Vascular Health and Risk Management最新文献

{"title":"Nasal versus Buccal Breathing and Non-Invasive Indices of Vascular Function in Healthy Young Adults: An Observational Crossover Study.","authors":"Thyl Snoeck, Frédéric Paillaugue, Steven Provyn","doi":"10.2147/VHRM.S570629","DOIUrl":"https://doi.org/10.2147/VHRM.S570629","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effects of nasal versus buccal breathing on non-invasive indices of vascular function under standardized resting conditions.</p><p><strong>Methods: </strong>This observational crossover study included 45 young healthy Caucasian male volunteers (mean age 21.3 ± 2.3 years). Each participant completed two breathing protocols: nasal breathing (NB) and buccal breathing (BB), in randomized order, separated by a washout period. Vascular responses were assessed using several non-invasive methods: Digital Plethysmography (DP) and UltraSound Flow-Mediated Dilation (US-FMD). Pulse Propagation Time (PPT) and Reflection Index (RI) were derived from DP, while brachial artery diameter was measured with US-FMD at rest and following each breathing condition.</p><p><strong>Results: </strong>Nasal breathing significantly increased PPT (6.35% ± 1.51) and reduced RI (4.6% ± 1.25) compared with buccal breathing, indicating changes consistent with increased vascular relaxation (p < 0.05). Ultrasound assessment demonstrated a significant increase in brachial artery diameter (4.46% ± 0.05) during nasal breathing (p < 0.001), an effect absent during buccal breathing. These findings indicate that nasal breathing is associated with enhanced vasodilation and differences in non-invasive vascular indices compared with buccal breathing.</p><p><strong>Conclusion: </strong>In healthy young adults, nasal and buccal breathing were associated with distinct patterns in non-invasive indices of vascular function. These findings highlight the physiological relevance of breathing route under resting conditions and warrant further investigation.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"570629"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Remnant Cholesterol with Obstructive Sleep Apnea and Coronary Heart Disease: A Cross-Sectional Study.","authors":"Tiantian Wen, Bo He, Miaomiao Ma, Liqun Ma","doi":"10.2147/VHRM.S601153","DOIUrl":"https://doi.org/10.2147/VHRM.S601153","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a significant risk factor for coronary heart disease (CHD), yet the precise pathophysiological mechanisms linking them remain incompletely understood. Remnant cholesterol (RC), as an atherogenic lipoprotein, is considered a key driver of residual cardiovascular risk. However, evidence regarding the role of RC in the association between OSA and CHD is still lacking.</p><p><strong>Methods: </strong>In this single-center, cross-sectional study, we enrolled 368 consecutive patients with suspected coronary heart disease (CHD). All participants underwent overnight polysomnography (PSG) and were categorized into none/mild or moderate/severe obstructive sleep apnea (OSA) groups based on the apnea-hypopnea index (AHI). Coronary artery disease was assessed via angiography or computed tomography angiography (CTA), and its severity was quantified by the number of diseased vessels.</p><p><strong>Results: </strong>Compared to the none/mild OSA group, patients with moderate/severe OSA had a significantly higher prevalence of CHD (73.0% vs. 15.2%, p<0.001) and a greater proportion of multi-vessel disease (p<0.001). AHI was strongly positively correlated with the number of diseased vessels (overall population r=0.612, p<0.001). Multiple Linear Regression identified AHI as an independent determinant of the number of diseased vessels (β=0.804, p<0.001). Logistic regression confirmed that the number of diseased vessels was an independent risk factor for moderate/severe OSA (OR=3.575, p<0.001). While remnant cholesterol was not significantly correlated with AHI in the overall population (r=-0.051, p=0.327), it showed weak negative correlations with the number of diseased vessels in males (r=-0.120, p=0.036) and in the moderate/severe OSA subgroup (r=-0.130, p=0.035), which may be influenced by residual confounding factors.</p><p><strong>Conclusion: </strong>This study demonstrates a strong and significant independent association between OSA severity and the presence and severity of CHD. Although remnant cholesterol showed no global association with OSA severity, its weak inverse correlation with coronary disease in males and severe OSA patients suggests a potential complex role, warranting further investigation into its mechanisms within specific populations.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"601153"},"PeriodicalIF":2.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Double Trouble\": Ultra-Early Formation and Rupture of a De Novo Terminal Basilar Artery Aneurysm After Aneurysmal Subarachnoid Hemorrhage.","authors":"Ying Wang, Fenghua Chen, Hua Chen, Longbo Zhang","doi":"10.2147/VHRM.S582055","DOIUrl":"https://doi.org/10.2147/VHRM.S582055","url":null,"abstract":"<p><strong>Introduction: </strong>The formation of de novo intracranial aneurysms (DNIAs) often occurs months or years after the initial identification of an intracranial aneurysm. Consensus on surveillance after surgery remains elusive.</p><p><strong>Case presentation: </strong>A 53-year-old woman presented with a recurrent subarachnoid hemorrhage (SAH) caused by a rapidly expanding de novo basilar tip aneurysm, which developed and ruptured within 6 days of a previous SAH due to the rupture of a posterior communicating artery aneurysm. Both SAH incidents were successfully treated with microsurgical clipping. A computed tomography angiography at a 1-year follow-up did not detect any DNIAs.</p><p><strong>Conclusion: </strong>DNIAs can form within days after primary surgery. Therefore, conducting early postoperative angiography is crucial to detect and manage DNIAs and prevent SAH, especially in high-risk cases. In addition, since DNIAs are more prone to rupture, early clinical intervention is recommended.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"582055"},"PeriodicalIF":2.8,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biochemical Alterations Related to Vascular Injury in Smokers: Evidence from Nitric Oxide, Malondialdehyde, Nicotinic Acetylcholine Receptors, and Cotinine.","authors":"Kumboyono Kumboyono, Indah Nur Chomsy, Cholid Tri Tjahjono, Yuliana Ratna Kumala, Titin Andri Wihastuti","doi":"10.2147/VHRM.S589069","DOIUrl":"https://doi.org/10.2147/VHRM.S589069","url":null,"abstract":"<p><strong>Purpose: </strong>To examine simultaneous alterations in nitric oxide (NO), malondialdehyde (MDA), nicotinic acetylcholine receptors (nAChRs), and cotinine levels in smokers compared with non-smokers, and to clarify early mechanistic pathways linking tobacco exposure with vascular-related and oxidative stress.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted among 200 adults (100 smokers, 100 non-smokers) meeting predefined eligibility criteria and free from major cardiometabolic disease. Venous blood samples were analyzed for NO, MDA, nAChRs, and cotinine using standardized ELISA methods. Anthropometric and hemodynamic measurements were obtained using validated procedures. Group differences were assessed using independent <i>t</i>-tests and chi-square tests. Correlations were evaluated using Pearson or Spearman coefficients. Multivariable linear regression models adjusted for age, BMI, systolic and diastolic blood pressure to determine the independent association of smoking with biomarker profiles.</p><p><strong>Results: </strong>Smokers demonstrated significantly lower NO levels (70.22 ± 9.54 vs 198.27 ± 13.85 µmol/L; p < 0.001) and markedly higher concentrations of MDA (39.48 ± 4.54 vs 19.72 ± 5.32 nmol/mL; p < 0.001), nAChRs (20.19 ± 3.25 vs 12.05 ± 2.13 ng/mL; p < 0.001), and cotinine (61.07 ± 8.84 vs 4.99 ± 1.95 pg/mL; p < 0.001). After adjustment, smoking remained a strong independent predictor of reduced NO (β = -128.29; p < 0.001) and elevated MDA (β = 19.89; p < 0.001), nAChRs (β = 8.03; p < 0.001), and cotinine (β = 55.50; p < 0.001). These findings indicate persistent oxidative, nitrosative, and receptor-mediated biochemical disturbances associated with smoking, irrespective of baseline physiological differences.</p><p><strong>Conclusion: </strong>Smokers exhibit a distinct biochemical pattern characterized by reduced NO bioavailability, heightened oxidative stress, increased nAChR activation, and elevated cotinine levels. These alterations reflect early vascular-related biochemical disturbances associated with smoking and support the utility of these biomarkers for early cardiovascular risk detection.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"589069"},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taoren Honghua Jian Regulate NLRP3 Inflammasome of Coronary Artery Disease Patients: A Multi-Center, Double-Blind, Randomized Controlled Trial.","authors":"Min Du, Xiaoteng Feng, Na Zhang, Meijiao Mao, Leyi Du, Ying Yang, Yifan Zhang, Sijin Li, Jiarou Wang, Xindi Chang, Jie Ding, Ping Liu, Yiyi Zhang, Yiru Wang","doi":"10.2147/VHRM.S569054","DOIUrl":"10.2147/VHRM.S569054","url":null,"abstract":"<p><strong>Objective: </strong>This multicenter, double-blind, randomized controlled trial sought to assess the clinical efficacy of Taoren Honghua Jian (THJ) in patients with coronary artery disease (CAD) exhibiting Qi stagnation and blood stasis syndrome, and investigated its effect on NLRP3 inflammasome expression in peripheral blood mononuclear cells (PBMCs).</p><p><strong>Methods: </strong>One hundred and twenty eligible CAD patients from three Shanghai hospitals were randomized to receive either the THJ granule (18.3 g, twice daily) or placebo for four weeks, with a four-week follow-up. Traditional Chinese Medicine Syndrome Score (TCMSS), Seattle Angina Questionnaire (SAQ), and lipid levels were measured before and after treatments. NLRP3 inflammasome components were examined in PBMCs using quantitative PCR, whereas plasma inflammatory cytokines were detected using ELISA.</p><p><strong>Results: </strong>A total of 120 participants participated in the trial. The THJ group showed reduced TCMSS compared to the placebo group (<i>P</i> < 0.01). After four weeks of intervention, the THJ group scored considerably higher on five SAQ aspects compared to the placebo group (<i>P</i> < 0.01). However, lipid levels showed no significance. In PBMCs, THJ lowered mRNA expression of NLRP3 inflammasome components (NLRP3, ASC, caspase-1, IL-1β, IL-18) (<i>P</i> < 0.01). Patients in the THJ group showed significantly lower plasma levels of IL-1β, IL-2, and IL-18 following therapy compared to the placebo group (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>THJ reduces angina symptoms and improves quality of life in CAD patients, which suggests that it suppresses NLRP3-related transcriptional activity and hence reduces pro-inflammatory cytokine production. These data suggest that THJ might be an effective adjuvant treatment for inflammation-driven coronary atherosclerosis.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"569054"},"PeriodicalIF":2.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and Validation of a Risk Prediction Model for Postoperative Lower Extremity Deep Vein Thrombosis in Patients with Vascular Access Devices: A Retrospective Analysis.","authors":"Yan Sun, Mi'ou Luo","doi":"10.2147/VHRM.S581063","DOIUrl":"https://doi.org/10.2147/VHRM.S581063","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative patients with indwelling vascular access devices (VADs) face a high risk of lower extremity deep vein thrombosis (DVT). This study sought to develop a VAD-specific DVT risk prediction model and verify the efficacy of a targeted three-phase VAD management system.</p><p><strong>Methods: </strong>A retrospective cohort study enrolled 156 postoperative VAD users (August 2023-August 2024), equally assigned to a conventional nursing group and an access management group. Clinical data were collected, and variables were screened via clinical relevance and univariate logistic regression (P<0.05), followed by multivariate logistic regression to build the prediction model. The model's performance was validated using ROC curves, Hosmer-Lemeshow test, and Brier score, with 5-fold cross-validation for stability. The three-phase system included pre-infusion VAD optimization, intra-infusion targeted monitoring, and post-infusion risk stratification with DVT screening.</p><p><strong>Results: </strong>Central venous catheter (CVC) use (OR=2.92, P=0.005) and prior thrombosis history (OR=3.61, P=0.002) were identified as independent predictors. The model exhibited good discriminative ability (AUC=0.83, 95% CI: 0.76-0.90) and stability (average AUC=0.81±0.03). DVT incidence showed a significant risk gradient (1.85% vs.6.94% vs.16.67%, P=0.013). The access management group had significantly lower VAD-related complications and DVT incidence, with higher DVT prevention effectiveness and cognitive scores (all P<0.05).</p><p><strong>Conclusion: </strong>The VAD-specific DVT risk prediction model achieves effective risk stratification for postoperative VAD users, and the three-phase management system markedly reduces VAD-related complications and lower extremity DVT incidence. This integrated strategy bridges the gap between VAD care and DVT prevention, providing actionable clinical guidance to enhance postoperative VAD use safety with evidence-based support.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"581063"},"PeriodicalIF":2.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Metabolic Scores for Visceral Fat and Arterial Stiffness.","authors":"Fang Liu, Beijia Lin, Wenhui Huang, Yangfan Hu, Ziheng Wu, Guoyan Xu, Liangdi Xie, Tingjun Wang","doi":"10.2147/VHRM.S588273","DOIUrl":"10.2147/VHRM.S588273","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the relationship between arterial stiffness and metabolic syndrome-related visceral fat index (METS-VF), a composite formula that inherently includes age, metabolic parameters, and visceral fat.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between January 2019 and December 2023, enrolling participants from Health Examination Center, and Departments of General Practice and Geriatrics at the First Affiliated Hospital of Fujian Medical University. Arterial stiffness was defined as carotid-femoral pulse wave velocity (cfPWV) of ≥ 10 m/s. METS-VF was calculated based on metabolic score for insulin resistance (METS-IR), waist-to-height ratio (WHtR), age, and gender. Participants were categorized into quartiles (Q1-Q4) according to their METS-VF values. The associations between METS-VF and arterial stiffness were evaluated using linear regression analysis, logistic regression models, stratified analyses, receiver operating characteristic (ROC) curve analysis, and restricted cubic splines (RCS) to identify potential non-linear associations.</p><p><strong>Results: </strong>A total of 3782 participants, with a mean age of 59.42 ± 11.89 years and 62.96% male, were included in this study. There was a trend of increasing arterial stiffness from lower to higher METS-VF quartile (Q1 to Q4: 19.98%, 28.68%, 37.99%, 49.37%, <i>χ</i> ² = 201.04, <i>P</i> < 0.001). Linear regression analysis showed an independent association between METS-VF with cfPWV (<i>β</i> = 0.19, 95% CI 0.03 ~ 0.35). In the fully adjusted model, compared with Q1, the participants in Q4 (OR= 1.38, 95% CI 1.06 ~ 1.79, <i>P</i> =0.016) exhibited an increase in arterial stiffness. RCS analysis revealed a non-linear association between METS-VF and arterial stiffness. ROC curve analysis demonstrated that METS-VF had superior discriminative ability for arterial stiffness compared with body mass index (BMI) and WHtR (<i>P</i> < 0.001). Similar results were observed in subgroup analyses.</p><p><strong>Conclusion: </strong>METS-VF is independently and positively associated with arterial stiffness. Its discriminative performance is superior to traditional anthropometric indices, though causality requires further investigation.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"588273"},"PeriodicalIF":2.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic-Guided Therapy is Associated with Better Hypertension Control Compared with Standard Care: A Comparative Clinical Analysis.","authors":"Yasser Nassef, Hsiao-En Tsai, Kuei-Chuan Chan, Shun-Fa Yang, Yih-Sharng Chen","doi":"10.2147/VHRM.S587746","DOIUrl":"10.2147/VHRM.S587746","url":null,"abstract":"<p><strong>Background: </strong>Blood pressure abnormalities are common in patients with heart-related conditions and substantially increase morbidity and mortality. This retrospective comparative study evaluated the value of a hemodynamic-guided therapy (HGT) intervention on systolic and diastolic blood pressure (SBP, DBP) compared with standard care.</p><p><strong>Methods: </strong>We retrospectively analyzed 156 patients with cardiovascular disease (HGT, n = 107; control, n = 49). SBP and DBP were measured at baseline and after treatment using standardized noninvasive hemodynamic monitoring. Hemodynamic parameters (including cardiac output, systemic vascular resistance, and total body fluids were used to guide medication selection and titration in the HGT group. Normality of paired difference scores was assessed with the Shapiro-Wilk test, and within‑group comparisons were performed with paired t‑tests. Categorical comparisons used chi‑square tests. Statistical significance was set at two‑sided p < 0.05.</p><p><strong>Results: </strong>Post‑treatment assessments showed significant reductions in both SBP and DBP in the HGT group but not in the control group. Among women receiving HGT, the mean post‑treatment SBP was 133.8 mmHg (baseline to post-treatment change, p < 0.001); among men receiving HGT, the mean post‑treatment SBP was 131.6 mmHg versus 150.5 mmHg at baseline (p < 0.001). DBP in women receiving HGT decreased to a mean of 74.2 mmHg, and in men to 74.7 mmHg from 85.5 mmHg at baseline (both p < 0.001). No significant SBP or DBP changes were observed in the control arm.</p><p><strong>Conclusion: </strong>In this retrospective analysis, hemodynamic‑guided therapy was associated with significant improvements in systolic and diastolic blood pressure compared with standard care. Using individualized hemodynamic profiles to guide medication selection and dosing may improve blood pressure control in patients with hypertension and cardiovascular comorbidities; prospective studies are warranted to confirm these findings.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"587746"},"PeriodicalIF":2.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Body Mass Index to High-Density Lipoprotein Cholesterol (BMI/HDL-C) Ratio in Predicting Coronary Artery Disease: A Multicenter Study.","authors":"Himayat Ullah, Sarwat Huma, Nafisa Tahir, Muhammad Ashraf, Qazi Tahirud Din, Mohammed Yunus, Bhaskar J Paul, Hossam Aladl Aladl Aladl, Hazem Sayed Ahmed Ayoub, Osama Safwat Hamed Ali, Mohammad Mossaad Alsayyad, Hesham El Sayed Lashin, Tamer Ahmed Fouad, Mahmoud Ezzat Abdelraouf, Ahmed Ahmed Mohamed Abotaha, Ali Hosni Farahat, Abdulrahman H Shalaby, Mostafa Haseeb El-Mahalawy, Omar Hassan El Metwally Hassan, Mostafa Ahmed Sabrh, Ahmed M Saba, Reda Fakhry Mohamed Elmezain, Magdy Ahmed Mohamed Mekheimar, Waleed Saber Abd Elnasser, Ahmed Mahrous Ahmed Ibrahim, Ahmed Mohamed Ewis Alhawy, Ahmed Ali Hassan Ali, Hani Abdelshafook Khalaf, Ibrahim Faragallah Said, Mohamed El Saeed Mohamed Habila, Ayman E Fayk, Arafat Kassem, Hossam Shabana","doi":"10.2147/VHRM.S582068","DOIUrl":"https://doi.org/10.2147/VHRM.S582068","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study is to search for simple, widely available markers that combine adiposity and lipoprotein status to improve coronary artery disease (CAD) risk discrimination. For this, we evaluated whether the body mass index to high-density lipoprotein cholesterol ratio (BMI/HDL-C) discriminates angiographically confirmed CAD better than BMI or HDL-C alone.</p><p><strong>Patients and methods: </strong>In this multicenter observational study, we enrolled 834 adults undergoing coronary angiography at three tertiary centers. CAD was defined as ≥50% stenosis in ≥1 major coronary artery and its branches. BMI and fasting HDL-C were measured on admission; BMI/HDL-C was calculated. We assessed associations using Spearman correlation, logistic regression, receiver operating characteristic (ROC) analysis, and Area under the curve (AUC).</p><p><strong>Results: </strong>Mean age was 58.5 ± 11.9 years; 53.7% were male; 440 had CAD. BMI/HDL-C correlated most strongly with CAD (rho = 0.68) versus HDL-C (rho = -0.65) and BMI (rho = 0.142). In logistic regression (after adjusting for Diabetes Mellitus, Hypertension, dyslipidemia, and smoking), a one-unit increase in the HDL-C was associated with a 26.2% reduction in the odds of CAD, while a 6.4% and 55.2% increase in the odds of CAD was noted with a one-unit increase in the BMI and BMI/HDL ratio, respectively. ROC analysis showed superior discrimination for BMI/HDL-C (AUC 0.892; 95% CI 0.870-0.913) compared with HDL-C (AUC 0.875; 95% CI 0.849-0.901) and BMI (AUC 0.582; 95% CI 0.543-0.621). An optimal BMI/HDL-C cutoff of 19.7 achieved 100% sensitivity and 83.5% specificity. AUC differences were statistically significant (p < 0.001).</p><p><strong>Conclusion: </strong>In conclusion, the BMI/HDL-C ratio demonstrated superior discriminatory ability for angiographically defined CAD compared to BMI or HDL-C alone, suggesting its potential as a simple and clinically useful marker, although further validation in prospective studies is warranted.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"582068"},"PeriodicalIF":2.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal Early Discharge Protocol for Acute Myocardial Infarction: A Single-Center Prospective Validation.","authors":"Dávid Bauer, Vojtech Berka, Marek Neuberg, Denisa Odvodyová, Ivana Maliničová, Silvie Lašmanská, Simona Smitalová, Petr Mašek, Viktor Kočka, Zuzana Moťovská, Martin Kozel, Karolína Bartošková, Petr Toušek","doi":"10.2147/VHRM.S581820","DOIUrl":"https://doi.org/10.2147/VHRM.S581820","url":null,"abstract":"<p><strong>Background and aims: </strong>Selected low-risk myocardial infarction (MI) patients may be safely discharged within 72 hours. The aim was to prospectively validate a previously created protocol for selecting low-risk MI patients and to assess their safety.</p><p><strong>Methods: </strong>We have previously proposed an early discharge protocol (EDP) for selecting low-risk acute coronary syndrome patients. We implemented EDP in July 2021 and selected patients were discharged within 72 hours. Survival was verified by the National Office of Health and Statistical Information. Finally, we compared all low-risk MI patients prior to (October 2018 to July 2021, Group A) and after (July 2021 to October 2023, Group B) EDP implementation in terms of length of hospital stay and financial costs.</p><p><strong>Results: </strong>From July 2021 to September 2024, we selected 101 low-risk MI patients treated by percutaneous coronary intervention. There were 41.6% STEMI (n = 42). We report 100% survival at 30 days. Only a single death occurred in an average follow-up of 1.9 years (± 0.9). Discharge within 3 days was more often after EDP implementation, with the mean hospital stay of 4.7 days (95% CI = 4.4 to 4.9) and 4.2 days (95% CI = 4.0 to 4.4) in Group A and Group B, respectively, p = 0.053. Department-associated healthcare costs decreased from 2,105.4 euros (95% CI = 1,922.6 to 2,288.3) in Group A to 1,557.9 euros (95% CI = 1,428.5 to 1,946.1) in Group B, p = 0.016.</p><p><strong>Conclusion: </strong>Implementation of a simple, universal protocol for selecting low-risk MI patients is feasible, represents excellent mid-term safety, and is associated with a decrease in healthcare-associated costs during index hospitalization.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"581820"},"PeriodicalIF":2.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}