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| 1 | Clinical significance of diabetes on symptom and patient delay among patients with acute myocardial infarction——an analysis from China Acute Myocardial Infarction(CAMI) registry显示文摘Background Diabetes is frequently associated with poor prognosis among acute myocardial infarction(AMI)patients.Patients with these comorbidities often have atypical symptoms and subsequent delay in treatment.Few studies have reported detailed AMI symptoms in patients with diabetes.This study compared AMI symptoms and presentation characteristics between diabetics and non-diabetics.Methods We included patients from the China AMI registry diagnosed with AMI between January 2013 and September 2014.Baseline characteristics,symptomology,and delay in treatment were compared between diabetics and non-diabetics.Multivariable logistic regression analysis was used to explore independent predictors of atypical symptoms.Results A total of 4450(20.2%)patients had diabetes.They were older,more often women,higher in body mass index,and more likely to have non-ST segment elevation myocardial infarction.Fewer diabetic patients presented with persistent precordial chest pain(63.1%vs.68%,P<0.0001),diaphoresis(60.1%vs.65.6%,P<0.0001),fatigue(16.7%vs.18.3%,P=0.0123),and incontinence(0.4%vs.0.7%,P=0.0093).Time to hospital presentation was longer among patients with diabetes than those without.In multivariable analysis,diabetes was identified as an independent predictor of atypical symptoms(OR:1.112,95%CI:1.034?1.196).Conclusions Our study is the first large-scale study providing evidence that diabetics are less likely to present with typical chest pain and more likely to experience treatment delay when suffering from an AMI.Our results may increase clinician awareness of recognizing AMI patients rapidly to reduce diagnosis and treatment delay,particularly in the context of diabetes. | Rui FU Si-Dong LI Chen-Xi SONG Jing-Ang YANG Hai-Yan XU Xiao-Jin GAO Yi XU Jian-Ping ZENG Jun-Nong LI Ke-Fei DOU Yue-Jin YANG on behalf of the CAMI Registry study group Beijing,China | 2019 | Journal of Geriatric Cardiology2019，16，5： | 21 |
| 2 | Angiographic characteristics and in-hospital mortality among patients with ST-segment elevation myocardial infarction presenting without typical chest pain: an analysis of China Acute Myocardial Infarction registry显示文摘Background:Patients with ST-segment elevation myocardial infarction(STEMI)who present without typical chest pain are associated with a poor outcome.However,whether angiographic characteristics are related to a higher risk of mortality in this population is unclear.This study aimed to investigate whether the higher mortality risk in patients with STEMI without chest pain could be explained by their'high-risk'angiographic characteristics.Methods:We used data of 12,145 patients with STEMI who was registered in China Acute Myocardial Infarction registry from January 2013 to September 2014.We compared the infarct-related artery(IRA),thrombolysis in myocardial infarction(TIMI)flow grade in the IRA,and other angiographic characteristics between patients without and those with chest pain.Multivariable logistic regression model was used to identify independent risk factor of in-hospital mortality.Results:The 2922(24.1%)patients with STEMI presented without typical chest pain.These patients had a higher TIMI flow grade(mean TIMI flow grade:1.00 vs.0.94,P=0.02)and a lower rate of IRA disease of the left anterior descending artery(44.6%vs.51.2%,χ^2=35.63,P<0.01)than did those with typical chest pain.Patients without chest pain were older,more likely to have diabetes,longer time to hospital and higher Killip classification,and less likely to receive optimal medication treatment and primary percutaneous coronary intervention and higher In-hospital mortality(3.3%vs.2.2%,χ^2=10.57,P<0.01).After adjusting for multi-variables,presentation without chest pain was still an independent predictor of in-hospital death among patients with STEMI(adjusted odds ratio:1.36,95%confidence interval:1.02–1.83).Conclusions:Presentation without chest pain is common and associated with a higher in-hospital mortality risk in patients with acute myocardial infarction.Our results indicate that their poor prognosis is associated with baseline patient characteristics and delayed treatment,but not angiographic lesion characteristics.Clinical trial registration:NCT01874691,http://gffzzd3f38a9638994581s0wxnvxbvc5nn6cfb.ffgz.tsg.suse.edu.cn. | Chen-Xi Song Rui Fu Jin-Gang Yang Hai-Yan Xu Xiao-Jin Gao Chun-Yue Wang Yang Zheng Shao-Bin Jia Ke-Fei Dou Yue-Jin Yang on behalf of the CAMI Registry study group | 2019 | Chinese Medical Journal2019，，19： | 11 |
| 3 | 急性高血糖对ST段抬高性心肌梗死院内预后的影响显示文摘目的探讨急性高血糖对 ST 段抬高性心肌梗死(STEMI)患者院内预后的影响。方法连续入选356例北京地区17家三级和二级医院所有在24h 内入院且符合 STEMI 诊断标准的患者。以人院血糖水平>11mmol/L 判定为高血糖,分为高血糖组和血糖正常组,观察两组患者院内死亡和心血管病事件的发生情况。院内心血管事件定义为院内再发心肌梗死、新发生的心力衰竭、严重心律失常及卒中。结果 356例 STEMI 患者中,存在急性高血糖患者共81例(22.8%)。其院内病死率较无急性高血糖患者显著增加(13.6%比5.1%,P=0.009),院内心血管事件发生率亦显著增多(32.1%比20.4%,P=0.027)。logistic 回归分析示,入院急性高血糖(OR 1.615,95%CI 1.116~2.338,P=0.011)为 STEMI 患者院内不良预后的独立危险因素。结论 STEMI 急性高血糖患者院内死亡及发生院内心血管事件的危险性显著高于入院血糖正常者。入院高血糖为 STEMI 患者院内不良预后的独立危险因素。 | Registry of acute treatment in myocardial infarction investigators. | 2007 | 中华内科杂志2007，46，10： | 9 |
| 4 | SinoSCORE:a logistically derived additive prediction model for post-coronary artery bypass grafting in-hospital mortality in a Chinese population显示文摘This study aims to construct a logistically derived additive score for predicting in-hospital mortality risk in Chinese patients undergoing coronary artery bypass surgery(CABG).Data from 9839 consecutive CABG patients in 43 Chinese centers were collected between 2007 and 2008 from the Chinese Coronary Artery Bypass Grafting Registry.This database was randomly divided into developmental and validation subsets(9:1).The data in the developmental dataset were used to develop the model using logistic regression.Calibration and discrimination characteristics were assessed using the validation dataset.Thresholds were defined for each model to distinguish different risk groups.After excluding 275 patients with incomplete information,the overall mortality rate of the remaining 9564 patients was 2.5%.The SinoSCORE model was constructed based on 11 variables:age,preoperative NYHA stageⅢorⅣ,chronic renal failure,extracardiac arteriopathy,chronic obstructive pulmonary disease,preoperative atrial fibrillation or flutter(within 2 weeks),left ventricular ejection fraction,other elective surgery,combined valve procedures,preoperative critical state,and BMI.In the developmental dataset,calibration using a Hosmer-Lemeshow(HL)test was at P=0.44 and discrimination based on the area under the receiver operating characteristic curve(ROC)was 0.80.In the validation dataset,the HL test was at P=0.34 and the area under the ROC(AUC)was 0.78.A logistically derived additive model for predicting in-hospital mortality among Chinese patients undergoing CABG was developed based on the most up-to-date multi-center data from China. | Zhe Zheng Lu Zhang Xi Li Shengshou Hu behalf of the Chinese CABG Registry Study | 2013 | Frontiers of Medicine2013，7，4： | 4 |
| 5 | Gender differences in clinical outcomes of acute myocardial infarction undergoing percutaneous coronary intervention: insights from the KAMIR-NIH Registry显示文摘Background There are numerous but conflicting data regarding gender differences in outcomes following percutaneous coronary intervention(PCI). Furthermore, gender differences in clinical outcomes with acute myocardial infarction(AMI) following PCI in Asian population remain uncertain because of the under-representation of Asian in previous trials. Methods A total of 13,104 AMI patients from Korea Acute Myocardial Infarction Registry-National Institute of Health(KAMIR-NIH) between November 2011 and December 2015 were classified into male(n = 8021, 75.9%) and female(n = 2547, 24.1%). We compared the demographic, clinical and angiographic characteristics, 30-days and 1-year major adverse cardiac and cerebrovascular events(MACCE) in women with those in men after AMI by using propensity score(PS) matching. Results Compared with men, women were older, had more comorbidities and more often presented with non-ST segment elevation myocardial infarction(NSTEMI) and reduced left ventricular systolic function. Over the median follow-up of 363 days, gender differences in both 30-days and 1-year MACCE as well as thrombolysis in myocardial infarction minor bleeding risk were not observed in the PS matched population(30-days MACCE: 5.3% vs. 4.7%, log-rank P = 0.494, HR = 1.126, 95% CI: 0.800-1.585;1-year MACCE: 9.3% vs. 9.0%, log-rank P = 0.803, HR = 1.032, 95% CI: 0.802-1.328;TIMI minor bleeding: 4.9% vs. 3.9%, log-rank P = 0.215, HR = 1.255, 95% CI: 0.869-1.814). Conclusions Among Korean AMI population undergoing contemporary PCI, women, as compared with men, had different clinical and angiographic characteristics but showed similar 30-days and 1-year clinical outcomes. The risk of bleeding after PCI was comparable between men and women during one-year follow up. | Myunhee Lee Dae-Won Kim Mahn-Won Park Kyusup Lee Kiyuk Chang Wook Sung Chung Tae Hoon Ahn Myung Ho Jeong Seung-Woon Rha Hyo-Soo Kim Hyeon Cheol Gwon In Whan Seong Kyung Kuk Hwang Shung Chull Chae Kwon-Bae Kim Young Jo Kim Kwang Soo Cha Seok Kyu Oh Jei Keon Chae Ji-Hoon Jung 无 KAMIR-NIH registry investigators | 2020 | Journal of Geriatric Cardiology2020，17，11： | 3 |
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