Objective Peripheral arterial disease (PAD) affects a large population and is associated with various adverse clinical outcomes. Lipoprotein(a) has proatherogenic properties and is associated with PAD incidence and severity. The aim of this study is to explore the association between LP(a) and PAD in coronary artery bypass grafting (CABG) patients. Methods A total of 1001 patients were included and divided into two groups: low Lp(a) group [LP(a) < 30 mg/dL] and high Lp(a) group [LP(a) ≥ 30 mg/dL]. A comparison of PAD incidence diagnosed by ultrasound was made between the groups. Multivariate logistic regression was conducted to explore the risk factors for PAD. During the analysis, the influence of diabetes mellitus (DM) and gender on LP(a) serum level was taken into consideration. Results DM history (odds ratio [OR], 2.330, p = .000 for males; OR, 2.499, p = .002 for females) and age (OR, 1.101, p = .000 for males; OR, 1.071, p = .001 for females) were risk factors for PAD. LP(a) ≥ 30 mg/dL was a risk factor for PAD only in female patients (OR, 2.589, p = .003), while smoking history was a risk factor only in male patients (OR, 1.928, p = .000). LP(a) level was not associated with PAD severity in DM patients of both gender. As for female patients without DM, PAD was more severe in the high LP(a) group. Conclusions In CABG patients, DM history and age were risk factors for PAD. But a high level of LP(a) was a significant risk factor only in female patients. In addition, we are the first to propose a gender deviation in the correlation between LP(a) serum level and severity of PAD diagnosed by ultrasound.
Introduction: Type 2 diabetes (T2D) is a multifactorial complex chronic disease with a high prevalence worldwide, and Type 2 diabetes patients with different comorbidities often present multiple phenotypes in the clinic. Thus, there is a pressing need to improve understanding of the complexity of the clinical Type 2 diabetes population to help identify more accurate disease subtypes for personalized treatment.Methods: Here, utilizing the traditional Chinese medicine (TCM) clinical electronic medical records (EMRs) of 2137 Type 2 diabetes inpatients, we followed a heterogeneous medical record network (HEMnet) framework to construct heterogeneous medical record networks by integrating the clinical features from the electronic medical records, molecular interaction networks and domain knowledge.Results: Of the 2137 Type 2 diabetes patients, 1347 were male (63.03%), and 790 were female (36.97%). Using the HEMnet method, we obtained eight non-overlapping patient subgroups. For example, in H3, Poria, Astragali Radix, Glycyrrhizae Radix et Rhizoma, Cinnamomi Ramulus, and Liriopes Radix were identified as significant botanical drugs. Cardiovascular diseases (CVDs) were found to be significant comorbidities. Furthermore, enrichment analysis showed that there were six overlapping pathways and eight overlapping Gene Ontology terms among the herbs, comorbidities, and Type 2 diabetes in H3.Discussion: Our results demonstrate that identification of the Type 2 diabetes subgroup based on the HEMnet method can provide important guidance for the clinical use of herbal prescriptions and that this method can be used for other complex diseases.
Background: There were few studies on risk factors predicting perioperative application of intra-aortic balloon pumping (IABP) in coronary artery bypass grafting (CABG) patients. The aim of the study is to explore risk factors for perioperative application of IABP in CABG patients. Methods: Patients with preoperative IABP implantation were excluded. 1337 patients undergoing CABG were finally included. Patients were divided into two groups: IABP group and non-IABP group. Medical history, biochemical and ultrasonagraphic parameters were compared between the groups. Multivariate logistic analyse was used to explore possible risk factors. Combined ROC analysis was performed and area under ROC (AUC) was used to decide diagnostic capability of the risk factors. Results: Patients in IABP group had a higher proportion of myocardial infarction (MI) history and atrial fibrillation(AF) history. IABP group also had a larger amount of blood loss and a higher serum level of small, dense low-density lipoprotein (sd-LDL). As for imaging results, IABP group had a lower Left ventricular ejection fraction (LVEF). Multivariate logistic analyse showed that LVEF< 50% (OR, 3.120) , history of MI (OR, 2.006), sd-LDL serum level (OR, 2.201) and blood loss during surgery>1000ml (OR, 2.545) were independent risk factors. Combined ROC analysis showed an AUC of 0.707. Conclusion: For CABG patients, LVEF<50%, history of MI, blood loss during surgery>1000ml and sd-LDL serum level were risk factors for perioperative application of IABP. Combined ROC analysis showed an AUC of 0.707.
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