Journal of atherosclerosis and thrombosis最新文献

{"title":"Association of Life's Essential 8 Scores with Carotid Artery Plaque in Chinese Adults: A Prospective Cohort Study.","authors":"Ping Yu, Dong-Yu Wu, Xiao-Wei Fan, Xue Tian, An-Xin Wang, Yong Jiang, Wei-Guo Ma, Ning Zhang, Chun-Xue Wang","doi":"10.5551/jat.65495","DOIUrl":"10.5551/jat.65495","url":null,"abstract":"<p><strong>Aim: </strong>The American Heart Association (AHA) proposed Life's Essential 8 score (LE8) in 2022 as a new metric for cardiovascular health (CVH). This study investigated the association between the LE8 score and the development of carotid artery plaque.</p><p><strong>Methods: </strong>Data were drawn from the Asymptomatic Polyvascular Abnormalities Community (APAC) cohort study. In 2010, 1,938 participants without carotid plaques were recruited and followed-up until 2012. LE8 scores ranging from 0 to 100 were categorized as low (0-49), moderate (50-79), and high (80-100), whereas carotid plaques were measured using color Doppler ultrasound. A logistic analysis was used to analyze the association between the LE8 score and carotid plaque.</p><p><strong>Results: </strong>During the 2-year follow up period, 350 (18.1%) patients developed new carotid plaques. The incidence of newly developed carotid plaques decreased from 27.0% in the low-LE8 group to 13.7% in the high-LE8 group (p＜0.001). Adjusted odds ratios (ORs) for plaque development were 0.65 (95% confidence interval [CI], 0.45-0.93) in the moderate-LE8 group and 0.55 (95% CI, 0.34-0.90) in the high-LE8 group compared to the low-LE8 group. Higher LE8 scores were associated with a lower risk of stable and multiple carotid plaques.</p><p><strong>Conclusions: </strong>An elevated LE8 score was associated with a lower risk of carotid plaque formation as well as plaque stability and quantity. Promoting adherence to optimal CVH levels may be beneficial in reducing the burden of carotid plaques and the risk of cardiovascular disease.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"1150-1163"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholesterol Uptake Capacity as a Prognostic Marker of Cardiovascular Events for Patients with Coronary Artery Disease.","authors":"Yusuke Yoshikawa, Ryuji Toh, Katsuhiro Murakami, Amane Harada, Jeeeun Kim, Yuto Kobayash, Keiko Miwa, Manabu Nagao, Tatsuro Ishida, Ken-Ichi Hirata, Misa Takegami, Kunihiro Nishimura","doi":"10.5551/jat.65520","DOIUrl":"10.5551/jat.65520","url":null,"abstract":"<p><strong>Aim: </strong>Cholesterol uptake capacity (CUC) is a functional assessment of high-density lipoprotein (HDL) and has drawn attention for the risk stratification of atherosclerotic cardiovascular disease (ASCVD). This study evaluated the usefulness of HDL-CUC as a predictive marker for long-term ASCVD events in patients with coronary artery disease (CAD).</p><p><strong>Methods: </strong>This retrospective observational study included 503 patients with CAD who underwent coronary revascularization. Blood was sampled from the participants within three months before or after index revascularization. The CUC was assayed using a previously reported automated system. The study population was divided into three groups according to the tertiles of CUC levels. The primary outcome was ASCVD events, which were defined as a composite of all-cause death, acute myocardial infarction, stroke, and peripheral artery disease.</p><p><strong>Results: </strong>A total of 29 events were observed during the follow-up (median 2.8 years). The risk of the primary outcome in the low-CUC group was significantly higher than that in the high-CUC group (3-year incidence: low CUC 8.8% vs. high CUC 4.0%; log-rank p = 0.046). After adjusting for age and sex, the risk in the low-CUC group relative to that in the high-CUC group remained significantly high (hazard ratio 3.17, 95% confidence interval 1.05-9.54, p = 0.040).</p><p><strong>Conclusion: </strong>Low CUC in patients with CAD were associated with a higher risk of ASCVD events after coronary revascularization than high CUC levels. The assessment of HDL functionality measured by CUC would be useful for the risk prediction of ASCVD after coronary revascularization.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"1189-1202"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel ELISA System for Measuring Modified LDL-Adiponectin Complex.","authors":"Mai Sasaoka, Akemi Kakino, Roberto Villalobos-Labra, Yuki Yamashita, Floor Spaans, Satoru Joshita, Hiroshi Hosoda, Takeshi Uehara, Chu-Huang Chen, Sandra T Davidge, Tatsuya Sawamura","doi":"10.5551/jat.65377","DOIUrl":"10.5551/jat.65377","url":null,"abstract":"<p><strong>Aim: </strong>Adiponectin is an anti-diabetic and anti-atherogenic protein secreted primarily from adipose tissue. Adiponectin and modified LDL (mLDL) form a complex to modulate their biological activity. To elucidate the significance of the complex formation, we analyzed its effects on vascular tissue and developed and verified novel quantifying methods for adiponectin.</p><p><strong>Methods: </strong>To study the significance of the mLDL-adiponectin complex (MAC) formation, we used the wire-myography method on rat mesenteric artery. We developed a method to measure MAC by using LOX-1 as the capture protein and anti-adiponectin antibody for detection. We compared serum MAC levels between hemodialysis patients and control subjects.</p><p><strong>Results: </strong>Administering mLDL alone to rat mesenteric artery impaired endothelium-dependent vasorelaxation, whereas simultaneously administering adiponectin with mLDL protected rat mesenteric artery from the mLDL-induced impairment of vasorelaxation. This finding indicates MAC formation prevents endothelium from mLDL-induced dysfunction in tissue. Using our novel ELISA for MAC, we found that MAC was increasingly detectable depending on the doses of mLDL and adiponectin in vitro. In serum, hemodialysis patients showed a significantly higher ratio of MAC-high patients (higher than the median level of MAC) than did healthy controls. Furthermore, the MAC-high hemodialysis group had lower mLDL activity measured as LOX-1 ligand containing apoB.</p><p><strong>Conclusion: </strong>Using our ELISA, we detected MAC in human serum that protected blood vessels from the deleterious effects of oxidized LDL.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"1109-1121"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Metabolic Syndrome and Cardiovascular Events in a Japanese Population with and without Obesity: The Shizuoka Kokuho Database Study.","authors":"Yasuharu Tabara, Aya Shoji-Asahina, Yoko Sato","doi":"10.5551/jat.65357","DOIUrl":"10.5551/jat.65357","url":null,"abstract":"<p><strong>Aim: </strong>The accumulation of metabolic risk factors, namely high blood pressure, hyperlipidemia, and hyperglycemia, has been associated with cardiovascular diseases. However, little evidence is available on the prognostic significance of metabolic risk factor accumulation in nonobese individuals. This study investigated this issue by analyzing prefecture-wide health checkup and health insurance data in Japan.</p><p><strong>Methods: </strong>We analyzed data from 366,881 adults aged 40-74 years who were enrolled in the National Health Insurance, excluding those who experienced a stroke or coronary artery diseases or required long-term care. Baseline clinical information was obtained from annual health checkup data. Incidences of stroke and coronary artery diseases were obtained from insurance data.</p><p><strong>Results: </strong>In the nonobese population, the hazard ratio for stroke increased linearly with the number of accumulated metabolic risk factors, particularly among those aged ＜65 years men (one factor: 2.21, two factors: 2.60; three factors: 3.93) and women (one factor: 1.49, two factors: 1.57; three factors: 2.27). Similar results were observed in the analysis for coronary artery diseases. After excluding participants receiving medications, the association of metabolic risk factor with stroke remained significant, although its association with coronary artery disease became less significant. In the analysis for each metabolic risk factors, high blood pressure (men: hazard ratio = 2.85; women: hazard ratio = 2.17; P＜0.001), but not hyperlipidemia and hyperglycemia, was associated with stroke in the nonobese population.</p><p><strong>Conclusion: </strong>The accumulation of metabolic risk factors needs to be considered a risk factor for cardiovascular diseases even in individuals without obesity.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"1122-1138"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein(a) Levels and the Risk of Coronary Heart Disease and Stroke: The Suita Study.","authors":"Ahmed Arafa, Yuka Kato, Yoshihiro Kokubo, Paramita Khairan, Chisa Matsumoto, Yoko M Nakao, Yu Kataoka, Mariko Harada-Shiba","doi":"10.5551/jat.65437","DOIUrl":"10.5551/jat.65437","url":null,"abstract":"<p><strong>Aims: </strong>Lipoprotein(a) (Lp[a]) exhibits atherogenic and thrombogenic properties. We investigated the association between Lp(a) levels and the risk of coronary heart disease (CHD) and stroke.</p><p><strong>Methods: </strong>We used data from 5138 people ≥ 30 years old registered in the Suita Study, a Japanese population-based prospective cohort study. All participants were initially free from CHD or stroke. Cox proportional hazard models were applied to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for CHD and stroke among participants with elevated Lp(a) levels.</p><p><strong>Results: </strong>At baseline, only 17.0% of participants had Lp(a) levels ≥ 30 mg/dL. Within the median follow-up period of 11.7 years, 164 CHD and 234 stroke events were detected. In the multivariable-adjusted regression model, Lp(a) ≥ 30 mg/dL was associated with an increased risk of CHD (HR, 1.52 [95% CI, 1.05-2.21]). Every 10-ml/dL increment in Lp(a) level was associated with a 7.9% increase in CHD risk. The association with CHD did not change significantly after adjusting for total cholesterol level or lipid-lowering drugs. In contrast, increased Lp(a) levels were not associated with stroke risk or any subtype.</p><p><strong>Conclusions: </strong>Lp(a) ≥ 30 mg/dL was associated with an increased risk of CHD in the Japanese population.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"1139-1149"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Depression with Walking in People with Peripheral Artery Disease: A Post-Hoc Analysis of the BIP Trial.","authors":"Jonathan Golledge, Alkira Venn, Anthony Leicht, Nicola Burton, Belinda Parmenter, Joseph V Moxon","doi":"10.5551/jat.65531","DOIUrl":"10.5551/jat.65531","url":null,"abstract":"<p><strong>Aims: </strong>This post-hoc analysis from the Behavioural Intervention by allied health professionals to promote Physical activity (BIP) trial examined the relationship between depression and step count and walking capacity over two years in people with peripheral artery disease (PAD).</p><p><strong>Methods: </strong>BIP included participants with walking impairment due to PAD followed up at 4, 12 and 24 months to measure step count over 7 days using an accelerometer and six-minute walking distance. The relationships between depression at entry with step count and walking distance during follow-up were assessed using linear mixed effects models.</p><p><strong>Results: </strong>At entry, 29 (14.5%) of the 200 participants had depression being treated with anti-depressant medication. Participants diagnosed with depression were more likely to be female (13 of 29, 44.8%) than those not diagnosed with depression (43 of 171, 25.1%). Over 24 months follow-up, daily step count progressively decreased in participants with depression (mean [SD] 4406 (2266) at entry to 3888 (2555) at 24 months) as compared to no change in participants without depression (mean (SD) 5271 (2526) at entry compared to 5120 (2446) at 24 months), inter-group difference p = 0.010. No significant difference in change in six-minute walking distance over 2 years was found between participants with and those without depression.</p><p><strong>Conclusion: </strong>Depression is associated with greater decline in self-regulated walking in patients with PAD. Effective treatments for depression are needed which help promote physical activity in people with PAD.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"1101-1108"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and Physical Activity in PAD: Addressing the Missing Link.","authors":"Takanori Yasu","doi":"10.5551/jat.ED286","DOIUrl":"10.5551/jat.ED286","url":null,"abstract":"","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"1098-1100"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANGPTL3: A Breakthrough Target in Treatment for Dyslipidemia and Atherosclerosis.","authors":"Hirotaka Fukami, Yuichi Oike","doi":"10.5551/jat.RV22038","DOIUrl":"10.5551/jat.RV22038","url":null,"abstract":"<p><p>Dyslipidemia is a major risk factor for atherosclerosis and subsequent cardiovascular disease (CVD). Despite conventional treatment with statins, ezetimibe, or PCSK9 inhibitors, there are cases of familial hypercholesterolemia (FH) in which LDL-C levels cannot be sufficiently lowered to the target level, resulting in failure to prevent CVD. Inhibition of Angiopoietin-like protein 3 (ANGPTL3) has emerged as a new therapeutic strategy to reduce LDL-C levels independent of the LDL receptor function. Since ANGPTL3 suppresses lipoprotein lipase (LDL) and endothelial lipase (EL) activities, its inhibition facilitates the clearance of very low-density lipoprotein cholesterol, decreasing both LDL-C and triglyceride (TG) levels. In fact, evinacumab, an anti-ANGPTL3 monoclonal antibody, has been shown to substantially reduce LDL-C and TG levels, even in FH patients with LDL receptor gene mutations who are resistant to the conventional treatments described above. Clinical trials have also shown that siRNA therapeutics, such as zodasiran and solbinsiran, improve lipid profiles in patients with dyslipidemia. Recently, we have begun developing a peptide-based anti-ANGPTL3 vaccine and confirmed in a preclinical FH mouse model that it significantly decreases LDL-C and TG levels, reduces atherosclerotic lesions and maintains long-term efficacy without adverse effects. In this review, we discuss the promising advances in ANGPTL3-targeted therapeutics that may overcome treatment-resistant dyslipidemia and reduce CVD risk in high-risk populations.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"1071-1078"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Specific Association between HO-1 (GT)n Promoter Polymorphism and Large-Artery Atherosclerosis Stroke.","authors":"Jintao Li, Junting Chen, Jia Wen, Kailin Cheng, Xiaoli Fu, Shuen Li, Zhu Shi","doi":"10.5551/jat.65595","DOIUrl":"10.5551/jat.65595","url":null,"abstract":"<p><strong>Aims: </strong>Oxidative stress is a central factor in the pathogenesis of atherosclerosis and potentially exhibits sexual dimorphism. The induction of heme oxygenase-1 (HO-1) serves as a crucial mechanism against reactive oxygen species toxicity in the vascular wall, and this induction is regulated by the promoter (GT)n repeat length. We aim to investigate whether or not HO-1 gene (GT)n polymorphism is associated with the occurrence of large-artery atherosclerotic (LAA) stroke.</p><p><strong>Methods: </strong>We consecutively recruited stroke patients, with a control group comprising age- and sex-matched non-stroke individuals. HO-1 (GT)n genotypes were determined using DNA extracted from the peripheral leukocytes. HO-1 (GT)n polymorphism was classified as short [S, ≤ 24 (GT)n], medium [M, 25 ≤ (GT)n ＜31], or long [L, 31 ≤ (GT)n]. Clinical data were collected, and stroke patients were categorized into LAA and non-LAA groups according to the TOAST classification. A multivariable logistic regression analysis was conducted to evaluate the association between HO-1 (GT)n variants and LAA occurrence stratified by sex.</p><p><strong>Results: </strong>There was no significant difference in the distribution of HO-1 (GT)n genotypes between the stroke and non-stroke populations. However, the proportion of S/S genotype was significantly lower in the LAA stroke patients than in the non-LAA stroke patients (7.08% vs. 21.78%, p＜0.001). A multivariable logistic regression analysis indicated that non-SS genotypes were associated with a significantly increased risk of LAA compared to the S/S genotype patients (odds ratio [OR] 3.35, 95% confidence interval [CI] 1.98-5.67, p＜0.001). After stratification by sex, the protective effect of the HO-1 (GT)n S/S genotype was highly significant in men (OR 5.50, 95% CI 2.67-11.34, p＜0.001), whereas the association was not significant in women (OR 1.60, 95% CI 0.75-3.34, p = 0.228).</p><p><strong>Conclusion: </strong>Short (GT)n variants in HO-1 may confer significant protection against LAA stroke in men but not in women.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"1176-1188"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint Impact of Smoking and Metabolic Syndrome on Cardiovascular Disease: A Cohort Study.","authors":"Huan Hu, Tohru Nakagawa, Toru Honda, Shuichiro Yamamoto, Hiroko Okazaki, Hiroshi Ide, Seitaro Dohi, Toshiaki Miyamoto, Makoto Yamamoto, Naoki Gommori, Takeshi Kochi, Takayuki Ogasawara, Maki Konishi, Isamu Kabe, Tetsuya Mizoue","doi":"10.5551/jat.65812","DOIUrl":"https://doi.org/10.5551/jat.65812","url":null,"abstract":"<p><strong>Aims: </strong>This study examined whether or not the coexistence of smoking and metabolic syndrome synergistically increases the risk of cardiovascular disease (CVD) beyond their individual effects.</p><p><strong>Methods: </strong>This prospective cohort study included 68,743 workers from the Japan Epidemiology Collaboration on Occupational Health Study. The participants were categorized into four groups based on their smoking status and metabolic syndrome. Biological interactions were evaluated using relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S).</p><p><strong>Results: </strong>During a mean follow-up of 7.2 (range: 0.1-10.9) years, 346 participants developed CVD. Current smokers with metabolic syndrome had the highest CVD risk (hazard ratio: 6.45, 95% confidence interval [CI]: 4.73-8.80). Approximately 35% of CVD cases among individuals exposed to both factors were attributed to their biological interactions (RERI: 2.27, 95% CI: 0.56-3.98; AP: 0.35, 95% CI: 0.15-0.55; S: 1.71, 95% CI: 1.16-2.52). An analysis of CVD subtypes revealed a significant biological interaction for myocardial infarction (RERI: 5.14, 95% CI: 0.65-9.62; AP: 0.52, 95% CI: 0.26-0.78; S: 2.38, 95% CI: 1.22-4.62) but not for stroke (RERI: 1.34, 95% CI: -0.46-3.13; AP: 0.25, 95% CI: -0.03-0.53; S: 1.44, 95% CI: 0.89-2.34).</p><p><strong>Conclusion: </strong>Smoking and metabolic syndrome interact synergistically to elevate CVD risk, particularly for myocardial infarction. Targeting both factors is essential for CVD prevention.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}