AimsIt is well-established that lipid disorder is an important cardiovascular risk factor, and failure to reach optimal lipid levels significantly contributes to the residual cardiovascular risks. However, limited information is available on the management and the attainment of recommended cholesterol targets in real-world practice in China.Methods and ResultsA nationally representative sample of 12,040 patients with dyslipidemia from 19 provinces and 84 hospitals across China were consecutively enrolled in this survey. Risk stratification and individual cholesterol target was established for all participants. This survey identified a high-risk cohort, with over 50% of patients had hypertension, 37.5% had coronary artery disease, and more than 30% had peripheral artery disease. Thirty-nine percent of all participants received lipid lowering medications. And the majority of them (94.5%) had statins (42.5% with atorvastatin, 29.0% with simvastatin, and 15.2% with rosuvastatin). However, the overall attainment for low-density lipoprotein cholesterol (LDL-C) target is low (25.8%), especially, in female (22.2%), and in patients with increased body mass index (BMI) (38.3% for BMI<18.5, 28.1% for BMI 18.5–24.9, 26.0% for BMI 25.0–29.9, and 17.4% for BMI≥30, P<0.0001). Subgroup analysis also showed the attainment is significantly lower in patients who were stratified into high (19.9%) and very high (21.1%) risk category. In logistic regression analysis, eight factors (BMI, gender, coronary artery disease, systolic and diastolic blood pressure, hypertension, family history of premature coronary artery disease and current smoking) were identified as independent predictors of LDL-C attainment.ConclusionsDespite the proven benefits of lipid-lowering therapies, current management of dyslipidemia continues to be unsatisfied. A considerable proportion of patients failed to achieve guideline-recommended targets in China, and this apparent treatment gap was more pronounced among patients with increased BMI, higher risk stratification and women.

Objectives: Genetic testing, a gold standard for long QT syndrome (LQTS) diagnosis, is time-consuming and costly when all the 15 candidate genes are screened. Since genotype-specific ECG patterns are present in most LQT1-3 mutation carriers, we tested the utility of ECG-guided genotyping in a large cohort of Chinese LQTS patients. Methods and Results: We enrolled 230 patients (26 ± 17 years, 66% female) with a clinical diagnosis of LQTS. Genotypes were predicted as LQT1-3 based on the presence of ECG patterns typical for each genotype in 200 patients (85 LQT1, 110 LQT2 and 5 LQT3). Family-based genotype prediction was also conducted if gene-specific ECG patterns were found in other affected family members. Mutational screening identified 104 mutations (44% novel), i.e. 46 KCNQ1, 54 KCNH2 and 4 SCN5A mutations. The overall predictive accuracy of ECG-guided genotyping was 79% (157/200) and 79% (67/85), 78% (86/110) and 80% (4/5) for LQT1, LQT2 and LQT3, respectively. The predictive accuracy was 98% (42/43) when family-based ECG assessment was performed. Conclusions: From this large-scale genotyping study, we found that LQT2 is the most common genotype among the Chinese. Family-based ECG-guided genotyping is highly accurate. ECG-guided genotyping is time- and cost-effective. We therefore recommend it as an optimal approach for the genetic diagnosis of LQTS.

The prevalence of HTN varies widely among China's ethnic groups. Treatment and control rates of HTN also vary and are inadequate in the minority ethnic groups as well as in the Han majority.

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The Chinese national registry of radiofrequency catheter ablation of tachyarrhythmias included data from 134 hospitals over 3 years from January 1995. Ablation was used in 24,343 patients, with 97% success, 3.1% recurrence, 0.95% complications, and 0.02% mortality overall. Accessory pathway ablation was performed in 15,617 patients (64.2%) with atrioventricular reciprocating tachycardia (97% success, 2.8% recurrence, 1% complications). The 6,746 patients (27.7%) with atrioventricular nodal reentrant tachycardia underwent slow pathway ablation (98% success, 2.7% recurrence, 1% complications). Focal ablation in the right or left ventricle was attempted in 1,025 patients (4.2%) with idiopathic or organic ventricular tachycardia (87% success, 6.8% recurrence, 0.5% complications). The 419 patients with atrial tachycardia underwent atrial focal ablation (84% success, 9.9% recurrence, 0% complications). Focal or linear ablation of the isthmus was conducted in 366 patients with atrial flutter (89% success, 10% recurrence, 1.1% complications). Atrioventricular junction ablation was used for rate control in 170 patients with atrial fibrillation (99% success). Multiple atrial linear ablations for rhythm control were 56% successful. Success rates and incidence of complications depended on the type of tachyarrhythmia, and remained constant over the 3 years. Further improvements in technique are needed to improve success rates and decrease the incidence of complications.