Frontiers in Cardiovascular Medicine最新文献

{"title":"Evaluating the role of pericoronary adipose tissue on coronary artery disease: insights from CCTA on risk assessment, vascular stenosis, and plaque characteristics.","authors":"Jingyue Wang, Huicong Zhang, Zihao Wang, Wenyun Liu, Dianbo Cao, Qian Tong","doi":"10.3389/fcvm.2024.1451807","DOIUrl":"10.3389/fcvm.2024.1451807","url":null,"abstract":"<p><strong>Introduction: </strong>Pericoronary adipose tissue (PCAT) plays a significant role in the occurrence and progression of coronary artery disease (CAD). This study investigates the relationship between PCAT and CAD, focusing on the occurrence of the disease, the severity of vascular narrowing, and the characteristics of arterial plaques.</p><p><strong>Methods: </strong>We analyzed a cohort of 152 individuals with CAD and 55 individuals with non-coronary artery disease (N-CAD). Participants underwent both coronary computed tomography angiography (CCTA) and digital subtraction angiography (DSA). Utilizing United Imaging software for artificial intelligence delineation, we measured the fat attenuation index (FAI) and volume of PCAT in the left anterior descending (LAD), left circumflex (LCX), and right coronary arteries (RCA).</p><p><strong>Results: </strong>Our findings demonstrate that while CCTA is effective in diagnosing CAD compared to DSA, its diagnostic power for individual coronary arteries remains limited. Further analysis revealed that the FAI of the RCA and the overall PCAT volume independently influenced CAD (OR: 1.057, 95% CI: 1.002 to 1.116; OR: 0.967, 95% CI: 0.936 to 0.999). FAI showed a significant independent effect on RCA stenosis (OR: 1.041, 95% CI: 1.003 to 1.081), while the fat volume of the LAD had a significant independent effect on LAD stenosis (OR: 0.884, 95% CI: 0.809 to 0.965). A higher FAI and a lower fat volume were significantly correlated with more severe vascular stenosis percentages in all three arteries (<i>p</i> < 0.05), except for the fat volume and stenosis of the LCX. Moreover, we found the significant differences in the fat volume of the LCX between different plaque types (<i>H</i> = 8.869, <i>p</i> = 0.012), with calcified plaques consistently exhibiting the lowest fat volume across all three arteries. Finally, the likelihood ratio test confirmed that incorporating the PCAT fat volume parameter of LAD significantly improved the diagnostic ability of CCTA for both CAD (<i>p</i> = 0.01543) and LAD stenosis (<i>p</i> = 0.001585).</p><p><strong>Conclusion: </strong>The quantification of PCAT has potential application value in the comprehensive assessment of CAD. It is recommended that cardiology and radiology departments consider incorporating PCAT into the assessment criteria for patients suspected of having CAD.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590281","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 varicose veins and constitution of traditional Chinese medicine plus heart-failure-like symptoms.","authors":"Cheng-Ken Tsai, Oswald Ndi Nfor, Wen-Yu Lu, Yung-Po Liaw","doi":"10.3389/fcvm.2024.1465843","DOIUrl":"10.3389/fcvm.2024.1465843","url":null,"abstract":"<p><strong>Background: </strong>Varicose veins are a common issue for employees in jobs that require prolonged standing compared with all other employees. However, its relationship with presentations of traditional Chinese medicine constitution is unknown. This study aimed to investigate their association.</p><p><strong>Material and methods: </strong>Data in the study were obtained from questionnaires of patients in Taiwan Biobank, enrolled from 2008 to 2020. The responses to the statement \"I can see distorted blood vessels on my four limbs (varicose veins).\" were categorized into none, mild, moderate, severe. and more severe, and the same scale was also used to classify breathing difficulties and hypotension.</p><p><strong>Results: </strong>A total of 11,293 participants were enrolled in the study. The prevalence of women was higher in the studied group compared with the control. Patients complained of breathing difficulties with moderate (30.49%) and severe discomfort (12.44%) in the diseased group. Regarding hypotension, 28.81% and 9.82% of the patients presented with moderate and severe hypotension, respectively. The cofactor odds ratio was 1.775 for severe breathing difficulty/moderate hypotension and 2.235 for severe breathing difficulty/severe hypotension, with statistical significance. The combined impact of breathing difficulties and hypotension increased with severity.</p><p><strong>Conclusions: </strong>Varicose veins had a higher association with breathing difficulties and hypotension as the severity of the condition worsened. The combined impact of breathing difficulties and hypotension increased as the disease progressed. Therefore, self-reported assessments can be a useful tool for evaluating patients with asymptomatic varicose veins before the development of \"heart-failure-like symptoms\" to reduce the risk of underdiagnosis.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590265","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 correlation between stable angina and inflammatory factors and blood lipids: a case-control study.","authors":"Lei Xiang","doi":"10.3389/fcvm.2024.1443450","DOIUrl":"10.3389/fcvm.2024.1443450","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we aimed to compare the levels of inflammatory markers (C-reactive protein, CRP; procalcitonin, PCT) and blood lipids (total cholesterol, TC; triglyceride, TG; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C) between patients with stable angina and control group, and to explore the correlation between these parameters and the severity and prognosis of stable angina.</p><p><strong>Methods: </strong>We retrospectively selected 113 patients with stable angina and 128 control group from the medical record system, and compared their inflammatory factors and blood lipids. We also assessed the severity of angina using the Canadian Cardiovascular Society (CCS) classification and followed up the patients for 1 year to record any cardiovascular events.</p><p><strong>Results: </strong>We found that patients with stable angina had significantly higher levels of CRP, TC, TG, and LDL-C, and lower levels of HDL-C than control group. Moreover, CRP, TC, TG, and LDL-C were positively correlated with the severity of angina, while HDL-C was negatively correlated. During the follow-up period, 37 patients with stable angina experienced cardiovascular events, and they had higher levels of CRP, TC, TG, and LDL-C, and lower levels of HDL-C than those who did not.</p><p><strong>Conclusion: </strong>Our study suggests that inflammation and dyslipidemia are closely related to stable angina, and that inflammatory factors and blood lipids can be used as indicators of the severity and prognosis of stable angina.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590310","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":"Predicting long-term risk of sudden cardiac death with automatic computer-interpretations of electrocardiogram.","authors":"Minna Järvensivu-Koivunen, Antti Kallonen, Mark van Gils, Leo-Pekka Lyytikäinen, Juho Tynkkynen, Jussi Hernesniemi","doi":"10.3389/fcvm.2024.1439069","DOIUrl":"10.3389/fcvm.2024.1439069","url":null,"abstract":"<p><strong>Background: </strong>Computer-interpreted electrocardiogram (CIE) data is provided by almost all commercial software used to capture and store digital electrocardiograms. CIE is widely available, inexpensive, and accurate. We tested the potential of CIE in long-term sudden cardiac death (SCD) risk prediction.</p><p><strong>Methods: </strong>This is a retrospective of 8,568 consecutive patients treated for acute coronary syndrome. The primary endpoint was five-year occurrence of SCDs or equivalent events (SCDs aborted by successful resuscitation or adequate ICD therapy). CIE statements were extracted from summary statements and measurements made by the GE Muse 12SL algorithm from ECGs taken during admission. Three supervised machine learning algorithms (logistic regression, extreme gradient boosting, and random forest) were then used for analysis to find risk features using a random 70/30% split for discovery and validation cohorts.</p><p><strong>Results: </strong>Five-year SCD occurrence rate was 3.3% (<i>n</i> = 287). Regardless of the used ML algorithm, the most significant risk ECG risk features detected by the CIE included known risk features such as QRS duration and factors associated with QRS duration, heart rate-corrected QT time (QTc), and the presence of premature ventricular contractions (PVCs). Risk score formed by using most significant CIE features associated with the risk of SCD despite adjusting for any clinical risk factor (including left ventricular ejection fraction). Sensitivity of CIE data to correctly identify patients with high risk of SCD (over 10% 5-year risk of SCD) was usually low, but specificity and negative prediction value reached up to 96.9% and 97.3% when selecting only the most significant features identified by logistic regression modeling (<i>p</i>-value threshold <0.01 for accepting features in the model). Overall, CIE data showed a modest overall performance for identifying high risk individuals with area under the receiver operating characteristic curve values ranging between 0.652 and 0.693 (highest for extreme gradient boosting and lowest for logistic regression).</p><p><strong>Conclusion: </strong>This proof-of-concept study shows that automatic interpretation of ECG identifies previously validated risk features for SCD.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590286","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":"Clinical decision-making in patients with non-ST-segment-elevation myocardial infarction: more than risk stratification.","authors":"Guangze Xiang, Gaoyang Cao, Menghan Gao, Tianli Hu, Wujian He, Chunxia Gu, Xulin Hong","doi":"10.3389/fcvm.2024.1382374","DOIUrl":"10.3389/fcvm.2024.1382374","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the association between risk stratification and total occlusion (TO) of the culprit artery and multivessel disease (MVD) in patients with non-ST-segment-elevation myocardial infarction (NSTEMI) and to obtain more data on clinical decision-making in addition to risk stratification.</p><p><strong>Methods: </strong>We retrospectively collected data from 835 patients with NSTEMI admitted to our hospital between 1 January 2016 and 1 August 2022. All patients underwent percutaneous coronary intervention (PCI) within 72 h of admission. We excluded patients with a history of cardiac arrest, myocardial infarction, coronary artery bypass grafting, or PCI. Univariate and multivariate regression analyses were performed to determine the predictors of acute TO and MVD.</p><p><strong>Results: </strong>A total of 349 (41.8%) patients presented with a TO culprit vessel, whereas 486 (58.2%) had a patent culprit vessel. Thrombolysis in myocardial infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk stratifications were similar between the two groups of patients (<i>P</i> = 0.712 and 0.991, respectively). The TO infarct vessel was more commonly observed in the left circumflex artery. Patients with TO were more likely to develop MVD (<i>P</i> = 0.004). Univariate and multivariate linear regression analyses were performed to evaluate the role of variables in the presence of TO and MVD in patients with NSTEMI. Regional wall motion abnormalities (RWMAs) [odds ratio (OR) = 4.022; confidence interval (CI): 2.782-5.813; <i>P</i> < 0.001] were significantly linked to TO after adjusting for potentially related variables. Furthermore, age (OR = 1.032; CI: 1.018-1.047; <i>P</i> < 0.001), hypertension (OR = 1.499; CI: 1.048-2.144; <i>P</i> = 0.027), and diabetes mellitus (OR = 3.007; CI: 1.764-5.125; <i>P</i> < 0.001) were independent predictors of MVD in patients with NSTEMI. TIMI and GRACE risk scores were related to MVD prevalence in the multivariate logistic regression model. Patients with a TO culprit vessel had a higher risk of out-of-hospital cardiac death after a 2-year follow-up compared with those without a TO culprit vessel (<i>P</i> = 0.022).</p><p><strong>Conclusion: </strong>TIMI and GRACE risk scores were not associated with a TO of the culprit artery; however, they correlated with the prevalence of MVD in patients with NSTEMI. RWMA is an independent predictor of acute TO in patients with NSTEMI. Patients with a TO culprit vessel had worse clinical outcomes than those without a TO culprit vessel.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590275","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":"Coronary artery disease and the risk of life-threatening cardiac events after age 40 in long QT syndrome.","authors":"Alon Barsheshet, Ilan Goldenberg, Milica Bjelic, Kirill Buturlin, Aharon Erez, Gustavo Goldenberg, Anita Y Chen, Bronislava Polonsky, Scott McNitt, Mehmet Aktas, Wojciech Zareba, Gregory Golovchiner","doi":"10.3389/fcvm.2024.1418428","DOIUrl":"10.3389/fcvm.2024.1418428","url":null,"abstract":"<p><strong>Background and aims: </strong>Long QT syndrome (LQTS) and coronary artery disease (CAD) are both associated with increased risk of ventricular tachyarrhythmia<i>.</i> However, there are limited data on the incremental risk conferred by CAD in adult patients with congenital LQTS. We aimed to investigate the risk associated with CAD and life threatening events (LTEs) in patients with LQTS after age 40 years.</p><p><strong>Methods: </strong>The risk of LTEs (comprising aborted cardiac arrest, sudden cardiac death, or appropriate defibrillator shock) from age 40 through 75 years was examined in 1,020 subjects from the Rochester LQTS registry, categorized to CAD (<i>n</i> = 137) or no-CAD (<i>n</i> = 883) subgroups.</p><p><strong>Results: </strong>Survival analysis showed that patients with CAD had a significantly higher cumulative event rate of LTEs from 40 to 75 years (35%) compared with those without CAD (7%; <i>p</i> < 0.001 for the overall difference during follow-up). Consistently, multivariate analysis showed that the presence of CAD was associated with a 2.5-fold (HR = 2.47; <i>p</i> = 0.02) increased risk of LTEs after age 40 years. Subgroup analyses showed that CAD vs. no CAD was associated with a pronounced >4-fold (<i>p</i> = 0.008) increased risk of LTEs among LQTS patients with a lower-range QTc (<500 ms). The increased risk of LTEs associated with CAD was not significantly different among the 3 main LQTS genotypes. Patient treatment was suboptimal, with only 63% on β-blockers and 44% on non-selective β-blockers.</p><p><strong>Conclusions: </strong>Our findings suggest that CAD is associated with a higher risk of LTEs in LQTS patients, with the risk being more pronounced in those with QTc <500 ms.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582232","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":"Prediction of in-hospital mortality risk for patients with acute ST-elevation myocardial infarction after primary PCI based on predictors selected by GRACE score and two feature selection methods.","authors":"Nan Tang, Shuang Liu, Kangming Li, Qiang Zhou, Yanan Dai, Huamei Sun, Qingdui Zhang, Ji Hao, Chunmei Qi","doi":"10.3389/fcvm.2024.1419551","DOIUrl":"10.3389/fcvm.2024.1419551","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate in-hospital mortality prediction following percutaneous coronary intervention (PCI) is crucial for clinical decision-making. Machine Learning (ML) and Data Mining methods have shown promise in improving medical prognosis accuracy.</p><p><strong>Methods: </strong>We analyzed a dataset of 4,677 patients from the Regional Vascular Center of Primorsky Regional Clinical Hospital No. 1 in Vladivostok, collected between 2015 and 2021. We utilized Extreme Gradient Boosting, Histogram Gradient Boosting, Light Gradient Boosting, and Stochastic Gradient Boosting for mortality risk prediction after primary PCI in patients with acute ST-elevation myocardial infarction. Model selection was performed using Monte Carlo Cross-validation. Feature selection was enhanced through Recursive Feature Elimination (RFE) and Shapley Additive Explanations (SHAP). We further developed hybrid models using Augmented Grey Wolf Optimizer (AGWO), Bald Eagle Search Optimization (BES), Golden Jackal Optimizer (GJO), and Puma Optimizer (PO), integrating features selected by these methods with the traditional GRACE score.</p><p><strong>Results: </strong>The hybrid models demonstrated superior prediction accuracy. In scenario (1), utilizing GRACE scale features, the Light Gradient Boosting Machine (LGBM) and Extreme Gradient Boosting (XGB) models optimized with BES achieved Recall values of 0.944 and 0.954, respectively. In scenarios (2) and (3), employing SHAP and RFE-selected features, the LGB models attained Recall values of 0.963 and 0.977, while the XGB models achieved 0.978 and 0.99.</p><p><strong>Discussion: </strong>The study indicates that ML models, particularly the XGB optimized with BES, can outperform the conventional GRACE score in predicting in-hospital mortality. The hybrid models' enhanced accuracy presents a significant step forward in risk assessment for patients post-PCI, offering a potential alternative to existing clinical tools. These findings underscore the potential of ML in optimizing patient care and outcomes in cardiovascular medicine.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582279","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":"Editorial: Global Excellence in Cardiovascular Medicine in Africa: challenges and opportunities.","authors":"Mahdi Garelnabi, Mpiko Ntsekhe, Anton Doubell, Masanori Aikawa","doi":"10.3389/fcvm.2024.1479281","DOIUrl":"10.3389/fcvm.2024.1479281","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582260","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 role of circulating cytokines in heart failure: a bidirectional, two-sample Mendelian randomization study.","authors":"Haoran Zheng, Xinxin Mao, Zhenyue Fu, Chunmei Chen, Jiayu Lv, Yajiao Wang, Yuxin Wang, Huaqin Wu, Yvmeng Li, Yong Tan, Xiya Gao, Lu Zhao, Xia Xu, Bingxuan Zhang, Qingqiao Song","doi":"10.3389/fcvm.2024.1332015","DOIUrl":"10.3389/fcvm.2024.1332015","url":null,"abstract":"<p><strong>Background: </strong>Cytokines play a pivotal role in the progression of heart failure (HF) by modulating inflammatory responses, promoting vasoconstriction, and facilitating endothelial injury. However, it is now difficult to distinguish the causal relationship between HF and cytokines in observational studies. Mendelian randomization (MR) analyses of cytokines probably could enhance our comprehension to the underlying biological processes of HF.</p><p><strong>Methods: </strong>This study was to explore the correlation between 41 cytokines with HF at the genetic level by MR analysis. We selected a HF dataset from the Heart Failure Molecular Epidemiology for Therapeutic Targets (HERMES) 2018 and a cytokine dataset from a meta-analysis of cytokine levels in Finns. Two-sample, bidirectional MR analyses were performed using Inverse Variance Weighted (IVW), Weighted Median and MR- egger, and the results were tested for heterogeneity and pleiotropy, followed by sensitivity analysis.</p><p><strong>Results: </strong>Genetic prediction of high levels of circulating Macrophage inflammatory pro-tein-1β(MIP-1β) (<i>P</i> = 0.0389), Interferon gamma induced protein 10(IP-10) (<i>P</i> = 0.0029), and Regu-lated on activation, normal T cell expressed and secreted(RANTES) (<i>P</i> = 0.0120) expression was associated with an elevated risk of HF. HF was associated with the increased levels of circulating Interleukin-2 receptor, alpha subunit(IL-2ra) (<i>P</i> = 0.0296), Beta nerve growth fac-tor(β-NGF) (<i>P</i> = 0.0446), Interleukin-17(IL-17) (<i>P</i> = 0.0360), Basic fibroblast growth factor(FGF-basic) (<i>P</i> = 0.0220), Platelet derived growth factor BB(PDGF-BB) (<i>P</i> = 0.0466), and Interferon-gamma(IFN-<i>γ</i>) (<i>P</i> = 0.0222); and with decreased levels of Eotaxin (<i>P</i> = 0.0133). The heterogeneity and pleiotropy of the cytokines were acceptable, except for minor heterogeneity of FGF-basic and IL-17.</p><p><strong>Conclusion: </strong>These findings provide compelling evidence for a genetically predictive relationship between cytokines and HF, emphasizing a great potential of targeted modulation of cytokines in slowing the progression of HF. This study draws further conclusions at the genetic level, providing a basis for future large-scale clinical trials.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582286","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":"Acetylsalicylic acid dosed at bedtime vs. dosed in the morning for circadian rhythm of blood pressure- a systematic review and meta-analysis.","authors":"Abdullah Nadeem, Taruba Rais, Minahil Aamir, Alexander Habte, Tasmiyah Siddiqui, Riyan Imtiaz Karamat, Rabbia Munsab, Ashna Habib","doi":"10.3389/fcvm.2024.1346265","DOIUrl":"10.3389/fcvm.2024.1346265","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease (CVD) is a leading global cause of morbidity and mortality, with high systolic blood pressure (SBP) identified as a major risk factor. Aspirin (Acetylsalicylic acid-ASA) has been considered for CVD prevention, prompting questions about its optimal use in primary and secondary prevention and the ideal dosing time to maximize its impact on circadian blood pressure rhythms. Previous research suggests a potential benefit of bedtime aspirin dosing in reducing blood pressure, attributed to its effects on the renin-angiotensin-aldosterone system and nitric oxide production. This systematic review and meta-analysis aim to further explore the circadian effects of aspirin on blood pressure, focusing on the timing of administration.</p><p><strong>Methods: </strong>Adhering to PRISMA guidelines, a comprehensive search of PubMed, Cochrane Library, and clinicaltrials.gov was conducted. Randomized controlled trials (RCTs) involving patients aged >18 with cardiovascular history and hypertension were included. The primary objective was to assess the impact of bedtime-dosed and morning-dosed aspirin on systolic and diastolic blood pressure. Low-dose aspirin was administered for primary or secondary prevention. The Cochrane Risk of Bias tool evaluated study quality. Meta-analyses were conducted using RevMan 5.3, with mean deviations and 95% confidence intervals employed for outcomes.</p><p><strong>Results: </strong>Initial searches yielded 1,181 articles, with six studies meeting the inclusion criteria. These RCTs involved 1,470 patients, with 1,086 completing follow-up. Bedtime aspirin dosing demonstrated a significant reduction in both systolic and diastolic blood pressure compared to morning dosing (<i>p</i> < 0.05). Meta-analysis results for systolic blood pressure revealed a weighted mean difference of approximately 3.65 mmHg in favour of bedtime dosing, with low heterogeneity (<i>I</i> ² = 0%). For diastolic blood pressure, the weighted mean difference was 1.92, again favouring bedtime dosing, with 3% heterogeneity.</p><p><strong>Conclusion: </strong>This meta-analysis, involving over 1,300 cardiovascular/hypertensive patients, supports the effectiveness of bedtime aspirin in reducing systolic and diastolic blood pressure compared to morning dosing. The results align with previous findings but distinguish themselves by incorporating a more diverse patient population and addressing moderate heterogeneity. While the study's outcomes are promising, further research, including larger sample sizes and longer durations, is warranted for comprehensive clinical implementation. As the study exclusively focused on aspirin timing, future investigations should explore sustained blood pressure effects in patients with clinical indications for aspirin alongside other hypertensive medications.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582223","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}