Zhengming Chen - Selected Publications#

Total >480 papers (H-index: 91; citations: 83,120, including 6685 for the 10 selected papers below)

1. Liu JM, Zhang L, Yan YQ, Zhou YC, Yin P, Qi JL, Wang LJ, Pan JG, You JL, Yang J, Zhao ZP, Wang W, Liu YN, Lin L, Wu J, Li XH, Chen ZM* (*joint senior & corresponding author), Zhou MG. Excess mortality in Wuhan city and other parts of China during the three months of the COVID-19 outbreak: findings from nationwide mortality registries. Br Med J 2021; 372:n145; doi:10.1136/bmj.n415 [35 citations]

First major study to comprehensively assess the excess mortality attributed to COVID-19 in Wuhan city and elsewhere in China during the 2020 outbreak. The study findings also informed investigation by the WHO into the origin of COVID-19 pandemic.

2. Millwood IY, Walters RG, Mei XW, Guo Y, Yang L, Bian Z, Bennet DA, Chen Y, Dong C, Hu R, Zhou G, Yu B, Jia W, Parish S, Clarke RJ, Davey Smith G, Collins R, Holmes MV, Li LM, Peto R, Chen ZM. Conventional and genetic evidence on alcohol and vascular disease aetiology: prospective study of 500,000 Chinese adults. Lancet 2019; 393: 1831-42 [280 citations]

Using East Asian specific genetic variants in alcohol metabolism, this study was the first in the world to reliably refute any apparent causal protective effects of moderate alcohol intake against stroke, leading to policy changes in many countries.
3. Sun LL, Clarke R, Bennett D, Guo Y, Walters R, Hill Michael, Parish S, Millwood I, Bian Z, Chen YP, Yu CQ, Lv J, Collins R, Chen JS, Peto R, Li LM, Chen ZM. Causal associations of blood lipids with risk of ischaemic stroke and intracerebral haemorrhage. Nature Med 2019; 25(4): 569-74 [125 citations]

Using genetic approaches, this study demonstrated reliably that LDL-cholesterol increases ischaemic stroke but decreases hemorrhagic stroke. Moreover, it also assessed optimal ways for safe use of statin therapy in low- and high-risk settings.

4. Bragg F, Holmes M, Iona A, Du H, Guo Y, Chen YP, Bian Z, Yang L, Herrington W, Chen JS, Collins R, Peto R, Li LM, Chen ZM. Association between diabetes and cause-specific mortality in rural and urban China. JAMA 2017; 317(3):280-89 [300 citations]

Based on the prospective China Kadoorie Biobank, this study showed the adverse effects of poorly-managed diabetes on a wide range of conditions (e.g. CVD, cancer, infection, and injuries), leading WHO’s then Director-General to call editorially for improved diabetes health care delivery in low- and middle-income countries and subsequent changes in health policy in China.
5. Du HD, Li LM, Bennett D, Guo Y, Key T, Bian Z, Sherliker P, Gao HY, Chen YP, Yang L, Wang SQ, Du RR, Su H, Chen JS, Collins R, Peto R, Chen ZM. Fresh fruit consumption and major cardiovascular diseases in China. NEJM 2016; 374(14): 1332-43 [220 citations]

Based on the prospective China Kadoorie Biobank, this study showed in urban and rural China a highly significant protective association of fresh fruit consumption with CVD risk, particularly stroke, a finding that subsequently informed nutrition guidelines in China.

6. Chen ZM, Peto R, Zhou MG, Iona A, Smith M, Yang L, Guo Y, Chen YP, Bian Z, Lancaster G, Sherliker P, Pang ST, Wang H, Su H, Wu M, Wu XP, Chen JS, Collins R, Li LM. Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective studies. Lancet 2015; 386:1447-56 [305 citations]

Based on two large successive nationwide cohort studies in China it documented clearly the growing epidemic of tobacco-attributed male mortality, and influenced tobacco control efforts (e.g. Government White Paper) and legislation.

7. COMMIT/CCS-2 Collaborative Group (Chen ZM, study PI and corresponding author). Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 2005; 366:1606-21 [2495 citations]

This large randomized trial showed dual-antiplatelet therapy was superior to aspirin in acute MI in reducing mortality and recurrence, leading to new US FDA labelling for clopidogrel and changes in international practice (e.g. 2007 ACC/AHA guidelines), saving many lives worldwide.

8. COMMIT/CCS-2 Collaborative Group (Chen ZM, study PI and corresponding author). Early intravenous then oral metoprolol in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 2005; 366:1622-32 [1105 citations]

Using factorial design, this large trial also demonstrated the beneficial and harmful effects of early beta-blockade in acute MI, showing when during the course of a heart attack beta-blockade should start. Again, it led to changes in international treatment guidelines and clinical practice.

9. CAST Collaborative Group (Chen ZM, study PI and corresponding author). CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. Lancet 1997; 349:1641-49 [1080 citations]

This large randomized trial reliably demonstrated the benefits of early aspirin in acute ischaemic stroke, leading to changes in international treatment guidelines and clinical practice.

10. Chen ZM, Peto R, Collins R, Lu JR, Li WX. Serum cholesterol concentration and coronary heart disease in a population with low cholesterol concentration. Br Med J 1991; 303:276-82 [740 citations]

Based on a cohort study in China, it demonstrated a continuous positive association between CHD risk and blood cholesterol, even well below levels considered “normal” in Western populations. This informed the design of subsequent major statin trials (eg, HPS, ASCOT) that went on to demonstrate the benefits of lowering LDL-cholesterol at all Western levels.