Journal of Cardiovascular Development and Disease最新文献

{"title":"Non-Invasive Mapping of Ventricular Action Potential Reconstructed from Contactless Magnetocardiographic Recordings in Intact and Conscious Guinea Pigs.","authors":"Riccardo Fenici, Marco Picerni, Peter Fenici, Donatella Brisinda","doi":"10.3390/jcdd12090343","DOIUrl":"10.3390/jcdd12090343","url":null,"abstract":"<p><p>Optical mapping, nanotechnology-based multielectrode arrays and automated patch-clamp allow transmembrane voltage mapping with high spatial resolution, as well as L-type calcium and inward rectifier currents measurements using native mammalian cardiomyocytes. However, these methods are limited to in vitro and ex vivo experiments, while magnetocardiography (MCG) might offer a novel approach for non-invasive preclinical safety assessments of new drugs in intact and even conscious rodents by reconstructing the ventricular action potential waveform (rVAPw) from MCG signals. <b>Objective:</b> This study aims to assess the feasibility of rVAPw reconstruction from MCG signals in Guinea pigs (GPs) and validate the results by comparison with simultaneously recorded epicardial ventricular monophasic action potentials (eVMAP). <b>Methods:</b> Unshielded MCG (uMCG) data of 18 GPs, investigated anaesthetized and awake at ages of 5, 14, and 26 months using a 36-channel DC-SQUID system, were analyzed to calculate rVAPw from MCG's current arrow map. <b>Results:</b> Successful rVAPw reconstruction from averaged MCG showed good alignment with eVMAP waveforms. However, some rVAPw displayed incomplete or distorted repolarization at sites with lower MCG amplitude. <b>Conclusions:</b> 300-s uMCG averaging allowed rVAPw reconstruction in intact GPs. Occasionally distorted rVAPw suggests the need for dedicated MCG devices development, with higher density of optimized vector sensors, and modelling tailored for small animal hearts.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study on Cardiac Findings in Patients with Transthyretin Amyloidosis Before and After Treatment with a Transthyretin Silencer.","authors":"Priya Arivalagan, Diego Hernan Delgado","doi":"10.3390/jcdd12090342","DOIUrl":"10.3390/jcdd12090342","url":null,"abstract":"<p><p>Transthyretin amyloidosis (ATTR) is a rare disease caused by misfolded proteins, amyloids, that are deposited in various organs and tissues, typically the heart and/or nerves, causing the development of cardiomyopathy (CM) and polyneuropathy (PN). Although this may be an incurable disease, there are various treatments that are currently available for patients with ATTR, including transthyretin (TTR) silencers such as inotersen and patisiran. The silencers help slow down the progression of disease and improve the quality of life of patients with ATTR by alleviating the cardiac and neurological symptoms that patients present. The purpose of this study was to compare the cardiac findings observed in the ⁹⁹Tc-PYP scintigraphy (PYP scan) parameters of patients with a mixed phenotype before and after treatment with inotersen or patisiran. This study included ten patients from the amyloidosis clinic at the University Health Network. All of the patients (average age: 63.80 ± 11.70; 60.0% males, 40.0% females) received inotersen or patisiran as their treatment. These patients underwent a PYP scan before and after treatment to observe any improvements in terms of their CM post-treatment. Nine (90.0%) patients showed an improvement with their CM, as they showed a decrease in their heart-to-contralateral lung (H/CL) ratio and/or pyrophosphate (PYP) grade based on their results from the PYP scan post-treatment with a TTR silencer. Only one patient (10.0%) had worsening results, as their H/CL ratio and PYP grade increased post-treatment in comparison to the PYP scan results pre-treatment. Patients with ATTR who have a mixed phenotype should undergo a PYP scan before and after treatment with a TTR silencer. By undergoing these scans, the effectiveness of this treatment could be determined by observing any improvements in the signs of CM. A decrease in the H/CL ratio and/or the PYP grade would indicate that the TTR silencer has been effective in alleviating the signs and symptoms of CM, and that the patients should continue with their treatment plan.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting Telomere Shortening in Vascular Aging and Atherosclerosis: Therapeutic Promise of <i>Astragalus membranaceus</i>.","authors":"Paola Canale, Maria Grazia Andreassi","doi":"10.3390/jcdd12090341","DOIUrl":"10.3390/jcdd12090341","url":null,"abstract":"<p><p>Telomere dysfunction has emerged as a pivotal contributor to vascular senescence, a fundamental process in the pathogenesis of age-related cardiovascular diseases such as atherosclerosis. This connection underscores the therapeutic potential of targeting telomere biology to prevent or mitigate the progression of vascular aging. In this context, <i>Astragalus membranaceus</i> and its bioactive constituents, including astragaloside IV, cycloastragenol, and the commercial telomerase activator TA-65, demonstrate significant promise in attenuating vascular aging and atherosclerotic disease. These compounds exert a range of pleiotropic effects, including anti-inflammatory, antioxidant, endothelial-protective, and lipid-modulating actions, while also modulating telomerase activity and supporting telomere maintenance. This review provides an overview of the mechanistic basis underlying the anti-atherosclerotic effects of <i>Astragalus</i>-derived compounds and underscores critical key knowledge gaps. It also outlines future research directions necessary to validate their efficacy and therapeutic potential in the prevention and treatment of atherosclerosis and other age-related vascular disorders.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CMR-Derived Global Longitudinal Strain and Left Ventricular Torsion as Prognostic Markers in Dilated Cardiomyopathy.","authors":"Alexandru Zlibut, Michael Bietenbeck, Lucia Agoston-Coldea","doi":"10.3390/jcdd12090340","DOIUrl":"10.3390/jcdd12090340","url":null,"abstract":"<p><strong>Background: </strong>Non-ischemic dilated cardiomyopathy (DCM) is a heterogeneous myocardial disease associated with variable progression and an increased risk of major adverse cardiovascular events (MACEs). Cardiovascular magnetic resonance (CMR) allows the comprehensive evaluation of myocardial structure, function, and fibrosis. This prospective study aimed to assess the prognostic value of CMR-derived global longitudinal strain (GLS) and left ventricular (LV) torsion in patients with DCM.</p><p><strong>Methods: </strong>We prospectively enrolled 150 patients with newly diagnosed non-ischemic DCM and 100 age- and sex-matched healthy controls. All participants underwent standardized CMR protocols including cine imaging, late gadolinium enhancement (LGE), and feature-tracking analysis for myocardial deformation. LV volumes, ejection fraction (LVEF), GLS, and LV torsion were quantified. The primary endpoint was the first occurrence of MACE, defined as cardiac death, sustained ventricular arrhythmia, or heart failure hospitalization. The median follow-up was 33 months.</p><p><strong>Results: </strong>Compared to controls, DCM patients had significantly impaired LV function and myocardial mechanics: lower LVEF (35.1% vs. 65.2%, <i>p</i> < 0.001), reduced GLS (-9.2% vs. -19.7%, <i>p</i> < 0.001), and diminished LV torsion (1.04 vs. 1.95 °/cm, <i>p</i> < 0.001). GLS ≤ -8.6% was independently associated with increased MACE risk (adjusted hazard ratio [HR]: 1.09; 95% confidence interval [CI]: 1.01-1.61; <i>p</i> < 0.01). Similarly, reduced LV torsion predicted adverse events (adjusted HR: 1.37; 95% CI: 1.03-1.81; <i>p</i> < 0.01). The presence of LGE (42% of patients) further stratified risk (HR: 2.86; 95% CI: 1.48-12.52; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>CMR-derived GLS and LV torsion are strong, independent predictors of adverse outcomes in DCM. Their integration into routine imaging protocols enhances risk stratification beyond conventional metrics such as LVEF and LGE. These findings support the use of myocardial deformation analysis in the comprehensive evaluation of patients with DCM.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation-Free Percutaneous Coronary Intervention: Myth or Reality?","authors":"Sotirios C Kotoulas, Andreas S Triantafyllis, Nestoras Kontogiannis, Pavlos Tsinivizov, Konstantinos Antoniades, Ibraheem Aqeel, Eleni Karapedi, Angeliki Kolyda, Leonidas E Poulimenos","doi":"10.3390/jcdd12090339","DOIUrl":"10.3390/jcdd12090339","url":null,"abstract":"<p><p><b>Background:</b> Radiation exposure in the cardiac catheterization laboratory remains a critical occupational hazard for interventional cardiologists and staff, contributing to orthopedic injuries, cataracts, and malignancy. In parallel, procedural complexity continues to increase, demanding both precision and safety. Robotic-assisted percutaneous coronary intervention (R-PCI), alongside advanced shielding systems and imaging integration, has emerged as a transformative strategy to minimize radiation and enhance operator ergonomics. <b>Objective:</b> This state-of-the-art review synthesizes the current clinical evidence and technological advances that support a radiation-reduction paradigm in percutaneous coronary intervention (PCI), with a particular focus on the role of R-PCI platforms, procedural modifications, and emerging shielding technologies. <b>Methods:</b> We reviewed published clinical trials, registries, and experimental studies evaluating robotic PCI platforms, contrast and radiation dose metrics, ergonomic implications, procedural efficiency, and radiation shielding systems. Emphasis was given to the integration of CT-based imaging (coronary computed tomography angiography-CCTA, fractional flow reserve computed tomography-FFR-CT) and low-dose acquisition protocols. <b>Results:</b> R-PCI demonstrated technical success rates of 81-100% and clinical success rates up to 100% in both standard and complex lesions, with significant reductions in operator radiation exposure (up to 95%) and procedural ergonomic burden. Advanced shielding technologies offer radiation dose reductions ranging from 86% to nearly 100%, while integration of (CCTA), (FFR-CT), and Artificial Intelligence (AI) -assisted procedural mapping facilitates further fluoroscopy minimization. Robotic workflows, however, remain limited by lack of device compatibility, absence of haptic feedback, and incomplete integration of physiology and imaging tools. <b>Conclusions:</b> R-PCI, in combination with shielding technologies and imaging integration, marks a shift towards safer, radiation-minimizing interventional strategies. This transition reflects not only a technical evolution but a philosophical redefinition of safety, precision, and sustainability in modern interventional cardiology.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid PET/CT and PET/MR in Coronary Artery Disease: An Update for Clinicians, with Insights into AI-Guided Integration.","authors":"Francesco Antonio Veneziano, Flavio Angelo Gioia, Francesco Gentile","doi":"10.3390/jcdd12090338","DOIUrl":"10.3390/jcdd12090338","url":null,"abstract":"<p><p>Imaging techniques such as positron emission tomography/computed tomography (PET/CT) and positron emission tomography/magnetic resonance imaging (PET/MR) have emerged as powerful and versatile tools for the comprehensive assessment of coronary artery disease (CAD). By combining anatomical and functional information in a single examination, these modalities offer complementary insights that significantly enhance diagnostic accuracy and support clinical decision-making. This is particularly relevant in complex clinical scenarios, such as multivessel disease, balanced ischemia, or suspected microvascular dysfunction, where conventional imaging may be inconclusive. This review aims to provide clinicians with an up-to-date summary of the principles, technical considerations, and clinical applications of hybrid PET/CT and PET/MR in CAD. Here, we describe how these techniques can improve the evaluation of myocardial perfusion, coronary plaque characteristics, and ischemic burden. Advantages such as improved sensitivity, spatial resolution, and quantification capabilities are discussed alongside limitations including cost, radiation exposure, availability, and workflow challenges. A dedicated focus is given to the emerging role of artificial intelligence (AI), which is increasingly being integrated to optimize image acquisition, fusion processes, and interpretation. AI has the potential to streamline hybrid imaging and promote a more personalized and efficient management of CAD. Finally, we outline future directions in the field, including novel radiotracers, automated quantitative tools, and the expanding use of hybrid imaging to guide patient selection and therapeutic decisions, particularly in revascularization strategies.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Need for Coronary Artery Bypass Grafting in Acute Type A Aortic Dissection: Clinical Insights, Diagnostic Gaps, and Surgical Outcomes.","authors":"Mohammed Morjan, Charlotte Philippa Jürgens, Tong Li, Luis Jaime Vallejo Castano, Freya Jenkins, Amin Thwairan, Vivien Weyers, Hannan Dalyanoglu, Sebastian Daniel Reinartz, Artur Lichtenberg","doi":"10.3390/jcdd12090336","DOIUrl":"10.3390/jcdd12090336","url":null,"abstract":"<p><p><b>Objectives:</b> The need for concomitant coronary artery bypass grafting during acute type A aortic dissection repair is common and associated with high mortality. This study aims to characterize the patient cohort, assess outcomes, and evaluate the role of preoperative diagnostics in these high-risk patients. <b>Methods:</b> Patients who underwent concomitant coronary artery bypass and acute type A aortic dissection repair between March 2007 and June 2023 were included. In-hospital survivors and non-survivors were compared. Logistic regression analyses were performed to identify predictors of in-hospital mortality. Preoperative computed tomography scans were independently reviewed by a cardiovascular radiologist to assess potential coronary involvement. The agreement between computed tomography and intraoperative reports of coronary dissection was evaluated using Cohen's κappa test. <b>Results:</b> The cohort consisted of ninety-eight patients. In-hospital mortality was 26.5% (n = 26). The right coronary artery was the most frequently grafted (57%, n = 56). Elevated preoperative creatine kinase was the only predictor of in-hospital mortality (<i>p</i> = 0.044). Of the 72 available preoperative CT scans, 76% (n = 55) indicated coronary involvement, whereas intraoperative coronary dissection requiring bypass grafting was documented in only 42% (n = 30)). The agreement between computer tomography and intraoperative dissection reports was poor (κappa 0.043 (95% CI, -0.155 to 0.241), <i>p</i> = 0.66). <b>Conclusion:</b> Simultaneous coronary artery bypass during acute type A aortic dissection repair remains associated with high mortality and morbidity. The right coronary artery is most often affected. Coronary bypass is not always linked to coronary dissection, making intraoperative detection challenging. This underscores the importance of preoperative diagnostics, especially computer tomography.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Assessment of Left Atrial Function: The Emerging Role of Cardiac Magnetic Resonance Feature Tracking.","authors":"Javier Solsona-Caravaca, Alessandro Giustiniani, Eduard Ródenas-Alesina, Laura Galian-Gay, Ruperto Oliveró, Filipa Valente, Guillem Casas, Gisela Teixidó-Turà, Nuria Vallejo, Rubén Fernández-Galera, Víctor González-Fernández, Pablo Escribano-Escribano, Axel Hernández-Pineda, Ignacio Ferreira-González, José Fernando Rodríguez-Palomares","doi":"10.3390/jcdd12090337","DOIUrl":"10.3390/jcdd12090337","url":null,"abstract":"<p><p>Traditional volumetric parameters fall short of capturing the complex, phasic nature of atrial function. In contrast, atrial strain has become recognized as a sensitive, non-invasive imaging marker that enables earlier detection of myocardial dysfunction, refined risk stratification, and individualized therapeutic decision-making across a wide range of cardiovascular diseases. Cardiovascular magnetic resonance feature tracking (CMR-FT) has emerged as a robust imaging technique for evaluating atrial strain, offering high spatial resolution, high reproducibility, and independence from acoustic window limitations. Despite its promise, the routine clinical adoption of CMR-FT atrial strain remains limited. Key barriers include intervendor variability in strain values, the absence of standardized post-processing protocols, the lengthy acquisition times inherent to CMR studies, and the time required for post-processing atrial strain analysis. Overcoming these barriers is crucial to facilitate the integration of atrial strain assessment into routine clinical CMR protocols, particularly in patients with heart failure, valvular disease, or cardiomyopathy who undergo imaging for diagnostic or prognostic evaluation.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Outcomes of Patients Presenting with Acute Coronary Syndromes and Suspected Plaque Erosion Based on Clinical and Laboratory Criteria.","authors":"Luca Di Vito, Giancarla Scalone, Federico Di Giusto, Filippo Bruscoli, Michele Alfieri, Domenico Delfino, Federico Panzella, Simona Silenzi, Ik-Kyung Jang, Pierfrancesco Grossi","doi":"10.3390/jcdd12090335","DOIUrl":"10.3390/jcdd12090335","url":null,"abstract":"<p><p><b>Background:</b> Plaque erosion (PE) ranks as the second most prevalent pathology associated with acute coronary events, following plaque rupture. PE is characterized by endothelial denudation and the development of neutrophil extracellular traps. Specific clinical and laboratory predictors were shown to be associated with PE in patients with acute coronary syndrome. The aim of this study was to evaluate the clinical and laboratory results, as well as the outcomes of ACS patients with a high likelihood of PE. <b>Methods:</b> A total of 696 ACS patients were categorized into the suspected PE group and the less likely PE group based on the five validated predictors of PE. Baseline clinical characteristics and laboratory evaluations were analyzed between the two groups. Major adverse cardiovascular events were compared between the two groups at 20 months. <b>Results:</b> The group suspected of PE comprised 41% of patients, whereas the group with a lower likelihood of PE constituted 59%. The suspected PE group exhibited a greater incidence of current smokers and a higher BMI. Both CRP and fibrinogen levels were decreased; the incidence of one coronary vessel disease was elevated. The suspected PE group exhibited a markedly reduced incidence of MACEs at 20 months (7.4% compared to 28.8%, <i>p</i> = 0.0001). The recurrence of non-fatal coronary events tended to occur later in the suspected PE group (15 months (6-20) compared to 9 months (6-13), <i>p</i> = 0.062). A reduced coronary plaque burden and a low level of systemic inflammation characterized the distinctive features of the suspected PE cohort. <b>Conclusions:</b> The suspected PE group exhibited a more favorable prognosis at the 20-month follow-up, characterized by a considerably reduced mortality rate from all causes, whereas non-fatal coronary events tended to manifest at a later time.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-to-Lymphocyte and Glucose-to-Lymphocyte Ratios as Prognostic Markers in Hospitalized Patients with Acute Coronary Syndrome.","authors":"Christos Kofos, Andreas S Papazoglou, Barbara Fyntanidou, Athanasios Samaras, Panagiotis Stachteas, Athina Nasoufidou, Aikaterini Apostolopoulou, Paschalis Karakasis, Alexandra Arvanitaki, Marios G Bantidos, Dimitrios V Moysidis, Nikolaos Stalikas, Dimitrios Patoulias, Apostolos Tzikas, George Kassimis, Nikolaos Fragakis, Efstratios Karagiannidis","doi":"10.3390/jcdd12090334","DOIUrl":"10.3390/jcdd12090334","url":null,"abstract":"<p><strong>Background: </strong>Novel and accessible biomarkers may add to the existing risk stratification schemes in patients with acute coronary syndrome (ACS). The platelet-to-lymphocyte ratio (PLR) and glucose-to-lymphocyte ratio (GLR) have emerged as potential indicators of systemic inflammation and metabolic stress, both of which are pivotal in ACS pathophysiology. The aim of this study was to investigate the prognostic significance of the PLR and GLR in patients with ACS.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of patients hospitalized with ACS between 2017 and 2023 at Hippokration Hospital of Thessaloniki, Greece. PLR and GLR were calculated from admission blood samples. The primary endpoint was all-cause mortality. Logistic and Cox regression models were used to investigate the associations of PLR and GLR with all-cause mortality. Receiver operating characteristic (ROC) analysis, Kaplan-Meier survival curves, and restricted cubic spline (RCS) modeling were also applied.</p><p><strong>Results: </strong>In total, 853 patients (median age: 65 years, 72.3% males) were included. Higher PLR and GLR were independently associated with increased risk of long-term mortality [adjusted Odds Ratio (aOR) for PLR: 1.007, 95% CI: 1.005-1.008; and for GLR: aOR = 1.006, 95% CI: 1.003-1.008]. The optimal cut-off values were 191.92 for PLR and 66.80 for GLR. Kaplan-Meier and Cox regression analyses confirmed significantly reduced survival in patients with GLR and PLR values exceeding these thresholds. RCS analysis revealed non-linear relationships, with mortality risk rising sharply at higher levels of both markers. PLR showed superior prognostic performance (AUC: 0.673, 95% CI: 0.614-0.723) compared to GLR (AUC: 0.602, 95% CI: 0.551-0.653).</p><p><strong>Conclusions: </strong>While PLR demonstrated greater predictive accuracy, both PLR and GLR were consistently associated with mortality and may provide complementary prognostic information. Incorporating those ratios into routine clinical assessment may improve risk stratification, particularly in resource-limited settings or for patients without traditional risk factors.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 9","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}