BMC Cardiovascular Disorders最新文献

{"title":"Link between C-reactive protein-triglyceride glucose index and cardiovascular disease risk in diverse glycemic statuses: a nationwide prospective cohort study.","authors":"Li Wang, Shan Peng, Yayan Zhang, Dongyue Huang, Ting Guo, Jia Qin, Jiaqi Chen, Mingming Li, Muyan Chen, Xue Li, Kai Cui, Xiaojin Li, Xiaobo Li, Shifeng Qiu","doi":"10.1186/s12872-026-06280-z","DOIUrl":"10.1186/s12872-026-06280-z","url":null,"abstract":"<p><strong>Objective: </strong>The C-reactive protein-triglyceride-glucose index (CTI) is a novel biomarker that integrates measures of insulin resistance and inflammation. Its association with cardiovascular disease (CVD) risk across various glycemic statuses remains unclear.</p><p><strong>Methods: </strong>This prospective study included 7,584 middle-aged and elderly participants from the China Health and Retirement Longitudinal Study (CHARLS). CTI was calculated using the formula 0.412*Ln(CRP) + Ln(TG × FPG)/2. Cox proportional hazards models and restricted cubic splines were employed to evaluate the relationship between CTI and CVD risk, with subgroup analyses conducted based on gender, age, and glycemic status.</p><p><strong>Results: </strong>Over a median follow-up period of 108.1 months, 1,989 participants (26.23%) developed CVD. The incidence of CVD increased significantly across ascending CTI quartiles (Q1: 20.78% to Q4: 31.65%). A positive linear association was observed that remained consistent across both genders and age groups. Higher CTI quartiles (Q3/Q4) were associated with a significantly elevated risk of CVD, particularly among males (hazard ratio [HR] up to 1.58) and middle-aged individuals (HR 1.57). Notably, an elevated CTI was linked to an increased risk of CVD in participants with normal glucose regulation but not in those classified as prediabetic or diabetic.</p><p><strong>Conclusions: </strong>The CTI serves as an independent predictor of CVD risk within the general middle-aged and elderly population. This association is most pronounced in individuals exhibiting normal glucose regulation, underscoring the potential utility of CTI for early risk stratification as well as the necessity for tailored prevention strategies informed by glycemic status.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology, comorbidity profiles, and oral anticoagulation patterns among patients with atrial fibrillation in Turkey: a meta-analysis of national registry-based and multicenter observational studies.","authors":"Mehmet Kış, Mehmet Emin Arayici, Bihter Şentürk, Mehdi Zoghi","doi":"10.1186/s12872-026-06342-2","DOIUrl":"10.1186/s12872-026-06342-2","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a major public health burden globally, associated with increased risk of stroke and mortality. While real-world data on AF management have expanded globally, comprehensive syntheses from developing countries such as Turkey remain limited. The objective of this study was to systematically evaluates the epidemiological characteristics, comorbidity profiles, and patterns of oral anticoagulant (OAC) use among patients with AF in Turkey based on national registry-based and multicenter observational studies.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, Web of Science, and Embase was conducted on 15 November 2025, and subsequently updated on 8 July 2026 to identify studies of Turkish AF patients. Included registries were conducted between 2013 and 2024. Data were extracted on demographics, clinical risk scores (CHA₂DS₂-VASc, HAS-BLED), comorbidities, AF type, and OAC patterns. Pooled estimates were calculated using random-effects meta-analyses with restricted maximum likelihood (REML) estimation and Knapp-Hartung adjustments.</p><p><strong>Results: </strong>Six registries comprising 18,219 Turkish AF patients were included. The pooled mean age was 69 years (95% CI: 66.9-71.2), with 58% (95% CI: 0.56-0.60) female representation. Hypertension (0.76, 95% CI: 0.71-0.80) and diabetes mellitus (0.25, 95% CI: 0.21-0.28) were the most common comorbidities. The mean CHA₂DS₂-VASc and HAS-BLED scores were 3.67 (95% CI: 2.99-4.35) and 1.72 (95% CI: 1.36-2.08), respectively, reflecting moderate-to-high thromboembolic risk and moderate bleeding risk. Persistent/permanent AF accounted for 0.73 (95% CI: 0.57-0.89) of cases, although the very high heterogeneity warrants caution. Because three registries enrolled patients on the basis of NOAC therapy by design, treatment-pattern estimates were stratified by registry type. Among all-comer registries, pooled NOAC use was 0.60 (95% CI: 0.20-0.90) and overall OAC use was 0.88 (95% CI: 0.49-0.98), whereas pooling all registries produced inflated estimates (NOAC 0.97, OAC 0.99); VKA use was correspondingly higher in all-comer registries (0.24, 95% CI: 0.10-0.47). Procedural interventions such as ablation (3%) and cardioversion (9%) remained infrequent.</p><p><strong>Conclusions: </strong>This meta-analysis of registry-based and multicenter observational studies suggests progress in pharmacological stroke prevention among AF patients in Turkey, with greater NOAC use in later and all-comer registries. However, the low use of rhythm-control strategies and the substantial inter-registry heterogeneity indicate ongoing gaps in AF management that warrant cautious interpretation and system-level improvements.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between hyperuricemia and cardiovascular risk among postmenopausal women in cameroon: a community-based study.","authors":"Stéphane Fargeon Massin Mbouna, Jan René Nkeck, Néri Ngole Atabe, Stéphane Yves Mbana Bikoi, Raphael Kinyuy Ndze, Emeraude Sorelle Mbock, Jean Maximilien Tang, Danielle Cécile Tang-Likeng, Claude Cyrille Ndoua Noa, Vicky Jocelyne Ama-Moor","doi":"10.1186/s12872-026-06335-1","DOIUrl":"10.1186/s12872-026-06335-1","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the known association between hyperuricemia and an increased risk of cardiovascular disease, the prevalence and epidemiology of hyperuricemia in postmenopausal women in Cameroon are not yet fully understood. This study aimed to evaluate the prevalence of hyperuricemia, identify its associated factors, and examine its association with cardiovascular risk markers among postmenopausal women living in Yaoundé.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in Yaoundé from November 2024 to June 2025, involving 206 postmenopausal women. Biological measurements were performed at PRIMA Lab using the Cobas 6000^®. Independent associated factors with hyperuricemia were analyzed using logistic regression. Association between hyperuricemia and cardiovascular risk markers was assessed, using chi². The significance level was set at 5%. SPSS 28 was used for statistical analysis.</p><p><strong>Results: </strong>Out of 206 postmenopausal women, the mean age was 63.5 ± 8.7 [48-87] years. The prevalence of hyperuricemia was 37.9%. Menopausal duration ≥ 14 years (OR = 2.8; P = 0.016), overweight/obesity (OR = 1.9; P = 0.030) and hypertension (OR = 2.0; P = 0.036). Hyperuricemia was significantly associated with non-HDL cholesterol ≥ 130 mg/dL (P = 0.001), LDL/HDL ratio (P = 0.001), WHO CVR score ≥ 10% (P = 0.018), and non-HDL/total cholesterol ratio (P = 0.045).</p><p><strong>Conclusion: </strong>More than one-third of postmenopausal women have been diagnosed with hyperuricemia. Long duration of menopause, overweight/obesity and hypertension were independently associated with hyperuricemia. Hyperuricemia was significantly associate with non-HDL cholesterol, LDL/HDL ratio, non-HDL/total cholesterol ratio and WHO CVR score.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between coronary angiography-derived index of microcirculatory resistance and ischemic stroke in patients with ST-segment elevation myocardial infarction.","authors":"Chenchen Cui, Zijia Sun, Mingchang Du, Peng Lu, Yuan Lu, He Zhang, Qihua Xiao, Fan Yang","doi":"10.1186/s12872-026-06348-w","DOIUrl":"10.1186/s12872-026-06348-w","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a devastating complication following ST-segment elevation myocardial infarction (STEMI). Coronary microcirculatory dysfunction (CMD) is implicated in adverse post-STEMI outcomes, but its relationship with subsequent stroke is unknown. We aimed to investigate the association of the coronary angiography-derived index of microcirculatory resistance (caIMR), a novel non-invasive tool for assessing CMD, for new-onset ischemic stroke in STEMI patients undergoing primary percutaneous coronary intervention (pPCI).</p><p><strong>Methods: </strong>This single-center, retrospective cohort study enrolled 602 consecutive STEMI patients who underwent successful pPCI between July 2020 and February 2025. The caIMR was calculated post-procedure using specialized software. The primary endpoint was new-onset ischemic stroke. Multivariable Cox proportional hazards regression and restricted cubic spline analyses were used to assess the association between caIMR and stroke risk.</p><p><strong>Results: </strong>Over a median follow-up of 29.3 months, 38 patients (6.3%) developed a new-onset ischemic stroke. In the multivariable Cox model, caIMR was independently associated with the risk of ischemic stroke (HR: 1.044, 95% CI: 1.022-1.065, P < 0.001), along with new-onset atrial fibrillation (HR: 9.113, 95% CI: 4.587-18.107, P < 0.001). A linear dose-response relationship was observed between caIMR levels and the risk of stroke (P for non-linearity = 0.975). Reclassification analysis showed that adding caIMR improved risk classification, with an IDI of 0.0307 (95% CI: 0.0031-0.0636; P = 0.030) and an NRI of 0.3887 (95% CI: 0.3156-0.4618; P < 0.001).</p><p><strong>Conclusion: </strong>Elevated caIMR is independently associated with an increased risk of long-term ischemic stroke in STEMI patients after pPCI. This easily accessible metric may serve as a valuable tool for future risk stratification in this patient population.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal ultrasound diagnosis and follow-up tracking of a case of congenital coronary artery fistula.","authors":"Haoliang Huang, Yuxia Liang, Yuhua Yu, Xuebing Zhao, Lijuan Sun","doi":"10.1186/s12872-026-06312-8","DOIUrl":"10.1186/s12872-026-06312-8","url":null,"abstract":"<p><strong>Background: </strong>Congenital coronary artery fistula (CAF) is a rare congenital cardiovascular malformation characterized by an anomalous connection between a coronary artery and a cardiac chamber or great vessel. Prenatal diagnosis remains challenging. A 29-year-old G2P1 pregnant woman was diagnosed with fetal left coronary artery-to-right ventricle fistula via prenatal ultrasound at 21 weeks. Postpartum follow-up showed progressive coronary dilation, leading to surgical repair. A cardiac enhanced CT scan also confirmed the diagnosis of CAF. One-year postoperative ultrasound revealed improved cardiac structure with residual mild complications.</p><p><strong>Conclusion: </strong>Prenatal ultrasound is pivotal for early CAF diagnosis, guiding postnatal intervention and improving prognosis.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of estimated glucose disposal rate with chest pain prevalence and mortality risks: a population-based study.","authors":"Jieke Wang, Manli Ye","doi":"10.1186/s12872-026-06336-0","DOIUrl":"10.1186/s12872-026-06336-0","url":null,"abstract":"<p><strong>Background: </strong>Estimated glucose disposal rate (eGDR), a validated surrogate for insulin resistance, is associated with cardiovascular disease, but its relationship with chest pain, which is a common presenting symptom of cardiovascular events, remains unclear. This study investigated the associations of eGDR with chest pain prevalence and all-cause mortality.</p><p><strong>Methods: </strong>Using cross-sectional and cohort study designs, we analyzed data from 1999 to 2018 National Health and Nutrition Examination Survey (NHANES). Survey-weighted logistic regression was used to examine the association between eGDR and chest pain prevalence, while weighted Cox model was used to evaluate the relationship between eGDR and all-cause mortality in participants with and without chest pain. Restricted cubic splines (RCS) examined potential nonlinearity, and Kaplan-Meier curves visualized survival differences by eGDR category. Mediation analysis examined whether white blood cells (WBC) count mediated the eGDR-mortality association.</p><p><strong>Results: </strong>The study included 13,161 participants, with the sample being weighted to reflect a population of 54,616,985 individuals. After full adjustment, each standard deviation (SD) increase in eGDR correlated with an 11% lower odds of chest pain (P < 0.001). Cox regression revealed each SD rise in eGDR was associated with a 7% lower risk of all-cause mortality among participants with chest pain (P = 0.004). RCS confirmed linear relationships for eGDR with both chest pain prevalence and mortality risk, irrespective of chest pain status. When eGDR was dichotomized at the population median (7.34 mg/kg/min), participants with high eGDR was significantly associated with reduced odds of chest pain (OR = 0.67, 95% CI: 0.59-0.77, P < 0.001) and lower all-cause mortality (HR = 0.85, 95% CI: 0.75-0.95, P = 0.006) compared to those with low eGDR. Kaplan-Meier curves demonstrated a clear survival advantage for participants with higher eGDR. WBC mediated 20.04% of the association between eGDR and all-cause mortality (P_indirect < 0.001).</p><p><strong>Conclusion: </strong>Higher eGDR is robustly associated with lower chest pain prevalence and reduced all-cause mortality risk, irrespective of chest pain status. The partial mediation by WBC suggests a potential inflammatory pathway. These findings support the potential value of eGDR in non-invasive cardiometabolic risk stratification.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glyceamic variability is a pridictor of in-hopital and long-term mortality of patients with dilated cardiomyopathy: a 5-year retrospective cohort study.","authors":"Yang Liu, Qiwei Shen, Hongyu Liu, Gregory Y H Lip, Kui Hong","doi":"10.1186/s12872-026-06338-y","DOIUrl":"10.1186/s12872-026-06338-y","url":null,"abstract":"<p><strong>Background: </strong>Dilated cardiomyopathy (DCM) is a major cause of heart failure with high morbidity and mortality, yet reliable prognostic markers remain limited. Glycaemic variability (GV), reflecting fluctuations in glucose levels, has been linked to adverse cardiovascular outcomes, but its role in DCM remains uncertain.</p><p><strong>Methods: </strong>Data were obtained from Beth Israel Deaconess Medical Center in Boston. We included patients with DCM as the primary diagnosis and ≥ 3 glucose measurements during hospitalization. GV was defined as the natural logarithm of the standard deviation-to-mean glucose ratio and analyzed continuously and categorically (GV ≥ 2.9 vs. <2.9). Outcomes included in-hospital, and 1-, 3-, and 5-year all-cause mortalities. Multivariable Cox regression models were adjusted for demographic, clinical, and laboratory covariates.</p><p><strong>Results: </strong>A total of 580 patients with DCM were included (mean age 64.20 (14.80); 73% male; 55% White). Patients with GV ≥ 2.9 had higher rates of in-hospital mortality (5.6% vs. 0.7%), ICU admission (52% vs. 28%) and worse long-term outcomes, including 1-year (20% vs. 10%), 3-year (26% vs. 17%), and 5-year (29% vs. 19%) mortalities. After adjusting for demographic, clinical, and laboratory variables, Each unit increase in GV increased the risk of in-hospital [adjusted OR(aOR): 5.12, 95% CI: 1.07-31.2], ICU admission (aOR 2.59),1-year [adjusted HR (aHR) 1.84], 3-year (aHR 1.65), and 5-year (aHR 1.60) death.</p><p><strong>Conclusion: </strong>GV is associated with both short- and long-term mortality in patients with DCM. The cohort median GV value of 2.9 might help stratify patients according to clinical risk.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the remnant cholesterol inflammatory index and frailty with cardiometabolic multimorbidity among Chinese middle-aged and elderly populations: a nationwide cohort study.","authors":"Shiyuan Zhao, Zhenhan Wang, Liping Chang","doi":"10.1186/s12872-026-06356-w","DOIUrl":"10.1186/s12872-026-06356-w","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic multimorbidity (CMM) is the co-occurrence of two or more cardiometabolic disorders including heart disease, diabetes and stroke. While the remnant cholesterol inflammatory index (RCII) and frailty have been independently associated with CMM, their joint association with CMM has not been fully elucidated. This study examined the joint-category associations of RCII or CumRCII with frailty in relation to incident CMM to characterize their combined epidemiological relationships with CMM risk.</p><p><strong>Methods: </strong>Based on the 2011-2020 China Health and Retirement Longitudinal Study (CHARLS), 5,779 participants were included in the final analysis. CumRCII represented time-weighted cumulative RCII exposure during 2011-2015. Kaplan-Meier curves were used to calculate CMM incidence across exposure groups. Multivariable Cox models were used to evaluate the joint-category associations of RCII or CumRCII with frailty in relation to incident CMM. Additive and multiplicative interactions were assessed separately. Restricted cubic spline models investigated potential nonlinear associations of RCII and CumRCII with CMM risk. Receiver operating characteristic curves were used in an exploratory analysis of in-sample model discrimination. The stability of the findings was assessed through subgroup and sensitivity analyses.</p><p><strong>Results: </strong>A total of 510 participants were diagnosed with CMM. Higher RCII or CumRCII in combination with frailty was associated with increased CMM incidence. RCII and CumRCII exhibited positive nonlinear associations with CMM risk. Compared with individuals with low RCII and without frailty, those with concurrent high RCII and frailty showed a higher risk of incident CMM (HR = 2.622, 95% CI 1.972-3.488). Similar results were observed for CumRCII (above optimal threshold) combined with frailty (HR = 2.849, 95% CI 2.178-3.726). However, additive and multiplicative interaction analyses did not remain statistically significant after full adjustment. The model incorporating CumRCII and frailty had a modestly higher in-sample AUC than the CumRCII-only model (0.757 vs. 0.740; ΔAUC = 0.017; DeLong P < 0.001). Subgroup and sensitivity analyses supported the robustness of the main findings.</p><p><strong>Conclusion: </strong>In joint-category Cox analyses, participants with concurrent elevated RCII or CumRCII and frailty showed the highest observed risk of incident CMM. These findings suggest that lipid-inflammatory burden and frailty may represent complementary dimensions of CMM risk.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between normal-weight central obesity and cardiometabolic disorders: a longitudinal analysis from health check-up data.","authors":"Yang Cheng, Hui Zheng, Hongli Yin, Donghua Yin, Hui Wang, Ying Wang","doi":"10.1186/s12872-026-06323-5","DOIUrl":"10.1186/s12872-026-06323-5","url":null,"abstract":"<p><strong>Background: </strong>Although several cross-sectional studies have examined the relationship between normal-weight central obesity (NWCO) and the risk of cardiometabolic disorders (CMD), longitudinal evidence from cohort studies is still limited, especially regarding diverse CMD outcomes in Chinese populations.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study by using health examination records from Jiangsu Province Geriatric Hospital. The study included 5,606 normal-weight (body mass index of 18.0-24.0 kg/m²) participants free of CMD at their baseline visit in 2022. NWCO was defined as normal-weight and central obesity (waist circumference ≥ 90 cm for men or ≥ 80 cm for women), whereas normal-weight non-central obesity (NWNO) was defined as normal-weight without central obesity. Participants were followed until the occurrence incident CMD events or the last visit in 2024. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CMD and its related components.</p><p><strong>Results: </strong>Among all participants (median age 40 years), 388 (6.9%) had NWCO. During a mean follow-up of 1.98[Formula: see text]0.18 years, NWCO was associated with a greater risk for CMD (HR: 1.39, 95% CI: 1.13-1.71) compared with NWNO group. Similar risk elevations were observed for CMD components, including hypertension (HTN), diabetes mellitus (DM) and hyperlipidemia (HLP).</p><p><strong>Conclusion: </strong>Our analysis of a longitudinal health check-up database demonstrated the potential impact of NWCO on the risk for CMD, confirming the importance of abdominal obesity in the development of CMD even in normal-weight individuals.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory rapidly progressive diffuse in-stent restenosis with left main involvement: a case report.","authors":"Xiaoyan Wang, Haichao Yang, Liqiang Qin, Wei Lu, Lijun Wang, Jianjun Wang, Juan Li, Kaibin Deng, Chenguang Gao","doi":"10.1186/s12872-026-06343-1","DOIUrl":"10.1186/s12872-026-06343-1","url":null,"abstract":"<p><strong>Background: </strong>Drug-eluting stents (DES) have significantly reduced the incidence of in-stent restenosis (ISR). However, a subset of patients still develop refractory, rapidly progressive, and diffuse ISR, which poses substantial therapeutic challenges and reflects its complex underlying mechanisms.</p><p><strong>Case presentation: </strong>We report a 46-year-old male who underwent five percutaneous coronary interventions (PCI) over five years, with repeated diffuse ISR in the left anterior descending artery (LAD). Initial PCI was followed by DCB therapy after first ISR, achieving temporary symptom relief. Four years later, ISR progressed to chronic total occlusion, requiring further stenting and DCB therapy. Within five months, he developed 99% LM stenosis and recurrent LAD ISR. Despite a SYNTAX score of 36 favoring CABG, the patient refused surgery. Under intra-aortic balloon pump support, a balloon-only PCI (stent-less) strategy was performed. IVUS revealed diffuse fibrous proliferation and neoatherosclerosis. During follow-up, the patient remained clinically stable overall.</p><p><strong>Conclusion: </strong>This case highlights a potential systemic hyperproliferative phenotype, in which repeated vascular injury triggers accelerated neoatherosclerosis and intimal hyperplasia. It challenges the conventional view of ISR as a local mechanical problem and underscores the importance of mechanism-driven risk stratification and individualized management, particularly when standard surgical therapy is declined.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}