Frontiers in Cardiovascular Medicine最新文献

{"title":"Ten-year clinical outcomes of everolimus- and biolimus-eluting coronary stents vs. everolimus-eluting bioresorbable vascular scaffolds—insights from the EVERBIO-2 trial","authors":"Samir Bengueddache, Malica Cook, Sonja Lehmann, Diego Arroyo, Mario Togni, Serban Puricel, Stephane Cook","doi":"10.3389/fcvm.2024.1426348","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1426348","url":null,"abstract":"BackgroundBioresorbable vascular scaffolds (BVSs) have been developed as a potential solution to mitigate late complications associated with drug-eluting metallic stents (DESs) in percutaneous coronary intervention for coronary artery disease. While numerous studies have compared BVSs to DESs, none have assessed clinical outcomes beyond 5 years.ObjectivesThis study aimed to compare the 10-year clinical outcomes of patients treated with BVSs vs. DESs.MethodsThe EverBio-2 trial (Comparison of Everolimus- and Biolimus-Eluting Coronary Stents with Everolimus-Eluting Bioresorbable Vascular Scaffold) is a single-center, assessor-blinded, randomized controlled trial that enrolled 240 patients allocated in a 1:1:1 ratio to receive BVSs, everolimus-eluting stents, or biolimus-eluting stents (BESs). Clinical follow-up was scheduled for 10 years.ResultsClinical follow-up was completed in 222 patients (93%) at the 10-year mark. The rate of device-oriented composite events (DOCE) was 28% in the DES group and 29% in the BVS group (<jats:italic>p</jats:italic> = 0.72) at 10 years. Similarly, the rate of patient-oriented composite events (POCE) was 55% in the DES group and 49% in the BVS group (<jats:italic>p</jats:italic> = 0.43) at 10 years. Notably, the rate of myocardial infarction (MI) within the target vessel was 5% in the BVS group and 0% in the BES group (<jats:italic>p</jats:italic> = 0.04), while the rate of any MI was 10% in the BVS group and 2% in the BES group (<jats:italic>p</jats:italic> = 0.04). In addition, the rate of Academic Research Consortium (ARC) possible stent thrombosis was 3% in the BVS group and 0% in the DES group (<jats:italic>p</jats:italic> = 0.04).ConclusionsOver 10 years, the rates of clinical DOCE and POCE were similar between the BVS and DES groups but individual outcomes of stent thrombosis were higher (3%) in the BVS group compared to the DES group.Clinical Trial Registration<jats:uri>ClinicalTrials.gov</jats:uri>, identifier (NCT01711931).","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The causal relationship between human blood metabolites and risk of peripheral artery disease: a Mendelian randomization study","authors":"Zhiyong Dong, Qingyun Wang","doi":"10.3389/fcvm.2024.1435106","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1435106","url":null,"abstract":"BackgroundPeripheral Artery Disease (PAD) is a common vascular disorder typically caused by atherosclerosis, leading to impaired blood supply to the lower extremities, resulting in pain, necrosis, and even amputation. Despite extensive research into the pathogenesis of PAD, many mysteries remain, particularly regarding its association with human blood metabolites.MethodsTo explore the causal relationship between 1,400 serum metabolites and PAD, a two-sample Mendelian randomization (MR) analysis was conducted. The Inverse Variance-Weighted (IVW) method was the primary technique used to estimate the causal impact of the metabolites on PAD. To enhance the analysis, several additional methods were employed: MR-Egger regression, weighted median, simple mode, and weighted mode. These methods provided a comprehensive evaluation beyond the primary IVW estimation. To ensure the validity of the MR findings, sensitivity analysis was performed. Furthermore, a bidirectional MR approach was applied to explore the possibility of a reverse causal effect between PAD and potential candidate metabolites.ResultsAfter rigorous selection, significant associations were found between 1-(1-enyl-stearoyl)-2-arachidonoyl-GPE (p-18:0/20:4) and X-17653 levels with PAD. 1-(1-enyl-stearoyl)-2-arachidonoyl-GPE (p-18:0/20:4) was positively associated with increased PAD risk (IVW OR = 1.13, 95% CI, 1.06–1.21; <jats:italic>P</jats:italic> &amp;lt; 0.001). X-17653 levels were associated with decreased PAD risk (IVW OR = 0.88, 95% CI, 0.83–0.94; <jats:italic>P</jats:italic> &amp;lt; 0.001). In the reverse direction, PAD was positively associated with increased 1-(1-enyl-stearoyl)-2-arachidonoyl-GPE (p-18:0/20:4) levels (IVW OR = 1.16, 95% CI, 1.01–1.34; <jats:italic>P</jats:italic> = 0.036). PAD was not associated with X-17653.ConclusionAmong 1,400 blood metabolites, 1-(1-enyl-stearoyl)-2-arachidonoyl-GPE (p-18:0/20:4) and X-17653 are significantly associated with PAD risk. Importantly, in the reverse direction, PAD was found to be positively associated with increased levels of 1-(1-enyl-stearoyl)-2-arachidonoyl-GPE (p-18:0/20:4). This highlights the bidirectional nature of the association and suggests a potential feedback mechanism between PAD and this specific lipid species. 1-(1-enyl-stearoyl)-2-arachidonoyl-GPE (p-18:0/20:4) may serve as potential biomarkers for PAD, aiding early diagnosis and providing novel avenues for personalized treatment and management. However, further validation and research are warranted despite the promising results.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cardiometabolic index and congestive heart failure among US adults: a cross-sectional study","authors":"Xi Luo, Bin Cai","doi":"10.3389/fcvm.2024.1433950","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1433950","url":null,"abstract":"BackgroundThe risk of congestive heart failure (CHF) is significantly affected by obesity. However, data on the association between visceral obesity and the risk of CHF remain limited. We explored the relationship between CHF and cardiometabolic index (CMI).MethodsDrawing from the National Health and Nutrition Examination Survey (NHANES) for 2011–2018, we enrolled 9,008 participants in a cross-sectional study. We calculated the CMI as triglyceride (TG)/high density lipid-cholesterol (HDL-C) × weight-to-height ratio (WHtR), and CMI-age as CMI × age. Then, we analyzed CMI and CMI-age as categorical and continuous variables to assess its correlation with CHF. To assess the relationships of CMI and CMI-age with CHF, we used multiple logistic regression models and performed subgroup analysis. To examine the predictive ability of CMI and CMI-age on patients with CHF, we used receiver operating characteristic (ROC) curves.ResultsThe overall prevalence of CHF was 3.31%. The results revealed significant differences in demographic data, comorbidities, lifestyle variables, standing height, BMI, WC, WHtR, TG, and HDL-C among the four groups classified by CMI quartile and CMI-age quartile. When indicators were analyzed as continuous variables, CMI and CMI-age showed positive correlations with CHF in both the crude and adjusted models (all <jats:italic>P</jats:italic> &amp;lt; 0.05). When indicators were analyzed as categorical variables, it was found that in all four models, the ORs of group Q4 was significantly different compared to Q1 (all <jats:italic>P</jats:italic> &amp;lt; 0.05), suggesting the risk of CHF is significantly increased with higher CMI, and CMI-age. The associations of CMI and CMI-age with CHF were similar in all stratified populations (<jats:italic>P</jats:italic> for interaction &amp;gt; 0.05). The areas under the ROC curve (AUCs) of CMI and CMI-age in predicting CHF were 0.610 (95% CI, 0.578–0.642) and 0.697 (95% CI, 0.668–0.725) separately, suggesting that CMI-age was significantly better than the CMI in predicting CHF (<jats:italic>P </jats:italic>&amp;lt; 0.001).ConclusionsBoth CMI and CMI-age were independently correlated with the risk for CHF. These results suggested that the CMI-age, which provides new insights into the prevention and management of CHF. CMI-age could serve as effective tools to identify CHF during primary care examinations and in medically resource-limited areas.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent factors for the development of vasoplegic syndrome in patients undergoing coronary artery bypass surgery","authors":"Constantin L. Palm, Lukas Baumhove, Simon Pabst, Ulf Guenther, Malte Book, Onise Chaduneli, Andreas Martens, Friedrich Mellert, Oliver Dewald","doi":"10.3389/fcvm.2024.1446861","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1446861","url":null,"abstract":"ObjectiveVasoplegic syndrome remains a common complication of cardiac surgery. It has serious implications for the healthcare system and individual patients, as it leads to rising healthcare costs and higher mortality. A better understanding of factors triggering vasoplegic syndrome is essential for the development of effective prevention strategies. We aimed to identify clinical characteristics and intraoperative parameters associated with the development of vasoplegic syndrome in coronary artery bypass graft surgery and the influence of vasoplegia on outcome.MethodsWe retrospectively analyzed the data of all patients who underwent isolated coronary artery bypass graft surgery or coronary artery bypass graft surgery combined with atrial appendage occlusion, using the heart-lung machine at our institution from 04/2019 to 12/2020. Vasoplegic syndrome was defined as MAP ≤60 mmHg and norepinephrine equivalence dosage of ≥0.2 μg/kg/min with a central venous saturation ≥60% within 2 days from surgery.ResultsOf 647 patients included in this study, 72 (11.1%) developed vasoplegic syndrome. Patients experiencing vasoplegia had longer stay in ICU, more frequently underwent tracheostomy and suffered more often from pneumonia. The duration of extracorporeal circulation, intraoperative application of platelet concentrates and usage of cold crystalloid cardioplegia (Bretschneider) independently predicted development of vasoplegic syndrome.ConclusionsEven in relatively low-risk cardiac surgery, vasoplegic syndrome is a common complication and was associated with serious adverse effects. The use of warm blood cardioplegia (Calafiore) seems to be safer than cold crystalloid cardioplegia (Bretschneider) and might be preferable in patients that are vulnerable to the consequences of vasoplegic syndrome.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary artery in situ thrombosis due to patent ductus arteriosus: a case report","authors":"Yin Wang, Chunyan Rong, Ming Lu, Weihua Zhang","doi":"10.3389/fcvm.2024.1433847","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1433847","url":null,"abstract":"BackgroundPulmonary Artery <jats:italic>in situ</jats:italic> Thrombosis (PAIST) refers to a thrombus forming within the pulmonary arterial system, distinct from an embolus originating from elsewhere in the body (e.g., the deep veins of the lower extremities) and traveling to the lungs where it lodges and forms.Case presentationWe present a case of PAIST caused by the arterial ductus arteriosus. The patient primarily presented with dyspnea, and the chest pain dichotomy Computed Tomography Angiography(CTA) suggested that a nodular low-density filling defect was seen in the lumen of the left pulmonary artery trunk. Initially, pulmonary embolism (PE) was suspected. However, upon reevaluation of the imaging, it became apparent that the patient's pulmonary artery obstruction was closely associated with the ductus arteriosus. After admission, the patient was treated with sodium ampicillin (2.0 g Q12H) for infection, heparin sodium (5,000 IU Q12H) for anticoagulation, and metoprolol succinate extended-release tablets (23.75 mg QD) to correct cardiac remodeling, among other treatments. Subsequently, the patient underwent a cardiac surgery involving the ligation of the arterial duct, resection of pulmonary artery lesions, and open-heart surgery with extracorporeal circulation support. Postoperative examination of the pulmonary artery mass indicated coagulation tissue. The final diagnosis was “PAIST”.ConclusionBoth PAIST and PE manifest as low-density filling defects in the pulmonary arteries. However, due to the relative unfamiliarity with PAIST, such findings are often initially attributed to PE.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-in-human cases and preclinical experience of a novel ICE catheter","authors":"Guangan Liu, Jingjing Wu, Fang Fang, Weipeng Zhao, Minmin Sun, Jihong Zhang, Simeng Liu, Mimi Wang, Feng Liu","doi":"10.3389/fcvm.2024.1406470","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1406470","url":null,"abstract":"IntroductionThe primary objective of our study was to evaluate the first use of a novel intracardiac echocardiography (ICE) catheter in human subjects. This study aimed to assess its practicality, image clarity, and guidance role during electrophysiology procedures.MethodsTwo patients underwent procedures using the novel ICE catheter. Post-procedure evaluations were conducted by four operators, who assessed the imaging quality and overall performance of the catheter. Anatomical and blood test results were also analyzed to determine the safety and impact on internal cardiac structures.ResultsBoth patients were discharged one day after the procedure without any complications. The novel ICE catheter provided comparable imaging quality to existing commercial catheters. The catheter's advanced design allowed for detailed imaging at short distances, essential for accurate diagnosis and treatment planning. Moreover, it successfully navigated complex anatomical structures like the atrial septum and left atrial appendage.DiscussionThese preliminary studies indicate that the novel ICE catheter achieves a level of safety and effectiveness comparable to previously available commercial catheters. The findings highlight its potential to meet current clinical needs, particularly in sophisticated anatomic interventions. Despite the prolonged thrombin time after anticoagulant administration, both types of ICE catheters were non-damaging to cardiac structures during routine operations. The study underscores the importance of using trans-septal large inner diameter sheaths to minimize complications when advancing the catheter into the left atrium.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoluminal rescue of false lumen graft deployment in TEVAR for type B aortic dissection: a case report and literature review","authors":"Hong Jiang Zhu, Feng Yan, Peng Peng Zhao","doi":"10.3389/fcvm.2024.1461511","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1461511","url":null,"abstract":"BackgroundThoracic endovascular aortic repair (TEVAR) has increasingly become the preferred surgical intervention for Stanford type B aortic dissection (TBAD). The primary objective of this procedure is to seal the primary entry tear to promote positive aortic remodeling. However, the increased use of TEVAR has also led to a rise in surgical complications. Among these, the accidental deployment of the stent into the false lumen is a rare but serious complication that can result in aortic false lumen rupture and inadequate perfusion of abdominal organs.Case summaryThis case report described a 78-year-old man who presented to our hospital with sudden onset chest and back pain and was subsequently diagnosed with TBAD via aortic CTA. As conventional medical therapy failed to alleviate his chest pain, the patient underwent TEVAR. During the procedure, a complication arose when the distal end of the endograft was mistakenly deployed into the false lumen, leading to insufficient perfusion of the abdominal organs. Recognizing this issue intraoperatively, an additional endograft was promptly inserted at the distal end to reroute blood flow back to the true lumen of the aorta, thereby restoring visceral perfusion. Post-intervention, the patient's chest pain improved, and he was successfully discharged from the hospital.ConclusionAccidental deployment of a endograft into the false lumen during TEVAR is a rare but serious complication. Intraoperative angiography plays a crucial role in rapidly and accurately identifying this issue by detecting insufficient perfusion of abdominal organs. The use of intravascular ultrasound may help reduce the incidence of this complication. Endovascular repair is an effective emergency strategy to quickly redirect blood flow back to the true lumen, making it the preferred method for managing such emergencies.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short term outcomes and resource utilization in de-novo versus acute on chronic heart failure related cardiogenic shock: a nationwide analysis","authors":"Mary Quien, Ju Young Bae, Sun-Joo Jang, Carlos Davila","doi":"10.3389/fcvm.2024.1454884","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1454884","url":null,"abstract":"BackgroundThere has been growing recognition of non-ischemic etiologies of cardiogenic shock (CS). To further understand this population, we aimed to investigate differences in clinical course between acute on chronic heart failure related (CHF-CS) and de-novo CS (DN-CS).MethodsUsing the Nationwide Readmission Database, we examined 92,426 CS cases. Outcomes of interest included in-hospital and 30-day outcomes and use of advanced heart failure therapies.ResultsPatients with DN-CS had higher in-hospital mortality than the CHF-CS cohort (32.6% vs. 30.4%, <jats:italic>p</jats:italic> &amp;lt; 0.001). Mechanical circulatory support (11.9% vs. 8.6%, <jats:italic>p</jats:italic> &amp;lt; 0.001) was more utilized in DN-CS. Renal replacement therapy (13.8% vs. 15.5%, <jats:italic>p</jats:italic> &amp;lt; 0.001) and right heart catheterization (16.0% vs. 21.0%, <jats:italic>p</jats:italic> &amp;lt; 0.001) were implemented more in the CHF-CS cohort. The CHF-CS cohort was also more likely to undergo LVAD implantation (0.4% vs. 3.6%, <jats:italic>p</jats:italic> &amp;lt; 0.001) and heart transplantation (0.5% vs. 2.0%, <jats:italic>p</jats:italic> &amp;lt; 0.001). Over the study period, advanced heart failure therapy utilization increased, but the proportion of patients receiving these interventions remained unchanged. Thirty days after index hospitalization, the CHF-CS cohort had more readmissions for heart failure (1.1% vs. 2.4%, <jats:italic>p</jats:italic> &amp;lt; 0.001) and all causes (14.1% vs. 21.1%, <jats:italic>p</jats:italic> &amp;lt; 0.001) with higher readmission mortality (1.1% vs. 2.3%, <jats:italic>p</jats:italic> &amp;lt; 0.001).ConclusionOur findings align with existing research, demonstrating higher in-hospital mortality in the DN-CS subgroup. After the index hospitalization, however, the CHF-CS cohort performed worse with higher all-cause readmission rate and readmission mortality. The study also underscores the need for further investigation into the underutilization of certain interventions and the observed trends in the management of these CS subgroups.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated remnant cholesterol as a potential predictor for cardiovascular events in rheumatoid arthritis patients","authors":"Ching-Kun Chang, Yi-Chen Li, Po-Ku Chen, Shih-Hsin Chang, Der-Yuan Chen","doi":"10.3389/fcvm.2024.1449219","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1449219","url":null,"abstract":"ObjectiveThe risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) remains inadequately defined. Consequently, this study aims to evaluate the predictive value of remnant cholesterol (RC) for assessing CVD risk in RA patients.MethodsPlasma RC levels were measured in 114 RA patients and 41 healthy controls, calculated as total cholesterol minus HDL-C and LDL-C. These levels were further analyzed using <jats:sup>1</jats:sup>H-NMR lipid/metabolomics. Meanwhile, the 28-joint Disease Activity Score (DAS28) assessed RA activity.ResultsRC levels were significantly elevated in RA patients (19.0 mg/dl, <jats:italic>p</jats:italic> &amp;lt; 0.001) compared to healthy controls (14.5 mg/dl). Furthermore, RC levels were significantly elevated at 37.4 mg/dl in patients who experienced cardiovascular event (CVE) compared to 17.4 mg/dl in those without CVE (<jats:italic>p</jats:italic> &amp;lt; 0.001). To enhance the precision and reliability of RC measurements, RC concentrations were further validated using <jats:sup>1</jats:sup>H-NMR spectroscopy. Additionally, a positive correlation was observed between RC levels and DAS28. Multivariate analysis identified RC as a significant predictor of CVE (odds ratio = 1.82, <jats:italic>p</jats:italic> = 0.013). ROC curve analysis revealed superior predictive capability of RC for CVE (AUC = 0.919, <jats:italic>p</jats:italic> &amp;lt; 0.001) compared to LDL-C (AUC = 0.669, <jats:italic>p</jats:italic> = 0.018), with a high sensitivity of 94.7% and a specificity of 82.1%.ConclusionElevated RC levels demonstrate greater accuracy in predicting CVE occurrence in RA patients compared to traditional measures such as LDL-C. These findings suggest that elevated RC levels may serve as a novel predictor for occurrence of CVE in RA patients, facilitating early intervention strategies based on the risk stratification.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the predictive values of CRP and lymphocytes in coronary artery disease based on a machine learning and Mendelian randomization","authors":"Yuan Liu, Xin Yuan, Yu-Chan He, Zhong-Hai Bi, Si-Yao Li, Ye Li, Yan-Li Liu, Liu Miao","doi":"10.3389/fcvm.2024.1442275","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1442275","url":null,"abstract":"PurposeTo investigate the predictive value of leukocyte subsets and C-reactive protein (CRP) in coronary artery disease (CAD).MethodsWe conducted a Mendelian randomization analysis (MR) on leukocyte subsets, C-reactive protein (CRP) and CAD, incorporating data from 68,624 patients who underwent coronary angiography from 2010 to 2022. After initial screening, clinical data from 46,664 patients were analyzed. Techniques employed included propensity score matching (PSM), logistic regression, lasso regression, and random forest algorithms (RF). Risk factors were assessed, and the sensitivity and specificity of the models were evaluated using receiver operating characteristic (ROC) curves. Additionally, survival analysis was conducted based on a 36-month follow-up period.ResultsThe inverse variance weight (IVW) analysis showed that basophil count (OR 0.92, 95% CI: 0.84–1.00, <jats:italic>P</jats:italic> = 0.048), CRP levels (OR 0.87, 95% CI: 0.73–1.00, <jats:italic>P</jats:italic> = 0.040), and lymphocyte count (OR 1.10, 95% CI: 1.04–1.16, <jats:italic>P</jats:italic> = 0.001) are significant risk factors for CAD. Using LASSO regression, logistic regression, and RF analysis, both CRP and lymphocyte counts were consistently identified as risk factors for CAD, prior to and following PSM. The ROC curve analysis indicated that the combination of lymphocyte and CRP levels after PSM achieves a higher diagnostic value (0.85). Survival analysis revealed that high lymphocyte counts and low CRP levels are associated with a decreased risk of Major Adverse Cardiovascular Events (MACE) (<jats:italic>P</jats:italic> &amp;lt; 0.001). Conversely, a higher CRP level combined with lymphocyte counts correlates with a poorer prognosis.ConclusionThere is a causal relationship between lymphocytes, CRP and CAD. The combined assessment of CRP and lymphocytes offers diagnostic value for CAD. Furthermore, high CRP levels coupled with low lymphocyte counts are associated with a poor prognosis.","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142221757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}