Xinwen Weekly 丨 Professor Mu Jianjun: What are the middle -aged crisis for children with hypertension for children?

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In this issue of "Heart News Weekly", 6 clinical studies and 6 industry information are brought to everyone in the field of cardiovascular fields. At the same time, Professor Mu Jianjun, Professor Mu Jianjun, the First Affiliated Hospital of Xi'an Jiaotong University, in -depth interpretation Essence

"International Heart Research" main content

Lotal protein B can predict the risk of acute coronary syndrome

Lotal protein B (that is, APOB) helps evaluate the risk of atherosclerosis, but it is uncertain whether the residual risk of acute coronary syndrome (ACS) can be predicted. On June 30, a study published by Circulation reminded that among patients with an increased level of ACS and increased atherosclerotic lipoprotein levels in the near future, the baseline APOB level is related to the incidence of major adverse vascular events (MACE).

Study in 18,924 patients in the Odyssey Outcomes test recently occurred, although patients with higher levels of arteriosclerotic lipoprotein are still optimized, and the level of arteriosclerotic lipoprotein is still high. Followed for 2.8 years. The results showed that the incidence of MACE increased with the rise of the baseline APOB level. Compared with the placebo group, the ALIROCUMAB treatment can reduce MACE risks, and the higher the baseline APOB level, the greater the relative and absolute decrease of MACE risks.

Ischemic stroke venous thrombolytic alcheosen is not inferior to Adapinase

At present, the most important measure for acute ischemia to restore blood flow is venous thrombolytic, and Adapinase is a standard therapeutic drug. On June 29, the results of the ACT research published by "Liuye Knife" confirmed that within 4.5 hours of acute ischemic stroke, the efficacy and safety of vitamin venous thrombolytic therapy were comparable to that of Adinlase.

The III RCT clinical trial is included in 22 patients with 22 primary and comprehensive stroke centers in Canada. MG/KG), 97 days follow -up. In terms of validity, the proportion of MRS scores in the Nunipuyrase group and the Adinase group was 36.9 % and 34.8 %, respectively. 95 % CI: 2.6 to 6.9), meet the pre -set non -inferiority threshold. Safety analysis shows that the proportion of symptomatic cerebral hemorrhage within 24 hours after treatment was 3.4 % and 3.2 %, respectively, and the percentage of death within 90 days after the start of treatment was 15.3 %, respectively 15.3 %, respectively. With 15.4 %, there is no statistical difference. The results of the study suggest that for all patients with acute ischemic strokes in accordance with thrombolytic indications, venous injection is a reasonable choice for alternative Antidase.

Postoperative atrial fibrillation increases the risk of heart failure hospitalization

Clinically, postoperative atrial fibrillation is usually deemed to be a relatively benign event caused by surgical stress and catecholamine release. On June 28, a retrospective queue published by the EUROPEAN Heart Journal showed that the risk of heart failure in patients with atrial fibrillation after surgery increased the risk of heart failure in the future.

Studies were included in patients with a history of more than 3 million centers in the United States. Of the 77,000 patients who underwent cardiac surgery, 18.8 % of the postoperative atrial fibrillation occurred by 18.8 %; after 1.7 years of follow -up, it was found that compared with patients who did not occur, patients with atrial fibrillation had increased by 33 % due to the risk of heart failure hospitalization due to heart failure. (95 % CI: 1.25 ～ 1.41). Among more than 2.92 million patients undergoing non -cardiac surgery, 0.8 % had atrial fibrillation, and patients with atrial fibrillation had doubled due to heart failure (HR = 2.02, 95 % CI: 1.94 ～ 2.10). The study reminds that postoperative atrial fibrillation is related to the hospitalization of heart failure in the future. After surgery, atrial fibrillation may be a pioneering sign of heart failure. Decreased systolic blood pressure is more common among patients with reflexive syncope

At present, there is still a lack of diagnostic standards for dynamic blood pressure monitoring in patients with suspected reflexive syncope. On June 29th, the results of the Synabpm 1 research published by EUROPEAN Heart Journal showed that the reduction of systolic blood pressure during dynamic blood pressure monitoring is more common among patients with reflex syncope.

Study analysis of derivative samples and verification samples, which were included in 158 syncous patients and 329 comparisons in derivative samples. Compared with the control group, daily systolic blood pressure is more common among syncidal patients. 1 or multiple daily contraction voltage drops to <90 mmHg's specificity of 91 %, sensitivity is 32 %, and the corresponding advantage ratio is to be the corresponding advantage ratio to the ratio. 4.6 (P <0.001). The positive and negative prediction values ​​are 62 % and 73 %, respectively. The verification sample analyzed and confirmed the 164 syncope patients and 164 controller. Compared with the control group, the proportion of daily systolic blood pressure during the control group increased significantly. As of <90 mmHg, the specificity and sensitivity of patients with halo were 94 % and 29 %, respectively, and the corresponding advantage ratio was 6.2 (P <0.001). Studies have shown that systolic blood pressure <90 mmHg is the best critical value to identify patients with hypotension perceptual reflexive syncope.

Chronic coronary heart disease combined with nephropathy, intrusion treatment benefits are limited

Research on the invasion and conservative treatment of chronic coronary arterial diseases did not include severe chronic nephropathy. On June 29, Jama Cardiology published a secondary analysis of iSchemia and iSchemia-CKD. The analysis was incorporated into 5,956 patients with chronic coronary heart disease with chronic nephropathy. End, death, cardiovascular death, myocardial infarction, and stroke risk monotonous increase. Invasive therapy is related to the increase of stroke and surgery -related cardiac infarction, and it is related to the reduction of spontaneous myocardial infarction. There is no difference in other endings and similar results in patients with chronic nephropathy at all stages. Invasive therapy is related to the improvement of angina pectoris related to patients with chronic nephropathy, and the quality of life of patients with 1 to 3, while patients with Phase 4 and Phase 5 have not been significantly improved.

Type 0 binary aortic valve is more conducive to protecting the tavr rear coronary pathway

It is unclear whether the coronary path path of the two -leaf and tritenal aortic valve after TAVR surgery is different. On June 24th, Professor Chen Mao of Huaxi Hospital of Sichuan University published a research results on the EuroIntervention. The anatomy of the type 0 dilateral aortic valve may be more conducive to the protection of the coronary pathway of the TAVR after surgery.

Studies were included in 86 patients with type 0 dilateral aortic valve, 70 patients with type 1 dilateral aortic valve and 132 three -leaf aortic valve patients. The proportion of non -performing coronary pathways associated with the Crossing Perid Vercles (THV) of the Self -Expansion Tube (THV) occurring the proportion of adverse coronary pathways related to the adverse coronary vein is 21.2 % and 17.7 %, respectively. The incidence of the pathway is lower than that of the trioma. Left and right coronary arteries are observed with adverse coronary pathways related to native petal leaves, respectively.

The main content of "industry mind dynamics"

On June 28, the latest SCI influence factor in 2022 was officially released. In the field of cardiovascular, the top five journals affecting factors are Nature Reviews Cardiology, Circulation, EUROPEAN Heart Journal, Jama Cardiology, and JACC.

On June 29, AHA released a document proposed the "Life's Essential 8", updated and strengthened the concept of cardiovascular health, and added sleep health.

Recently, the American Heart Association (AHA) issued a statement on the Circulation Research, suggesting that adolescents sucking electronic cigarettes may affect respiratory and cardiovascular systems.

Recently, the American Ultrasonic Cardiac Map Society (ASE) jointly learned the "Multi -Mode Cardiovascular Imaging Examination (Update)" of hypertrophic cardiomyopathy patients.

On June 29, the National Pharmaceutical and Health Technology Comprehensive Evaluation Center, together with relevant units, formulated the "Technical Guide to Clinical Evaluation of Cardiovascular Diseases (Trial of the 2022 Edition)".

Recently, EuroIintervention published the FIM research results of the mechanical embolism device NEVA, which confirmed the safety and effectiveness of patients with acute coronary syndrome with acute coronary syndrome with a large number of thrombosis."Every week's heart comment" content summary

Review new views and talk about new trends. This is a weekly comments.Recently, the Hypertension Magazine published the latest achievements of Professor Mu Jianjun, Professor Mu Jianjun, the First Affiliated Hospital of Xi'an Jiaotong University, to further reveal the connection between long -term blood pressure variability and adult sub -clinical kidney damage.In this issue, we specially invited Professor Mu Jianjun to interpret the results of the research.

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