Gender-Related Differences in Clinical Characteristics and Outcomes of Premature Coronary Artery Disease: Insight from the FOCUS Registry.

INTRODUCTION: Although coronary artery disease (CAD) presentations and clinical outcomes differ by sex, little is known about premature CAD (PCAD). The present analysis aimed to evaluate the gender-related differences of PCAD in an Asian population from the FOCUS registry. METHODS: A total of 1397 Asian young patients with angiographically confirmed CAD undergoing drug-eluting stent implantation were included in this analysis and divided into two groups according to the genders. Patients were followed up for three years and clinical outcomes were compared between groups. RESULTS: Young women were older and more likely to have hypertension and diabetes than men (all p<0.001). In contrast, males with PCAD had higher BMI and higher prevalence of current smoking as well as previous vessel revascularizations (all p<0.05). Men were more likely to be manifested as total occlusive lesions (p<0.001). Regardless of the clinical characteristics, the cumulative incidences of adverse events such as major adverse cardiovascular event (MACE), cardiovascular death, and all-cause death were not significantly different at one- or three-year follow-up (all p>0.05). CONCLUSION: Despite remarkable differences in clinical characteristics between Asian males and females with PCAD, the two groups did not differ significantly in clinical outcomes.

Relationship between body mass index and outcomes of coronary artery disease in Asian population: Insight from the FOCUS registry.

BACKGROUND: Obesity is often considered as a risk factor of cardiovascular events, but recent researches showed conflicting results regarding to the effect of body weight on prognosis of coronary artery disease (CAD). This study aimed to evaluate the relationship between body mass index (BMI) and clinical outcomes of CAD in Asian population. METHODS: A total of 4315 patients from the FOCUS registry were enrolled into this analysis. Patients were divided into 4 groups according to BMI: lean group (BMI<18.5 kg/m2), normal group (BMI 18.5-24.9 kg/m2), overweight group (BMI 25-30 kg/m2) and obesity group (BMI>30 kg/m2). Follow-up was continued to 3 years to evaluate clinical outcomes, and the primary endpoint was a composite of all-cause death and myocardial infarction (MI). RESULTS: Patients with higher BMI were more likely to be associated with cardiovascular risk factors like hypertension, hypercholesterolemia and diabetes, but not smoking. At the end of the follow-up period, however, the incidence of a composite endpoint of all-cause death and MI was significantly lower in the higher BMI (overweight and obese) subsets, as compared with the lower BMI group (5.2% vs. 8.0%, p < 0.001). So did the cumulative rates of all-cause death (p < 0.001), cardiovascular death (p < 0.001), and a combined endpoint of cardiovascular death and MI (p = 0.001). CONCLUSIONS: In Asian patients with CAD, an inverse association between BMI and long-term prognosis was observed. Although overweight or obese patients were associated with more metabolism-associated comorbidities, they had significantly lower adverse events at 3-year follow up after percutaneous coronary intervention.

Leaching of metals from asphalt pavement incorporating municipal solid waste incineration fly ash.

Rising municipal solid waste incineration (MSWI) makes it imperative to recycle the fly ash (FA). FA can be solidified by asphalt and then applied in the asphalt road. However, little information on the metal leaching and associated with risks from asphalt solidified forms for FA is available. In the present study, metal leaching characteristics and long-term leaching potential from the asphalt-based FA matrices was determined based on the national standard method and simulating the actual using of the solidified forms in highways, respectively. The immobilization effect of asphalt on MSWI FA is well. Leaching velocity was in the order of magnitude of 10~10-6 cm h-1 during the entire leaching period. At the early age, leaching velocity of metals is high, especially Zn, Cd, and Ba. Cumulative leaching concentration of metals and leaching time has positive correlation. Only considering the leaching of simulating acid, leaching of metals in asphalt-based matrices is very slow, and the leaching toxicity of metals is lower than the Chinese National Standard.