Frontiers in Cardiovascular Medicine最新文献

{"title":"Plasma thrombin-antithrombin complex as a candidate biomarker for coronary slow flow.","authors":"Jian-Hong Mo, Bo Liang, Jing-Tao Cen, Wan-Ying Li, Yong-An Mo, Ming-Cheng Tang, Dong Ye, Qiu-Xia Long, Xun Hu, Yuan-Sheng Zhai","doi":"10.3389/fcvm.2025.1621655","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1621655","url":null,"abstract":"<p><strong>Background: </strong>Coronary slow flow (CSF), characterized by delayed coronary perfusion without significant coronary artery stenosis, remains a diagnostic challenge due to its elusive pathophysiology. This retrospective study aimed to evaluate the association between the thrombin-antithrombin (TAT) complex and CSF.</p><p><strong>Patients and methods: </strong>Ninety-one CSF patients and 74 subjects with normal coronary flow were recruited in this cohort. Coronary artery blood flow was quantified using the thrombolysis in myocardial infarction frame count (TFC) method. Plasma TAT complex levels were measured via chemiluminescent immunoassay. Logistic regression analyses and a receiver operating characteristic (ROC) curve were performed to determine the predictive value of TAT for CSF.</p><p><strong>Results: </strong>Compared with patients without CSF, patients with CSF showed higher plasma levels of TAT complex, total cholesterol, and low-density lipoprotein cholesterol, all of which were also positively correlated with TFC. However, multivariate logistic regression identified TAT as the only independent predictor of CSF after adjustment (OR: 1.71, 95% CI: 1.39-2.10, <i>p</i> < 0.001). More specifically, ROC analysis revealed that a plasma TAT complex levels of 3.875 ng/ml predicted CSF with a specificity of 89.2% and a sensitivity of 62.6%.</p><p><strong>Conclusion: </strong>Elevated plasma TAT complex levels are strongly associated with CSF and may serve as a candidate diagnostic biomarker.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1621655"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: The Parkes-Weber syndrome in the patient who underwent coronary surgery.","authors":"Nemanja Milosevic, Bogdan Okiljevic, Slobodan Micovic, Milovan Bojic, Igor Zivkovic","doi":"10.3389/fcvm.2025.1479811","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1479811","url":null,"abstract":"<p><p>Parkes-Weber Syndrome is a rare congenital vascular abnormality characterized by aneurismatic illness of blood arteries in the afflicted limb, as well as hypertrophy, ulceration, ischemia, and high-output heart failure. Imaging investigations are required to provide a diagnosis, with contrast arteriography being the gold standard. The majority of treatment options are endovascular, with surgical excision for arteriovenous malformations and limb amputation as alternatives. We describe a 73-year-old male patient with mainly asymptomatic PWS, coronary disease, and borderline EF (45%) who had CABG surgery. In individuals with established CAD and other cardiac disorders, it is critical to identify additional diseases or syndromes that might have a compounding effect on the heart, such as PWS and high-output heart failure.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1479811"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating extra-cellular RNAs and atrial fibrillation: data from the TRACE-CORE cohort.","authors":"Katherine Tak, Darleen Lessard, Catarina I Kiefe, Jane E Freedman, Matthew Parker, Gerard P Aurigemma, Kevin Donahue, David D McManus, Khanh-Van Tran","doi":"10.3389/fcvm.2025.1623112","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1623112","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most common sustained arrhythmia and is linked to increased risk of stroke, heart failure, and mortality. Circulating extracellular RNAs (exRNAs), which regulate gene expression and reflect underlying biological processes, are potential biomarkers for atrial fibrillation.</p><p><strong>Methods: </strong>As part of an ongoing, larger study into extracellular RNAs (exRNAs) as potential biomarkers for cardiovascular disease, we analyzed exRNA profiles in a subset of 296 survivors of acute coronary syndrome (ACS) enrolled in the Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) cohort. A total of 318 exRNAs were quantified, selected <i>a priori</i> based on prior findings from the Framingham Heart Study. We assessed associations between circulating exRNAs and echocardiographic intermediate phenotypes relevant to atrial fibrillation (AF), including left atrial dimension, left ventricular (LV) mass, LV end-diastolic volume, and global longitudinal strain. Subsequently, we used logistic regression models to evaluate whether the exRNAs associated with these phenotypes were also associated with a history of AF (<i>n</i> = 18, 5.4%). Downstream bioinformatics analyses were performed to identify putative target genes, enriched gene ontology categories, and molecular pathways regulated by these candidate microRNAs.</p><p><strong>Results: </strong>We identified 77 extracellular RNAs (exRNAs) that were significantly associated with increased left ventricular (LV) mass and at least one additional echocardiographic intermediate phenotype. Among these, miR-17-5p and miR-574-3p were also significantly associated with a history of atrial fibrillation (AF), with odds ratios of 1.58 (95% CI: 1.10-2.26) and 2.16 (95% CI: 1.03-4.54), respectively. Predicted gene targets of these miRNAs were enriched in pathways implicated in atrial remodeling and arrhythmogenesis. Key overlapping canonical pathways included the Senescence Pathway, Idiopathic Pulmonary Fibrosis Signaling, ERK5 Signaling, RHO GTPase Cycle, and HGF Signaling.</p><p><strong>Conclusions: </strong>Circulating exRNAs, including miR-17-5p and miR-574-3p, are associated with cardiac remodeling and a history of AF in ACS survivors. These findings highlight their potential as biomarkers of atrial remodeling and implicate key molecular pathways involved in AF pathogenesis.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1623112"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-translational modifications orchestrate mTOR-driven cell death in cardiovascular disease.","authors":"Jiawei Guo, Yiting Wu, Zhengdong Wan, Zhaoshan Zhang","doi":"10.3389/fcvm.2025.1620669","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1620669","url":null,"abstract":"<p><p>The mechanistic target of rapamycin (mTOR) signaling pathway is a central regulator of cellular physiology, modulating processes such as metabolism, protein synthesis, growth, and various forms of cell death. Increasing evidence has revealed that dysregulation of mTOR activity, often triggered or exacerbated by aberrant post-translational modifications (PTMs), contributes to the onset and progression of cardiovascular diseases (CVDs), including atherosclerosis, myocardial infarction, heart failure, and ischemia-reperfusion injury. PTMs such as phosphorylation, ubiquitination, SUMOylation, acetylation, and glycosylation alter mTOR's upstream regulators and downstream effectors, influencing the balance between apoptosis, autophagy, pyroptosis, and ferroptosis. These regulatory mechanisms provide a molecular basis for cell fate decisions during cardiovascular stress and injury. In this review, we systematically summarize recent advances in the understanding of PTM-mediated control of mTOR signaling, with a focus on cardiovascular pathophysiology. We also highlight emerging therapeutic strategies that target PTMs or the mTOR axis, including mTOR inhibitors, AMPK activators, proteasome blockers, and SUMOylation modulators, all of which show promise in preclinical or clinical settings. Understanding how PTMs fine-tune mTOR activity and cell death may pave the way for novel, targeted interventions in cardiovascular medicine and offer potential avenues for the development of precision therapies.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1620669"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between acupuncture treatment exposure and mortality in patients with heart failure: a nationwide cohort study.","authors":"Hyungsun Jun, Hanbit Jin, Haerim Kim, Jungtae Leem","doi":"10.3389/fcvm.2025.1461302","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1461302","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with heart failure (HF) require continuous management, creating a need for alternative treatments to reduce mortality. In Korea, acupuncture treatment is covered by national health insurance, offering accessible care without financial burden. Hence, this study utilized claims data from the Korean National Health Insurance Service to examine the association between acupuncture exposure and mortality in patients with HF.</p><p><strong>Methods: </strong>Adults aged 20 years or older with newly diagnosed HF were included. Patients who received two or more acupuncture sessions within one year of diagnosis comprised the acupuncture treatment-exposed group (AT group), while those who received none were classified as the non-exposed group (non-AT group). Propensity score matching was used to generate a balanced 1:1 matched cohort. From one year after diagnosis, the study tracked circulatory and all-cause mortality over a five-year period, performing survival and dose-response analyses.</p><p><strong>Results: </strong>Each group included 4,315 patients, and the AT group showed significantly lower adjusted hazard ratios (aHRs) for circulatory disease-related mortality (0.79; 95% CI: 0.67-0.94) and all-cause mortality (0.73; 95% CI: 0.66-0.81). A clear dose-response relationship was observed, with greater exposure to acupuncture associated with lower aHRs.</p><p><strong>Discussion: </strong>Acupuncture within one year of HF diagnosis correlated with lower mortality from circulatory diseases and all causes. Future studies should adopt prospective and methodologically rigorous designs to validate the findings of this study.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1461302"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: The ETP-based APC resistance assay remains the gold standard for evaluating the APC resistance phenotype in users of combined oral contraceptives.","authors":"Laure Morimont, Jonathan Douxfils","doi":"10.3389/fcvm.2025.1611404","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1611404","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1611404"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of moxibustion in chronic heart failure patients: a systematic review and meta-analysis.","authors":"Guancheng Chen, Wenxin Song, Weiwei Wu, Xuan Li, Jinyan Chen, Qiao Yang, Huili Liao","doi":"10.3389/fcvm.2025.1552091","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1552091","url":null,"abstract":"<p><strong>Objective: </strong>Moxibustion has been utilized in China for 2,000 years as a safe and straightforward intervention for chronic heart failure (CHF). Numerous articles indicate that moxibustion enhances quality of life and certain heart failure indicators in CHF patients; however, there is a deficiency of high-quality, evidence-based studies with large sample sizes. Our objective was to systematically summarize and assess the clinical efficacy of moxibustion as an adjunctive treatment for CHF.</p><p><strong>Methods: </strong>A thorough search was performed across the PubMed, Cochrane Library, Embase, Web of Science, China Knowledge Network Database, Vipers Database, Wanfang, and China Biomedical Literature Database from their inception until 1 August 2024. A meta-analysis of randomized controlled trials was utilized to aggregate the pooled metrics in patients with chronic heart failure (CHF) and to compare the clinical efficacy rate, N-terminal pro-B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), 6 min walk test (6MWT), and cardiac output (CO) variations between standard CHF treatment and standard treatment combined with moxibustion for CHF.</p><p><strong>Results: </strong>The study encompassed 22 randomized controlled trials (RCTs) involving 2,039 participants, with 1,021 in the experimental group and 1,018 in the control group. The experimental group exhibited a superior clinical efficacy rate compared with the control group (RR = 1.230, 95% CI: 1.173-1.289, <i>p</i> < 0.05), reduced NT-proBNP levels [standardized mean difference (SMD) = -1.035, 95% CI: -1.730 to -0.340, <i>p</i> < 0.05], enhanced LVEF (SMD = 0.909, 95% CI: 0.704-1.114, <i>p</i> < 0.001), improved 6MWT (SMD = 0.909, 95% CI: 0.704-1.114, <i>p</i> < 0.001), and increased CO (SMD = 1.0873, 95% CI: 0.882-1.293, <i>p</i> < 0.001). Following the application of funnel plots and the trim-and-fill method, the findings regarding clinical efficacy rate, LVEF, 6MWT, and CO were deemed reliable, whereas the results for NT-proBNP were found to be unstable. Subgroup analysis revealed that the number of moxibustion points contributed to heterogeneity in LVEF, 6MWT, and CO, while treatment duration accounted for heterogeneity in 6MWT.</p><p><strong>Conclusion: </strong>The study demonstrates that, in comparison with standard treatment, the integration of moxibustion for CHF patients markedly enhanced the efficacy rate, LVEF, CO, and 6MWT and may reduce NT-proBNP levels, but this result requires further validation with larger sample sizes and standardized testing methods.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/, PROSPERO (CRD42022372386).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1552091"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling mitochondrial crosstalk: a new frontier in heart failure pathogenesis.","authors":"Hongbo Chang, Pingge He, Weidi Liu, Hong Wu, Zhentao Wang","doi":"10.3389/fcvm.2025.1641023","DOIUrl":"https://doi.org/10.3389/fcvm.2025.1641023","url":null,"abstract":"<p><p>Mitochondria play a central role in energy production and signal transduction in cardiomyocytes. Their dysfunction is a key contributor to the development and progression of heart failure (HF). Beyond energy metabolism, mitochondria regulate calcium homeostasis, autophagy, protein synthesis, lipid metabolism, and gene expression through close interactions with other organelles. Disruption of these interactions has been linked to HF pathophysiology.This review focuses on the dynamic communication between mitochondria and five major organelles-the endoplasmic reticulum, lysosomes, ribosomes, lipid droplets, and the nucleus. We outline how these interactions maintain cardiac homeostasis and describe how their dysfunction contributes to HF. We also highlight emerging therapeutic strategies targeting these organelle networks.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1641023"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A \"giant bomb\" in acute myocardial infarction due to coronary artery aneurysm: a case report.","authors":"Jin Chen, Wei Du, Jianyu Jiang, Liugang Xu","doi":"10.3389/fcvm.2025.1631992","DOIUrl":"10.3389/fcvm.2025.1631992","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery aneurysm associated with acute coronary syndromes represents a rare clinical entity, particularly in cases with persistent significant thrombus burden following aspiration therapy. The novel pathomechanism of intra-aneurysmal thrombosis secondary to pathological flow dynamics-characterized by endothelial shear stress perturbation and blood stasis-has been rarely documented. While existing literature describes therapeutic applications of surgical repair, percutaneous intervention, and pharmacotherapy in coronary artery aneurysm management, no consensus-driven protocol has been established, reflecting critical knowledge gaps in risk-stratified treatment algorithms for thrombus-laden aneurysms.</p><p><strong>Case outline: </strong>A 51-year-old female presenting with acute ST-segment elevation myocardial infarction underwent emergency coronary angiography, revealing a large right coronary artery aneurysm with significant intra-aneurysmal thrombus burden. Despite successful thrombus aspiration restoring distal TIMI 3 flow, persistent residual thrombus within the aneurysmal segment prompted the selection of intensified anticoagulation combined with dual antiplatelet therapy over percutaneous intervention. Throughout the therapeutic course, the patient remained asymptomatic without recurrent angina. Follow-up angiography performed after 7 days of targeted antithrombotic therapy demonstrated near-complete resolution of the intra-aneurysmal thrombus, accompanied by preserved coronary flow and no evidence of distal embolization.</p><p><strong>Conclusion: </strong>We present a rare case of ST-segment elevation myocardial infarction complicated by a coronary artery aneurysm, highlighting the therapeutic challenges in managing such complex pathologies. While intensified anticoagulation combined with dual antiplatelet therapy constitutes a clinically valid approach, the absence of consensus guidelines results in significant variability in treatment protocols. This case underscores the urgent need for large-scale multicenter studies to establish evidence-based management strategies for patients with coronary artery aneurysm associated with acute coronary syndromes.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1631992"},"PeriodicalIF":2.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the triglyceride glucose-waist circumference index and cardiovascular disease across different glycemic statuses among middle-aged and older Chinese adults.","authors":"Yuyu Cui, Zhening Xu, Lijuan Ding, Yanju Li, Xiaoyan Zhou, Lingxia Li","doi":"10.3389/fcvm.2025.1608655","DOIUrl":"10.3389/fcvm.2025.1608655","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to systematically investigate the association between the triglyceride-glucose index multiplied by waist circumference (TyG-WC) and the risk of cardiovascular disease (CVD) and further explore how this relationship varies across different glycemic statuses, including normal glucose regulation (NGR), prediabetes (Pre-DM), and diabetes mellitus (DM).</p><p><strong>Methods: </strong>Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), including a total of 7,812 middle-aged and older adults. Kaplan-Meier survival analysis, multivariable Cox proportional hazards models, and restricted cubic spline (RCS) regression were employed to assess the association between baseline TyG-WC and incident CVD risk. Subgroup analyses were conducted based on glucose metabolism status to evaluate potential heterogeneity in the associations.</p><p><strong>Result: </strong>During an average follow-up period of 8.25 years, a total of 1,638 incident CVD events were recorded, corresponding to a cumulative incidence of 20.97%. Kaplan-Meier curves showed that individuals in higher TyG-WC strata had significantly greater cumulative CVD incidence compared to those in lower strata across all glucose metabolism categories (log-rank test, <i>P</i> < 0.05). After adjusting for potential confounders, the hazard ratios (HRs) [95% confidence intervals (CIs)] for CVD in the second, third, and fourth TyG-WC quartiles (Q2-Q4) were 1.20 (1.05-1.37), 1.30 (1.14-1.49), and 1.54 (1.34-1.77), respectively, compared to Q1. In the NGR and Pre-DM groups, TyG-WC was positively and linearly associated with CVD risk. In contrast, a significant non-linear association was observed in the DM group (<i>P</i> for non-linear = 0.046). Specifically, TyG-WC was positively associated with CVD risk when values were below 816.16, whereas above this threshold the increased risk plateaued and was no longer statistically significant.</p><p><strong>Conclusion: </strong>TyG-WC is a practical and effective metabolic indicator for evaluating CVD risk among middle-aged and older Chinese adults. Its clinical application may facilitate early identification and precise stratification of high-risk individuals, thereby providing strong support for CVD prevention and targeted intervention strategies.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1608655"},"PeriodicalIF":2.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}