Coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China, in late December 2019 (refs 1-3). Since then, COVID-19 has spread rapidly worldwide and has become a global pandemic affecting >200 countries and territories, with an unprecedented effect not only on public health, but also social and economic activities. The exponential increase in the number of patients with COVID-19 in the past 6 months has overwhelmed health-care systems in numerous countries across the world. At present, preventive vaccines and prophylactic therapies for COVID-19 are not available. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is a member of the genus Betacoronavirus like the two other coronaviruses that have caused pandemic diseases (severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV)) 1-4. As with SARS-CoV and MERS-CoV, SARS-CoV-2 causes a respiratory infection, which leads to viral pneumonia and acute respiratory distress syndrome (ARDS) in some patients 1. However, in addition to respiratory symptoms, uncontrolled SARS-CoV-2 infection can trigger a cytokine storm, whereby pro-inflammatory cytokines and chemokines such as tumour necrosis factor-α, IL-1β and IL-6 are overproduced by the immune system, resulting in multiorgan damage 5. Furthermore, COVID-19 causes coagulation abnormalities in a substantial proportion of patients, which can lead to thromboembolic events 6,7. The genomic sequence 1-3,8 and viral protein structure 9-11 of SARS-CoV-2 have been studied intensively since its emergence. To date, research shows that SARS-CoV-2 shares many biological features with SARS-CoV owing to 79.6% genomic sequence identity 1,2. In particular, both SARS-CoV and SARS-CoV-2 use the same system of cell entry, which is triggered by binding of the viral spike (S) protein to angiotensin-converting enzyme 2 (ACE2) on the surface of the host cell 4. Understanding the biological features of the virus will contribute to the development of diagnostic tests, vaccines and pharmacological therapies and can further our knowledge of tissue tropism. Early clinical data indicate that both the susceptibility to and the outcomes of COVID-19 are strongly associated with cardiovascular disease (CVD) 12-16. A high prevalence of pre-existing Acute respiratory distress syndrome (ArDs). A type of severe, acute respiratory failure characterized by bilateral pulmonary infiltrates and severe hypoxaemia that occurs as a result of illness or injury. Cytokine storm A form of severe immune reaction characterized by overproduction of cytokines and chemokines that can be triggered by a variety of factors such as infection and drugs.

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In the present trial, characterized by low event rates, we did not observe a significant difference in net clinical outcome between 6 and 12 months of clopidogrel therapy after DES implantation. However, the results of the trial must be considered in view of its premature termination and lower than expected event rates. The trial is registered with ClinicalTrials.gov, Identifier: NCT00661206.

Rosuvastatin significantly reduced the risk of CI-AKI in patients with DM and CKD undergoing arterial contrast medium injection. (Rosuvastatin Prevent Contrast Induced Acute Kidney Injury in Patients With Diabetes [TRACK-D]; NCT00786136).

Background: Coronary heart disease is a leading cause of mortality among women. Systematic evaluation of the quality of care and outcomes in women hospitalized for acute coronary syndrome (ACS), an acute manifestation of coronary heart disease, remains lacking in China. Methods: The CCC-ACS project (Improving Care for Cardiovascular Disease in China–Acute Coronary Syndrome) is an ongoing nationwide registry of the American Heart Association and the Chinese Society of Cardiology. Using data from the CCC-ACS project, we evaluated sex differences in acute management, medical therapies for secondary prevention, and in-hospital mortality in 82 196 patients admitted for ACS at 192 hospitals in China from 2014 to 2018. Results: Women with ACS were older than men (69.0 versus 61.1 years, P <0.001) and had more comorbidities. After multivariable adjustment, eligible women were less likely to receive evidence-based acute treatments for ACS than men, including early dual antiplatelet therapy, heparins during hospitalization, and reperfusion therapy for ST-segment–elevation myocardial infarction. With respect to strategies for secondary prevention, eligible women were less likely to receive dual antiplatelet therapy, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, statins at discharge, and smoking cessation and cardiac rehabilitation counseling during hospitalization. In-hospital mortality rate was higher in women than in men (2.60% versus 1.50%, P <0.001). The sex difference in in-hospital mortality was no longer observed in patients with ST-segment–elevation myocardial infarction (adjusted odds ratio, 1.18; 95% CI, 1.00 to 1.41; P =0.057) and non-ST–segment elevation ACS (adjusted odds ratio, 0.84; 95% CI, 0.66 to 1.06; P =0.147) after adjustment for clinical characteristics and acute treatments. Conclusions: Women hospitalized for ACS in China received acute treatments and strategies for secondary prevention less frequently than men. The observed sex differences in in-hospital mortality were mainly attributable to worse clinical profiles and fewer evidence-based acute treatments provided to women with ACS. Specially targeted quality improvement programs may be warranted to narrow sex-related disparities in quality of care and outcomes in patients with ACS. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02306616.

Culotte stenting for UPLMCA bifurcation lesions was associated with significantly increased MACEs, mainly due to the increased TVR. (Double Kissing [DK] Crush Versus Culotte Stenting for the Treatment of Unprotected Distal Left Main Bifurcation Lesions: DKCRUSH-III, a Multicenter Randomized Study Comparing Double-Stent Techniques; ChiCTR-TRC-00000151).