistic回归分析识别PMI的独立危险因素.结果 纳入通过PCI成功完成血运重建的CTO病变415例,PMI发生率4.8％.经多因素Logistic回归分析,供血血管闭塞(OR 48.818,95％CI 2.365～1007.888,P=0.012)、边支血管损伤(OR 20.332,95％CI 4.439～93.132,P<0.01)、术后心肌梗死溶栓治疗试验(TIMI)血流分级

To investigate a scoring system for predicting the risk of successful percutaneous coronary intervention (PCI) after prior failed chronic total occlusion (CTO). Patients with previously attempted CTO-PCI were enrolled in our study retrospectively from January 2016 to December 2019. All clinical and procedural data were collected and analyzed. Univariate and multivariate logistic regression was performed to investigate the predictors of technical success. A total of 194 patients/CTO lesions were studied. The multivariate logistic regression showed that occlusion length < 20 mm (odds ratio (OR) = 2.94, score = 1), non-calcification (OR = 2.93, score = 1), adequate distal landing zone (OR = 4.46, score = 1), Rentrop grade ≥ 2 (OR = 5.98, score = 1), and retrograde approach as the initial strategy (OR = 10.28, score = 2) were predictors of the success of re-attempt PCI. The technical success rate for scores from 0 to ≥ 4 were 0

Objective:To investigate the status of implantable cardioverter defibrillator (ICD) implantation in patients with ischemic cardiomyopathy after revascularization, and to find the relevant factors affecting ICD implantation in China.Methods:This study was a single-center cohort study.Patients with left ventricular ejection fraction (LVEF) of 40% or less who received coronary artery bypass grafting or percutaneous coronary intervention with drug-eluting stent in Beijing Anzhen Hospital from January 2005 to December 2014 were enrolled.Three months after revascularization, patients with LVEF≤35% were divided into two groups according to whether ICD implantation was performed.Multivariate Logistic regression was used to identify independent correlates of ICD implantation.Results:Two thousand eight hundred and fifty-two patients were enrolled.The average age at baseline was (66.2±10.5) years.Among them, 2 366 (83.0%, 2 366/2 852) were male.One hundred and sixty-two patients died within 3 months after revascularization.Only 1 105 (51.2%, 1 105/2 160) patients had LVEF reassessment 3 months after revascularization.The baseline LVEF was improved from 36.1%±4.4% to 45.1%±11.3% ( P<0.001). However, 229 (20.7%, 229/1 105) patients had LVEF ≤35%.The rate of ICD implantation was 6.5% in patients with LVEF≤35%.Patients with ICD were associated with lower all-cause mortality compared with patients without ICD (7.7% vs. 35.5%, P=0.040). Multivariate Logistic regression analysis indicated that the history of ventricular tachycardia/ventricular fibrillation was independently associated with ICD implantation ( OR=12.67, 95% CI 1.87-85.59, P=0.009). Conclusion:The rate of ICD implantation in patients with ischemic cardiomyopathy was extremely low.It is necessary to further improve the utilization of ICD to prevent sudden cardiac death after revascularization.

目的:探讨冠状动脉单支临界病变患者功能性缺血的危险因素,并分析其对于功能性缺血的诊断价值.方法:回顾性分析2014年1月至2021年10月,于北京安贞医院行冠状动脉造影后,因单支临界病变而接受血流储备分数(FFR)检查的460例冠心病患者的临床基本资料及手术情况,分为FFR＜0.8和FFR≥0.8两组,比较两组临床资料并分析与FFR＜0.8相关的影响因素.结果:两组中男性、BMI、WBC、中性粒细胞、HDL-C、总胆汁酸、尿素、尿酸、肌酐等差异统计学意义(P＜0.05).相关性分析表明,HDL-C和尿酸与FFR间有相关性(R＞0.3,P＜0.001).多因素 Logistic 回归分析显示尿酸(OR=1.008,95％CI:1.005～1.012)和总胆汁酸(OR=1.171,95％CI:1.037～1.321)是 FFR＜0.8 的危险因素,而 HDL-C(OR=0.055,95％CI:0.014～0.209)是FFR＜0.8的保护因素.尿酸、HDL-C和总胆汁酸的曲线下面积分别为0.723,0.702和0.599.结论:对于冠状动脉单支临界病变,尿酸和HDL-C具有较好的预测能力,对指导是否进行血运重建具有一定的价值.

Background: The triglyceride-glucose index (TyG index) is a reliable surrogate marker of insulin resistance, which is associated with cardiovascular disease morbidity and prognosis. However, the predictive value of the TyG index for cardiovascular events in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO) after percutaneous coronary intervention (PCI) has not been specifically studied. Method: The study retrospectively enrolled 687 patients with T2DM and CTO after PCI in the final analysis. Patients were divided into three groups according to the TyG index tertiles. The TyG index was calculated as ln [ fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2 ]. The primary observational endpoint was the composite of overall death, non-fatal stroke, non-fatal myocardial infarction (MI), or unplanned revascularization.Results: During a median follow-up of 22.0 months, 159 patients (23.14%) experienced primary endpoint events. Multivariate Cox hazards regression analysis showed that the TyG index was significantly correlated with the primary endpoint [HR 2.827, 95% CI (1.877-4.529), P＜0.001]. Kaplan–Meier curves for the primary endpoint showed a significant difference between the lower and higher TyG index group was mainly driven by the increased incidence of unplanned revascularization (Log-rank P＜0.001).Conclusion: The TyG index may be a remarkable predictor of adverse cardiovascular events, especially unplanned revascularization in patients with T2DM and CTO who are treated by PCI.

Aging augments postischemic apoptosis via incomplete mechanisms. Our previous animal study suggests that in addition to proapoptotic effects, lncRNAs also exert antiapoptotic effects in cardiomyocytes. However, whether this unexpected phenomenon exists in humans is unknown. In the present study, we investigated the relationship between aging and apoptosis regulation in human blood samples and confirmed their role by utilizing the cardiomyocyte lines (AC16 cells). Human blood samples were collected from 20 pairs of older adult and young volunteers. Age-different apoptotic regulatory lncRNAs and miRNAs were identified by microarray and bioinformatics analysis. The results indicated that lncRNA (NONHSAT069381 and NONHSAT140844) and miRNA (hsa-miR-124-5p and hsa-miR-6507-5p) were increased in aging human blood, confirmed by both bioinformatics analysis and polymerase chain reaction (PCR). Overexpression of NONHSAT069381 in AC16 cells increased caspase-3 levels and increased cardiomyocyte apoptotic cell death (determined by TUNEL staining and caspase activity assays) after hypoxia/reoxygenation (H/R), while overexpression of NONHSAT140844 increased X-chromosome-linked inhibitor of apoptosis protein (XIAP) content and decreased the myocardial apoptotic cell death. Furthermore, luciferase reporter assay revealed that hsa-miR-124-5p might be a mediator between NONHSAT069381 and mCASP3 and hsa-miR-6507-5p might be a mediator between NONHSAT140844 and mXIAP. Overexpression of hsa-miR-124-5p decreased caspase-3 levels and overexpression of hsa-miR-6507-5p decreased XIAP content in AC16 cells. We have found evidence that lncRNAs are important regulatory molecules in aging-mediated effects upon apoptosis. More interestingly, besides apoptosis-promoting effects, aging also inhibits myocardial apoptosis after H/R. This phenomenon also exists in the human cardiomyocyte line.