There is little information about the prognostic value of double product (DP) for acute coronary syndrome (ACS) patients treated with percutaneous coronary intervention (PCI). The aim of this study was to investigate whether DP reflects the predictive power of heart rate (HR) or systolic blood pressure (SBP) in ACS patients treated with PCI. A total of 7590 ACS patients who had undergone PCI, free from cardiac shock, were included. The follow-up duration was two years. The main adverse cardiovascular events (MACEs) included all-cause death, recurrent myocardial infarction and stroke. In the unadjusted model, significantly higher rates of MACEs were recorded in the high DP group (relative risk 1.41, 95%CI 1.08 to 1.83, p = 0.012). However, in the full adjusted models, after including HR and SBP, the predictive value of DP was not significant (relative risk 0.86, 95%CI 0.55 to1.33, p = 0.499). The predictive value of HR for MACEs was statistically significant (relative risk 1.74, 95% CI 1.33–2.28, p < 0.001). It was worth noting that the history of hypertension was strongly associated with MACEs (relative risk 1.53, 95% CI 1.11–2.11, p = 0.009). High DP is associated with MACEs for ACS patients treated with PCI. However, the predictive value of DP weakened when adjusted for HR. Therefore, we have shown that DP may reflect the predictive power of HR for ACS patients treated with PCI.
ABSTRACT
Objective: Induced abortion is widely practiced in China. However, the information on induced abortion is limited. A national cross-sectional survey was designed to determine the risk factors of induced abortion among Chinese women with one child.
Methods: We sampled 16,881 Chinese women with one living child for the study. A structured questionnaire was used to collect induced abortion and related health information. The National Research Institute for Family Planning of China conducted a cross-sectional study among women who had delivered a baby between 2006 and 2008. Information was collected in relation to demographic characteristics (age, ethnicity, region, area etc.), social economic status (education level and occupation), marriage, and the attitude towards potential child’s gender. Multi-logistic regression was used to test potential predictors for conducting abortion stratified by consistency between gender preference and current infants’ gender, and indicating adjusted estimation on selected models of risk factors for abortion.
Results: The mean age of participants was 27.96 ± 4.10 years (median 27 years). Among those women, the prevalence of induced abortion was 8.13 %. In the final model, females living in rural areas (OR = 1.21, 95 %CI: 1.04-1.39), individuals ages 18-25 (OR = 0.84, 95% CI: 0.72-0.99), individuals ages 30 or older (OR = 1.63, 95% CI: 1.42-1.86), and single individuals (OR = 1.72, 95% CI: 1.05-2.83) were more likely to experience induced abortion. Wife gender preference (OR = 0.66, 95 %CI: 0.53-0.83), husband gender preference (Boy: OR = 1.33, 95 %CI: 1.10-1.63; Girl: OR = 1.5, 95% CI: 1.22-1.86), and the area where the individuals were located were significantly associated with the reporting of induced abortion.
Conclusion: The prevalence of induced abortion is high among married women with child in China. There are also socio-demographic characteristics associated with induced abortion in China.
Purpose: To study the association between blood pressure (BP) SBP, DBP, mean arterial pressure (MAP) and pulse pressure (PP) and clinical outcome in acute hemorrhagic stroke patients in the Chinese population. Methods: 1,760 hemorrhagic stroke patients admitted to six hospitals from January 1, 2003 to December 31, 2005 were included in the study. BP and other variables were collected within the first 24-hr of admission. Clinical outcomes at discharge were evaluated by neurologists. Multivariate-adjusted odds ratios associated with increment of 1 standard deviation (SD) mmHg in four BP were determined by multiple logistic regression analysis. Results: The four BP indexes at admission were positively associated with death and SBP, DBP, MAP were associated with dependency. Adjusted odds ratios (95% confident interval) of death associated with increment of 1 SD mmHg were 1.74 (1.44,2.12), 1.39 (1.15,1.69),1.61 (1.32,1.96) and 1.66 (1.39,1.99) for SBP, DBP, MAP and PP, respectively (all P < 0.01), and adjusted odds ratio of dependency associated with increment of 1 SD mmHg was 1.15 (1.03,1.27), 1.21 (1.09,1.34) and 1.19 (1.07,1.32) for SBP, DBP and MAP, respectively (all P < 0.05). Conclusion: Increased SBP, DBP, MAP and PP at admission were all associated with in-hospital mortality, and increased SBP, DBP and MAP were associated with dependency at discharge among hemorrhagic stroke patients.
Interferon-induced protein 35 (IFI35) play a crucial role in the host's antiviral responses. However, research focusing on the characteristics of IFI35 genes in fish remains limited. In the present study, the IFI35 gene from hybrid snakehead was cloned and characterized. The potential interacting proteins of IFI35 to elucidate its role in disease resistance was also investigated. The open reading frame (ORF) of IFI35 was found to be 1119 bp, encoding a polypeptide with 372 amino acids. Sequence analysis revealed that the IFI35 protein in hybrid snakehead shares the highest identity with those in Micropterus salmoides and Siniperca chuatsi. Expression of the IFI35 gene was detected in all examined tissues of healthy fish, with the highest levels in the spleen, gills, and intestine. Under viral stress from SHVV, a significant induction of IFI35 expression was observed, especially in the liver and spleen. Yeast two-hybrid assays identified 21 proteins that interact with IFI35, including elongation factor 1-alpha (EF1α), ribosomal proteins, transcription factors, collagen, ferritin-like domain, cytochrome c oxidase, and short chain dehydrogenase, etc. Subsequent validation confirmed the interaction between IFI35 and EF1α by point-to-point validation. These findings suggest a significant role for IFI35 in the immune regulation of hybrid snakeheads, enhancing our understanding of its function and interaction networks, which could facilitate future explorations of IFI35 mechanisms in snakehead fish.
Introduction: We conducted a prespecified subgroup analysis to assess whether disease severity modifies the effect of early antihypertensive treatment on two-year mortality and major disability in acute ischemic stroke patients. Methods: The China Antihypertensive Trial in Acute Ischemic Stroke, a randomized, single-blind, blinded end-points trial, was conducted in 4,071 patients with ischemic stroke within 48 hours of onset and elevated systolic BP (SBP). Patients were randomly assigned to receive antihypertensive treatment (n=2,038) or to discontinue all antihypertensive medications (n=2,033) during hospitalization. Post-treatment follow-ups were conducted at 3, 12, and 24 months after hospital discharge. The primary outcome was a composite of death and major disability at the two-year follow-up visit. Results: At 24 hours after randomization, mean SBP differences (95% CIs) were -8.5 (-10.0 to -7.1), -9.8 (-11.4 to -8.3), and -9.1 (-14.4 to -3.8) mmHg between the treatment and control groups (all P <0.001) for patients with a baseline NIHSS score of 0-4, 5-15, and ≥16, respectively. At day 7 after randomization, the corresponding mean SBP differences were -9.3 (-10.5 to -8.2), -9.1 (-10.3 to -7.8), and -10.1 (-15.1 to -5.1) mm Hg between the treatment and control groups (all P <0.001). The event rates of primary outcome were not statistically significantly different between the antihypertensive treatment group and the control group according to baseline NIH stroke score or Rankin score (Table). Conclusions: Among patients with acute ischemic stroke, BP reduction with antihypertensive medications during hospitalization did not reduce or increase the composite outcome of death and major disability over two years according to disease severity at baseline.
To study the prognostic significance of multiple novel biomarkers in combination after ischemic stroke.We derived data from the China Antihypertensive Trial in Acute Ischemic Stroke, and 12 informative biomarkers were measured. The primary outcome was the combination of death and major disability (modified Rankin Scale score ≥3) at 3 months after ischemic stroke, and secondary outcomes included major disability, death, and vascular events.In 3,405 participants, 866 participants (25.4%) experienced major disability or died within 3 months. In multivariable analyses, elevated high-sensitive C-reactive protein, complement C3, matrix metalloproteinase-9, hepatocyte growth factor, and antiphosphatidylserine antibodies were individually associated with the primary outcome. Participants with a larger number of elevated biomarkers had increased risk of all study outcomes. The adjusted odds ratios (95% confidence intervals) of participants with 5 elevated biomarkers were 3.88 (2.05-7.36) for the primary outcome, 2.81 (1.49-5.33) for major disability, 5.67 (1.09-29.52) for death, and 4.00 (1.22-13.14) for vascular events, compared to those with no elevated biomarkers. Simultaneously adding these 5 biomarkers to the basic model with traditional risk factors led to substantial reclassification for the combined outcome (net reclassification improvement 28.5%, p < 0.001; integrated discrimination improvement 2.2%, p < 0.001) and vascular events (net reclassification improvement 37.0%, p = 0.001; integrated discrimination improvement 0.8%, p = 0.001).We observed a clear gradient relationship between the numbers of elevated novel biomarkers and risk of major disability, mortality, and vascular events. Incorporation of a combination of multiple biomarkers observed substantially improved the risk stratification for adverse outcomes in ischemic stroke patients.
Background and purpose Whether the association between galectin‐3 and stroke outcome is modified by fasting plasma glucose (FPG) is unknown. The aim was to evaluate the prognostic effect of galectin‐3 amongst ischaemic stroke patients stratified by FPG. Methods In all, 3082 ischaemic stroke patients were included in this study and serum galectin‐3 was tested at baseline. The primary outcome was a composite outcome of death and vascular events, and secondary outcomes were death, stroke recurrence and vascular events within 1 year after stroke. Results Increased galectin‐3 was significantly associated with the primary outcome, stroke recurrence and vascular events in the patients with hyperglycemia but not in those with normoglycemia ( P for interaction < 0.05 for all). The multivariate‐adjusted hazard ratios (95% confidence intervals) were 1.72 (1.05–2.84), 2.64 (1.14–6.12) and 2.68 (1.33–5.38) for the primary outcome, stroke recurrence and vascular events, respectively. A linear association between galectin‐3 and the primary outcome was observed in hyperglycemic patients ( P for linearity = 0.007). Conclusion Increased galectin‐3 was associated with the primary outcome, stroke recurrence and vascular events within 1 year after stroke in the patients with hyperglycemia, suggesting that galectin‐3 may be an important prognostic factor for ischaemic stroke patients with hyperglycemia.
To examine the association between serum matrix metalloproteinases-9 (MMP-9) levels and prognosis of acute ischemic stroke.We measured serum MMP-9 levels in 3,186 participants (2,008 men and 1,178 women) from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). Study outcome data on death, major disability (modified Rankin Scale score ≥3), and vascular disease were collected at 3 months after stroke onset.During 3 months of follow-up, 767 participants (24.6%) experienced major disability or died. Serum MMP-9 was significantly associated with an increased risk of death and major disability after adjustment for age, sex, time from onset to randomization, current smoking, alcohol drinking, admission NIH Stroke Scale score, diastolic blood pressure, plasma glucose, white blood cell counts, use of antihypertensive medications, and history of hypertension, coronary heart disease, and diabetes mellitus. For example, 1-SD (0.32 ng/mL) higher log-MMP-9 was associated with an odds ratio (95% confidence interval) of 1.16 (1.06-1.28) for the combined outcome of death and major disability, 1.12 (1.01-1.23) for major disability, and 1.29 (1.01-1.66) for death. The addition of serum MMP-9 to conventional risk factors improved risk prediction of the combined outcome of death or major disability (net reclassification index 9.1%, p = 0.033; integrated discrimination improvement 0.4%, p = 0.004).Higher serum MMP-9 levels in the acute phase of ischemic stroke were associated with increased risk of mortality and major disability, suggesting that serum MMP-9 could be an important prognostic factor for ischemic stroke.
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