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盘点：Circulation 9月原始研究第四期汇总

2017-09-28 MedSci MedSci原创

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【1】心血管病和高危患者不能停用阿司匹林DOI：10.1161/CIRCULATIONAHA.117.028321现行指南建议，心血管病高危人群以及心血管病患者需要终生服用小剂量阿司匹林，除非有出血或需要择期行大手术。但在实际生活中，部分患者会在服用阿司匹林一段时间后停用。近期，来自瑞典的一项全国性队列研究表明，在没有大出血或计划做大手术的前提下，停用小剂量阿司匹林会导致患者的心血管事件发生风险增

【1】心血管病和高危患者不能停用阿司匹林

DOI：10.1161/CIRCULATIONAHA.117.028321

现行指南建议，心血管病高危人群以及心血管病患者需要终生服用小剂量阿司匹林，除非有出血或需要择期行大手术。但在实际生活中，部分患者会在服用阿司匹林一段时间后停用。近期，来自瑞典的一项全国性队列研究表明，在没有大出血或计划做大手术的前提下，停用小剂量阿司匹林会导致患者的心血管事件发生风险增加30%以上，包括心血管死亡、因心肌梗死或脑卒中住院。此外，研究还发现，停用阿司匹林不久后，患者发生心血管事件的风险即增加，而且随着时间的延长，这种风险增加的情况并不会消失。

【2】糖尿病心血管疾病患者的危险因素和预后的关系

DOI：10.1161/CIRCULATIONAHA.117.027252

改变一些危险因素可以显著改善伴有糖尿病的心血管患者的预后。但是，将这些危险因素改变到什么程度才能最大化改善预后仍没有大型的临床试验数据支持。本研究通过对来自38个国家的13616例患有糖尿病和心血管疾病的患者在以下5个指标进行分析评估：阿司匹林的使用、脂质的控制、血压控制、血管紧张素转换酶抑制剂或血管紧张素受体阻断剂的使用和无烟状态。结果证实，通过改变危险因素是可以显著改善伴有糖尿病的心血管患者预后的。

【3】电子心血管数据的有效性

DOI：10.1161/CIRCULATIONAHA.117.027436

了解电子数据研究网络数据的有效性对于国家研究计划和心血管治疗学习系统至关重要。这项研究的目标是评估电子数据研究网络与通过标准研究方法收集的数据的一致程度。研究人员将来自基于社区队列的多种族动脉粥样硬化研究的个人级数据与HealthLNK链接起来。使用Pearson相关系数和Bland-Altman图评估HealthNNK中的血压（BP）以及BMI与个体MESA检查的相关性和一致性。此外还明确了HealthLNK中潜在的心肌梗塞（MI），中风和心力衰竭事件，并将其与MESA中确定的事件进行比较。结果证明在确定CVD危险因素和事件方面，电子数据存储库与传统标准流行病学收集的信息相比，具有局限性和优势。

【4】d流通过血小板反应蛋白-1促进动脉硬化

DOI：10.1161/CIRCULATIONAHA.116.026361

动脉硬度和动脉壁剪切应力是心血管健康的重要决定因素，动脉僵硬与心血管死亡率增加相关。称为d流的低壁面剪切力和震荡壁面剪切力促进动脉粥样硬化动脉重塑，但d流与动脉壁僵硬之间的关系尚未明了。本研究旨在确定d流对动脉硬化的作用，并发现d流增加动脉硬化的相关信号通路。结果表明，TSP-1在剪切介导的动脉硬化中发挥关键作用，部分通过TSP-1激活转化生长因子-β的促纤维化信号传导途径介导。该途径中的分子靶点可能是动脉硬化中限制动脉壁硬化及进展的新的治疗靶点。

【5】组蛋白甲基转移酶G9a与心肌细胞稳态和肥大密切相关

DOI：10.1161/CIRCULATIONAHA.117.028561

心肌细胞基因的正确表达是心脏发挥正常功能的基础。基因表达异常可能会导致心脏稳态丧失，引发心脏功能障碍。尽管研究已经证实一些组蛋白甲基转移酶在心脏发育过程中的作用，但是这类遗传酶在成人心脏中的作用并不清楚。在这项研究中，研究人员探究了组蛋白甲基转移酶G9a/ehmt2的作用，结果表明G9a在生理和病理状况下协调心肌细胞的关键表观遗传变化，从而为与这些机制调节异常相关的心脏疾病提供新的治疗途径。

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    2017-12-31 1e145228m78(暂无匿称)

    学习了谢谢作者分享!

    0

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    2017-12-28 1e145228m78(暂无匿称)

    学习了谢谢作者分享!

    0

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    2017-09-29 三生有幸9135

    学习一下谢谢分享

    0

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    2017-09-29 飛歌

    学习了很有用不错

    0

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    2017-09-29 1e0f8808m18(暂无匿称)

    学习了.新研究成果.

    0

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    2017-09-29 执着追梦

    学习.谢谢分享

    0