European Heart Journal - Cardiovascular Pharmacotherapy最新文献

{"title":"Inotropes and mortality in patients with cardiogenic shock: more questions than answers.","authors":"Achim Lother, Dawid Staudacher","doi":"10.1093/ehjcvp/pvaf010","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaf010","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valve Thrombosis and Antithrombotic Therapy After Bioprosthetic Mitral Valve Replacement: A Systematic Review And Meta-Analysis.","authors":"Mark J Zorman, Jonathan Vibhishanan, Katerina Dangas, James Castle, Ka Hou Christien Li, Marco Coronelli, Kate Eastwick-Jones, Alexander Swan, Nicky Johnson, Anurag Choksey, Helen Yan, Sam G C Scott, Matthew Henry, Mark Philip Cassar, Cara Barnes, Joao Ferreira-Martins, James Newton, Sam Dawkins, Mohamad Alkhouli, Charanjit Rihal, Mackram F Eleid, Sorin V Pislaru, Mayra E Guerrero, Jose Ordonez-Mena, Thomas J Cahill","doi":"10.1093/ehjcvp/pvaf005","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaf005","url":null,"abstract":"<p><strong>Aims: </strong>Transcatheter mitral valve replacement (TMVR) has become a feasible alternative to surgical mitral valve replacement (SMVR) in selected patients at high surgical risk. The risk of valve thrombosis following SMVR and TMVR, and the optimal antithrombotic therapy following these procedures, remains uncertain. We aimed to compare the incidence of bioprosthetic mitral valve thrombosis (bMVT) after SMVR and TMVR, and the incidence of bMVT between patients on different antithrombotic regimens.</p><p><strong>Methods and results: </strong>A literature search of Medline, Embase and Cochrane Library was performed between January 2000 and August 2024. Random-effects models were used to derive pooled estimates of the incidence of bMVT in the absence of prior or active endocarditis and valve thrombosis. 47 studies (6170 patients, total follow-up 9541.8 patient-years) were eligible for inclusion. The overall incidence of bMVT was 5.05 (95%CI 3.18-8.01, I2 = 82%) per 100-patient-years. Subclinical bMVT was more common than clinically significant bMVT: incidence 19.11 vs 7.91 per 100-patient-years, adjusted incidence rate ratio (aIRR) 4.62 (95%CI 1.39-15.36), p = 0.012. bMVT was numerically more common after TMVR than SMVR, but the comparison was not statistically significant: incidence 7.03 vs 0.58 per 100-patient-years, aIRR 2.19 (95%CI 0.72-6.72), p = 0.170. Patients on vitamin-K antagonists (VKA) had a lower incidence of bMVT than patients on direct oral anticoagulants (DOAC; incidence 5.72 vs 17.08, aIRR 0.31, 95%CI 0.13-0.73, p = 0.007).</p><p><strong>Conclusions: </strong>bMVT is not uncommon, with numerically higher incidence in transcatheter compared to surgical valves, but the comparison was not statistically significant. VKAs are associated with a lower incidence of bMVT compared to DOACs.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of SGLT2i on kidney outcomes of individuals with type 2 diabetes according to body mass index: nationwide cohort study.","authors":"Takahiro Jimba, Hidehiro Kaneko, Yuta Suzuki, Akira Okada, Tatsuhiko Azegami, Toshiyuki Ko, Katsuhito Fujiu, Hiroyuki Morita, Norifumi Takeda, Kaori Hayashi, Takashi Yokoo, Koichi Node, Issei Komuro, Hideo Yasunaga, Masaomi Nangaku, Norihiko Takeda","doi":"10.1093/ehjcvp/pvae094","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvae094","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the clinical significance of the modification of the kidney protective effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors by baseline body mass index (BMI).</p><p><strong>Methods and results: </strong>We included individuals with SGLT2 inhibitors or dipeptidyl peptidase-4 (DPP4) inhibitors newly prescribed for type 2 diabetes using a nationwide epidemiological cohort and performed propensity score matching (1:2). The primary outcome was the annual eGFR decline, assessed using a linear mixed-effects model, compared between individuals with SGLT2 inhibitors and DPP4 inhibitors. We investigated the interaction effect of BMI at the time of prescription using a three-knot restricted cubic spline model. We analysed 2165 individuals with SGLT2 inhibitor prescriptions and 4330 individuals with DPP4 inhibitor prescriptions. Overall, the annual decline in eGFR was less pronounced in the group treated with SGLT2 inhibitors than in those treated with DPP4 inhibitors (-1.34 mL/min/1.73 m2 vs. -1.49 mL/min/1.73 m2). The advantage of SGLT2 inhibitors in mitigating eGFR decline was augmented in the individuals with higher BMI (P-value for interaction 0.0017). Furthermore, even upon adjusting the definition of outcomes to encompass a 30 or 40% reduction in eGFR, the potential advantages of SGLT2 inhibitors over DPP4 inhibitors persisted, with a trend of augmented effects with higher BMI. This interaction effect was evident in the individuals with preserved kidney function.</p><p><strong>Conclusion: </strong>Our nationwide epidemiological study substantiated the improved kidney outcomes in the SGLT2 inhibitor users compared with the DPP4 inhibitor users across a wide range of BMI, which was pronounced for individuals with higher BMI.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspirin versus Clopidogrel monotherapy beyond 1 month after complex percutaneous coronary intervention: A pre-specified subgroup analysis of the STOPDAPT-3 trial.","authors":"Takenori Domei, Ko Yamamoto, Masahiro Natsuaki, Hirotoshi Watanabe, Takeshi Morimoto, Yuki Obayashi, Ryusuke Nishikawa, Tomoya Kimura, Kenji Ando, Satoru Suwa, Tsuyoshi Isawa, Hiroyuki Takenaka, Tetsuya Ishikawa, Toshihiro Tamura, Kando Kawahatsu, Fujio Hayashi, Mitsuru Abe, Takeshi Serikawa, Hiroyoshi Mori, Takayuki Kawamura, Arata Hagikura, Naoki Shibata, Koh Ono, Takeshi Kimura","doi":"10.1093/ehjcvp/pvaf002","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaf002","url":null,"abstract":"<p><strong>Aims: </strong>There were no previous studies comparing aspirin versus P2Y12 inhibitor monotherapy following short dual antiplatelet therapy (DAPT) after complex percutaneous coronary intervention (PCI).</p><p><strong>Methods and results: </strong>We conducted a prespecified subgroup analysis based on complex PCI in the 1-year results of the STOPDAPT-3 trial, which randomly compared 1-month DAPT followed by aspirin monotherapy (aspirin group) to 1-month prasugrel monotherapy followed by clopidogrel monotherapy (clopidogrel group). The main analysis in the present study was the 30-day landmark analysis. The co-primary endpoints were cardiovascular events (a composite of cardiovascular death, myocardial infarction, definite stent thrombosis, or stroke) and major bleeding (Bleeding Academic Research Consortium 3 or 5). In the 30-day landmark analysis (N = 5833), there were 1415 patients (24.3%) who underwent complex PCI. There was a significant interaction between complex PCI and the effect of aspirin group relative to clopidogrel group for cardiovascular events (complex PCI: 3.3% versus 5.2%, non-complex PCI, 4.3% versus 3.6%, interaction P = 0.04) and net adverse clinical events (complex PCI: 4.8% versus 7.2%, non-complex PCI: 5.3% versus 4.4%, interaction P = 0.02), but not for bleeding events (complex PCI: 2.1% versus 2.7%, non-complex PCI: 1.7% versus 1.4%, interaction P = 0.35).</p><p><strong>Conclusions: </strong>There was a significant interaction between complex PCI and the effect of aspirin monotherapy relative to clopidogrel monotherapy beyond 1 month and up to 1 year for cardiovascular events due to numerically lower risk of aspirin monotherapy in patients with complex PCI, while the effect of aspirin monotherapy relative to clopidogrel monotherapy was not different for bleeding regardless of complex PCI. Clinical trial registration: ShorT and OPtimal duration of Dual AntiPlatelet Therapy after everolimus-eluting cobalt-chromium stent-3 [STOPDAPT-3]; NCT04609111.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a personalized, strike early and strong lipid-lowering approach on LDL-cholesterol levels and cardiovascular outcome in patients with acute myocardial infarction.","authors":"Giuseppe Patti, Luca Cumitini, Manuel Bosco, Alessandra Marengo, Domenico D'Amario, Marco Mennuni, Martina Solli, Leonardo Grisafi","doi":"10.1093/ehjcvp/pvaf004","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaf004","url":null,"abstract":"<p><strong>Aims: </strong>Considering the lack of evidence, we evaluated the impact on cardiovascular outcome of the systematic introduction in our institution of a personalized strike early and strong (SES) approach for lipid-lowering therapy (LLT) in patients admitted for acute myocardial infarction (MI).</p><p><strong>Methods and results: </strong>We retrospectively analyzed data from 500 consecutive patients hospitalized across three periods: Period A (N=198, January-June 2019), when the LDL-C goal was <70 mg/dL and a stepwise LLT approach was recommended; Period B (N=180, January-June 2021), when the LDL-C goal was <55 mg/dL and a stepwise approach was recommended; Period C (N=122, January-June 2023), when the LDL-C goal was <55 mg/dL and our SES protocol was implemented. Primary endpoints were achievement of the LDL-C goal during follow-up and one-year incidence of major adverse cardiovascular events (MACE). Compared to the other periods, in Period C there was a higher use of potent statins, alone or in combination with ezetimibe, and of PCSK9 inhibitors at discharge. This translated into higher achievement of the LDL-C goal (83% vs 55% in Period A and 43% in Period B; p<0.001) and reduced incidence of MACE (3% vs 12% and 11%; p=0.026). MACE rates were lowest in patients with early and sustained LDL-C <55 mg/dL and in those achieving both LDL-C <55 mg/dL and ≥50% LDL-C reduction.</p><p><strong>Conclusion: </strong>The systematic introduction of a personalized, SES strategy for LLT in patients with acute MI led to greater achievement of LDL-C goal and lower risk of MACE at one year vs the stepwise approach.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipid-Lowering and Antihypertensive Drugs on Aortic Disease Risk: Insights from Mendelian Randomization Analysis and Real-World Pharmacovigilance Data.","authors":"Nie Han, Wenpeng Zhao, Qingqing Wang, Weimin Zhou","doi":"10.1093/ehjcvp/pvaf001","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaf001","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of lipid-lowering drugs (LLDs) and antihypertensive drugs on the risk of aortic diseases.</p><p><strong>Methods: </strong>Mendelian randomization was utilized to analyze data from 500,000 participants in the UK Biobank to evaluate the effects of statins, PCSK9 inhibitors (PCSK9i), beta-blockers, and calcium channel blockers on the risks of thoracic aortic aneurysm (TAA), abdominal aortic aneurysm (AAA), and aortic dissection (AD) using genetic variants as proxies. Real-world pharmacovigilance data from the FAERS database was used.</p><p><strong>Results: </strong>PCSK9i and statins significantly reduced the risks of aortic aneurysms and AD, respectively. Furthermore, the two LLDs reduced the risk of aortic diseases through certain metabolites. Meanwhile, real-world pharmacovigilance reports also indicated a low incidence of aortic diseases with PCSK9i and statin treatment.</p><p><strong>Conclusion: </strong>LLDs, particularly statins and PCSK9i, significantly protect against aortic diseases, providing a scientific basis for preventing and treating aortic diseases.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Revolution in Pharmacotherapy: From Herbs to Pills, Molds, Antibodies to Genetic Tools.","authors":"Thomas F Lüscher","doi":"10.1093/ehjcvp/pvae098","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvae098","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and outcomes of transient new-onset atrial fibrillation complicating acute coronary syndromes: results from a systematic review and meta-analysis.","authors":"Nadia Salerno, Jessica Ielapi, Angelica Cersosimo, Isabella Leo, Jolanda Sabatino, Salvatore De Rosa, Sabato Sorrentino, Daniele Torella","doi":"10.1093/ehjcvp/pvae066","DOIUrl":"10.1093/ehjcvp/pvae066","url":null,"abstract":"<p><strong>Background: </strong>The overall risk of long-term adverse events of a transient episode of new-onset atrial fibrillation (AF) in patients with acute coronary syndrome (ACS) remains uncertain. This meta-analysis aimed to assess the prognostic impact of transient new-onset AF complicating ACS.</p><p><strong>Methods and results: </strong>Cohort studies examining the risk of adverse events in patients with transient new-onset AF compared to those in sinus rhythm after ACS were identified through a comprehensive search of MEDLINE, Scopus, Cochrane, and Google Scholar Library. Studies reporting the incidence of ischaemic stroke events, recurrent AF, or all-cause mortality at the longest follow-up were included. Adjusted hazard ratios (aHRs) with 95% confidence intervals (CI) were synthesized using inverse variance-weighted random-effects meta-analysis. In the seven observational studies included, comprising 151 735 patients, 6 597 (4.3%) experienced transient new-onset AF, which was associated with an increased risk of ischaemic stroke, recurrent AF, or all-cause mortality (HR: 2.24, 95% CI: 1.75-2.85; P < 0.0001; I2 = 30.76%; seven studies). The results remained consistent across each individual endpoint, including ischaemic stroke (HR 2.38, 95% CI: 1.64-3.44; P < 0.01; I2 = 50.2%; five studies), recurrent AF (HR 4.68, 95% CI: 2.07-10.59; P = 0.0002; I2 = 50.2%; four studies), and all-cause mortality (HR 1.36, 95% CI: 1.08-1.71; P = 0.0089; I2 = 53.25%; four studies). Meta-regression analyses revealed a significant increase in these adverse events associated with ST-elevation myocardial infarction (P = 0.001), while there was a tendency for their decrease associated with oral anticoagulant prescription at discharge (P = 0.07).</p><p><strong>Conclusions: </strong>The occurrence of transient new-onset AF is associated with an elevated long-term risk of stroke, recurrent AF, and all-cause mortality in patients with ACS. Consequently, these data urge randomized clinical trials to assess the best antithrombotic regimen while potentially helping the current treatment decision-making process for these patients.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"652-661"},"PeriodicalIF":5.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention is the key.","authors":"Stefan Agewall","doi":"10.1093/ehjcvp/pvae090","DOIUrl":"10.1093/ehjcvp/pvae090","url":null,"abstract":"","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":"10 8","pages":"649-651"},"PeriodicalIF":5.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated impact of guidelines-based initiation of dual antihypertensive therapy on long-term cardiovascular outcomes in 1.1 million individuals.","authors":"Antonio Coca, Claudio Borghi, George S Stergiou, Irfan Khan, Alexandra Koumas, Jacques Blacher, Mohamed Abdel-Moneim","doi":"10.1093/ehjcvp/pvae048","DOIUrl":"10.1093/ehjcvp/pvae048","url":null,"abstract":"<p><strong>Aims: </strong>Guidelines recommend initiation of dual combination antihypertensive therapy, preferably single-pill combination (SPC), in most patients with hypertension. Evidence on narrowing gaps in clinical practice relative to guidelines is limited.</p><p><strong>Methods and results: </strong>Monte Carlo simulation was applied to 1.1 million patients qualifying for dual combination therapy from a previously conducted retrospective analysis of clinical practice, hospital statistics, and national statistics in the UK. We provide 10-year Kaplan-Meier event rates for the primary endpoint representing a composite of non-fatal myocardial infarction, non-fatal stroke (ischaemic or haemorrhagic), non-fatal heart failure hospitalization, or cardiovascular death. Cox model results from a previously conducted study were utilized to estimate baseline risk, together with evidence on risk reduction from the Blood Pressure Lowering Treatment Trialists' Collaboration (BPLTTC) meta-analysis and published evidence on blood pressure-lowering efficacy of antihypertensive therapies. In the overall population, estimated 10-year event rates for the primary endpoint in patients with 100% persistence in monotherapy were 17.0% for irbesartan and 17.6% for ramipril. These rates were only modestly better than those observed in clinical practice (17.8%). In patients with 100% persistence in dual therapy, estimated event rates were 13.6% for combinations of irbesartan + amlodipine [absolute risk reduction (ARR) = 8.7% compared with untreated] and 14.3% for ramipril + amlodipine (ARR = 8.0% compared with untreated). The absolute risk of the primary endpoint was reduced by 15.9% in patients with atherosclerotic cardiovascular disease (ASCVD) and 6.6% in those without ASCVD. Similarly, the absolute risk was reduced by 11.7% in patients with diabetes and 7.8% in those without diabetes.</p><p><strong>Conclusions: </strong>This study represents the first to investigate guidelines-based treatment in hypertensive patients and demonstrates the opportunity for considerable risk reduction by ensuring recommended dual therapy in clinical practice, particularly in the form of SPC with high persistence, relative to no treatment or monotherapy.</p>","PeriodicalId":11982,"journal":{"name":"European Heart Journal - Cardiovascular Pharmacotherapy","volume":" ","pages":"697-707"},"PeriodicalIF":5.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}