Background This prospective study integrated multiple clinical indexes and inflammatory markers associated with coronary atherosclerotic vulnerable plaque to establish a risk prediction model that can evaluate a patie...Background This prospective study integrated multiple clinical indexes and inflammatory markers associated with coronary atherosclerotic vulnerable plaque to establish a risk prediction model that can evaluate a patient with certain risk factors for the likelihood of the occurrence of a coronary heart disease event within one year. Methods This study enrolled in 2686 patients with mild to moderate coronary artery lesions. Eighty-five indexes were recorded, included baseline clinical data, laboratory studies, and procedural characteristics. During the 1-year follow-up, 233 events occurred, five patients died, four patients suffered a nonfatal myocardial infarction, four patients underwent revascularization, and 220 patients were readmitted for angina pectoris. The Risk Estimation Model and the Simplified Model were conducted using Bayesian networks and compared with the Single Factor Models. Results The area under the curve was 0.88 for the Bayesian Model and 0.85 for the Simplified Model, while the Single Factor Model had a maximum area under the curve of 0.65. Conclusion The new models can be used to assess the short-term risk of individual coronary heart disease events and may assist in guiding preventive care.展开更多
Background Growth differentiation factor-15(GDF-15)is involved in multiple processes that are associated with coronary artery disease(CAD).However,little is known about the association between GDF-15 and the future is...Background Growth differentiation factor-15(GDF-15)is involved in multiple processes that are associated with coronary artery disease(CAD).However,little is known about the association between GDF-15 and the future ischemic events in patients with intermediate CAD.This study was conducted to investigate whether plasma GDF-15 constituted risk biomarkers for future cardiovascular events in patients with intermediate CAD.Methods A prospective study was performed based on 541 patients with intermediate CAD(20%–70%).GDF-15 of each patient was determined in a blinded manner.The primary endpoint was major adverse cardiac event(MACE),which was defined as a composite of all-cause death,nonfatal myocardial infarction,revascularization and readmission due to angina pectoris.Results After a median follow-up of 64 months,504 patients(93.2%)completed the follow-up.Overall,the combined endpoint of MACE appeared in 134 patients(26.6%)in the overall population:26 patients died,11 patients suffered a nonfatal myocardial infarction,51 patients underwent revascularization,and 46 patients were readmitted for angina pectoris.The plasma levels of GDF-15(median:1172.02 vs.965.25 pg/m L,P=0.014)were higher in patients with ischemic events than those without events.After adjusting for traditional risk factors,higher GDF-15 levels were significantly associated with higher incidence of the composite endpoint of MACE(HR=1.244,95%CI:1.048–1.478,Quartile 4 vs.Quartile 1,P=0.013).Conclusions The higher level of GDF-15 was an independent predictor of long-term adverse cardiovascular events in patients with intermediate CAD.展开更多
BACKGROUND The association between uric acid-albumin ratio(UAR)with different diseases has been evaluated before.However,the association between UAR with spontaneous reperfusion(SR)in patients with ST-segment elevatio...BACKGROUND The association between uric acid-albumin ratio(UAR)with different diseases has been evaluated before.However,the association between UAR with spontaneous reperfusion(SR)in patients with ST-segment elevation myocardial infarction(STEMI)has not been explored.METHODS STEMI patients admitted to our department and underwent primary coronary angiography between 1st November 2018 and 31st December 2020 were retrospectively enrolled.The patients were divided into the SR group and the non-SR group according to the index coronary angiography results.The association between UAR and SR was evaluated by uni-variable and multi-variable logistic analysis.Receiver operating characteristic curve analysis was used to determine the optimum cut-off level of UAR in predicting SR.RESULTS Three hundred and fifty-seven patients were finally enrolled in our study,55 patients were divided into the SR group and 302 patients were divided into the non-SR group.In uni-variable analysis,patients with SR were older(P=0.032),with higher red blood cell distribution width(P<0.001)and red blood cell distribution width-to-platelet ratio(P<0.001),higher level of C-reactive protein(P=0.046),higher level of uric acid(P<0.001)compared with patients without SR.Patients with SR had a lower level of platelets(P=0.008),lower level of on-admission B-type natriuretic peptide(P<0.001).As for the level of UAR,STEMI patients with SR had significantly higher levels of UAR compared with STEMI patients without SR[11.1(8.9–13.4)vs.8.3(6.6–10.0),P<0.001].Further multi-variable logistic analysis reveals that UAR was the independent risk factor of SR in different models after adjusting different variables.Receiver operating characteristic analysis showed that UAR had good predictive value in SR(AUC=0.75,95%CI:0.702–0.794,P<0.01).CONCLUSIONS Our study shows that UAR is an independent risk factor for predicting SR in STEMI patients.展开更多
Platelets are reprogrammed by cancer via a process called education,which favors cancer development.The transcriptional profile of tumor-educated platelets(TEPs)is skewed and therefore practicable for cancer detection...Platelets are reprogrammed by cancer via a process called education,which favors cancer development.The transcriptional profile of tumor-educated platelets(TEPs)is skewed and therefore practicable for cancer detection.This intercontinental,hospital-based,diagnostic study included 761 treatment-naive inpatients with histologically confirmed adnexal masses and 167 healthy controls from nine medical centers(China,n=3;Netherlands,n=5;Poland,n=1)between September 2016 and May 2019.The main outcomes were the performance of TEPs and their combination with CA125 in two Chinese(VC1 and VC2)and the European(VC3)validation cohorts collectively and independently.Exploratory outcome was the value of TEPs in public pan-cancer platelet transcriptome datasets.The AUCs for TEPs in the combined validation cohort,VC1,VC2,and VC3 were 0.918(95%CI 0.889-0.948),0.923(0.855-0.990),0.918(0.872-0.963),and 0.887(0.813-0.960),respectively.Combination of TEPs and CA125 demonstrated an AUC of 0.922(0.889-0.955)in the combined validation cohort;0.955(0.912-0.997)in VC1;0.939(0.901-0.977)in VC2;0.917(0.824-1.000)in VC3.For subgroup analysis,TEPs exhibited an AUC of o.858,0.859,and 0.920 to detect early-stage,borderline,non-epithelial diseases and 0.899 to discriminate ovarian cancer from endometriosis.TEPs had robustness,compatibility,and universality for preop.erative diagnosis of ovarian cancer since it withstood validations in populations of different ethnicities,heterogeneous histoiogical subtypes,and early-stage ovarian cancer.However,these observations warrant prospective validations in a larger population beforeclinicalutilities.展开更多
文摘Background This prospective study integrated multiple clinical indexes and inflammatory markers associated with coronary atherosclerotic vulnerable plaque to establish a risk prediction model that can evaluate a patient with certain risk factors for the likelihood of the occurrence of a coronary heart disease event within one year. Methods This study enrolled in 2686 patients with mild to moderate coronary artery lesions. Eighty-five indexes were recorded, included baseline clinical data, laboratory studies, and procedural characteristics. During the 1-year follow-up, 233 events occurred, five patients died, four patients suffered a nonfatal myocardial infarction, four patients underwent revascularization, and 220 patients were readmitted for angina pectoris. The Risk Estimation Model and the Simplified Model were conducted using Bayesian networks and compared with the Single Factor Models. Results The area under the curve was 0.88 for the Bayesian Model and 0.85 for the Simplified Model, while the Single Factor Model had a maximum area under the curve of 0.65. Conclusion The new models can be used to assess the short-term risk of individual coronary heart disease events and may assist in guiding preventive care.
基金supported by the Beijing Municipal Science and Technology Committee(D0906006000091)the Ministry of Science and Technology of the People’s Republic of China,State Science and Technology Support Program(No.2011BAI11B05).
文摘Background Growth differentiation factor-15(GDF-15)is involved in multiple processes that are associated with coronary artery disease(CAD).However,little is known about the association between GDF-15 and the future ischemic events in patients with intermediate CAD.This study was conducted to investigate whether plasma GDF-15 constituted risk biomarkers for future cardiovascular events in patients with intermediate CAD.Methods A prospective study was performed based on 541 patients with intermediate CAD(20%–70%).GDF-15 of each patient was determined in a blinded manner.The primary endpoint was major adverse cardiac event(MACE),which was defined as a composite of all-cause death,nonfatal myocardial infarction,revascularization and readmission due to angina pectoris.Results After a median follow-up of 64 months,504 patients(93.2%)completed the follow-up.Overall,the combined endpoint of MACE appeared in 134 patients(26.6%)in the overall population:26 patients died,11 patients suffered a nonfatal myocardial infarction,51 patients underwent revascularization,and 46 patients were readmitted for angina pectoris.The plasma levels of GDF-15(median:1172.02 vs.965.25 pg/m L,P=0.014)were higher in patients with ischemic events than those without events.After adjusting for traditional risk factors,higher GDF-15 levels were significantly associated with higher incidence of the composite endpoint of MACE(HR=1.244,95%CI:1.048–1.478,Quartile 4 vs.Quartile 1,P=0.013).Conclusions The higher level of GDF-15 was an independent predictor of long-term adverse cardiovascular events in patients with intermediate CAD.
文摘BACKGROUND The association between uric acid-albumin ratio(UAR)with different diseases has been evaluated before.However,the association between UAR with spontaneous reperfusion(SR)in patients with ST-segment elevation myocardial infarction(STEMI)has not been explored.METHODS STEMI patients admitted to our department and underwent primary coronary angiography between 1st November 2018 and 31st December 2020 were retrospectively enrolled.The patients were divided into the SR group and the non-SR group according to the index coronary angiography results.The association between UAR and SR was evaluated by uni-variable and multi-variable logistic analysis.Receiver operating characteristic curve analysis was used to determine the optimum cut-off level of UAR in predicting SR.RESULTS Three hundred and fifty-seven patients were finally enrolled in our study,55 patients were divided into the SR group and 302 patients were divided into the non-SR group.In uni-variable analysis,patients with SR were older(P=0.032),with higher red blood cell distribution width(P<0.001)and red blood cell distribution width-to-platelet ratio(P<0.001),higher level of C-reactive protein(P=0.046),higher level of uric acid(P<0.001)compared with patients without SR.Patients with SR had a lower level of platelets(P=0.008),lower level of on-admission B-type natriuretic peptide(P<0.001).As for the level of UAR,STEMI patients with SR had significantly higher levels of UAR compared with STEMI patients without SR[11.1(8.9–13.4)vs.8.3(6.6–10.0),P<0.001].Further multi-variable logistic analysis reveals that UAR was the independent risk factor of SR in different models after adjusting different variables.Receiver operating characteristic analysis showed that UAR had good predictive value in SR(AUC=0.75,95%CI:0.702–0.794,P<0.01).CONCLUSIONS Our study shows that UAR is an independent risk factor for predicting SR in STEMI patients.
文摘Platelets are reprogrammed by cancer via a process called education,which favors cancer development.The transcriptional profile of tumor-educated platelets(TEPs)is skewed and therefore practicable for cancer detection.This intercontinental,hospital-based,diagnostic study included 761 treatment-naive inpatients with histologically confirmed adnexal masses and 167 healthy controls from nine medical centers(China,n=3;Netherlands,n=5;Poland,n=1)between September 2016 and May 2019.The main outcomes were the performance of TEPs and their combination with CA125 in two Chinese(VC1 and VC2)and the European(VC3)validation cohorts collectively and independently.Exploratory outcome was the value of TEPs in public pan-cancer platelet transcriptome datasets.The AUCs for TEPs in the combined validation cohort,VC1,VC2,and VC3 were 0.918(95%CI 0.889-0.948),0.923(0.855-0.990),0.918(0.872-0.963),and 0.887(0.813-0.960),respectively.Combination of TEPs and CA125 demonstrated an AUC of 0.922(0.889-0.955)in the combined validation cohort;0.955(0.912-0.997)in VC1;0.939(0.901-0.977)in VC2;0.917(0.824-1.000)in VC3.For subgroup analysis,TEPs exhibited an AUC of o.858,0.859,and 0.920 to detect early-stage,borderline,non-epithelial diseases and 0.899 to discriminate ovarian cancer from endometriosis.TEPs had robustness,compatibility,and universality for preop.erative diagnosis of ovarian cancer since it withstood validations in populations of different ethnicities,heterogeneous histoiogical subtypes,and early-stage ovarian cancer.However,these observations warrant prospective validations in a larger population beforeclinicalutilities.
