Frontiers in Cardiovascular Medicine最新文献

{"title":"SMOC2, OGN, FCN3, and SERPINA3 could be biomarkers for the evaluation of acute decompensated heart failure caused by venous congestion.","authors":"Yiding Yu, Huajing Yuan, Quancheng Han, Jingle Shi, Xiujuan Liu, Yitao Xue, Yan Li","doi":"10.3389/fcvm.2024.1406662","DOIUrl":"10.3389/fcvm.2024.1406662","url":null,"abstract":"<p><strong>Background: </strong>Venous congestion (VC) sets in weeks before visible clinical decompensation, progressively increasing cardiac strain and leading to acute heart failure (HF) decompensation. Currently, the field lacks a universally acknowledged gold standard and early detection methods for VC.</p><p><strong>Methods: </strong>Using data from the GEO database, we identified VC's impact on HF through key genes using Limma and STRING databases. The potential mechanisms of HF exacerbation were explored via GO and KEGG enrichment analyses. Diagnostic genes for acute decompensated HF were discovered using LASSO, RF, and SVM-REF machine learning algorithms, complemented by single-gene GSEA analysis. A nomogram tool was developed for the diagnostic model's evaluation and application, with validation conducted on external datasets.</p><p><strong>Results: </strong>Our findings reveal that VC influences 37 genes impacting HF via 8 genes, primarily affecting oxygen transport, binding, and extracellular matrix stability. Four diagnostic genes for HF's pre-decompensation phase were identified: SMOC2, OGN, FCN3, and SERPINA3. These genes showed high diagnostic potential, with AUCs for each gene exceeding 0.9 and a genomic AUC of 0.942.</p><p><strong>Conclusions: </strong>Our study identifies four critical diagnostic genes for HF's pre-decompensated phase using bioinformatics and machine learning, shedding light on the molecular mechanisms through which VC worsens HF. It offers a novel approach for clinical evaluation of acute decompensated HF patient congestion status, presenting fresh insights into its pathogenesis, diagnosis, and treatment.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1406662"},"PeriodicalIF":2.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881759","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: Case reports in heart surgery: 2023.","authors":"Giuseppe Gatti","doi":"10.3389/fcvm.2024.1527906","DOIUrl":"https://doi.org/10.3389/fcvm.2024.1527906","url":null,"abstract":"","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1527906"},"PeriodicalIF":2.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885475","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":"Interleukin-6 and thyroid-stimulating hormone index predict plaque stability in carotid artery stenosis: analyses by lasso-logistic regression.","authors":"Li Zhigao, Qin Jiabo, Zheng Lei, Qiao Tong","doi":"10.3389/fcvm.2024.1484273","DOIUrl":"10.3389/fcvm.2024.1484273","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a new prediction model based on the Lass-logistic regression with inflammatory serologic markers for the assessment of carotid plaque stability, providing clinicians with a reliable tool for risk stratification and decision-making in the management of carotid artery disease.</p><p><strong>Methods: </strong>In this study, we retrospectively collected the data of the patients who underwent carotid endarterectomy (CEA) from 2019 to 2023 in Nanjing Drum Tower Hospital. Demographic characteristics, vascular risk factors, and the results of preoperative serum biochemistry were measured and collected. The risk factors for vulnerable carotid plaque were analyzed. A Lasso-logistic regression prediction model was developed and compared with traditional logistic regression models. The Akaike information criterion (AIC) and Bayesian information criterion (BIC) were used to evaluate the performance of three models.</p><p><strong>Results: </strong>A total of 131 patients were collected in this study, including 66 (50.4%) in the vulnerable plaque group and 65 (49.6%) in the stable plaque group. The final Lasso-logistic regression model included 4 features:IL-6, TSH, TSHI, and TT4RI; AIC = 161.6376, BIC = 176.0136, both lower than the all-variable logistic regression model (AIC = 181.0881, BIC = 261.5936), and the BIC was smaller than the stepwise logistic regression model (AIC = 154.024, BIC = 179.9007). Finally, the prediction model was constructed based on the variables screened by the Lasso regression, and the model had favorable discrimination and calibration.</p><p><strong>Conclusions: </strong>The noninvasive prediction model based on IL-6 and TSHI is a quantitative tool for predicting vulnerable carotid plaques. It has high diagnostic efficacy and is worth popularizing and applying.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1484273"},"PeriodicalIF":2.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881739","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":"Optimization of the cardiac delirium index by including age, decrease in butyrylcholinesterase actitivity, preoperative HbA1c, and postoperative hemoglobin levels: results of a secondary analysis of a prospective observational study.","authors":"Thomas S Zajonz, Fabian Edinger, Melanie Markmann, Katrin Gräb, Michael Sander, Christian Kunzemann, Christian Koch, Emmanuel Schneck","doi":"10.3389/fcvm.2024.1459268","DOIUrl":"10.3389/fcvm.2024.1459268","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative delirium (POD) after cardiac surgery significantly affects the perioperative morbidity and mortality. Butyrylcholinesterase (BChE) is an enzyme primarily produced in the liver, which plays a crucial role in the hydrolysis of acetylcholine outside of neuronal synapses, referred to as extraneuronal hydrolysis. The integration of BChE activity into the cardiac delirium (CARDEL) index might increase its predictive power for identifying POD after cardiac surgery. Therefore, the primary aim of this study was to assess the applicability of the CARDEL index and determine whether integrating the BChE activity enables optimization of the predictive model.</p><p><strong>Methods: </strong>This secondary analysis of a prospective observational study included patients undergoing elective coronary artery bypass graft surgery. BChE activity is expressed in units per liter (U/L), while the BChE drop refers to the percentage decrease in BChE activity from pre- to postoperative levels. POD risk factors were identified using multivariate regression analysis. The predictive power of the CARDEL index and an optimized model including BChE was calculated with receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Of 93 included patients, 20 (21.5%) developed POD. Elevated preoperative HbA1c [OR 2.5 (1.2-4.8), <i>p</i> = 0.01], a decrease in BChE activity [%, OR 1.1 (1.0-1.2), <i>p</i> = 0.04], age [1 (0.94-1.1), <i>p</i> = 0.55], and a postoperative hemoglobin change [OR 0.86 (0.78-0.96), <i>p</i> < 0.001] were identified as independent risk factors for POD. While the CARDEL index showed a moderate prediction of POD [AUCROC of 0.74 (0.60-0.87)], the optimization including BChE resulted in a significant prognostic improvement: AUCROC of 0.84 (0.72-0.94, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Despite the small size of this derivation cohort, this study identified elevated HbA1c as the strongest risk factor for the development of POD, followed by a decrease in BChE activity, postoperative anemia, and age, respectively. By including these parameters to the CARDEL index, its predictive power for the identification of POD significantly improved in this derivation cohort. Moving forward, integrating these findings into clinical practice could enhance early risk stratification and targeted intervention for patients at high risk of POD. Therefore, further research should evaluate these results in a larger, external cohort.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1459268"},"PeriodicalIF":2.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Surgical treatment of type B aortic dissection in an adult with double aortic arch.","authors":"Chong Luo, Longrong Bian, Weitao Liang, Zhong Wu","doi":"10.3389/fcvm.2024.1511677","DOIUrl":"10.3389/fcvm.2024.1511677","url":null,"abstract":"<p><strong>Background: </strong>Double aortic arch (DAA) with type B aortic dissection in adults is a rare aortic vascular disease. The abnormal anatomical structure of the aortic arch in such patients presents significant challenges in the selection of surgical approaches, and there is a notable lack of exploration into endovascular repair approaches that simultaneously preserve asymptomatic vascular rings.</p><p><strong>Case description: </strong>A 43-year-old female patient was admitted due to recurrent chest and back pain lasting for over a month. Computed tomography angiography (CTA) indicated a double aortic arch anomaly with localized dissection of the descending aorta. Esophagography with barium swallow revealed vascular indentation on the upper and middle thoracic esophagus, with mild to moderate local narrowing. Based on a comprehensive preoperative evaluation of the imaging and the patient's clinical history, a thoracic endovascular aortic repair (TEVAR) procedure was performed. Considering that the deformity did not cause any clinical symptoms and that the vessel diameter and distance from the proximal anchoring area were sufficient, the posterior section of the dominant arch was chosen as the proximal anchorage zone, and a stent with proximal bare zone was deployed to maintain blood flow to the distal non-dominant arch and preserve the integrity of the vascular ring. Follow-up CTA scans at one- and six-month post-operation showed that the aortic stent was well-positioned, with no visible primary lesion. The patient reported complete resolution of chest pain and no difficulties with swallowing or breathing.</p><p><strong>Conclusion: </strong>In adult patients with DAA complicated by aortic dissection, the abnormal anatomy of the aortic arch poses significant challenges in making treatment decisions. After a comprehensive, multidimensional evaluation of the patient's medical history, CTA, and esophagography, we successfully performed TEVAR procedure. This case provides new insights into the surgical strategy for treating such rare conditions.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1511677"},"PeriodicalIF":2.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram model to predict non-retrieval of short-term retrievable inferior vena cava filters.","authors":"Lihao Qin, Xiaocheng Gu, Caifang Ni, Kai Wang, Tongqing Xue, Zhongzhi Jia, Yun Wang","doi":"10.3389/fcvm.2024.1393410","DOIUrl":"10.3389/fcvm.2024.1393410","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a nomogram for predicting non-retrieval of the short-term retrievable inferior vena cava (IVC) filters.</p><p><strong>Methods: </strong>In this study, univariate and multivariate logistic regression analyses were performed to identify predictive factors of short-term retrievable filter (Aegisy or OptEase) non-retrieval, and a nomogram was then established based on these factors. The nomogram was created based on data from a training cohort and validated based on data from a validation cohort. The predictive value of the nomogram was estimated using area under the curve (AUC) and calibration curve analysis (Hosmer-Lemeshow test).</p><p><strong>Results: </strong>A total of 1,321 patients who had undergone placement of short-term retrievable filters (Aegisy or OptEase) were included in the analysis. The overall retrieval rate was 68.7%. Age, proximal and distal deep vein thrombosis (DVT) vs. distal DVT, active cancer, history of long-term immobilization, VTE was detected in the intensive care unit, active/recurrent bleeding, IVC thrombosis, and history of venous thromboembolism were independent predictive risk factors for non-retrieval of filters. Interventional therapy for DVT, acute fracture, and interval of ≥14 days between filter placement and patient discharge were independent protective factors for non-retrieval of filters. The nomogram based on these factors demonstrated good ability to predict the non-retrieval of filters (training cohort AUC = 0.870; validation cohort AUC = 0.813.</p><p><strong>Conclusion: </strong>This nomogram demonstrated strong predictive accuracy and discrimination capability. This model may help clinicians identify patients who are not candidates for short-term retrievable filter placement and help clinicians make timely, individualized decisions in filter choice strategies.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1393410"},"PeriodicalIF":2.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876703","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":"Atherogenic circulating lipoproteins in ischemic stroke.","authors":"Sonia Benitez, Núria Puig, Pol Camps-Renom, José Luis Sánchez-Quesada","doi":"10.3389/fcvm.2024.1470364","DOIUrl":"10.3389/fcvm.2024.1470364","url":null,"abstract":"<p><p>The fundamental role of qualitative alterations of lipoproteins in the early development of atherosclerosis has been widely demonstrated. Modified low-density lipoproteins (LDL), such as oxidized LDL (oxLDL), small dense LDL (sdLDL), and electronegative LDL [LDL(-)], are capable of triggering the atherogenic process, favoring the subendothelial accumulation of cholesterol and promoting inflammatory, proliferative, and apoptotic processes characteristic of atherosclerotic lesions. In contrast, high-density lipoprotein (HDL) prevents and/or reverses these atherogenic effects. However, LDL's atherogenic and HDL's anti-atherogenic actions may result altered in certain pathological conditions. The molecular mechanisms underlying the impaired effects of altered lipoproteins have been studied in numerous <i>in vitro</i> and <i>in vivo</i> studies, and have been extensively analyzed in coronary atherosclerosis, especially in the context of pathologies such as dyslipidemia, diabetes, obesity, and metabolic syndrome. However, the corresponding studies are scarcer in the field of ischemic stroke, despite carotid arteriosclerosis progression underlies at least 20% of ischemic strokes. The present review relates qualitative alterations of LDL and HDL with the development of carotid arteriosclerosis and the occurrence of ischemic stroke.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1470364"},"PeriodicalIF":2.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876705","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":"Transcatheter mitral valve replacement to treat rheumatic mitral stenosis: a case series.","authors":"Ping Jin, Hong Guo, Yu Mao, Mengen Zhai, Yang Liu, Jian Yang","doi":"10.3389/fcvm.2024.1424105","DOIUrl":"10.3389/fcvm.2024.1424105","url":null,"abstract":"<p><strong>Background: </strong>Rheumatic mitral stenosis (RMS) is a common valvular heart disease in developing countries. We sought to evaluate the early experience of patients with RMS undergoing transcatheter mitral valve replacement (TMVR).</p><p><strong>Methods: </strong>In this retrospective study, a total of 5 RMS patients accepted TMVR. All patients underwent computed tomography and echocardiography before having the procedure. After the preprocedural comprehensive evaluations, the surgeons planned to use the Prizvalve (a novel balloon-expandable transcatheter aortic valve system which is now under the clinical registration study) for TMVR. Clinical data were collected at baseline, before discharge, and at the 30-day follow-up.</p><p><strong>Results: </strong>The median age of the 5 RMS patients was 61 years (range 60-77 years); 60% were male, and the median Society of Thoracic Surgeons score was 13.3% (range 6.2-17.1%). TMVR was successful in all patients. Postoperative transesophageal echocardiography showed that 60.0% (<i>n</i> = 3) of the patients had no paravalvular leakage and 40.0% (<i>n</i> = 2) had trace paravalvular leakage. The median postoperative peak velocity decreased to 1.4 m/s (range 1.1-1.7 m/s), and the median pressure gradient decreased to 3 mmHg (range 2-3 mmHg). No deaths occurred at the 30-day follow-up, and all patients had an improvement of ≥1 on the New York Heart Association functional rating.</p><p><strong>Conclusions: </strong>Our early experience with TMVR in RMS patients suggests that it is a safe and feasible procedure. The early results of the procedure are acceptable and provide bright prospects and directions for the precision treatment of RMS.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, identifier (NCT02917980).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1424105"},"PeriodicalIF":2.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863829","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":"Screening and regulatory mechanism exploration of M1 macrophage polarization and efferocytosis-related biomarkers in coronary heart disease.","authors":"Hong Gao, Junhua Li, Jianxin Huang, Xiaojie Jiang","doi":"10.3389/fcvm.2024.1478827","DOIUrl":"10.3389/fcvm.2024.1478827","url":null,"abstract":"<p><strong>Background: </strong>Macrophage polarization and efferocytosis have been implicated in CHD. However, the underlying mechanisms remain elusive. This study aimed to identify CHD-associated biomarkers using transcriptomic data.</p><p><strong>Methods: </strong>This study examined 74 efferocytosis-related genes (ERGs) and 17 M1 macrophage polarization-related genes (MRGs) across two CHD-relevant datasets, GSE113079 and GSE42148. Differential expression analysis was performed separately on each dataset to identify differentially expressed genes (DEGs1 and DEGs2). The intersection of upregulated and downregulated genes from both sets was then used to define the final DEGs. Subsequently, MRG and ERG scores were calculated within the GSE113079 dataset, followed by weighted gene co-expression network analysis (WGCNA) to identify key module genes. The overlap between these module genes and the DEGs yielded candidate biomarkers, which were further evaluated through machine learning, receiver operating characteristic (ROC) curve analysis, and expression profiling. These biomarkers were subsequently leveraged to explore immune infiltration patterns and to construct a molecular regulatory network. To further validate their expression, quantitative reverse transcriptase PCR (qRT-PCR) was performed on clinical CHD samples, confirming the relevance and expression patterns of these biomarkers in the disease.</p><p><strong>Results: </strong>A total of 93 DEGs were identified by intersecting the upregulated and downregulated genes from DEGs1 and DEGs2. WGCNA of the MRG and ERG scores identified 15,936 key module genes in the GSE113079 dataset. Machine learning and ROC analysis highlighted four biomarkers: C5orf58, CTAG1A, ZNF180, and IL13RA1. Among these, C5orf58, and ZNF180 were downregulated in CHD cases, while CTAG1A and IL13RA1 was upregulated. qRT-PCR results validated these findings for C5orf58, CTAG1A, ZNF180, and IL13RA1 showed inconsistent expression trends. Immune infiltration analysis indicated IL13RA1 all had a positive correlation with M0 macrophage, while had a negative correlation with. NK cells activated. The molecular regulatory network displayed that GATA2 and YY1 could regulate CTAG1A and ZNF180.</p><p><strong>Conclusions: </strong>These results suggest that C5orf58, CTAG1A, ZNF180, and IL13RA1 serve as biomarkers linking M1 macrophage polarization and efferocytosis to CHD, providing valuable insights for CHD diagnosis and therapeutic strategies.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1478827"},"PeriodicalIF":2.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893405","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":"Triglyceride-glucose index mediates the association between residual cholesterol and stroke among middle-aged and older adults in China: a prospective, nationwide, population-based study.","authors":"Xu Li, Jia-Guang Hu, Qian Liao, Ying Wu, Rong-Rui Huo","doi":"10.3389/fcvm.2024.1429993","DOIUrl":"10.3389/fcvm.2024.1429993","url":null,"abstract":"<p><strong>Background: </strong>Both triglyceride-glucose (TyG) index and residual cholesterol (RC) are predictors of stroke; however, to what extent the RC is associated with stroke through TyG index is unclear. This study examined whether the TyG index mediates the association of RC with incident stroke and the extent of interaction or joint relations of RC and TyG index with stroke in middle-aged and older Chinese adults.</p><p><strong>Methods: </strong>This is an ongoing prospective cohort study initiated in 2011 that included 10,569 middle-aged and older Chinese adults without stroke at baseline. The exposure was RC, the mediator was TyG index, and the outcome was stroke which followed up from June, 2011, to June, 2018. Mediation analysis was used to explore whether the TyG index mediated the association between RC and stroke risk.</p><p><strong>Results: </strong>Of the 10,569 participants, 4,978 (47.1%) were men; the mean (SD) age was 59.01 (9.43) years. During a median follow-up of 7.1 years, 734 (7.0%) participants experienced a stroke. In the adjusted Cox models, A one SD increase in RC was associated with an elevated risk of stroke (HR, 1.09; 95% CI, 1.02-1.16), as well as TyG index (HR, 1.14; 95% CI, 1.06-1.23). No significant multiplicative or additive interactions were found between the TyG index and RC on stroke risk (HR for multiplicative: 1.07, 95% CI, 0.67-1.70; Synergy index: 1.05, 95% CI, 0.16-6.88). TyG index mediated the association between RC and stroke (b, -0.16; 95% CI, -0.30 to -0.03). Subgroup analyses and sensitivity analyses showed consistent results.</p><p><strong>Conclusions: </strong>This study evidence that the TyG index completely mediates the association between RC and stroke risk among middle-aged and older Chinese adults. These findings highlight the importance of considering RC and the TyG index in stroke risk assessment.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1429993"},"PeriodicalIF":2.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876036","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}