MedicinePub Date : 2025-03-28DOI: 10.1097/MD.0000000000041940
Jiajun Pan, Zhimin Zhao, Bailing Li, Hao Zhang, Chengliang Cai, Yun Tao, Fan Qiao, Fanglin Lu, Lin Han, Zhiyun Xu
{"title":"Wider means worsen? Influence of QRS duration of left bundle branch block on prognosis of patients after transcatheter aortic valve replacement.","authors":"Jiajun Pan, Zhimin Zhao, Bailing Li, Hao Zhang, Chengliang Cai, Yun Tao, Fan Qiao, Fanglin Lu, Lin Han, Zhiyun Xu","doi":"10.1097/MD.0000000000041940","DOIUrl":"10.1097/MD.0000000000041940","url":null,"abstract":"<p><p>The impact of QRS duration on postoperative LBBB and its implications for the prognosis of patients undergoing transcatheter aortic valve replacement (TAVR) remained uncertain. This study enrolled consecutive patients who underwent TAVR with self-expanding prostheses in our department from September 2017 to January 2021. Based on the pro-discharge electrocardiogram, patients were categorized into 3 groups: Group-NCD (no conduction disorder), Group-sLBBB (LBBB, QRS ≥ 150 ms), and Group-mLBBB (LBBB, QRS < 150 ms). Basic characteristics were compared among these groups. Furthermore, differences in left ventricular ejection fraction (LVEF), survival rates, and clinical events were assessed at baseline, discharge, and during a one-year follow-up period. A total of 56 patients were included in the study. With 17 (30.36%) experiencing new-onset LBBB, of which eleven had a QRS duration ≥ 150 ms. Group-sLBBB exhibited a longer left ventricular end-diastolic diameter at baseline. At a one-year follow-up, the LVEF improved in Group-NCD, but not in the LBBB groups. At discharge, the LVEF of Group-sLBBB was lower than that of Group-NCD (52.82 ± 11.48 vs 61.48 ± 10.10, P = .036) and remained lower at follow-up (57.10 ± 9.49 vs 65.85 ± 7.58, P = .011). Additionally, the LVEF of Group-sLBBB was lower than that of Group-mLBBB at discharge (52.82 ± 11.48 vs 63.17 ± 4.31, P = .018). However, there were no significant differences in survival and event-free survival among the groups. The study revealed a notable occurrence of new-onset LBBB following TAVR, with a majority of cases exhibiting a significantly prolonged QRS duration (≥150 ms). While the presence of LBBB did not impact one-year survival or clinical events, it did exert adverse effects on LVEF. Notably, when QRS duration was markedly prolonged, these adverse effects manifested earlier and were more pronounced.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41940"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MedicinePub Date : 2025-03-28DOI: 10.1097/MD.0000000000041897
Yang Xiaowen, Zhang Shenzhong, Ding Jingjing, Ji Hanzhen, Pan Huiling
{"title":"A study on the practical logic and promotion path of agile governance of distorted health information on the internet: A review.","authors":"Yang Xiaowen, Zhang Shenzhong, Ding Jingjing, Ji Hanzhen, Pan Huiling","doi":"10.1097/MD.0000000000041897","DOIUrl":"10.1097/MD.0000000000041897","url":null,"abstract":"<p><p>This paper aims to introduce the use of the agile governance theory in improving the identification and processing speed of distorted health information on the internet to ensure the security of public health information and maintain the authenticity of the network environment. Use literature research and content analysis to summarize the governance challenges of distorted health information and the shortcomings of governance responses. The governance of distorted health information encounters difficulties such as the rapid release of information, frequent updates, and the diversity and anonymity of information publishers. The current countermeasures against distorted health information mainly include community participation, technological means of monitoring, cross-platform cooperation, and data-driven governance. However, existing countermeasures still suffer from the governance process relying on community participation, poor cross-platform collaboration, limited application of algorithms, and insufficient enforcement of information regulation. These shortcomings affect the effectiveness and timeliness of countermeasures against disinformation, and there is an urgent need to further optimize and improve governance mechanisms. To assess the advantages of agile governance theory in the governance of distorted health information, and propose that the agile governance model of distorted health information contains three dimensions, namely, data empowerment, process reengineering, and role reconstruction, and that the implementation path is based on regulations and stipulations, scientific and technological empowerment, and educational guidance, and the interaction of these three dimensions achieves the ability of agile governance of distorted health information with rapid perception, flexible response, and continuous coordination.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41897"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patient physical condition and functional sequelae following hospitalization with COVID-19: A cross-sectional observational study.","authors":"Daniel Ángel García, Inmaculada Calvo Muñoz, Ismael Martínez Nicolás, Bianca Salmeri","doi":"10.1097/MD.0000000000041948","DOIUrl":"10.1097/MD.0000000000041948","url":null,"abstract":"<p><p>After hospitalization caused by COVID-19, a high prevalence of physical deterioration has been observed, hence the importance of having tests to evaluate the functional status of patients and to be able to perform a partition and subsequent referral to the physiotherapy service. This cross-sectional observational study describes the physical status according to the short physical performance battery (SPPB) of patients admitted to the hospital setting for COVID-19 and to identify variables potentially related to this outcome. Thirty-six patients admitted to the hospital setting for COVID-19 in the first wave living in the community. Patients were evaluated with the SPPB, strength test, the International Physical Activity Questionnaire, the 1-minute sit-to stand, spirometry, the Barthel index, the Hospital Anxiety and Depression Scale, and other patient-related data were collected. We performed bivariate and regression analyses. A linear regression was fitted, having SPPB as a dependent variable to ascertain the impact of intensive care unit (ICU) admission on physical performance. Five variables were related to SPPB. There was a significant relationship between admission to the ICU and having a heart disease (P = .015), the level of physical activity (P = .049), number of years smoking (P = .029) and days of hospitalization (P = .005). A total of 22.22% of analyzed patients suffered frailty. SPPB is related to altered respiratory pattern, quadriceps strength, 1-minute sit-to-stand and FEV1, Barthel score, days of hospitalization and FEV/FVC ratio. Lack of association between ICU stay, age or sex with SPPB results differs from the results of other studies.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41948"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MedicinePub Date : 2025-03-28DOI: 10.1097/MD.0000000000041950
Uğur Demir, Mahmut Asirdizer, Muhammet Bahattin Bingül
{"title":"An evaluation of the demographic features and causes of mandible fractures and the relationships with the side, type, and anatomic location.","authors":"Uğur Demir, Mahmut Asirdizer, Muhammet Bahattin Bingül","doi":"10.1097/MD.0000000000041950","DOIUrl":"10.1097/MD.0000000000041950","url":null,"abstract":"<p><p>Mandibular fractures are one of the most common maxillofacial bone fractures that can occur during many activities in daily life. The aim of this study was to provide data for practitioners and researchers about the variables and outcomes associated with mandibular fractures by examining the relationships between gender, age groups, trauma causes, side, type, and anatomic location of mandibular fractures and concomitant injuries. The demographic and clinical data of the patients were obtained from the hospital information management system of a university hospital. The hospital records for the 10-year period between 2014 and 2023 were examined retrospectively. The mandible fractures were classified according to type, side, and location and compared against gender, age group, and trauma cause. Evaluation was made of 142 patients with traumatic mandibular fracture, comprising 76.8% males and 23.2% females. Of these cases with mandible fracture, 82.4% were aged < 35 years, and 45.1% of the fractures occurred in road traffic accidents. The majority of mandibular fractures were caused by road traffic accidents in males and adults over the age of 18, whereas home, environmental, and leisure accidents were the major cause of mandibular fractures in females and persons under the age of 18. Compound fractures were determined in 59.2% of the cases, single fractures in 80.3%, and parasymphysis and symphysis fractures in 46.2%. The compound and parasymphysis/symphysis region fractures were more common in males, patients aged < 35 years, and those who had undergone any type of trauma. We consider the information obtained through this study could make significant contributions to the data bank for multicenter prospective in-depth epidemiological research in clinical and forensic sciences in the future.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41950"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A combination of drug, behavioral and surgical therapy to relieve from severe obesity complicated with multiple organs failure: A case report.","authors":"Feng Feng, Jiaqi Zhang, Yuqi Gao, Qiaoni Ye, Guiqi Wang, Jingfeng Gu, Liping Peng","doi":"10.1097/MD.0000000000041846","DOIUrl":"10.1097/MD.0000000000041846","url":null,"abstract":"<p><strong>Rationale: </strong>The prevalence of obesity and its associated complications is on the rise globally. Bariatric surgery has proven to be a very effective method to induce sustained weight loss as well as reduce obesity-related diseases, such as type 2 diabetes, hypertension and hyperlipemia.</p><p><strong>Patient concerns: </strong>The 30-year-old female patient, with BMI at 79.2 kg/m2 and abdominal circumference at 199 cm, gained weight continually, felt chest tightness and shortness of breath for 10 days.</p><p><strong>Diagnoses: </strong>The patient was diagnosed with severe obesity complicated with multiple organs failure.</p><p><strong>Interventions: </strong>The patient was given a personal diet plan to lose weight. Besides, she was given noninvasive ventilator to improve ventilation dysfunction during night sleep, and hypoglycemic therapy and treatment of pulmonary hypertension were given to improve heart failure. When the weight was effectively reduced, bariatric surgery was performed to reduce weight more remarkable.</p><p><strong>Outcomes: </strong>One month after surgery, the overall weight of the patient was significantly reduced with meliorative BMI at 58.6, and the blood glucose was significantly reduced to the normal level and her overall physique was thin down and slimmer than before.</p><p><strong>Lessons: </strong>Multi-disciplinary combination and comprehensive treatment can effectively reduce the risk of surgery. Moreover, surgery should not be performed as soon as possible for patients with extremely severe obesity, and preoperative weight loss can improve the organs function of patients.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41846"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MedicinePub Date : 2025-03-28DOI: 10.1097/MD.0000000000041741
Lijun Cai, Wenying Yuan
{"title":"Analysis of the influence of emotional factors on the efficacy and prognosis of endoscopic treatment of functional abdominal pain in children.","authors":"Lijun Cai, Wenying Yuan","doi":"10.1097/MD.0000000000041741","DOIUrl":"10.1097/MD.0000000000041741","url":null,"abstract":"<p><p>This study aimed to explore the influence of emotional factors on the efficacy and prognosis of endoscopic treatment in children with functional abdominal pain (FAP), and to identify related risk factors. A total of 66 children with FAP treated with endoscopy from January 2018 to June 2024 were evaluated using the Child Depression Scale, Child Anxiety Scale, Quality of Life Scale, and visual analog scoring. Patients' demographics, clinical symptoms, treatment methods, and outcomes were recorded. Symptom remission, recurrence rates, and quality of life changes were compared after 6 months. Pearson correlation and logistic regression analyses were conducted. High-anxiety (35 cases) and low-anxiety (31 cases) groups had mean pain scores of 4.85 ± 1.21 and 2.10 ± 0.85, respectively (P = .001). Recurrence rates were 34.3% and 9.7%, respectively (P = .012). Good-mood (20 cases) and bad-mood (46 cases) groups had quality of life scores of 85.50 ± 5.50 and 63.50 ± 7.00 (P < .05). High-depression (25 cases) and low-depression (41 cases) groups had mean pain scores of 5.10 ± 1.10 and 2.40 ± 0.75 (P < .05), with recurrence rates of 36.0% and 14.6%, respectively (P = .009). Anxiety and depression were positively correlated with pain scores (r = 0.60, r = 0.58, P < .05) and negatively correlated with quality of life (r = -0.56, r = -0.54, P < .05). Anxiety (OR = 3.20, P = .003) and depression (OR = 2.80, P = .007) were independent risk factors for recurrence. Emotional factors significantly affect the efficacy and prognosis of endoscopic treatment in children with FAP. Negative emotions increase recurrence risk and reduce treatment efficacy and quality of life. Psychological intervention should be considered to improve outcomes.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41741"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MedicinePub Date : 2025-03-28DOI: 10.1097/MD.0000000000041790
Shanshan Jin, Shiquan Wu, Bin Cai, Jian Luo
{"title":"Coronavirus disease 2019 and catastrophic antiphospholipid syndrome: Case report.","authors":"Shanshan Jin, Shiquan Wu, Bin Cai, Jian Luo","doi":"10.1097/MD.0000000000041790","DOIUrl":"10.1097/MD.0000000000041790","url":null,"abstract":"<p><strong>Rationale: </strong>The emergence of catastrophic antiphospholipid syndrome (CAPS) alongside coronavirus disease 2019 (COVID-19) is of great concern, because of its high mortality and unclear mechanism. This severe disease, characterized by multiple thrombi and multisystem disorder, has notably diverse clinical presentations, which complicates its diagnosis in clinical practice. Now, we report a rare case of CAPS in a patient with COVID-19.</p><p><strong>Patient concerns: </strong>A 64-year-old patient who mainly presented with pain and swelling 2 months ago progressed gradually into multiple thrombi, including pulmonary embolism, renal embolism, and deep vein thrombosis; transient ischemic attack; multiple organ dysfunction with acute kidney injury; and necrosis of both lower limbs, left upper extremity, both ears, and penile gangrene.</p><p><strong>Diagnoses: </strong>He was diagnosed as CAPS with COVID-19 by positive severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) testing and high-titer immunoglobulin (Ig) A anti-β2-glycoprotein I antibody (anti-β2GPI).</p><p><strong>Interventions: </strong>Active rescue treatments such as anticoagulants, plasmapheresis, glucocorticoid pulse therapy, antibiotics, and multi-organ functional support alleviated the disease effectively.</p><p><strong>Outcomes: </strong>Although his clinical symptoms were successfully controlled, we could not save the necrotic tissue. The patient refused to undergo limb amputation and died of necrotic tissue infection.</p><p><strong>Lessons: </strong>CAPS in patients with COVID-19 is an extremely serious disease with a high mortality rate. A delay in diagnosis and treatment can result in potentially devastating consequences. Therefore, physicians should be alert to the possibility of CAPS in patients with multiple thrombi and COVID-19. Furthermore, this case serves as a foundation upon which future studies can build to investigate the possible mechanisms of IgA anti-β2GPI-positive CAPS in patients with COVID-19, which may guide the exploration of potential therapeutic strategies to prevent the disease's progression.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41790"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MedicinePub Date : 2025-03-28DOI: 10.1097/MD.0000000000041968
Yiying Zhao, Hanwen Liu, Dechao Guo
{"title":"Diagnostic efficacy of ultrasound and computed tomography for acute appendicitis: A single center retrospective study.","authors":"Yiying Zhao, Hanwen Liu, Dechao Guo","doi":"10.1097/MD.0000000000041968","DOIUrl":"10.1097/MD.0000000000041968","url":null,"abstract":"<p><p>The aim of this study was to evaluate the diagnostic efficacy of ultrasonography (US) and computed tomography (CT) examination for acute appendicitis (AA). A total of 41 patients with suspected AA were enrolled in this study. CT scan was performed in 24 patients, and US was performed in 17 patients. Both CT scan and US were performed in 7 patients. The primary outcomes were the performance characteristics (sensitivity, specificity) of US and CT in the patients with suspected AA. The secondary outcomes included the diagnostic accuracy of CT and US. By using US, 6 patients (35%) were incorrectly diagnosed and 2 other patients (12%) had equivocal results. By using CT as the primary diagnostic tool, 4 patients (17%) were misdiagnosed and 8 patients (33%) had equivocal results. Even if the equivocal results of CT and US were excluded from the calculation, the sensitivity and specificity of CT was 88% and 71% respectively, while the sensitivity and specificity of US was 73% and 50%, respectively. Although CT and US are believed to be reliable diagnostic tool to precisely diagnose AA. The rate of negative appendectomy still remains high. There is a need to develop a more accurate methods to diagnose AA, and therefore rate of negative appendectomy can be reduced.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41968"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Factors affecting knowledge and practices towards prevention of chronic kidney disease among hypertensive patients at public hospital in Bale and East Bale zone, Oromia, Southeast Ethiopia, 2023: A cross-sectional study.","authors":"Deriba Fetene, Mulugeta Adugnew, Hailye Mamo, Sana'a Kedir, Kidist Asmamaw","doi":"10.1097/MD.0000000000041989","DOIUrl":"10.1097/MD.0000000000041989","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a growing health concern worldwide. It is crucial to prevent CKD to mitigate its impact and enhance health results. Recognizing and managing the risk factors of chronic kidney disease at an early stage can aid in stopping its advancement. A cross-sectional study was carried out at a hospital from March 1 to April 30, 2023, involving 422 hypertensive patients. The participants were chosen using systematic random sampling. Data on socio-demographic and clinical factors, as well as knowledge and practices, were gathered through interviews, medical record reviews using structured questionnaires. Descriptive statistics were used to determine the frequency and percentage of variables. The data was entered into Epi-data version 4.6 and analyzed using SPSS version 23 (Chicago). Variables with P-values < .25 were considered for multivariable analysis, and those with P-values < .05 were deemed to be factors associated with knowledge and practices. The study found that 42.2% (178) of hypertensive patients had good knowledge about chronic kidney disease, and 43.6% (184) had good practices. Living in urban areas (with an adjusted odds ratio [AOR] of 3.94 at a 95% confidence interval [CI] of 2.42-6.42) and having a family history of kidney disease (AOR 5.59 at a 95% CI of 3.21-9.75) were factors associated with good knowledge. Being a government employee (AOR 7.29, at 95% CI 1.79-29.58) and maintaining a normal body mass index (AOR 8.03, at 95% CI 3.54-18.19) were linked to good practices. Less than half of the study participants had good knowledge and practices toward prevention of chronic kidney disease. Identifying factors that affect knowledge and practices towards the prevention of chronic kidney disease can offer healthcare providers, governmental and nongovernmental organizations (NGOs), and policymakers' valuable insights for developing strategic interventions and education programs to promote better management of hypertension and CKD.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41989"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Predictive value of cumulative SII for MACE in STEMI patients after PCI.","authors":"Weifeng Zhang, Haiyan Jia, Xingzhou Zhao, Wanqing Song, Weiwei Sun, Qianyi Wang, Yanling Li, Xiaowei Wang","doi":"10.1097/MD.0000000000041983","DOIUrl":"10.1097/MD.0000000000041983","url":null,"abstract":"<p><p>The systemic immune-inflammation index (SII) has been used effectively to effectively assess the prognosis of patients with a variety of diseases. But few evidence on the relationship between SII and long-term prognosis of myocardial infarction. We thus aimed to evaluate the relationships of cumulative exposure to SII and its accumulation time course with major adverse cardiovascular events (MACE) events in patients with acute myocardial infarction after percutaneous coronary intervention. To evaluate the predictive value of SII in MACE events in patients with acute myocardial infarction. A total of 480 patients with acute ST-elevation myocardial infarction who underwent emergency coronary angiography at the Department of Cardiology, Affiliated Hospital of Hebei University from August 2022 to August 2023 were enrolled in this study. Eighteen patients were lost to follow-up, with a loss rate of 3.8%. Time-weighted cumulative SII was calculated as the weighted sum of the mean SII value for each time interval, then normalized by total exposure duration, the exposure duration was from hospitalization to 1-year follow-up. Duration of high SII exposure was defined as the duration with high SII and ranged from hospitalization to 1-year follow-up. The time course of SII accumulation was categorized by the combination of time-weighted cumulative SII < or ≥ median and SII slope. At 1-year follow-up, after adjusting for potential confounders, the time-weighted cumulative SII was divided into 2 groups. The S2 group which is above the median had a higher risk of MACE (hazard ratio, 1.090; 95% confidence interval 1.035-1.149), the high time-weighted cumulative SII group with a positive slope had a higher risk of MACE (hazard ratio, 4.096; 95% confidence interval 1.851-9.065). Long-term cumulative exposure to SII increases the risk of MACE in patients with acute ST-elevation myocardial infarction undergoing coronary angiography, and late high SII results in a higher risk of MACE events at the same time-weighted cumulative SII, underscoring the importance of late inflammation control.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 13","pages":"e41983"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}