International Journal of Cardiology Cardiovascular Risk and Prevention最新文献

{"title":"Cardiovascular disease risk assessment, exercise training, and management of complications in patients with chronic kidney disease","authors":"Francesco Perone ,&nbsp;Marco Bernardi ,&nbsp;Monica Loguercio ,&nbsp;Francesca Jacoangeli ,&nbsp;Silvia Velardi ,&nbsp;Theodora Metsovitis ,&nbsp;Federica Ramondino ,&nbsp;Matteo Ruzzolini ,&nbsp;Marco Ambrosetti","doi":"10.1016/j.ijcrp.2025.200386","DOIUrl":"10.1016/j.ijcrp.2025.200386","url":null,"abstract":"<div><div>Patients with chronic kidney disease are at high and very high risk of cardiovascular disease. As estimated glomerular filtration rate declines, the incidence and severity of risk factors, complications, and atherosclerotic cardiovascular events increase. In this scenario, tailored assessment is the key to evaluate the severity of chronic kidney disease and estimate cardiovascular disease risk. Personalized stratification differentiates patients with chronic kidney disease without diabetes mellitus or established atherosclerotic cardiovascular disease in their management and beneficial treatment. Exercise intensity assessment and prescription is suggested to propose specific and safe recommendations for physical activity, training, and cardiac rehabilitation. Programs are based on a combination of endurance and resistance exercise and should be adapted to very high risk chronic kidney disease and haemodialysis patients and after kidney transplantation. Appropriate management of cardiovascular complications in these patients, such as risk factors, heart failure, arrhythmias, and coronary artery disease, is essential to ensure the best treatment and improve the prognosis. Therefore, we propose a critical and comprehensive review to suggest how to manage patients with chronic kidney disease in clinical practice and, specifically, with regard to cardiovascular risk assessment, exercise training prescription, and management of complications.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"25 ","pages":"Article 200386"},"PeriodicalIF":1.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipid-lowering prescription patterns after a non-fatal acute coronary syndrome: A retrospective cohort study","authors":"Cristina Gavina ,&nbsp;Daniel Seabra Carvalho ,&nbsp;Marta Afonso-Silva ,&nbsp;Inês Costa ,&nbsp;Ana Sofia Freitas ,&nbsp;Mariana Canelas-Pais ,&nbsp;Nuno Lourenço-Silva ,&nbsp;Tiago Taveira-Gomes ,&nbsp;Francisco Araújo","doi":"10.1016/j.ijcrp.2025.200385","DOIUrl":"10.1016/j.ijcrp.2025.200385","url":null,"abstract":"<div><h3>Background</h3><div>After an acute atherosclerotic cardiovascular event, high-intensity lipid-lowering therapy (LLT) is needed to reduce recurrence risk. This study aimed to describe LLT prescription patterns and LDL-C levels change after non-fatal acute coronary syndrome (ACS) events and to determine if the recommended goals for LDL-C levels were achieved.</div></div><div><h3>Methods</h3><div>Retrospective cohort study using electronic health records (EHR) of Unidade Local de Saúde de Matosinhos between 2015 and 2023. Participants were adults aged 40–80 years, with a non-fatal ACS hospitalization between 2016 and 2022 (index date); ≥1 general practice appointment in the three years before ACS; and one-year follow-up post-ACS. Sub-analyses focused on gender, age (&lt;and ≥65 years), and whether patients met LDL-C control (55 mg/dL) at one-year post-ACS.</div></div><div><h3>Results</h3><div>Of 544 patients, 270 (49.6 %) were under 65 years, and 164 (30.1 %) were females. Before the ACS, 71.1 % of men and 56.7 % of women had no previous LLT prescription and younger patients showed poorer LDL-C control (132(IQR 64)mg/dL) than older patients (102(IQR 50)mg/dL). One-year post-ACS, only 11.3 % of males and 8.5 % of females met LDL-C target. The proportion of patients without LLT decreased from 66.7 % at baseline to 13.6 % post-ACS. High-intensity LLT prescriptions increased from 2.4 % to 16.5 %, while moderate-intensity LLT remained predominant (65.8 %). Still, 89.5 % of patients had uncontrolled LDL-C levels.</div></div><div><h3>Conclusion</h3><div>Despite initiating/intensifying LLT, one year after ACS most patients did not achieve LDL-C goals. This indicates a significant gap in guideline implementation in clinical practice.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"25 ","pages":"Article 200385"},"PeriodicalIF":1.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580118","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":"Digital self-assessment: A new and innovative way for identifying cardiovascular risks","authors":"John Patrick C. Toledo","doi":"10.1016/j.ijcrp.2025.200380","DOIUrl":"10.1016/j.ijcrp.2025.200380","url":null,"abstract":"","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"25 ","pages":"Article 200380"},"PeriodicalIF":1.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580119","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":"Exploring sex-based differences in patient outcomes: A secondary analysis of Heartwatch, an Irish cardiovascular secondary prevention programme","authors":"Ivana Keenan ,&nbsp;Fintan Stanley ,&nbsp;Robyn Homeniuk ,&nbsp;Joseph Gallagher ,&nbsp;Michael O'Callaghan ,&nbsp;Claire Collins","doi":"10.1016/j.ijcrp.2025.200376","DOIUrl":"10.1016/j.ijcrp.2025.200376","url":null,"abstract":"<div><h3>Background</h3><div>In the last two decades, sex-related differences regarding cardiovascular diagnosis, treatment, and risk factors management have been reported. The current study aims to explore differences in cardiovascular outcomes among male and female patients attending the Irish secondary cardiovascular prevention programme - Heartwatch.</div></div><div><h3>Methods</h3><div>This is a retrospective observational study. Anonymous data was extracted from the Heartwatch database from 2003 to 2017. Cardiovascular risk factors were analysed at sign-up and at four years follow-ups. An 8-point aggregate risk score (CCare Score) was assessed to calculate targeted outcomes. Generalized estimating equations models were applied for data analysis.</div></div><div><h3>Results</h3><div>In total 8893 patients (77 % male) were included. Females exhibited a higher risk profile across all cardiovascular risk factors and were more likely to be off target than males at baseline and after 4 years of programme attendance [M to F odds ratios(95 % CI); systolic blood pressure: 1.35 (1.21–1.49), waist circumference: 2.11(1.89–2.36), physical activity: 1.72 (1.53–1.95)]. CCare scores also demonstrated the gap between male and female patients at baseline [mean(sd); M: 5.1(1.2), F: 4.8(1.2)] and after 4 years of structured care [mean(sd); M: 5.3(1.2), F: 4.9(1.2)]. Female patients were less likely to be prescribed aspirin and ACE inhibitors but more likely to be prescribed AT2 inhibitors, calcium channel blockers, and diuretics compared to male patients.</div></div><div><h3>Conclusions</h3><div>The Heartwatch programme has demonstrably improved patient care, however, the continuous underperformance of female patients necessitates further investigation to ensure appropriate and equitable secondary CVD prevention among the Irish population.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"24 ","pages":"Article 200376"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510405","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":"Temporal trends and disparities in mortality from hypertensive heart disease with heart failure: A nationwide analysis (1999–2020)","authors":"Aman Goyal ,&nbsp;Humza Saeed ,&nbsp;Ajeet Singh ,&nbsp;Abdullah ,&nbsp;Wania Sultan ,&nbsp;Zubair Amin ,&nbsp;Hritvik Jain ,&nbsp;Zainali Chunawala ,&nbsp;Mohamed Daoud ,&nbsp;Sourbha S. Dani","doi":"10.1016/j.ijcrp.2025.200378","DOIUrl":"10.1016/j.ijcrp.2025.200378","url":null,"abstract":"<div><h3>Introduction</h3><div>By 2019, nearly 20 million people worldwide had hypertensive heart disease (HHD), resulting in over 1.1 million deaths and 21.5 million disability-adjusted life years (DALYs). Hypertension is a significant factor in heart failure (HF), contributing to about a quarter of cases, increasing to 68 % in older adults. This study examines mortality trends among patients in the United States (US) affected by HHD and HF.</div></div><div><h3>Methodology</h3><div>This study used Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data from 1999 to 2020 to analyze deaths in the United States among adults aged 25 and older from HHD and (congestive) HF (ICD-10 code I11.0). Age-adjusted mortality rates (AAMRs) and annual percent change (APC) were calculated by year, sex, age groups, race/ethnicity, geographics, and urbanization status.</div></div><div><h3>Results</h3><div>Between 1999 and 2020, AAMRs increased from 3.7 to 13.5 per 100,000 population, with a steep increase from 2014 to 2020 (APC: 14.44; 95 % CI: 11.12 to 20.62). Men had slightly higher AAMRs than women (6.3 vs. 6.1). Additionally, AAMRs were highest among non-Hispanic (NH) Black individuals. Non-metropolitan areas had higher AAMRs than metropolitan areas (6.6 vs 6.2). The average AAMR during the COVID-19 pandemic (2020–2022) was nearly three times the pre-pandemic average (1999–2019).</div></div><div><h3>Conclusions</h3><div>Mortality from combined HHD and HF has risen since 1999, with higher rates among men, NH Black individuals, and those in non-metropolitan areas. Policy changes are needed to address these disparities and enhance healthcare equity.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"24 ","pages":"Article 200378"},"PeriodicalIF":1.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452991","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":"Trends and regional variations in chronic ischemic heart disease and lung cancer-related mortality among American adults: Insights from retrospective CDC wonder analysis","authors":"Eman Ali ,&nbsp;Hafsah Alim Ur Rahman ,&nbsp;Usama Hussain Kamal ,&nbsp;Muhammad Ahmed Ali Fahim ,&nbsp;Madiha Salman ,&nbsp;Afia Salman ,&nbsp;Hamza Nawaz Khan ,&nbsp;Farah Yasmin ,&nbsp;Chmsalddin Alkhas ,&nbsp;Afsana Ansari Shaik ,&nbsp;Muhammad Sohaib Asghar ,&nbsp;M. Chadi Alraies","doi":"10.1016/j.ijcrp.2025.200377","DOIUrl":"10.1016/j.ijcrp.2025.200377","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer remains the leading cause of cancer-related mortality in the United States and shares cardiovascular risk factors with chronic ischemic heart disease (CIHD). However, the cumulative mortality burden of these comorbid conditions is underexplored. This study aims to retrospectively assess mortality trends among American adults with concurrent lung cancer and CIHD.</div></div><div><h3>Methods</h3><div>We utilized death certificate data from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, encompassing ICD-10 codes for individuals aged ≥45 years from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 population, annual percentage change (APC), and corresponding 95 % confidence intervals (CIs) were calculated. Data were further stratified by year, sex, race, and geographic region (state, rural-urban, and census regions).</div></div><div><h3>Results</h3><div>A total of 214,785 deaths were identified in adults aged ≥45 years with comorbid lung cancer and CIHD. The overall AAMR between 1999 and 2020 was 8.4 per 100,000 (95 % CI: 8.3 to 8.4). AAMRs remained relatively stable from 1999 to 2005 (APC: −0.84 %; 95 % CI: −1.91 to 1.54), followed by a significant decline from 2005 to 2010 (APC: −2.37 %; 95 % CI: −5.58 to −0.61) and from 2010 to 2017 (APC: −4.72 %; 95 % CI: −7.61 to −3.60). A subsequent period of stability was noted between 2017 and 2020 (APC: 0.86 %; 95 % CI: −2.17 to 5.22). In 1999, men had a threefold higher mortality rate compared to women (AAMR: 17.8 vs. 5.7), with a non-significant decline by 2020 (AAMR: 10 vs. 4). Stratification by race/ethnicity revealed that non-Hispanic (NH) Whites exhibited the highest AAMR at 9.3, followed by NH American Indian or Alaska Natives (7.3), NH Blacks (6.8), Hispanic/Latinos (3.3), and NH Asians or Pacific Islanders (3.2). Geographically, AAMRs were highest in the Midwest (9.6), followed by the Northeast (8.8), South (8.4), and West (6.8). Non-metropolitan regions exhibited higher AAMRs compared to metropolitan areas (10.3 vs. 8.0). States in the top 90th percentile, such as West Virginia, Kentucky, Vermont, Ohio, and Rhode Island, had nearly triple the AAMRs compared to states in the lower 10th percentile, including Utah, Nevada, Arizona, New Mexico, and Hawaii.</div></div><div><h3>Conclusions</h3><div>From 1999 to 2020, mortality rates for adults aged ≥45 years with concurrent lung cancer and CIHD declined. The highest AAMRs were observed among men, NH Whites, individuals residing in the Midwest, and non-metropolitan populations. This highlights the need for a more comprehensive and tailored approach to managing these patients moving forward.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"24 ","pages":"Article 200377"},"PeriodicalIF":1.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419265","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":"Trends in atherosclerotic heart disease-related mortality among U.S. adults aged 35 and older: A 22-year analysis","authors":"Muzamil Akhtar ,&nbsp;Danish Ali Ashraf ,&nbsp;Muhammad Salman Nadeem ,&nbsp;Ayesha Maryam ,&nbsp;Hasan Ahmed ,&nbsp;Mehmood Akhtar ,&nbsp;Sarah MaCKenzie Picker ,&nbsp;Raheel Ahmed","doi":"10.1016/j.ijcrp.2025.200374","DOIUrl":"10.1016/j.ijcrp.2025.200374","url":null,"abstract":"<div><h3>Background</h3><div>Atherosclerotic heart disease (ASHD) remains a leading cause of mortality worldwide, especially among older adults. Understanding the long-term mortality trends in ASHD can guide public health strategies and address demographic disparities.</div></div><div><h3>Methods</h3><div>Mortality data for individuals aged 35 years and older were extracted from the CDC WONDER database. Age-adjusted mortality rates (AAMR) per 100,000 persons were calculated and stratified by year, gender, race, urbanization, and place of death. The trends were assessed using the annual percent change (APC) and average annual percent change (AAPC) with 95 % confidence intervals (CI) calculated through Joinpoint regression analysis.</div></div><div><h3>Results</h3><div>From 1999 to 2020, 7,638,608 ASHD-related deaths were recorded. The overall AAMR declined from 291.08 in 1999 to 170.07 in 2020, with an AAPC of −2.70 % (95 % CI: 2.96 to −2.54). However, an abrupt rise was observed from 2018 to 2020 (APC: 4.55; 95 % CI: 0.77 to 6.75). Males reported higher AAMR than females (Males: 271.9 vs. Females: 151.9). Non-Hispanic (NH) White individuals had the highest AAMR (209.38), followed by NH Black (202.47), NH American Indian (176.12), Hispanic (158.1), and NH Asian (113.7) populations. Nonmetropolitan areas reported the highest AAMR (214.77), while medium metropolitan areas reported the lowest (195.41). The majority of deaths occurred in medical facilities (42.81 %), followed by decedent's homes (25.67 %), and nursing homes (24.79 %).</div></div><div><h3>Conclusion</h3><div>Despite a long-term decline in ASHD-related mortality, the recent increase from 2018 to 2020 requires further study. Gender and racial disparities persist, highlighting the need for targeted public health efforts to reduce these inequities.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"24 ","pages":"Article 200374"},"PeriodicalIF":1.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419264","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":"Implications for global health of heart failure and lung cancer mortality trends in aging populations","authors":"John Patrick C. Toledo","doi":"10.1016/j.ijcrp.2025.200373","DOIUrl":"10.1016/j.ijcrp.2025.200373","url":null,"abstract":"","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"24 ","pages":"Article 200373"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349975","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":"Vaping illusions: The hidden risks of E-cigarette use among young Filipinos and adolescents in Latin America","authors":"John Patrick C. Toledo","doi":"10.1016/j.ijcrp.2025.200375","DOIUrl":"10.1016/j.ijcrp.2025.200375","url":null,"abstract":"<div><div>The study \"E-cigarette use among adolescents in Latin America\" reveals a high prevalence of e-cigarette use among teenagers, with a pooled mean of 18.9 %. This highlights the misconception that e-cigarettes are safer than traditional smoking and calls for focused public health initiatives to combat this growing problem. The study aims to examine the prevalence of e-cigarette use among Latin American teenagers, identify contributing factors, and guide public health initiatives to reduce the hazards associated with vaping. Its methodology comprises the following steps: first, a comprehensive assessment of the body of research on teen e-cigarette use was carried out; second, information on prevalence rates and related variables from multiple studies was gathered. Finally, the pooled mean prevalence was computed to give a bigger picture of the problem. The findings suggest that e-cigarettes, particularly for minors, may prolong nicotine dependency without providing a true cessation pathway. Social and cultural factors also complicate understanding how young Filipinos vape. The study underscores the need for well-informed public health initiatives to reduce the dangers of teen vaping.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"24 ","pages":"Article 200375"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350574","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":"Predicting cardiovascular disease and all-cause mortality using the lymphocyte-to-monocyte ratio: Insights from explainable machine learning models","authors":"Jichao Wu ,&nbsp;Die Huang ,&nbsp;Jiefang Li ,&nbsp;Jingxing Yi ,&nbsp;Yu Lei ,&nbsp;Jun Yin","doi":"10.1016/j.ijcrp.2025.200372","DOIUrl":"10.1016/j.ijcrp.2025.200372","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) is a leading cause of death globally, with its incidence and mortality rates continuing to rise. While commonly used biomarkers such as low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and blood glucose are widely applied, they have certain limitations. This study investigates the lymphocyte-to-monocyte ratio (LMR), a simple immune biomarker associated with inflammation, to assess whether it can serve as a new marker for predicting chronic inflammation in cardiovascular disease, and compares it to traditional biomarkers.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, utilizing a cohort of 1518 participants with a median follow-up period of 150 months. During this time, 522 participants died, including 166 from cardiovascular disease. We employed various statistical methods, including weighted Cox proportional hazards models, restricted cubic spline models, and time-varying receiver operating characteristic curves, to examine the association between LMR and mortality risk.</div></div><div><h3>Results</h3><div>The analysis revealed an L-shaped relationship between LMR and the incidence of cardiovascular disease. Lower LMR levels were negatively correlated with all-cause and cardiovascular mortality. The XGBoost model yielded the best performance metrics (AUC and F1 scores), and SHAP value analysis indicated that LMR significantly contributes to CVD outcomes. Non-linear analyses confirmed a stable negative correlation between LMR and all-cause mortality.</div></div><div><h3>Conclusion</h3><div>The study concludes that LMR is a simple and practical indicator for predicting cardiovascular disease and its mortality. Low levels of LMR significantly increase the risk of both cardiovascular disease and all-cause mortality in patients.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"24 ","pages":"Article 200372"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372661","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}