Medicine最新文献

{"title":"Comparative analysis of demographic, clinical, biochemical, and predictors of mortality in COVID-19 and NON-COVID-19 ARDS patients: A retrospective cohort study.","authors":"Matheus Furlan Paulo, Alessandra Fabiane Lago, Fernando Bellíssimo-Rodrigues, João Manoel da Silva, Anibal Basile-Filho","doi":"10.1097/MD.0000000000041851","DOIUrl":"10.1097/MD.0000000000041851","url":null,"abstract":"<p><p>The COVID-19 pandemic has brought a significant increase in the incidence of acute respiratory distress syndrome (ARDS). This retrospective study aims to compare the differences in demographic, clinical, and biochemical variables and predictive factors in 2 situations of ARDS cause (COVID-19 vs NON-COVID-19) in patients admitted to the intensive care unit. The Mann-Whitney rank-sum test was performed for quantitative variables, and Fisher exact test for qualitative variables. 115 patients with ARDS were enrolled (53 patients with COVID-19 ARDS and 62 NON-COVID-19 ARDS). The COVID-19 ARDS group consisted of 33 male patients (66.2%), whereas the NON-COVID-19 ARDS group had 25 male patients (40.3%) (P = .0248). The median and interquartile age difference of the COVID-19 ARDS group was 64.0 [52.0-69.5], and non-COVID-19 ARDS was 49.0 [34.0-63.0] (P = .0011). Body mass index, simplified acute physiology score, sequential organ failure assessment, and intensive care unit length of stay, with P-values of .0061, .0002, .0003, and <.0001, respectively (COVID-19 vs NON-COVID-19 ARDS). Diabetes, arterial hypertension, venous thrombosis, and chronic obstructive pulmonary disease had values of <.0001, .0234, .0358, and .0001, respectively. On the other hand, the NON-COVID-19 ARDS group had a greater need for dialysis (P = .0109). The stepwise logistic regression showed that relevant clinical, and demographic characteristics associated with ARDS due to COVID-19, such as male gender, diabetes, chronic obstructive pulmonary disease, and body mass index, were independent prognostic factors of severity in patients with COVID-19 ARDS, compared to NON-COVID-19 ARDS. The overall mortality rate was 62.9% for COVID-19 ARDS and 77.4% for the non-COVID-19 ARDS group (P = .2950). Ventilatory parameters of COVID-19 ARDS and NON-COVID-19 ARDS were similar.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41851"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700909","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":"Time trends in disability-adjusted life years for cataracts attributable to indoor air pollution across 17 low- and middle-income countries.","authors":"Yue Yang, Justino Jose Capapelo, Yanrong Wang, Yueping Wu, Yongbin Zhu, Liping Shi, Xian Sun, Ping Chen, Jiangping Li","doi":"10.1097/MD.0000000000041914","DOIUrl":"10.1097/MD.0000000000041914","url":null,"abstract":"<p><p>Indoor air pollution (IAP) is a risk factor leading to cataracts. The disease burden of cataracts due to IAP is currently greater in low- and middle-income countries, an in-depth analysis is necessary to track the current time trend of cataracts caused by IAP in low- and middle-income countries. Our data from the global burden of disease 2021 study. In our study, disability-adjusted life years (DALYs) and DALYs rate were used to assess the disease burden of cataracts due to IAP across 17 low- and middle-income countries. The contribution of IAP exposure to the associated burden of cataracts was quantified by using population attribution fractions. Additionally, the estimated annual percentage change was calculated to quantify the long-term trend in the burden of cataracts due to IAP from 1990 to 2021. An age-period-cohort model was used to estimate the effects of age, period, and cohort on time trend of disease burden. In 2021, age-standardized DALY rates (ASDR) values varied widely across the 17 countries. Pakistan had the highest ASDR 122.5 (-35.3 to 247.4). ASDR declined in all 17 countries. For all countries, the age effect increases rapidly after about age 55. South Africa, Brazil, and Mexico have made great progress in the period and cohort effects. The situation of burden for IAP-related cataracts varies across countries, and it is necessary to set targeted public health strategies and interventions.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41914"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700967","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":"Pan-cancer analysis of PDGFRB: Laying the foundation for the development of targeted immunotherapy drugs.","authors":"Qian Gao, Yan Cui, Feng Gao, Yan Yang, Weizhong Huangfu, Minjie Wang","doi":"10.1097/MD.0000000000041797","DOIUrl":"10.1097/MD.0000000000041797","url":null,"abstract":"<p><p>PDGFRB is a type III tyrosine-protein kinase that is abnormally expressed in various cancers and can serve as a biomarker for cancer prognosis, as studies have demonstrated. However, a pan-cancer analysis of PDGFRB has not yet been carried out. The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) databases were utilized to analyze PDGFRB expression levels. Differential expression of PDGFRB in standard, tumor, and different clinical stage samples was calculated using R software (version 3.6.4). Immunohistochemical staining for Cholangiocarcinoma (CHOL) and Esophageal carcinoma (ESCA) was conducted on clinical patient samples. High-quality prognostic datasets from TCGA have been published in previous studies. Additionally, the TARGET follow-up data were obtained as supplementary information, excluding models with a follow-up period of less than 30 days. After conducting a rain analysis of PDGFRB, Kaplan-Meier and univariate Cox regression analyses were performed using the R software package. The DNA tumor stemness scores, derived from methylation signatures for each tumor, were obtained from previous studies. Finally, the infiltration of immune cells was analyzed, and the Pearson correlation between PDGFRB and five immune pathway marker genes was assessed. PDGFRB exhibited differential expression across most tumor types in TCGA, indicating a correlation with poor survival outcomes. The expression of PDGFRB influences the regulation of the immune system and is closely associated with immune cell infiltration, immune checkpoints, immune-activating genes, immune suppressor genes, chemokines, and chemokine receptors. PDGFRB is a cancer gene closely associated with prognosis and immunity in cancer patients, and it may serve as an immune checkpoint.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41797"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700609","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":"Prediction of medication nonadherence in patients with lung cancer based on nomogram model construction.","authors":"Jiuli Hu, Chanchan Hu, Yunwei Liang, Ziwei Wang, Yunfei Liang, Jiying Ma, Ying Wang","doi":"10.1097/MD.0000000000041900","DOIUrl":"10.1097/MD.0000000000041900","url":null,"abstract":"<p><p>Lung cancer is the leading cause of death among patients with cancer. Medication nonadherence affects survival time and remission of disease symptoms in patients with lung cancer. Therefore, this study analyzed the risk factors for medication nonadherence in patients with lung cancer and established a nomogram prediction model. The basic information and clinical characteristics of patients with lung cancer were collected from the Affiliated Hospital of Chengde Medical University from April 2020 to March 2023. The Chinese version of the Morisky Medication Adherence Questionnaire-8 was used to evaluate patients' medication adherence. A least absolute shrinkage and selection operator regression model and multivariate logistic regression analysis were used to identify the risk factors for medication nonadherence and establish a nomogram prediction model. The predictive ability of the nomogram was evaluated using the concordance index (C-index) and the area under the operating characteristic curve. Decision curve analysis (DCA) and the clinical impact curve were used to assess the potential clinical value of the nomogram. A total of 161 patients with lung cancer were included in this study, with a medication nonadherence rate of 47.20%. Risk factors included age, surgery, education level, bone metastases, comorbidities, well-being, and constipation. The C-index and area under the operating characteristic curve were 0.946. The threshold probability for DCA ranged from 0.07 to 0.95. The nomogram can predict the risk of medication nonadherence in patients with lung cancer and help identify those at risk early in clinical settings, allowing for the development of intervention programs and improved clinical management.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41900"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700684","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":"Exploring resistance to initial chemotherapy in small cell lung cancer: The role of bone metastasis and other clinicopathologic characteristics.","authors":"Yulong He, Xiaorong Tang, Fang Yang, Qinling Jiang, Lin Deng, Wenwang Lang","doi":"10.1097/MD.0000000000041953","DOIUrl":"10.1097/MD.0000000000041953","url":null,"abstract":"<p><p>Clinically, approximately 10% to 20% of small cell lung cancer (SCLC) patients do not respond well to initial platinum-based first-line chemotherapy. Knowledge about the clinicopathologic characteristics of these primary drug-resistant populations is limited. This study aimed to explore the clinicopathologic characteristics in SCLC populations insensitive to initial chemotherapy. This study enrolled SCLC patients with insensitivity to initial chemotherapy and analyzed their clinicopathological characteristics. Binary logistic regression analysis was used to determine the independent factors that influence chemosensitivity. The study evaluated 142 cases to determine the clinicopathologic characteristics of SCLC populations with insensitivity to initial chemotherapy. Between the chemotherapy-insensitive group (n = 32) and the chemotherapy-sensitive group (n = 110), no significant differences were observed in sex, age, smoking status, tumor size, lymph-node metastasis, vascular invasion, carcinomatous lymphangitis, mediastinal invasion, superior vena cava syndrome, tumor stage, brain metastases, pleural metastasis, lung metastasis, adrenal metastasis, or the immunohistochemical markers cytokeratin, synaptophysin, chromogranin A, thyroid transcription factor-1, and Ki-67 (all P > .05). However, significant differences in liver metastasis (P = .005), bone metastasis (P < .001), and neural cell adhesion molecule expression (P = .027) were identified. Binary logistic regression analysis revealed that bone metastasis (P = .008) was an independent high-risk factor for insensitivity to initial first-line chemotherapy. Bone metastasis is an independent high-risk factor for insensitivity to initial chemotherapy in SCLC. Enhancing our understanding of SCLC biology and osteoimmuno-oncology could identify new vulnerabilities and better define patient populations that may benefit from tailored clinical treatments to overcome drug resistance.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41953"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700869","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":"Exploring the positive association of blood lipid levels with prostate cancer risk and their relationship to pathological features in the Chinese population.","authors":"Qian Gui, Dandan Wu, Fan Xu, Yonglian Guo","doi":"10.1097/MD.0000000000041762","DOIUrl":"10.1097/MD.0000000000041762","url":null,"abstract":"<p><p>Presently, the majority of investigations into the effects blood lipids on prostate cancer (PCa) primarily involve Western populations. Our study endeavors to investigate the impact of blood lipid levels on the risk of PCa among the Chinese population and to elucidate their potential association with the pathological characteristics of PCa. This study drew data from a dataset for early warning of PCa from the China National Population Health Science Data Center, encompassing 2624 patients who had undergone prostate biopsy. We utilized binary logistic regression to assess the ability of blood lipid levels to distinguish between PCa and non-PCa, as well as to differentiate clinically significant prostate cancer (csPCa) from non-PCa. Additionally, we assessed the ability of these lipid markers to predict whether the Gleason Grade (GG) would be upgraded or downgraded following radical prostatectomy compared to the biopsy GG. Furthermore, ordered multiclass logistic regression was employed to explore the relationship between these indicators and GG. In the Chinese population, triglycerides (P = .004; OR: 1.344; 95% CI: 1.201-1.503), low-density lipoprotein cholesterol (P < .001; OR: 1.314; 95% CI: 1.200-1.439), and apolipoprotein A1 (P < .001; OR: 2.451; 95% CI: 1.714-3.504) were identified as independent risk factors for predicting PCa. Additionally, triglycerides (P = .013; OR: 1.156; 95% CI: 1.031-1.295) and apolipoprotein A1 (P < .001; OR: 2.580; 95% CI: 1.809-3.680) were found to be independent risk factors for predicting csPCa. Our study demonstrated a positive association between blood lipid levels and PCa risk in the Chinese population, highlighting the potential utility of blood lipids as biomarkers for PCa. In male individuals with a familial predisposition to PCa or other recognized risk factors for PCa, the assessment of blood lipid levels can be incorporated as an auxiliary biomarker in the routine health screening protocol.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41762"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700875","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":"Mechanistic insights into Guizhi Fuzi decoction for lumbar disc herniation: Integrating network pharmacology and bioinformatics approach.","authors":"Jiafeng Peng, Hongxing Zhang, Huaize Wang, Qianqian Meng, Danyang Li, Minglei Gao, Yingchun Li, Xingfu Ma, Li Xia, Ran Xu, Junchen Zhu","doi":"10.1097/MD.0000000000041917","DOIUrl":"10.1097/MD.0000000000041917","url":null,"abstract":"<p><p>The ancient Chinese medical texts have recorded Guizhi Fuzi decoction (GZFZT) as a therapeutic intervention for lumbar disc herniation (LDH), and its clinical efficacy has been validated in medical practice. This research endeavor is specifically designed to delve into and elucidate its precise underlying mechanisms of action, leveraging the sophisticated methodologies of network pharmacology and bioinformatics. In this study, we used the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform to extract active compounds and targets from the traditional Chinese medicine GZFZT. Subsequently, we integrated LDH disease target information from DisGeNET, GeneCards, OMIM, and GEO database. By combining this with drug-effective targets, we screened for common targets. Based on these, we conducted protein-protein interaction network analysis and performed gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses on core targets to explore LDH treatment pathways. Finally, we used molecular docking to evaluate potential targets and compounds, identifying the optimal core protein-compound complex. Our study identified 154 active compounds and 230 corresponding targets of GZFZT. Additionally, we collected a total of 1492 LDH disease targets. Topological analysis of the protein-protein interaction network for common drug-disease targets revealed 6 core targets: TNF, STAT3, MAPK1, IL6, MAPK3, and AKT1. Gene ontology enrichment analysis indicated that the mechanism of action of GZFZT is associated with inflammatory responses, apoptotic processes, and oxidative stress states. Kyoto Encyclopedia of Genes and Genomes enrichment analysis suggested that the mechanism of action of GZFZT is closely related to genes involved in the AGE-RAGE and IL-17 signaling pathways. Molecular docking results demonstrated that the selected compounds exhibit strong binding affinity to the targets, indicating their good biological activity. This study unveils novel insights into the active ingredients, targets, and signaling pathways of Guizhi Fuzi decoction in the treatment of lumbar disc herniation. Furthermore, this study suggests that the 3 bioactive components of Guizhi Fuzi decoction (naringenin, β-sitosterol, and stigmasterol) may exert their therapeutic effects on lumbar disc herniation by specifically targeting MAPK3.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41917"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700930","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":"Oxidative stress biomarkers of neonates in Saudi population: An observational study.","authors":"Sobhy M Yakout, Malak A AlSubhi, Syed D Hussain, Abdullah M Alnaami, Abir A Alamro, Nasser M Al-Daghri","doi":"10.1097/MD.0000000000041926","DOIUrl":"10.1097/MD.0000000000041926","url":null,"abstract":"<p><p>Oxidative stress results from an imbalance between free radical production and antioxidant defense, significantly impacting neonatal health, particularly in preterm infants with immature antioxidant systems. This study aims to assess oxidative stress in Saudi neonates by measuring key antioxidants, both enzymatic (superoxide dismutase, catalase, glutathione peroxidase) and nonenzymatic (glutathione, bilirubin, uric acid), and comparing them across sex (male vs female) and term status (full term vs preterm). A total of 110 Saudi neonates (55 normal neonates and 55 preterm neonates; 52 females and 58 males) were included in this study. The gestational age of preterm neonates ranged from 28 to 36 weeks, with a mean of 32 weeks. Serum samples were retrieved from the chair for biomarkers of chronic diseases BioBank. Ethical approval was obtained from the College of Medicine, King Saud University. GSH levels were higher in preterm neonates compared to normal neonates (16.4 vs 11.0 µmol/L, P < .001), and uric acid levels were higher in normal neonates compared to preterm neonates (246.2 vs 206.2 µmol/L, P < .015). SOD1 levels were higher in preterm neonates compared to normal neonates (291.5 vs 225.4 ng/mL, P < .040). In terms of both term and sex of neonates, GSH levels were higher in preterm female neonates compared to normal female neonates (16.8 vs 13.8 µmol/L, P < .054), and in preterm male neonates compared to normal male neonates (16.4 vs 9.2 µmol/L, P < .001). SOD1 levels were higher in preterm male neonates compared to normal male neonates (300.1 vs 198.8 ng/mL, P < .038), and uric acid levels were higher in normal male neonates compared to preterm male neonates (243.9 vs 200.1 µmol/L, P < .011). GPx-1 levels were higher in preterm neonates compared to normal neonates (14.6 vs 7.9 ng/mL, P < .006). There are no differences in antioxidant parameters between female and male neonates. However, some antioxidants differ between preterm and normal neonates. The comparison according to both sex and term status also showed differences in some antioxidant parameters.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41926"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699591","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":"Impact of hypoxia on the hippocampus: A review.","authors":"Guan Lu, Ge Rili, Ma Shuang","doi":"10.1097/MD.0000000000041479","DOIUrl":"10.1097/MD.0000000000041479","url":null,"abstract":"<p><p>Oxygen is the most abundant chemical substance and is a basic material for human activities. A decline in oxygen concentration affects many physiological processes in the body, leading to pathological changes and even the occurrence of diseases. Therefore, an increasing number of studies have focused on the pathological state of hypoxia. The hippocampus is the most sensitive tissue to oxygen in the brain. The reduction in oxygen concentration affects the morphology and functioning of the hippocampus, including a decline in learning and memory, immunity, and energy metabolism, causing great problems to people's physical and mental health. To keep people healthy in hypoxic environments, adapt to hypoxic environments, and avoid diseases, it is necessary to review the morphology and function of the hippocampus, as well as the effect of oxygen on the hippocampus.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41479"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700898","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 efficacy of intravascular ultrasound and fractional flow reserve in guiding percutaneous coronary intervention.","authors":"Huiting Wu, Xingan Wu, Wen Yu, Han Wang, Baozhen Tan, Liang Hou, Jilin Xu","doi":"10.1097/MD.0000000000041743","DOIUrl":"10.1097/MD.0000000000041743","url":null,"abstract":"<p><p>This study aimed to compare the postoperative function of patients with critical coronary artery lesions undergoing intervention guided by intravascular ultrasound (IVUS) vs those guided by fractional flow reserve (FFR). A total of 226 patients (293 lesions) with coronary angiography-confirmed stenosis of 40% to 70% were enrolled and divided into 3 groups: the IVUS-guided group (98 lesions), the FFR-guided group (101 lesions), and the medical treatment group (94 lesions). In the IVUS-guided group, coronary stent implantation was performed if the minimum lumen area at the stenosis was < 4 mm2. In the FFR-guided group, intervention was performed if FFR < 0.8. Patients were followed for 1-year postoperatively, and the incidence of major adverse cardiovascular events (MACE), including death, myocardial infarction, and target vessel revascularization, was compared among the 3 groups. There were no significant differences in the degree of stenosis or lesion length among the 3 groups as determined by coronary angiography. The proportion of patients undergoing coronary intervention was significantly higher in the IVUS-guided group compared to the FFR-guided group (P < .001). However, there was no significant difference in the incidence of MACE among the 3 groups (P = .182). This study found no significant difference in MACE between the 3 guidance strategies - IVUS, FFR, and angiography - in patients with intermediate coronary lesions undergoing PCI. These findings suggest that, in this patient population, the choice of guidance method may not impact MACE outcome.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 12","pages":"e41743"},"PeriodicalIF":1.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700923","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}