Impact of Duration of Diabetes Mellitus on Long-Term Outcome in Type 2 Diabetic Patients with Primary Percutaneous Coronary Intervention after the First Myocardial Infarction.

BACKGROUND: Diabetes mellitus (DM) increases the risk of mortality in patients with acute myocardial infarction (AMI). The impact of the diabetes duration on the long-term outcome of those with percutaneous coronary intervention (PCI) after the first AMI is unclear. In this study, we evaluated the predictive value of diabetes duration in the occurrence of major adverse cardiovascular and cerebrovascular events (MACCEs). METHODS: A total of 394 type 2 DM patients with PCI after the first AMI were enrolled and were divided into two groups by the diabetes duration: a short-DM group with diabetes duration of <5 years and a long-DM group with a duration of ≥5 years. The clinical endpoint was MACCEs. RESULTS: Multivariate Cox regression analysis found that the diabetes duration was independently associated with increased occurrence of MACCEs (HR: 1.512, 95% CI: 1.033, 2.215, p = 0.034), along with hypertension, Killip class III or IV, creatinine, multivessel disease, and continuous hypoglycemic therapy. After adjusting for the confounding variables, a nested Cox model showed that diabetes duration was still an independent risk factor of MACCEs (HR: 1.963, 95% CI: 1.376, 2.801, p < 0.001). The Kaplan-Meier survival curve illustrated a significantly high risk of MACCEs (HR: 2.045, p < 0.0001) in long-duration DM patients. After propensity score matching, a longer diabetes duration was associated with an increased risk of MACCE occurrence. CONCLUSION: Long-duration diabetes was independently associated with poor clinical outcomes after PCI in patients with their first myocardial infarction. Despite the diabetes duration, continuous hypoglycemic therapy significantly improved long-term clinical outcomes.

Effects of Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting on Clinical Outcomes in Patients with Reduced Ejection Fraction Heart Failure and Coronary Heart Disease: A Meta-Analysis.

OBJECTIVE: To clarify the effects of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) on the clinical outcomes of patients with coronary heart disease (CHD) complicated with reduced ejection fraction heart failure (HFrEF) through meta-analysis. METHODS: Three major literature databases - PubMed, Web of Science, and Cochrane - were searched by search terms and the literature retrieval time was publications dating from January 2007 to December 2021. To search for observational studies and randomized controlled trials (RCT) comparing the efficacy of PCI and CABG in patients with CHD and HFrEF, the abstract or full text of the literature was read and the final included literature was determined, according to inclusion and exclusion criteria. The quality of the included literature was evaluated using the Ottawa scale and data extraction was further completed. Data analysis was made using RevMan5.4 and R4.1 software; relevant forest plots and funnel plots were made, according to the extracted data. Egger's test was used to evaluate whether the data had publication bias. Outcomes were the major adverse cardiovascular events (MACE). RESULTS: A total of 10 studies were included and 11,032 subjects were included, made up of 5,521 cases of PCI and 5,511 cases of CABG. The results showed no significant difference between the two groups in cardiac mortality (CM) (RR=1.13, 95% CI 0.98-1.30, P = 0.10) and in overall all-cause mortality (ACM) (RR=1.12, 95% CI 0.92-1.37, P = 0.25). In the subgroup analysis of ACM, in the subgroups with left ventricular ejection fraction (LVEF) less than 35% and exceeding 35% and less than 50% (RR=1.12, 95% CI 0.92-1.37, P = 0.25) between the two groups, there was no statistical difference. However, among other MACE, compared with the PCI group, the CABG group had a lower risk of MACE (RR=1.58, 95%CI 1.49-1.70, P < 0.00001), myocardial infarction (MI) (RR=1.99, 95% CI 1.02-3.88, P = 0.04), heart failure (HF) (RR=1.29, 95% CI 1.17-1.43, P < 0.00001) and revascularization (RR=2.74, 95% CI 1.93-3.90, P < 0.00001). Finally in the CABG group, the risk of stroke or transient ischemic attack (TIA) was higher (RR=0.71, 95% CI 0.58-0.86, P = 0.0006) than the PCI group. CONCLUSIONS: The mortality rates of PCI and CABG were similar in patients with CHD complicated with HFrEF. Compared with PCI, CABG had a lower incidence of MACE, MI, HF, and revascularization, and a higher incidence of stroke or TIA.

rAAV9-Mediated MEK1 Gene Expression Restores Post-conditioning Protection Against Ischemia Injury in Hypertrophic Myocardium.

PURPOSE: We investigated whether increased expression of activated mitogen-activated protein kinase (MAPK) kinases 1 (MEK1) restores ischemic post-conditioning (IPostC) protection in hypertrophic myocardium following ischemia/reperfusion (I/R) injury. METHODS: C57Bl/6 mice received recombinant adeno-associated virus type 9 (rAAV9)-mediated activated MEK1 gene delivery systemically, then following the induction of cardiac hypertrophy via transverse aortic constriction for 4 weeks. In a Langendorff model, hypertrophic hearts were subjected to 40 min/60 min I/R or with IPostC intervention consisting of 6 cycles of 10 s reperfusion and 10 s no-flow before a 60-min reperfusion. Hemodynamics, infarct size (IS), myocyte apoptosis and changes in expression of reperfusion injury salvage kinase (RISK) pathway were examined. RESULTS: rAAV9-MEK1 gene delivery led to a 4.3-fold and 2.7-fold increase in MEK1 mRNA and protein expression in the heart versus their control values. I/R resulted in a larger IS in hypertrophic than in non-hypertrophic hearts (52.3 ± 4.7% vs. 40.0 ± 2.5%, P < 0.05). IPostC mediated IS reduction in non-hypertrophic hearts (27.6 ± 2.6%, P < 0.05), while it had no significant effect in hypertrophic hearts (46.5 ± 3.1%, P=NS) compared with the IS in non-hypertrophic or hypertrophic hearts subjected to I/R injury only, respectively. Hemodynamic decline induced by I/R was preserved by IPostC in non-hypertrophic hearts but not in hypertrophic hearts. rAAV9-MEK1 gene delivery restored IPostC protection in hypertrophic hearts evidenced by reduced IS (32.0 ± 2.8% vs. 46.5 ± 3.1%) and cardiac cell apoptosis and largely preserved hemodynamic parameters. These protective effects were associated with significantly increased phosphorylation of ERK1/2 and ribosomal protein S6 kinases (p70S6K), but it had no influence on Akt and glycogen synthase kinase-3ß. CONCLUSION: These results demonstrated that rAAV9-mediated activated MEK1 expression restores IPostC protection in the hypertrophic heart against I/R injury through the activation of ERK pathway.

Monocyte to high-density lipoprotein cholesterol ratio as long-term prognostic marker in patients with coronary artery disease undergoing percutaneous coronary intervention.

BACKGROUND: The relation between monocyte to high-density lipoprotein cholesterol ratio (MHR) and coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains controversial. The present study aims to assess the prognostic value of MHR in patients with CAD who underwent PCI. METHODS: A total of 673 CAD patients were retrospectively enrolled and divided into four groups according to MHR values. Multivariate Cox regression analysis was performed to study the effects of different variables to clinical outcomes reported as major adverse cardiac events (MACE) and all-cause mortality (ACM). RESULTS: In a multivariate Cox analysis, after adjustment of other confounders, MHR was found to be an independent predictor of ACM (HR: 3.655; 95% CI: 1.170-11.419, P = 0.026) and MACE (HR =2.390, 95% CI 1.379-4.143, p < 0.002). Having a MHR in the third and fourth quartile were associated with a 2.83-fold and 3.26 -flod increased risk of MACE. CONCLUSIONS: MHR is an independent predictor of ACM and MACE in CAD patients undergoing PCI.

FrzA gene protects cardiomyocytes from H2O2-induced oxidative stress through restraining the Wnt/Frizzled pathway.

BACKGROUND: Lately, there is accumulating evidence that the Wnt/Frizzled pathway is reactivated after myocardial infarction, the inhibition of the pathway is beneficial since it reduce of myocardial apoptosis and prevents heart failure. FrzA/Sfrp-1, a secreted frizzled-related protein and antagonist for the wnt/frizzled pathway. We assessed the hypothesis that FrzA protects cardiomyocytes from H2O2-Induced Oxidative damage through the inhibition of Wnt/Frizzled pathway activity. METHODS: We used a recombinant AAV9 vector to deliver FrzA gene into neonatal rat ventricle myocytes and developed an oxidative stress model using H2O2. The cell vitality was measured by MTT colorimetric assay. Western blot and RT-PCR were used to evaluate the expressions of Dvl-1, ß-catenin, c-Myc, Bax and Bcl-2. Flow cytometry analysis of cardiomyocytes apoptosis. RESULTS: We confirmed that Wnt/frizzled pathway is involved in H2O2-induced apoptosis in cardiomyocytes. Compared with controls, H2O2 induced the upregulation of Dvl-1, ß-catenin, and c-Myc. FrzA suppressed the expression of Dvl-1, ß-catenin, c-Myc and the activity of the Wnt/frizzled pathway. Furthermore, FrzA over-expression decreased the apoptotic rate, and the Bax/Bcl-2 ratio in cardiomyocytes treated with H2O2. CONCLUSIONS: FrzA, through the inhibition of Wnt/Frizzled pathway activity reduced H2O2-induced cardiomyocytes apoptosis and could be a potential therapeutic target for prevention of cardiac oxidative damage.

Optimal cutoff of the waist-to-hip ratio for detecting cardiovascular risk factors among Han adults in Xinjiang.

BACKGROUND: The optimal cutoff of the waist-to-hip ratio (WHR) among Han adults in Xinjiang, which is located in the center of Asia, is unknown. We aimed to examine the relationship between different WHRs and cardiovascular risk factors among Han adults in Xinjiang, and determine the optimal cutoff of the WHR. METHODS: The Cardiovascular Risk Survey was conducted from October 2007 to March 2010. A total of 14618 representative participants were selected using a four-stage stratified sampling method. A total of 5757 Han participants were included in the study. The present statistical analysis was restricted to the 5595 Han subjects who had complete anthropometric data. The sensitivity, specificity, and distance on the receiver operating characteristic (ROC) curve in each WHR level were calculated. The shortest distance in the ROC curves was used to determine the optimal cutoff of the WHR for detecting cardiovascular risk factors. RESULTS: In women, the WHR was positively associated with systolic blood pressure, diastolic blood pressure, and serum concentrations of serum total cholesterol. The prevalence of hypertension and hypertriglyceridemia increased as the WHR increased. The same results were not observed among men. The optimal WHR cutoffs for predicting hypertension, diabetes, dyslipidemia and ≥ two of these risk factors for Han adults in Xinjiang were 0.92, 0.92, 0.91, 0.92 in men and 0.88, 0.89, 0.88, 0.89 in women, respectively. CONCLUSIONS: Higher cutoffs for the WHR are required in the identification of Han adults aged ≥ 35 years with a high risk of cardiovascular diseases in Xinjiang.

Prevalence, awareness, treatment and control of dyslipidemia among adults in northwestern China: the cardiovascular risk survey.

AIM: The aim of this study was to estimate the prevalence, awareness, treatment, and control of dyslipidemia in Xinjiang, China. METHOD: Stratified sampling method was used to select a representative sample of the general population including Chinese Han, Uygur, and Kazak in this geographic area. Seven cities were chosen. Based on the government records of registered residences, one participant was randomly selected from each household. The eligibility criterion for the study was ≥ 35 years of age. RESULTS: A total of 14,618 participants (5,757 Han, 4,767 Uygur, and 4,094 Kazak), were randomly selected from 26 villages in 7 cities. The prevalence of dyslipidemia was 52.72% in the all participants. The prevalence of dyslipidemia was higher in Han than that in the other two ethnic (58.58% in Han, 48.27% in Uygur, and 49.60% in Kazak, P < 0.000). The prevalence of dyslipidemia was higher in men than that in women (56.4% vs. 49.3%, P < 0.000). Among the participants with dyslipidemia, the proportion of those who aware, treat, control of dyslipidemia were 53.67%, 22.51%, 17.09% in Han, 42.19%, 27.78%, 16.20% in Uygur, 37.02%, 21.11%, 17.77% in Kazak. CONCLUSION: Dyslipidemia is highly prevalent in Xinjiang. The proportion of participants with dyslipidemia who were aware, treated, and controlled is unacceptably low. These results underscore the urgent need to develop national strategies to improve the prevention, detection, and treatment of dyslipidemia in Xinjiang.

An analysis of the door-to-balloon time in STEMI patients in an underdeveloped area of China: a single-centre analysis.

OBJECTIVES: This study was conducted to break the door-to-balloon time (DTBT) into constituent elements, and compared which components prolonged markedly. We identified the factors that significantly prolonged the DTBT in an underdeveloped area of China. METHODS: The patients were included from January 2008 to December 2010 in 301 consecutive patients presenting with STEMI in our hospital. We analysed the components of total DTB times, such as 'Diagnosis time', 'Cardiologist consultation time', 'Explain the patient's condition time', 'Transferring time', 'Preparation of the catheterisation laboratory (CL) time', and determined which factors significantly prolonged the DTBT potentially. RESULTS: The median DTBT of all patients was 134 (98-186) min. The group was divided by the DTBT into two: ≤120 min and >120 min. In the ≤120 min group, more patients (68.1%) presented to our hospital during working hours (p=0.000), whereas in the >120 min group, more patients (63.2%) presented out of hours (p=0.000). More patients (49.3%) presented when the interventionist was on site (p=0.000) in the ≤120 min group. In the >120 min group, the times for consultation by the cardiologist and explaining the patient's condition to the family prolonged markedly, as compared to the ≤120 min group (p=0.000) when the interventionist was off-duty (OR=4.050, p=0.000) and presentation during non-working hours (OR=3.334, p=0.000) were significant predictors of >120 min DTB times. CONCLUSIONS: In our centre, the time of consultation by the cardiologists and explaining the patient's condition to the family accounted for most of the delay in reperfusion. A lack of interventionists usually resulted in a delay during non-working hours in the CL. Several measures should be taken involving asking emergency department physicians to awake CL directly, sending the patients' information to the cardiologists, popularising medical knowledge to the citizens, and increasing the numbers of interventionists qualified to carry out primary percutaneous coronary intervention, should be developed to shorten the DTBT.

Prevalence of major cardiovascular risk factors and adverse risk profiles among three ethnic groups in the Xinjiang Uygur Autonomous Region, China.

BACKGROUND: Prevalence of cardiovascular disease (CVD) risk factors have been scarcely studied in Xinjiang, a multi-ethnic region. METHODS: Multi-ethnic, cross-sectional cardiovascular risk survey study in Xinjiang, including individuals of Uygur (n = 4695), Han (n = 3717) and Kazakh (n = 3196) ethnicities, aged 35-74 years. Analyses involved 11,608 participants with complete data enrolled between October 2007 and March 2010. RESULTS: There were differences in age-standardized prevalence of CVD risk factors between the three groups (all P < 0.001). Hypertension, obesity and smoking rates were higher among Kazakh (54.6%, 24.5%, and 35.8%, respectively). Dyslipidemia prevalence was higher among Uygur (54.3%), and diabetes prevalence was higher among Hans (7.1%). Age-standardized prevalence of adverse CVD risk profiles was different across different ethnicities. Compared with the Han participants, the Uygur and Kazakh had more CVD risk factors (P < 0.001). Compared with the Han participants, the adjusted odds ratios of 1, 2, and ≥3 risk factors profiles for Kazakh and Uygur participants were higher (all P < 0.001). CONCLUSIONS: The present study showed the pervasive burden of CVD risk factors in all participant groups in the Xinjiang region. Three major ethnic groups living in Xinjiang had striking differences in the prevalence of major CVD risk factors and adverse risk profiles. Ethnic-specific strategies should be developed to prevent CVD in different ethnic groups, as well as to develop strategies to prevent future development of adverse CVD risk factors at a younger age.

Decreased estimated glomerular filtration rate (eGFR) is not an independent risk factor of arterial stiffness in Chinese women.

Recent studies suggest that decreased estimated glomerular filtration rate (eGFR) and uric acid (UA) may be independent risk factors for arterial stiffness (AS). As serum UA level is linked to renal function, we hypothesize that decreased eGFR may be not an independent risk factor of AS, but may be related to UA level. In this study, we aimed to validate this hypothesis in a large community-based Chinese population. A total of 13,899 people were selected from the Cardiovascular Risk Survey (CRS) from October 2007 to March 2010. Pulse wave velocity (PWV) was calculated using the established methods. The relationships between eGFR, fasting blood glucose (FBG), UA and PWV were analyzed with multivariate linear regression. We found that PWV was significantly correlated to FBG (r = 0.173, p < 0.001) and UA (r = 0.177, p < 0.001), and inversely correlated to eGFR (r = - 0.161, p < 0.001). A multivariable regression analysis revealed that FBG (ß = 0.056, p < 0.001) and UA (ß = 0.039, p < 0.001), but not eGFR (ß = - 0.011, p = 0.062) were significantly related to elevation of PWV. In women, eGFR was not an independent risk factor of AS with progressively decreasing renal function (all p > 0.05). However, in men, eGFR was associated with PWV in subjects with eGFR < 60 ml/min/1.73 m(2). Our results suggest that decreased eGFR is not independently associated with AS in Chinese women.

[Efficacy comparison between endovascular aneurysm repair versus open surgery for patients with abdominal aortic aneurysms: a meta-analysis].

OBJECTIVE: To compare the efficacy between endovascular aneurysm repair versus open surgery in patients with abdominal aortic aneurysms (AAA). METHODS: A systematic review was performed to identify clinical outcomes of randomized controlled trials for AAA patients receiving endovascular aneurysm repair or open surgery. The Cochrane Library (issue 7 of 2011), MEDLINE (1996 to 2011), EMBASE (1974 to 2011), CBM (1989 to 2011), CNKI (1997 to 2011), Wanfang data (1989 to 2011) were searched. Randomized trials that compared open or endovascular AAA repair and published clinical outcomes were selected. The outcome included all-cause mortality, aneurysm-related mortality, technical complications and re-open surgery. Data analyses were performed with the RevMan5.1 software. Publication bias was assessed by STATA software. A meta-regression model was used to describe between study variability. A total of 123 trials were excluded according to criteria. Four randomized controlled trials with 2607 patients met the inclusion criteria. RESULTS: There were no publication bias (Begg's test, Z = 1.02, P > 0.05; Egger's test, t = 0.98, P > 0.05). The meta-analysis showed that the incidence of all-cause mortality of endovascular repair was significantly lower than that of open repair up to 30 days post procedures [ RR = 0.32, 95%CI (0.18 - 0.56), P < 0.01] while long-term all-cause mortality was similar: DREAM study: [RR = 1.18, 95%CI (0.88 - 1.58), P > 0.05], EVAR study: [RR = 1.04, 95%CI (0.88 - 1.22), P > 0.05]. The incidence of aneurysm-related mortality of endovascular repair was lower than that of open repair in two studies [RR = 0.53, 95%CI (0.33 - 0.85), P < 0.01]. Technical complication between open repair group and endovascular repair group was similar [RR = 1.43, 95%CI (0.68 - 2.98), P > 0.05]. Incidence of re-open surgery was higher in endovascular repair group than in open surgery group [RR = 2.03, 95%CI (1.14 - 3.62), P < 0.05]. CONCLUSION: Compared with open surgery, endovascular repair is associated with lower 30-day all-cause mortality and aneurysm-related mortality, similar technical complication and long-term all-cause mortality, but higher risk for re-open surgery.

[Detection rate of carotid artery plaque in Uygur, Kazakh and Han populations of Xinjiang].

OBJECTIVE: To investigate the detection rate of carotid artery plaque in Han, Uygur and Kazakh adult populations of Xinjiang. METHODS: During the period of October 2007 to March 2010, the present study was performed in 13896 Han, Uygur and Kazakh adults of Xinjiang aged 35 years old and over by a four-stage random sampling method. All subjects were investigated by a standardized questionnaire, physical, biochemical examination and ultrasonography of carotid arteries. Risk factors were analyzed by a logistic regression model. RESULTS: The prevalence of carotid artery plaque was 10.2%. After standardization, the detection rate of Chinese Han, Uygur and Kazakh populations was 2.46%, 2.31% and 1.84% respectively. By the analysis of multivariate logistic regression, age (OR 1.032, 95%CI 1.026-1.037), smoking (OR 1.358, 95%CI 1.164-1.585), total cholesterol (OR 1.075, 95%CI 1.018-1.135), blood glucose (OR 1.050, 95%CI 1.020-1.081) and systolic blood pressure (OR 1.011, 95%CI 1.008-1.014) were independent risk factors in the occurrence of carotid artery plaque. Females (OR 0.653, 95%CI 0.545-0.738) and high-density lipoprotein (OR 0.864, 95%CI 0.751-0.994) were the protective factors in the occurrence of carotid artery plaque. CONCLUSION: The detection of carotid artery plaque in Xinjiang increases substantially with age and difference exists between nationalities. The associated risk factors of the formation of carotid artery plaque include gender, age, smoking, high-density lipoprotein, total cholesterol, blood glucose and systolic blood pressure. The effect of these factors is different between genders.

[Epidemiological survey of carotid artery intima-media thickness in Han, Uygur and Hazakh population of Xinjiang Uygur autonomous region].

OBJECTIVE: To investigate carotid artery intima-media thickness (IMT) and the correlated risk factors in Han, Uygur, Hazakh residents over 35 years old of Xinjiang Uygur autonomous region. METHOD: Cross-sectional and cluster sampling random selected method was carried out for residents over 35 years old in Han, Uygur, Hazakh population of Xinjiang to investigate IMT and correlated risk factors. RESULTS: IMT of Han, Uygur, Hazakh residents over 35 years old of Xinjiang Uygur autonomous region was (0.0761 ± 0.0283) cm, (0.0663 ± 0.0262) cm, and (0.0781 ± 0.0274) cm, respectively. There were significantly difference between various nationality (all P < 0.05). IMT was thicker in male Han people than in female Han people [(0.0807 ± 0.0288) cm vs. (0.0717 ± 0.0270) cm, P < 0.01] and in male Uygur than in female Uygur residents [(0.0706 ± 0.0270) cm vs. (0.0633 ± 0.0252) cm, P < 0.01] and in male Hazakh and female Hazakh residents [(0.0794 ± 0.0280) cm vs. (0.0768 ± 0.0268) cm, P < 0.01]. Linear correlation analysis showed that age (r = 0.176, P < 0.05), systolic blood pressure (r = 0.168, P < 0.05), diastolic blood pressure (r = 0.167, P < 0.05), fasting blood glucose (r = 0.053, P < 0.05), total cholesterol (r = 0.097, P < 0.05) and ankle brachial index (r = 0.067, P < 0.05) were significantly correlated with IMT. CONCLUSIONS: Our results showed that IMT was thicker in Hazakh residents than in Han and Uygur residents. IMT was closely related to known cardiovascular risk factors including age, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol and ankle brachial index level.

[Association of the Pro1770Leu polymorphism in CYP5A1 gene with myocardial infarction in Uigur population of Xinjiang].

OBJECTIVE: To investigate the association between the polymorphism of the thromboxane synthase gene and Uigur patients with myocardial infarction (MI) in Xinjiang. METHODS: Three hundred and fifteen patients with MI and 218 healthy control subjects were detected by polymerase chain reaction and restriction fragment length polymorphism. The serum thromboxane B2 (TXB2) in all subjects was detected with radioimmunoassay kit. RESULTS: The genotype distributions of the MI group and control group were in Hardy-Weinberg equilibrium (Chi-square=0.375,0.029, P>0.05). The frequencies of CC and TC were 0.933 and 0.067 in MI group while they were 0.977 and 0.023 in controls. There was significant difference in frequencies of the TC genotype and T allele but no difference in frequencies of CC genotype between controls and MI cases. There was significant difference in serum TXB2 level between the MI and control group (P<0.05), and between individuals of the TC and CC genotypes (P<0.05). The serum TXB2 level in the MI cases with TC genotype was increased compared with that of other genotypes (P<0.05). CONCLUSION: The TC genotype and T allele of thromboxane synthase gene might be risk factors of MI in Uigur population in Xinjiang, which might result from the increased serum TXB2 level.

[Prevalence of peripheral arterial disease and its correlative risk factors in Xinjiang Uygur and Kazak adult populations].

OBJECTIVE: To investigate the prevalence of peripheral arterial disease (PAD) and its correlative risk factors in Xinjiang Uygur and Kazak adult populations. METHODS: The subjects over the age of 35 years old in Urumqi, Karamay City, Fukang City, Turpan Region, Hotan Prefecture and Yili Kazak Autonomous Prefecture were selected by the four-stage random sampling method. The investigators collected the data of PAD prevalence in different nationalities, different age groups and different gender groups and analyzed its risk factors. RESULTS: The prevalence of PAD in Uygur and Kazak adults was 6.46% (n = 542). The standardized prevalence was 6.51%. The prevalence of PAD was 7.05% (n = 315) in Uygur adults and 5.79% (n = 227) in Kazak adults. The standardized prevalence in the Uygur and Kazak adults was 7.08% and 5.83% respectively. The prevalence of PAD of different nationalities was different (χ(2) = 5.55, P < 0.05). And its prevalence was 4.49% (n = 170) in males and 8.08% (n = 372) in females. The standardized prevalence was 4.30% in males and 7.90% in females. The prevalence of PAD in males and females was significantly different (χ(2) = 44.26, P < 0.01). The multivariate logistic regression analysis was performed. Age (OR = 1.01, 95%CI 1.00 - 1.02), females (OR = 1.75, 95%CI 1.45 - 2.14), overweight or obesity (OR = 1.04, 95%CI 1.01 - 1.06), diabetes (OR = 1.59, 95%CI 1.01 - 2.36), elevated systolic blood pressure (OR = 1.02, 95%CI 1.01 - 1.03), elevated diastolic blood pressure (OR = 1.08, 95%CI 1.01 - 1.11) and history of coronary heart disease (OR = 1.69, 95%CI 1.14 - 2.50) were associated with an elevated prevalence of PAD. CONCLUSION: The prevalence of PAD is lower in Xinjiang Uygur and Kazak adult populations. Females, age, overweight or obesity, diabetes, elevated systolic blood pressure and a history of coronary heart disease are risk factors of PAD.

[Association of Rs10487667 genetic polymorphism of thromboxane synthase with myocardial infarction in Uigur population of Xinjiang].

OBJECTIVE: To investigate the association between the polymorphism of thromboxane synthase gene (CYP5A1) and myocardial infarction (MI) of Uigur nationality patients in Xinjiang. METHODS: Rs10487667 site polymorphism in CYP5A1 gene of 318 patients with MI (MI group) and 232 healthy control subjects (control group) were analyzed by polymerase chain reaction and restriction fragment length polymorphism. The serum thromboxane B(2)(TXB(2)) concentration was also detected in all subjects. The relationship of multiple factors and myocardial infarction was evaluated comprehensively by non-condition logistic regression analysis. RESULTS: The frequencies of CYP5A1 gene Rs10487667 site polymorphism in MI group and control group were: GG type 0.204 (65/318) and 0.155 (36/232), GT type 0.553 (176/318) and 0.466 (106/232), TT type 0.242 (77/318) and 0.379 (88/232), respectively. There was significant difference in frequencies of GG genotype (χ(2) = 12.193, P = 0.002) between two groups and G allele frequency in MI group (0.481 (306/636)) was significant higher than control group (0.388 (180/464)) (χ(2) = 9.449, P = 0.021), but no difference in frequencies of GT and TT genotypes (χ(2) = 0.699, P > 0.05)between controls and MI cases. There was significant difference in serum TXB(2) level between MI ((184.3 ± 34.7) pg/ml) and control ((124.3 ± 28.1) pg/ml) groups (t = 5.503, P = 0.034). In the case and control group, the serum TXB(2) level of the person with GT + GG genotype ((164.21 ± 22.56) and (134.26 ± 19.83) pg/ml)) was significant higher than those of TT genotypes ((113.67 ± 54.23) and (98.54 ± 13.11) pg/ml) (t values were 5.433 and 5.108, respectively, both P values < 0.05). Logistic regression analysis showed that the T allele of the CYP5A1 gene was one independent risk factor of MI (OR = 1.673, 95%CI: 1.020 - 2.156) after adjustment of risk factors. CONCLUSION: Rs10487667 polymorphism in CYP5A1 gene might be a risk factor of MI in Uigur population in Xinjiang, which maybe related with the significant high serum TXB(2) level.

[Incidence and distributing feature of chronic heart failure in adult population of Xinjiang].

OBJECTIVE: To investigate the prevalence and distributing feature of chronic heart failure (CHF) in adult population of Xinjiang. METHODS: Four-stage random sampling method was used to analyze the prevalence and distributing feature of self-reported congestive heart failure among different nationalities in adult (35 years and over) population of Xinjiang. Sampling was collected from 6 localities (Urumqi, Kelamayi, Fukang, Turfan Basin, Hetian, Yili Hazakh). RESULTS: A total of 8459 adults were surveyed. The prevalence of CHF was 1.26% in this cohort. The prevalence of CHF was 0.89%, 1.11% and 2.14%(*) in Han, Uygur and Hazakh population, respectively ((*)P < 0.05 vs. Han and Uygur). The risk of CHF was higher in the males than in the females (1.61% vs. 0.93%, u = 2.79, P < 0.05). The prevalence of CHF increased in proportion with aging and was 0.29%, 0.60%, 1.32%, 2.55% and 4.10% in 35 - 44, 45 - 54, 55 - 64, 65 - 74, 75 years and over age groups, respectively. Common complications of CHF were hypertension (63.55%), coronary heart disease (42.99%), diabetes (18.69%), valvular heart disease (5.61%) and atrial fibrillation (4.67%). CONCLUSION: The prevalence of CHF in Xinjiang was higher than the average level in China (0.9%) and was the highest in the Hazakh population.

[Outcome of percutaneous balloon pulmonary valvuloplasty for patients with pulmonary valve stenosis].

OBJECTIVE: To assess the effects of percutaneous balloon pulmonary valvuloplasty (PBPV) for patients with pulmonary valve stenosis (PS). METHODS: From February 1996 to March 2003, 65 patients with isolated PS were diagnosed by echocardiography and received PBPV in our department, clinical data were analyzed in this study. RESULTS: Age of 65 patients ranged from 1 to 48 years [mean (13.5 +/- 9.3) years]. The pulmonary transvalvular gradient (PTG) was (86.4 +/- 33.6) mm Hg(1 mm Hg = 0.133 kPa) and the right ventricular systolic pressure was (107.5 +/- 36.5) mm Hg before PBPV. Single-balloon valvuloplasty was performed in 41 patients, double-balloon valvuloplasty in 6 patients and Inoue-balloon valvuloplasty in 18 patients. The ratio of balloon/valve ranged from 1.00 to 1.19 in 19 patients, from 1.20 to 1.39 in 42 patients, and greater than 1.40 in 4 patients. The procedure was classified as successful when the RV-PA gradient was < 36 mm Hg post procedure, 6 to 12 months follow up was finished after PBPV by catheterization or echocardiography in 25 patients. Immediate post procedure success rate was 81.5% (53/65). The lowest PTG immediately post procedure was seen in Inoue balloon group and balloon/valve ratio between 1.20 to 1.39 group. Post procedure, tricuspid valve regurgitation was evidenced in 2 patients, reactive right ventricular outflow tract stenosis was shown in 26 patients (13 from Inoue group) and pulmonary regurgitation was detected in 3 patients. The mean PTG was (35.7 +/- 23.9) mm Hg at follow-up. PTG gradually reduced to normal in 6 patients with post procedure PTG > or = 36 mm Hg. Right ventricular outflow tract stenosis was attenuated in all 11 followuped patients. There was no restenosis during follow-up. CONCLUSION: Percutaneous balloon valvuloplasty was effective and safe for treating patients with pulmonary valve stenosis. Superior outcome was linked with balloon/valve ratio between 1.20 to 1.39 and Inoue balloon valvuloplasty in this cohort.

The burden and correlates of hypertension among Chinese rural population in Han, Uygur, and Kazak: a cross-sectional study.

The present study was conducted to investigate the prevalence, awareness, treatment, control, and associated risk factors of hypertension among rural population in Xinjiang Province in Northwest China. The Cardiovascular Risk Survey study was conducted on a representative sample of the Northwest China adult population. A four-stage stratified cluster random sampling scheme was adopted to recruit representative samples. The data were collected by trained staff. Multivariable logistic regression models were used to identify the associated risk factors. Overall, 8295 study participants aged 35-101 years were enrolled. The overall hypertension prevalence was 35.01%. The prevalence of hypertension in Han, Uygur, and Kazak population was 36.84%, 33.32%, and 52.57%, respectively. The hypertension awareness, treatment, control, and control among treated participants were 56.1%, 44.7%, 10.9%, and 24.3%, respectively. Multivariate logistic regression showed that age, body mass index, central obesity, ethnic, and drinking status were identified as risk factors for hypertension. Hypertension was found to be highly prevalent in rural adults in Xinjiang, China, especially in Kazak population. Although the levels of awareness, treatment, and control have improved, it was still lower than developed countries. Effective measures should be adopted to promote the prevention and control of hypertension.

Exome Sequencing in a Family Identifies RECQL5 Mutation Resulting in Early Myocardial Infarction.

Coronary artery disease (CAD) including myocardial infarction (MI) is the leading cause of death worldwide and is commonly caused by the interaction between genetic factors and environmental risks. Despite intensive efforts using linkage and candidate gene approaches, the genetic etiology for the majority of families with a multigenerational early CAD /MI predisposition is unknown.In this study, we used whole-exome sequencing of 10 individuals from 1 early MI family, in which 4 siblings were diagnosed with MI before the age of 55, to identify potential predisposing genes.We identified a mutation in the RECQL5 gene, 1 of the 5 members of the RECQ family which are involved in the maintenance of genomic stability. This novel mutation, which is a TG insert at position 73,626,918 on the 13 chromosome and occurs before the last nucleotide of the introns 11 acceptor splice site affecting splicing of RECQL5. RT-PCR suggested the control subject had a full-length mRNA including exon 12, but the patients with RECQL5 mutation had a shorter mRNA form involving splicing of exons 11 to 13 directly, with skipping of exon 12. Quantitative RT-PCR analysis of RECQL5 exon 12 demonstrated that individuals whose genotype is mutant homozygote had only trace amounts of mRNA containing this exon and the family members who carry the heterozygous genotype had a level at 48% to 55% of the control's level.These findings provide insight into both the pathogenesis of MI and the role of RECQL5 gene in human disease.