Frontiers in Cardiovascular Medicine最新文献

{"title":"Opportunistic coronary calcium progression on routine chest CT improves cardiovascular risk stratification in patients with inflammatory bowel disease: a multicenter study.","authors":"Qi Zhang, Yanxun Su, Chenyao Song, Ting Xu, Wenyan Liu, Jiaxin Cao, Binwei Guo, Lingjie Wang, Huajie Yue, Cheng Xu, Xuhui Zhao, Sijin Li","doi":"10.3389/fcvm.2026.1804400","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1804400","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel disease (IBD) have increased atherosclerotic cardiovascular risk that may be underestimated by conventional factors. Whether coronary artery calcium (CAC) progression adds prognostic value beyond baseline CAC in IBD is unclear.</p><p><strong>Methods: </strong>In this multicenter retrospective cohort, 467 IBD patients without known atherosclerotic cardiovascular disease underwent ≥2 routine non-contrast chest CT scans (mean interval 21.2 months). CAC progression was defined as incident CAC (0 to >0), absolute progression (0 < baseline <100 with annualized increase ≥10), or relative progression (baseline ≥100 with annualized increase ≥10%). Major adverse cardiovascular events (MACE) were the primary outcome; incident atrial fibrillation (AF) was secondary. Cox proportional hazard regression was utilized to estimate hazard ratios (HRs) for time to MACE regarding CAC progression. Incremental value was assessed by C-index and continuous net reclassification improvement (NRI).</p><p><strong>Results: </strong>Over a median follow-up of 37 months, 59 patients had MACE and 41 developed AF. CAC progression occurred in 27.6% and predicted MACE (HR 7.41, <i>P</i> < 0.001), with graded risk (relative HR 10.31; absolute HR 8.14; incident HR 5.22; all <i>P</i> < 0.001). Adding CAC progression to conventional factors improved discrimination (C-index 0.67 vs. 0.73) and reclassification (NRI 0.22, <i>P</i> < 0.001), whereas baseline CAC added modest value (C-index 0.67 vs. 0.68; NRI 0.04, <i>P</i> = 0.021). CAC progression was also associated with incident AF.</p><p><strong>Conclusions: </strong>Opportunistic CAC progression assessment from routine chest CT improves cardiovascular risk stratification in IBD beyond conventional factors and baseline CAC, including among patients with zero baseline CAC.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1804400"},"PeriodicalIF":2.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812109","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":"Global prevalence of hypertensive disorders of pregnancy: a scoping review and global perspective by country and region.","authors":"Yunjie Li, Rana F Chehab, Emily Z Wang, Sita Manasa Susarla, Clara Voong, Hongyi Chen, Mariana C Cabatu, Hadley Sorsby-Jones, Yeyi Zhu","doi":"10.3389/fcvm.2026.1692590","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1692590","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertensive disorders of pregnancy (HDP) are among the leading causes of maternal morbidity and mortality worldwide and an increasing global concern. This review aimed to estimate the global prevalence of HDP by country and World Health Organization (WHO) region using nationally representative, population-based studies.</p><p><strong>Methods: </strong>We searched PubMed and Embase for articles published between January 2004 and December 2023 and included population-based, observational studies with nationally or internationally representative samples reporting primary data on HDP prevalence. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>A total of 143 studies from 31 countries across six WHO regions met the inclusion criteria. The African Region reported the highest prevalence of chronic hypertension (4.80%), gestational hypertension (17.50%), and composite HDP (22.20%), although nationally representative prevalence estimates for preeclampsia and eclampsia were not available for this region. In contrast, the Eastern Mediterranean Region reported the lowest rates of chronic hypertension (1.10%), gestational hypertension (1.70%), preeclampsia (1.45%), and HDP (5.10%). The European Region had intermediate rates of chronic hypertension (1.70%), gestational hypertension (2.90%), preeclampsia (2.50%), eclampsia (0.02%) and HDP (5.90%). The Americas Region and the Western Pacific Region had varying rates across the HDP spectrum: chronic hypertension (2.35%, 3.15%), gestational hypertension (5.10%, 1.98%), preeclampsia (5.35%, 2.45%), eclampsia (0.08%, 0.06%), and HDP (8.04%, 5.60%, respectively). High-income countries had more studies of higher methodological quality than low- and middle-income countries.</p><p><strong>Discussion: </strong>We observed considerable variability in HDP prevalence and study quality across countries and regions. This may stem from variations in screening methods, diagnostic criteria, and data availability, highlighting critical gaps in standardized protocols particularly in resource-limited settings.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1692590"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835469","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":"Development and validation of a machine learning-based predictive model for new-onset atrial fibrillation after CABG.","authors":"JiaLiang Zheng, ZiRu Li, ShaoTing Sun, MingHao Shi, XiaoBing Lu, DaLin Sun, RuoPu Wang, Song He, ChengZhi Niu, CunTao Yu, Xin Zhang","doi":"10.3389/fcvm.2026.1783636","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1783636","url":null,"abstract":"<p><strong>Objective: </strong>New-onset atrial fibrillation (NOAF) after coronary artery bypass grafting (CABG) is one of the most common post-operative complications in patients undergoing cardiac surgery and is strongly associated with adverse outcomes. We aimed to develop a machine learning (ML) model for predicting NOAF after CABG.</p><p><strong>Method: </strong>We studied 925 patients who underwent coronary artery bypass grafting (CABG). We randomly split the data into a training set (70%) and a validation set (30%). Our primary outcome was new-onset atrial fibrillation (NOAF) after surgery (i.e., the first episode of atrial fibrillation within 7 days post-operatively in patients who were in sinus rhythm before CABG). We developed eight predictive models based on machine learning algorithms and evaluated their performance using area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, F1 score, and the Youden index. SHapley Additive exPlanations (SHAP) values were computed and plotted to interpret the contribution of individual features to model predictions.</p><p><strong>Results: </strong>The incidence of NOAF was 19%. For predicting new-onset atrial fibrillation after CABG, the Gradient Boosting model achieved the highest AUC [0.842 (0.785-0.899)], outperforming the logistic regression model [0.790 (0.722-0.858)]. In addition, AUCs of all machine learning models [0.761-0.842] exceeded those of conventional risk scores, such as CHA2DS2-VASc and HATCH [0.587 (0.55-0.724), 0.62 (0.543-0.697), respectively].</p><p><strong>Conclusion: </strong>The key features selected by machine learning methods and the resulting predictive models can predict new-onset atrial fibrillation after CABG with reasonable accuracy, which may support exploratory risk stratification and hypothesis generation; external validation is required before clinical implementation.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1783636"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835927","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":"Amlodipine monotherapy vs. amlodipine-ARB combination therapy as first-line treatment for primary hypertension: a systematic review and meta-analysis.","authors":"Yusra Pintaningrum, Claresta Salsabila Putri Evianto, Romi Ermawan, Fitri Damayanti, R Mohamad Javier, Kristian Kurniawan","doi":"10.3389/fcvm.2026.1779673","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1779673","url":null,"abstract":"<p><strong>Background: </strong>Some clinical guidelines recommend initiating combination antihypertensive therapy as first-line treatment rather than monotherapy. Evidence indicates that a substantial proportion of patients with hypertension require more than one antihypertensive agent to achieve recommended blood pressure targets. However, it remains unclear whether the benefits of initiating combination therapy outweigh the potential risks compared with antihypertensive monotherapy.</p><p><strong>Objective: </strong>This systematic review and meta-analysis was conducted to assess the efficacy of blood pressure control and the risk of drug-related adverse events associated with amlodipine monotherapy compared against first-line combination therapy of amlodipine and an angiotensin receptor blocker (ARB) in patients with primary hypertension.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, PubMed Central, and the Cochrane Library up to 15 November 2025, using the following search terms: \"amlodipine\" AND \"angiotensin receptor blocker\" AND \"primary hypertension\" AND \"randomized controlled trial.\" Only randomized controlled trials comparing amlodipine monotherapy with first-line combination therapy of amlodipine and an ARB, administered for at least 8 weeks, were included. The primary outcomes were blood pressure control and drug-related adverse events. Meta-analysis was performed using Review Manager (RevMan), version 5.4.</p><p><strong>Results: </strong>Based on six included studies, the analytical results showed that combination therapy with Calcium Channel Blocker (CCB) and an ARB was associated with 2.25 (odds ratio = 2.25: 95% CI: 1.78-2.83) times odds ratio with statistically significant overall effect (<i>P</i> < 0.00001) and 0.93 (risk ratio = 0.93: 95% CI: 0.82-1.05) times risk ratio with statistically insignificant overall effect (<i>P</i> = 0.24) compared with CCB (amlodipine 5 mg) monotherapy.</p><p><strong>Conclusions: </strong>The results of this study indicate that combination therapy with CCB and an ARB is associated with a 2.25-fold higher likelihood of achieving blood pressure control, with a significant correlation, and a lower risk of drug-related adverse events, without a significant correlation, compared with CCB monotherapy.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1779673"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835807","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":"Wrist-based wearable oscillometric blood pressure monitoring during Ramadan: a comparative study with standard devices.","authors":"Eyad Talal Attar","doi":"10.3389/fcvm.2026.1655897","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1655897","url":null,"abstract":"<p><p>The determination of blood pressure (BP) is crucial for the regulation of cardiovascular health status, particularly under the condition of physiological stress as seen during Ramadan fasting. Conventional BP measurement techniques are, accurate, intermittent and do not reflect the dynamic changes of fasting and rehydration. Wrist-based wearable oscillometric blood pressure monitoring devices, incorporating miniaturized inflatable cuffs, provide a portable and non-invasive approach for assessing BP outside traditional clinical settings. To assess the reliability of a consumer-grade wearable device (Huawei Watch D) for measuring systolic and diastolic blood pressure during Ramadan fasting, and to compare its performance with a validated electronic upper-arm monitor after pre-fast and post-fast conditions (Sahoor and If tar).</p><p><strong>Methods: </strong>A within subject, repeated-measures investigation was performed with 101 healthy fasting subjects (ages 22-70). Each participant recorded BP twice daily during Sahoor and If tar using both the Huawei Watch D and an upper-arm electronic monitor, both are FDA-approved. Statistical methods comprised paired t tests, as well as Pearson correlations and Bland-Altman plots. To evaluate prediction accuracy and discover subgroups, we also used machine learning approaches (linear regression and K-means clustering).</p><p><strong>Results: </strong>Compared with the electronic upper-arm monitor, the Huawei Watch D demonstrated minimal mean bias for both systolic and diastolic blood pressure (SBP: +0.9 to +1.4 mmHg; DBP: -0.6 to -0.2 mmHg). However, SBP exhibited wide limits of agreement (±18-21 mmHg), whereas DBP showed narrower dispersion (±11-13 mmHg). Machine-learning models achieved moderate prediction accuracy for DBP (MAE ≈ 4.3-6.1 mmHg, R² up to 0.74), while SBP prediction remained less accurate (MAE ≈ 6.5-8.9 mmHg, R² up to 0.64).However, SBP exhibited wide limits of agreement (±20 mmHg), limiting diagnostic interchangeability. DBP showed narrower error dispersion, supporting the use of wearable devices for trend monitoring and screening rather than clinical diagnosis.</p><p><strong>Conclusions: </strong>Smartwatch BP estimates are associated with standard devices, however, individual differences are considerable and therefore do not allow for diagnostic interchangeability. Wearables, such as the Huawei Watch D, provide the interesting data on the BP trend during fasting and rehydration, especially in diastolic pressure. These devices may assist with culturally appropriate monitoring and early identification of BP abnormalities however are in need of validation in a clinical context.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1655897"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835870","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":"Role of exercise in cardiovascular health: a narrative review from prevention to therapeutic utilizations.","authors":"Yong Wang, Xingbin Du, Qifei Wang","doi":"10.3389/fcvm.2026.1746819","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1746819","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) continues to be the leading cause of morbidity and mortality globally, imposing a substantial burden on healthcare systems worldwide. Physical inactivity is a significant modifiable risk factor that contributes to the onset and progression of CVD. Current guidelines recommend regular aerobic and muscle-strengthening exercise, with even below-guideline volumes reducing mortality risk significantly. Notably, even physical activity levels below these recommendations can significantly reduce mortality risk, emphasizing the importance of any movement over a sedentary lifestyle. Exercise functions as both a preventive and therapeutic intervention, helping individuals with and without CVD, including those recovering from myocardial infarction or managing heart failure. At the molecular level, the IGF-1/PI3K/Akt signaling pathway plays a crucial role in exercise-induced cardiac protection by promoting balanced cardiac growth, enhancing contractility, and reducing fibrosis. Furthermore, increased endothelial nitric oxide synthase (eNOS) activity improves vascular function, antioxidant enzymes mitigate oxidative stress, and peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1<i>α</i>) stimulates mitochondrial biogenesis, while pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) are downregulated. Large-scale cohort studies have proved that regular exercise can reduce all-cause and CVD mortality by 36%-56%. This magnitude of risk reduction rivals or exceeds that achieved by pharmacological interventions such as statins or antihypertensives, positioning physical activity as a foundational, cost-effective intervention for population-level cardiovascular disease prevention. However, excessive exercise may pose risks such as arrhythmias or myocardial strain, underscoring the need for personalized, balanced exercise programs. Future research should focus on defining best exercise prescriptions, understanding exercise-drug interactions, and developing biomarkers to check adaptive responses. Ultimately, integrating personalized exercise medicine into healthcare and public policy offers a cost-effective strategy for preventing and managing CVD, promoting lifelong cardiovascular resilience and well-being.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1746819"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835856","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":"Angio-fusion net: dual-stream enhanced VGG16 attention U-Net for vessel morphology preservation in XCA segmentation.","authors":"G Sunilkumar, P Kumaresan","doi":"10.3389/fcvm.2026.1748962","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1748962","url":null,"abstract":"<p><p>The accumulation of atherosclerotic atheroma in coronary arteries leads to significant cardiac risks. Accurate segmentation of coronary arteries in X-ray coronary angiographic (XCA) images is essential for diagnosing atherosclerotic disease and guiding interventional procedures. However, low image quality and complex vascular morphology pose significant challenges. To address these issues, we proposed Angio-Fusion Net, a deep learning framework designed to enhance vessel delineation in challenging angiographic conditions. Angio-Fusion Net employs a single Attention-VGG16-U-Net model for segmentation, while applying two different preprocessing methods to improve image quality. The first combines Top-Hat Morphology and Contrast Limited Adaptive Histogram Equalization (CLAHE) to enhance fine vascular structures, while the second integrates Gamma Correction with CLAHE to improve visibility in low-contrast conditions. The segmentation model leverages VGG16's hierarchical feature extraction and U-Net's spatial precision, enhanced by attention mechanisms that highlight salient vascular regions and reduce background interference. Skip connections further preserve the integrity of complex coronary morphology. Experimental results on low-quality XCA images demonstrate that Angio-Fusion Net outperforms existing state-of-the-art methods. The Gamma-CLAHE + Attention-VGG16-U-Net version achieved a Dice score of 96.15% ± 0.47%, Jaccard index of 92.61% ± 0.65%, and Accuracy of 98.02%, while the Top-Hat-CLAHE version yielded a Dice score of 93.21% ± 0.45%, Jaccard index of 87.39% ± 0.67%, and Accuracy of 93.27%. These results show that Angio-Fusion Net works well in different imaging conditions and can help cardiologists detect blocked arteries early, thereby improving treatment decisions.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1748962"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835903","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":"Heart-brain axis pathophysiological understanding and clinical impact.","authors":"Federico Vancheri, Sergio Vancheri, Giovanni Longo, Edoardo Vancheri, Michael Y Henein","doi":"10.3389/fcvm.2026.1681715","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1681715","url":null,"abstract":"<p><p>The heart and brain are anatomically and functionally interconnected through nervous and humoral feedback mechanisms. Under physiological conditions, the heart-brain axis helps maintain cardiovascular and cerebral homeostasis. Pathology affecting one organ can profoundly impact the other, significantly worsening prognosis. The term <i>stroke-heart syndrome</i> refers to cardiovascular complications following acute ischemic stroke, including myocardial injury, infarction, ventricular dysfunction, arrhythmias (e.g., atrial fibrillation), heart failure, takotsubo syndrome, and sudden cardiac death. Brain damage-induced cardiac injury arises from a complex interplay of neuroinflammation, systemic immune activation, sympathetic-immune interactions, catecholamine toxicity, endothelial dysfunction, and gut-brain-heart axis involvement. Conversely, cardiac conditions, including myocardial ischemia, heart failure, and atrial fibrillation, are associated with an increased risk of stroke and cognitive decline. Myocardial ischemia can initiate systemic inflammation and neuroinflammation through sympathetic overdrive and platelet activation. Heart failure causes cerebral hypoperfusion and high thromboembolic risk, and atrial fibrillation promotes thrombus formation due to blood stasis. Atrial dysfunction and prothrombotic states may also occur independently of arrhythmia. This review summarises current evidence on the pathological interactions within the heart-brain axis, in the context of stroke, mental stress, ischemic heart disease, heart failure, and atrial fibrillation.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1681715"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835455","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":"Predictive value of ALBI score in assessing prognosis of NSTEMI: a retrospective cohort study.","authors":"Xiaoqiang Chen, Xintao Zhou, Chuanglu Zhao, Lishan Chen, Shuyin Wang, Xinwen Min, Jishun Chen, Xiaolei Li","doi":"10.3389/fcvm.2026.1768037","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1768037","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the predictive value of the albumin-bilirubin (ALBI) score for mortality risk in patients with non-ST-segment elevation myocardial infarction (NSTEMI).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 982 patients with NSTEMI. A multivariate Cox proportional hazards model was established to analyze the predictive value of ALBI for mortality after hospital discharge in NSTEMI patients. Additionally, restricted cubic spline (RCS) plots were used to analyze the relationship between ALBI and post-discharge mortality. Operating characteristic (ROC) curves were generated to assess the predictive accuracy of ALBI, and nomograms were constructed to facilitate clinical application in predicting mortality after hospital discharge in patients with NSTEMI.</p><p><strong>Results: </strong>Among the 982 participants, 62 (6.3%) developed death during the follow-up. In unadjusted Cox regression models, the ALBI index had a hazard ratio (HR) of 5.07 (95% confidence interval CI: 3.13-8.20, <i>P</i> < 0.001). In the adjusted models, the relationship still persisted. Furthmore, a non-linear and dose-response relationship between the ALBI index and the primary endpoint was observed (non-linear <i>P</i> = 0.050, <i>P</i> overall < 0.001). ROC curve analysis revealed good predictive performance for ALBI. The nomogram model correctly separates patients with and without death risk, with an AUC of 0.835. Our model showed improved prediction of death compared to GRACE, or NT-proBNP (all <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>ALBI was significantly associated with the risk of out-of-hospital death in NSTEMI patients. The novel nomogram based on ALBI, NT-proBNP, and GRACE scores showed an improvement in predicting mortality.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1768037"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835935","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":"Empagliflozin attenuates elaidic acid-exacerbated cardiac dysfunction post-myocardial infarction via suppression of the NF-κB/NLRP3 pathway.","authors":"Qingkai Yan, Jin Xiao, Changqing Yu, Yuehui Yin","doi":"10.3389/fcvm.2026.1765915","DOIUrl":"https://doi.org/10.3389/fcvm.2026.1765915","url":null,"abstract":"<p><strong>Objective: </strong>Myocardial infarction leads to heart failure greatly increasing the risk of adverse cardiovascular events. Empagliflozin (EMPA), a sodium-dependent glucose transporters 2 (SGLT2) inhibitor, has been demonstrated to provide effective cardiovascular protection, while the underlying metabolic mechanisms of EMPA on protecting cardiac dysfunction post-MI remain incompletely clear. The current study was conducted to investigate the metabolic effects of EMPA in hearts with cardiac dysfunction post-MI.</p><p><strong>Methods: </strong>Bioinformatics analysis revealed activation of the NF-κB/NLRP3/pyroptosis signaling pathway in AMI patients. <i>In vivo</i>, MI mice were generated and treated with empagliflozin (EMPA) or saline for 4 weeks, assessing cardiac structure and function via ultrasound and histological staining. Concurrently, Fatty acid content in cardiac tissues was evaluated from all three groups using targeted metabolomics, with an assessement of the NF-κB/NLRP3/pyroptosis signaling pathway in each group via western blot and immunohistochemistry.</p><p><strong>Results: </strong>The bioinformatics analysis was conducted using GSE97320 dataset found the activation of the NF-κB/NLRP3/pyroptosis signaling pathway in MI patients. <i>In vivo</i> experiments revealed that cardiac structural abnormalities and functional impairment in MI mice were significantly improved by EMPA treatment. Concurrently, EMPA treatment effectively suppressed activation of the NF-κB/NLRP3 signaling pathway, accompanied by reduced levels of IL-1β and IL-18, suggesting decreased levels of cardiomyocyte pyroptosis and markedly alleviated inflammatory infiltration and myocardial fibrosis. Furthermore, targeting lipid metabolism revealed marked accumulation of elaidic acid in cardiomyocytes of MI mice, which was significantly reduced in myocardial tissue following EMPA treatment. This improvement was accompanied by restoration of mitochondrial structure and function.</p><p><strong>Conclusion: </strong>EMPA treatment effectively improves cardiac structure and function in MI mice, potentially through regulating lipid metabolism and reducing tissue EA levels, thereby inhibiting NF-κB/NLRP3/pyroptosis while alleviating mitochondrial structural and functional abnormalities.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"13 ","pages":"1765915"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835370","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}