Frontiers in Cardiovascular Medicine最新文献

{"title":"Clinical characteristics and outcomes of hospitalized patients with intracranial hemorrhage after percutaneous coronary intervention.","authors":"Yujing Zhou, Xin Su, Peng Liu, Yi Tang, Dong Cheng, Haiyu Li, Haiqiang Sang","doi":"10.3389/fcvm.2025.1424598","DOIUrl":"10.3389/fcvm.2025.1424598","url":null,"abstract":"<p><strong>Objectives: </strong>Complications of intracranial hemorrhage (ICH) after percutaneous coronary intervention (PCI), although rare, have a poor prognosis with high mortality rates. This study aims to provide information on the clinical characteristics and outcomes of hospitalized patients with ICH after PCI.</p><p><strong>Materials and methods: </strong>This retrospective study included 24 patients enrolled from February 2014 to September 2023, which occurred ICH during post-PCI hospitalization. We mainly analyzed general, procedural, ICH features and subsequent outcomes. In addition, the predictive ability of the CRUSADE, ARC-HBR, and ACUITY scores was assessed with the receiver operating characteristics area under the curve (AUC).</p><p><strong>Results: </strong>Among the 24 patients, the mean age was 62.21 ± 10.01 years, and 66.7% (<i>n</i> = 16) were men. The mortality of ICH patients after PCI was very high (<i>n</i> = 13, 54.2%). In addition, the most common initial manifestation of ICH patients was the disturbance of consciousness (<i>n</i> = 14, 58.3%). Over half of the cases (58.3%) occurred ICH within the first 12 h following PCI. 13 patients (54.2%) had an ICH volume ≥30 cm³, and of these patients, a total of 11(84.6%) died. ICH volume ≥30 cm³ (<i>p</i> = 0.038), and the use of mechanical ventilators (<i>p</i> = 0.011) were significantly higher in patients who died. The AUC of CRUSADE, ARC-HBR, and ACUITY scores were 0.500, 0.619, and 0.545, respectively.</p><p><strong>Conclusions: </strong>In our study, the mortality of ICH after PCI was high. The high volume of ICH indicates a high risk of death.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1424598"},"PeriodicalIF":2.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709286","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":"Twig-like middle cerebral artery: a case report and literature review.","authors":"Kai-Meng Wang, Yan-Zhao Xie, Guo-Dong Xu, Wentao Yao, He-Bo Wang","doi":"10.3389/fcvm.2025.1530241","DOIUrl":"10.3389/fcvm.2025.1530241","url":null,"abstract":"<p><strong>Background: </strong>Twig-like middle cerebral artery (T-MCA) is a rare cerebrovascular malformation with an incidence of approximately 0.11% to 1.17%. It is challenging to distinguish T-MCA from Moyamoya Angiopathy (MMA), particularly from unilateral MMA.</p><p><strong>Case presentation: </strong>A middle-aged female patient was admitted to our hospital for diagnosis and treatment due to intermittent dizziness lasting for two months. Neurological examination upon admission revealed no significant abnormalities.Whole-brain angiography showed clear blood flow in the left common carotid artery and internal carotid artery; however, no main trunk of the distal left middle cerebral artery M1 segment was visualized, and a network of small arteries supplying blood was observed. High-resolution intracranial arterial plaque imaging revealed no visualization of the LM1 main trunk on plain scan or enhanced high-resolution black-blood sequence; the proximal segment showed significant narrowing with circumferential thickening of the vessel wall. The patient was ultimately diagnosed with left-sided T-MCA.</p><p><strong>Conclusions: </strong>Asymptomatic T-MCA is challenging to identify clinically, making it essential to perform DSA or high-resolution MRI for suspected cases promptly. Regular follow-up is also necessary to confirm the final diagnosis in these patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1530241"},"PeriodicalIF":2.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709294","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":"Fractional flow reserve-guided complete vs. culprit-only revascularization in ST-elevation myocardial infarction patients with multivessel disease: a meta-analysis.","authors":"Jingxian Yang, Peng Wang, Jun Wan, Na Li, Jiajia Didi, Binger Shen, Xinyu Yang, Feina Li, Yu Zhang","doi":"10.3389/fcvm.2025.1509912","DOIUrl":"10.3389/fcvm.2025.1509912","url":null,"abstract":"<p><strong>Background: </strong>Among patients with ST-elevation myocardial infarction (STEMI) and multivessel disease, whether fractional flow reserve (FFR) guided complete revascularization (CR) is superior to the now widely used culprit-only (COR) revascularization is unclear.</p><p><strong>Methods: </strong>We conducted a search of PubMed, Embase, the Cochrane Library, and CNKI for randomized controlled trials comparing FFR-guided CR with COR in STEMI patients with multivessel disease. Data extraction and analysis adhered to Cochrane guidelines, with major adverse cardiac events as the primary outcome.</p><p><strong>Results: </strong>This meta-analysis included 6 trials involving 3,482 patients. FFR-guided CR was associated with a reduction in major adverse cardiac events (RR: 0.66, 95% CI: 0.46-0.94, 95% PI: 0.20-2.19), ischemia-driven revascularization (RR: 0.27, 95% CI: 0.19-0.40, 95% PI: 0.16-0.46), and repeat percutaneous coronary interventions (RR: 0.35, 95% CI: 0.22-0.50, 95% PI: 0.16-0.78) compared to COR. However, no difference was observed in all-cause mortality (RR: 1.12, 95% CI: 0.86-1.46, 95% PI: 0.79-1.58) or safety outcomes.</p><p><strong>Conclusion: </strong>FFR-guided CR reduces major adverse cardiac events compared to COR, though benefits may vary across settings. It significantly lowers ischemia-driven revascularization and repeat percutaneous coronary interventions, with no difference in all-cause mortality compared to COR.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024567524, PROSPERO (CRD42024567524).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1509912"},"PeriodicalIF":2.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709234","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":"Takotsubo syndrome following mitral transcatheter edge-to-edge repair: a case report and literature review.","authors":"Si Pang, Haobo Huang, Yunlong Zhu, Rong Zhou, Dan Tan, Yuqing Zhang, Mingxing Wu","doi":"10.3389/fcvm.2025.1516080","DOIUrl":"10.3389/fcvm.2025.1516080","url":null,"abstract":"<p><strong>Background: </strong>Takotsubo syndrome (TTS), characterized by transient wall motion aberrations and clinical manifestations akin to acute coronary syndrome, predominantly arises from significant physical or emotional stress, often throughout the perioperative period. The prevalence and mechanisms of this condition remain inadequately elucidated, particularly in the context of transcatheter valvular disease procedures. This knowledge gap may result in under-recognition and subsequent delays in diagnosis.</p><p><strong>Case summary: </strong>A 76-year-old female was scheduled in our department for mitral transcatheter edge-to-edge repair (TEER). Despite the procedural success, multi-lead T-wave inversions and a 43% decrease in ejection fraction accompanied by new apical hypokinesis were noted postoperatively. Subsequent assessment revealed TTS. After receiving the optimal medical therapy, the patient was discharged after 10 days without experiencing acute chest pain or shortness of breath. The patient's electrocardiogram (ECG) and function of the left ventricular function, particularly regional wall motion abnormalities, recovered on the 20th day after surgery.</p><p><strong>Discussion: </strong>The limited literature reporting TTS post-TEER that we reviewed suggests that this rare complication must be anticipated in patients exhibiting an unexpected postoperative ECG and impaired myocardial contraction.</p><p><strong>Conclusion: </strong>Researchers call for high-risk patient identification, adequate preoperative evaluation, and vigilant postoperative monitoring, and note the significance of early detection in optimizing therapeutic outcomes. Further research is imperative to further explore the management and prognosis of TTS following TEER.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1516080"},"PeriodicalIF":2.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709274","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":"Contextual challenges in implementing artificial intelligence for healthcare in low-resource environments: insights from the SPEC-AI Nigeria trial.","authors":"Demilade A Adedinsewo, Damilola Onietan, Andrea Carolina Morales-Lara, Serin Moideen Sheriff, Bosede B Afolabi, Oyewole A Kushimo, Amam C Mbakwem, Kehinde F Ibiyemi, James Ayodele Ogunmodede, Hadijat Olaide Raji, Sadiq H Ringim, Abdullahi A Habib, Sabiu M Hamza, Okechukwu S Ogah, Gbolahan Obajimi, Olugbenga Oluseun Saanu, Solomon Aborisade, Olusoji E Jagun, Francisca O Inofomoh, Temitope Adeolu, Kamilu M Karaye, Sule A Gaya, Yahya Sa'ad, Isiaka Alfa, Cynthia Yohanna, Peter A Noseworthy, Rickey E Carter","doi":"10.3389/fcvm.2025.1516088","DOIUrl":"10.3389/fcvm.2025.1516088","url":null,"abstract":"<p><p>Nigeria is the most populous country in Africa with the highest gross domestic product (GDP) as of 2022. However, Nigeria is burdened by significant health challenges including an extremely high maternal mortality ratio, inadequate human resources, poor healthcare infrastructure, and population-level poverty rates as high as 40%. Nigeria also has the highest reported prevalence of peripartum cardiomyopathy worldwide which contributes to maternal mortality. Unfortunately, the diagnosis of peripartum cardiomyopathy is often delayed and mortality rates following diagnosis are extremely high (approximately 50%). Thus, there is a huge unmet need for simple, effective, and accessible solutions for cardiomyopathy detection in this population. To address maternal mortality through screening and early diagnosis, we designed and conducted a randomized controlled clinical trial (NCT05438576) of an artificial intelligence (AI) technology in Nigeria. The objective of the study was to evaluate the impact of AI-guided screening on cardiomyopathy detection in obstetric patients. The study findings showed AI-guided screening doubled the detection of cardiomyopathy (defined as left ventricular ejection fraction <50%) when compared to usual care with a number needed to screen of 47. As we explore next steps in relation to deploying this technology for clinical use in Nigeria, we sought to gather contextual information and broadly share lessons learned from the recently completed trial. To that end, we convened a round table discussion with all study site investigators aimed at identifying site-specific contextual challenges related to the development and conduct of the study. The SPEC-AI Nigeria study is the first published randomized controlled clinical trial of a health AI intervention in Nigeria. Insights gained from this study can inform future AI intervention studies in clinical care, guide the development of implementation strategies to ensure effective interventions are successfully incorporated into clinical care, and provide a roadmap for key stakeholders to consider when evaluating AI-technologies for use in low-resource settings.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1516088"},"PeriodicalIF":2.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709230","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 effect of HA380 blood adsorption on patients with acute infective endocarditis undergoing cardiac surgery: a retrospective study.","authors":"Xiao Jiefei, Cao Lu, Shi Han, Shi Yongxu, Mo Shaoyan, Qin Kai, Li Yonghua, Zhu Yanling, Jiang Yumei, Rong Jian","doi":"10.3389/fcvm.2025.1512619","DOIUrl":"10.3389/fcvm.2025.1512619","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis is a major cause of ICU admission and mortality in patients with infective endocarditis patients. This study aimed to explore the effect of intraoperative HA380 blood adsorption on surgical outcomes in infective endocarditis patients, given its ability to adsorb inflammatory factors.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of patients who underwent surgical treatment for infective endocarditis at our hospital. After propensity score matching, eligible patients were matched in a 1:1 ratio between HA380 users and non-users. The primary endpoint was the incidence of postoperative sepsis, while secondary outcomes included ICU stay, postoperative hospital stay, and the need for CRRT, IABP, and ECMO therapies. Laboratory results were compared at 24, 48, and 72 h postoperatively.</p><p><strong>Results: </strong>A total of 148 patients were included in the analysis. After 1:1 matching, 39 pairs were further analyzed. There was no significant difference in the incidence of postoperative sepsis (20.5% vs. 15.4%, <i>p</i> = 0.724). However, HA380 patients had a significantly shorter postoperative hospital stay (21.2 vs. 28.1 days, <i>p</i> = 0.014), with no differences observed in the use of CRRT, IABP, or ECMO. Laboratory results showed that HA380 patients had significantly lower fibrinogen levels and a higher albumin-to-fibrinogen ratio.</p><p><strong>Discussion: </strong>This study did not demonstrate a reduced risk of postoperative sepsis with HA380 blood adsorption. Although the HA380 group had a shorter postoperative hospital stay, lower fibrinogen levels, and a higher albumin-to-fibrinogen ratio, the overall effectiveness of HA380 requires further investigation.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1512619"},"PeriodicalIF":2.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709248","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":"Sauna use as a novel management approach for cardiovascular health and peripheral arterial disease.","authors":"Sergio Sastriques-Dunlop, Santiago Elizondo-Benedetto, Mohamed A Zayed","doi":"10.3389/fcvm.2025.1537194","DOIUrl":"10.3389/fcvm.2025.1537194","url":null,"abstract":"<p><strong>Introduction: </strong>Heat therapy (HT), particularly in the form of whole-body sauna bathing, has emerged as a promising intervention for the management of cardiovascular disease (CVD). Passive HT can induce both local and systemic physiological responses, primarily through repeated thermal stress consisting of short-term passive exposure to high temperatures. Such responses closely parallel the physiological adaptations observed during aerobic exercise. Peripheral arterial disease (PAD) poses significant health challenges, impacting millions of individuals worldwide. Supervised exercise is considered a cornerstone therapy for PAD, yet many patients face significant health-related barriers that complicate its broad implementation.</p><p><strong>Methods: </strong>We conducted a comprehensive review of the literature to explore the therapeutic implications of various HT practices beyond sauna. The review aimed to evaluate the potential use of these practices as adjunctive management strategies for cardiovascular diseases, particularly in patients with PAD.</p><p><strong>Results: </strong>Recent studies have demonstrated the potential role of HT in alleviating PAD symptoms, improving functional capacity, and reducing cardiovascular and limb events. HT practices might be beneficial as adjunctive management strategies, in addition to or as alternatives to exercise, for management of cardiovascular diseases.</p><p><strong>Discussion: </strong>This review highlights the potential benefits, underlying mechanisms of action, challenges, and safety considerations associated with HT. We emphasize the importance of exploring HT as a viable option for patients with cardiovascular conditions, particularly those with PAD, who face barriers to traditional exercise regimens.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1537194"},"PeriodicalIF":2.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709269","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":"Co-administration of isoprenaline and phenylephrine induced a new HFrEF mouse model through activation of both SNS and RAAS.","authors":"Huimin Su, Ming Liu, Siteng Wang, Beiduo Tian, Hao Hu, Li-Kun Ma, Jianyuan Pan","doi":"10.3389/fcvm.2025.1531509","DOIUrl":"10.3389/fcvm.2025.1531509","url":null,"abstract":"<p><strong>Introduction: </strong>The pathogenesis of human heart failure is diverse, and a large number of animal models have emerged to better understand the development of heart failure in humans. Among them, there are several methods of induction in mouse heart failure models, each with its advantages and disadvantages. The use of drug induced heart failure models has greatly facilitated basic research and reduced the disadvantages of time-consuming and labor-intensive surgical modeling.</p><p><strong>Methods: </strong>In our experiments, we used a combination of isoprenaline (ISO) and phenylephrine (PE) for modeling; we aimed to evaluate whether it is superior to conventional drug-induced models, especially those induced by isoprenaline alone. The ISO and PE were administered for 2 weeks by subcutaneous implantation with a micro-osmolar pump, and the mice were monitored dynamically for cardiac ultrasound and blood pressure.</p><p><strong>Results: </strong>RNA sequencing of myocardial tissues after execution of mice further clarified that hypertrophy, fibrosis genes, Sympathetic nervous system (SNS), and Renin-angiotensin-aldosterone system (RAAS) pathways were upregulated.</p><p><strong>Discussion: </strong>Therefore, we conclude that the ISO/PE-induced mouse heart failure model can activate both the SNS and RAAS, through the activation of both α-adrenergic receptor (α-AR) and β-adrenergic receptor (β-AR), which is more consistent with the development of human heart failure than the ISO-induced model and is expected to be a unique and representative heart failure modeling method.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1531509"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700058","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":"Optimal antithrombotic therapy after transcatheter aortic valve replacement: a comprehensive review.","authors":"Nguyen Van Thai Thanh, Myeong-Ki Hong, Young-Guk Ko","doi":"10.3389/fcvm.2025.1528071","DOIUrl":"10.3389/fcvm.2025.1528071","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement (TAVR) has become a leading treatment for aortic stenosis, but managing thromboembolic and bleeding risks post-procedure remains challenging. This review examines current evidence on antithrombotic therapy after TAVR. Subclinical leaflet thrombosis is observed in 10%-20% of patients, though its clinical significance remains uncertain. Clinical valve thrombosis is rare. Current guidelines favor single antiplatelet therapy for patients without indications for long-term anticoagulation, as dual antiplatelet therapy increases bleeding risk without improving outcomes. For patients requiring long-term anticoagulation, monotherapy with direct oral anticoagulants or vitamin K antagonists is recommended to minimize bleeding. Ongoing trials aim to clarify optimal antithrombotic regimens and strategies for preventing subclinical leaflet thrombosis. Individualized therapy based on patient risk profiles is likely needed to improve the efficacy and safety of antithrombotic treatment post-TAVR.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1528071"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700069","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":"Remnant cholesterol, lipid ratios, and the severity of coronary artery lesions: a retrospective cohort study in patients with coronary heart disease.","authors":"Yu Li, Yumei Zhai, Songli Hu, Jing Liu, Wenchen Zhang, Jianwei Yue, Zichao Wang","doi":"10.3389/fcvm.2025.1516326","DOIUrl":"10.3389/fcvm.2025.1516326","url":null,"abstract":"<p><strong>Background: </strong>Emerging genetic and observational evidence indicates that remnant cholesterol (RC) is a significant residual risk factor for cardiovascular diseases. However, there is a relative paucity of evidence exploring the correlation among RC, lipid ratios, and atherosclerotic lesion severity. This study aimed to investigate the predictive value of RC and lipid ratios alone or in combination for the severity of coronary artery stenosis in patients with coronary heart disease (CHD).</p><p><strong>Methods: </strong>The Gensini score was used to assess the severity of coronary atherosclerotic lesions. CHD patients were categorized into mild stenosis and moderate-to-severe stenosis groups. Logistic regression was used to evaluate the risk of a high Gensini score associated with RC and lipid ratios. Our study also examined the relationship between inconsistencies in RC and non-high-density lipoprotein cholesterol (non-HDL-C) levels and the severity of coronary artery stenosis. Receiver operating characteristic (ROC) curves were used to assess the predictive power of RC and lipid ratios alone or in combination for moderate to severe coronary artery lesions.</p><p><strong>Results: </strong>Multivariate regression models suggested that RC was a strong predictor of moderate to severe coronary artery stenosis [odds ratio (OR): 5.44, <i>P</i> < 0.001]. When grouped by curve-fitting inflection points, the group with inconsistent high RC/low non-HDL-C, rather than the low RC/high non-HDL-C group, was associated with an increased risk of moderate to severe coronary stenosis compared with the consistent low RC group (OR: 2.72, <i>P</i> < 0.001). ROC curves showed that RC predicted an area under the curve (AUC) of 0.715 for coronary stenosis severity, improving the predictive efficacy of the combined predictors comprising lipid ratios (AUC: 0.723 vs. 0.703, <i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>RC and various lipid ratios [triglyceride/HDL-C, total cholesterol/HDL-C, low-density lipoprotein cholesterol/HDL-C, and apoloprotein (apo)B/apoA] correlated with the degree of coronary artery stenosis in patients with CHD, suggesting that RC has potential value as a biomarker reflecting the degree of coronary artery stenosis independent of the traditional risk factors and the levels of non-HDL-C. This could enhance the predictive efficacy based on the lipid ratio model and had better predictive value for moderate to severe coronary artery lesions.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1516326"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700073","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}