BMC Cardiovascular Disorders最新文献

{"title":"Association of red cell distribution width/albumin ratio and 28-day mortality in chronic obstructive pulmonary disease patients with atrial fibrillation: a medical information mart for intensive care IV study.","authors":"Jian-Min Qu, Xia-Hong Tang, Wen-Juan Tang, Li-Ya Pan","doi":"10.1186/s12872-025-04537-7","DOIUrl":"10.1186/s12872-025-04537-7","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) complicated by atrial fibrillation (AF) in ICU patients is associated with higher risks of adverse outcomes. The red cell distribution width to albumin ratio (RAR), may predict mortality in critical illness, yet its link to 28-day mortality in ICU patients with COPD and AF remains unclear.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 693 ICU patients with COPD and AF from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, grouped by RAR tertiles. The primary endpoint was 28-day mortality, with secondary endpoints including 90-day, 365-day, and ICU mortality. Multivariate cox models estimated hazard ratios (HRs) for mortality, while restricted cubic spline regression assessed the linearity of the RAR-mortality relationship. Kaplan-Meier curves compared survival across tertiles, and subgroup analyses explored RAR's impact across age, gender, race, and comorbidities.</p><p><strong>Results: </strong>Our study included 693 ICU patients with both COPD and AF, with an average age of 74.9 years. The 28-day mortality was 30.7%. Patients in the highest RAR tertile had significantly worse 28-day survival (p < 0.0001). Higher RAR was linearly associated with increased 28-day mortality (p for non-linearity > 0.05), with each 1-unit increase in RAR linked to an 18% rise in mortality risk (95% CI: 1.08-1.29). Sensitivity analyses confirmed RAR's relevance for 90-day, 365-day, and ICU mortality.</p><p><strong>Conclusions: </strong>RAR is independently associated with 28-day mortality in COPD patients with AF. Elevated RAR levels correlate with higher 28-day mortality rates in this population.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"146"},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The link between adherence to antihypertensive medications and mortality rates in patients with hypertension: a systematic review and meta-analysis of cohort studies.","authors":"Xuemei Peng, Lihong Wan, Benkai Yu, Jianhui Zhang","doi":"10.1186/s12872-025-04538-6","DOIUrl":"10.1186/s12872-025-04538-6","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HTN) significantly contributes to cardiovascular disease (CVD) and mortality. This systematic review and meta-analysis specifically investigates how different levels of adherence to antihypertensive therapy (AHT) affect mortality rates in HTN patients. By synthesizing cohort studies, it aims to enhance understanding and inform clinical practices to improve outcomes in hypertensive populations.</p><p><strong>Methods: </strong>Our meta-analysis employed a comprehensive search strategy using keywords related to hypertension, medical adherence, and mortality across PubMed, Scopus, and Web of Science, up to July 2024. The eligibility criteria focused on cohort studies linking AHT adherence to mortality. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias (ROB). Quantitative analyses involved hazard ratios (HR) and confidence intervals (CI), with an 80% adherence threshold. Subgroup and meta-regression analyses were also conducted using STATA-17 to explore various outcome factors.</p><p><strong>Results: </strong>From initial 1,999 studies 12 cohort studies included in our analysis. All included studies had low ROB score. A meta-analysis of 12 studies involving 2,198,311 patient with HTN revealed that poor adherence to treatment significantly increased all-cause mortality (HR: 1.32 [1.14, 1.51], p < 0.001) with high heterogeneity (I²: 98.73%). Additionally, an analysis of four studies with 1,695,872 patients indicated that low adherence was linked to elevated cardiovascular mortality (HR: 1.61 [1.43, 1.78], p < 0.001), showing moderate heterogeneity (I²: 49.51%).</p><p><strong>Conclusions: </strong>The study found that poor adherence to AHT significantly increases overall and cardiovascular mortality risk, underscoring the need for improved compliance strategies. Limitations like inconsistent definitions, observational biases, and varying follow-up durations necessitate further research to validate these findings.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"145"},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of the C-reactive protein-albumin-lymphocyte index with all-cause and cardiovascular mortality among individuals with cardiovascular disease: evidence from the NHANES 2001-2010.","authors":"Dunzheng Han, Lanlan Wu, Haobin Zhou, Yuting Xue, Shangfei He, Zhuang Ma, Shuwen Su, Peixin Li, Shenrong Liu, Zheng Huang","doi":"10.1186/s12872-025-04596-w","DOIUrl":"10.1186/s12872-025-04596-w","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding the C-reactive protein‒albumin‒lymphocyte (CALLY) index and mortality risk in individuals with cardiovascular disease (CVD) is scarce. This study investigated the relationships of the CALLY index with all-cause and cardiovascular mortality risk in CVD patients among American adults.</p><p><strong>Methods: </strong>This study enrolled 2183 CVD individuals from five NHANES cycles (2001-2010), and mortality outcomes were determined by linking the data to National Death Index (NDI) records up to December 31, 2019. Weighted multivariate Cox regression models and subgroup analyses were performed to assess the associations of the CALLY index with all-cause and cardiovascular mortality. A restricted cubic spline (RCS) was used to visualize the association of the CALLY index with mortality risk.</p><p><strong>Results: </strong>During a median follow-up of 122 months (interquartile range, 71-157 months), 1208 (weighted percentage, 49.62%) of the 2183 CVD individuals died, including 398 (weighted percentage, 24.85%) with cardiovascular deaths and 810 (weighted percentage, 75.15%) with noncardiovascular deaths. Cox regression revealed an inverse correlation between the CALLY index and the risk of all-cause and cardiovascular mortality after adjusting for covariates. Compared with individuals with a lower CALLY index, those with a higher CALLY index had a significantly lower risk of both all-cause (HR 0.58, 95% CI: 0.48, 0.71, p < 0.001) and cardiovascular mortality (HR 0.54, 95% CI: 0.38, 0.76, p < 0.001). The RCS regression analysis revealed a nonlinear association between the CALLY index and all-cause and cardiovascular mortality (p < 0.05 for nonlinearity) in CVD patients. The associations were consistent in the subgroup analyses regardless of age, sex, income, education level, race, smoking status, diabetes, and hypertension (all p values for interactions > 0.05).</p><p><strong>Conclusion: </strong>An increased CALLY index is independently associated with decreased all-cause and cardiovascular mortality in CVD patients.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"144"},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): a comprehensive meta-analysis of clinical characteristics, management, and prognosis compared to MI with the Obstructive Coronary Artery (MIOCA).","authors":"Nahid Khorasani, Yaser Mohammadi, Mahdiye Sarpoli, Toba Kazemi, Seyed Mohammad Riahi","doi":"10.1186/s12872-025-04504-2","DOIUrl":"10.1186/s12872-025-04504-2","url":null,"abstract":"<p><strong>Background: </strong>MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries) represents a unique subset of acute coronary syndrome, distinct from MIOCA (Myocardial Infarction with Obstructive Coronary Arteries) and a control group. This study systematically compares their prevalence, clinical characteristics, management strategies, and outcomes to improve understanding and treatment approaches.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA guidelines across multiple databases up to 2024. STATA 17 was used for statistical analyses, and the Newcastle-Ottawa Scale was employed to assess study quality.</p><p><strong>Results: </strong>One-hundred and twelve studies, including 5,908,768 patients, were analyzed. The pooled prevalence of MINOCA among patients undergoing coronary angiography was 8.92% (95% CI: 8.90-8.94). MINOCA patients were generally younger, predominantly female, and more likely to present with atypical chest pain and dyspnea compared to MIOCA patients. Laboratory findings showed higher levels of CRP, BNP, and fibrinogen in MINOCA patients, suggesting inflammation and microvascular dysfunction as key mechanisms. In contrast, MIOCA patients had higher rates of diabetes and dyslipidemia, highlighting differences in pathophysiological processes. Medication use differed between the groups, with MINOCA patients more likely to be prescribed anticoagulants and β-blockers. Prognostically, MINOCA patients experienced significantly lower rates of adverse short- and long-term outcomes, including major adverse cardiac events (MACE) and cardiovascular death, compared to MIOCA patients.</p><p><strong>Conclusions: </strong>This study demonstrated that patients with MINOCA have a better prognosis compared to those with MIOCA and are at a lower risk of serious cardiac events. Based on the findings of this study, we emphasize that microcirculation and vascular spasm are the main mechanisms involved in MINOCA. Considering these findings, it is suggested that a better management strategy for MINOCA patients can be established by precisely defining diagnostic criteria and focusing on anti-inflammatory treatments and risk factor control.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"143"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphocyte to c-reactive protein ratio predicts the risk of contrast-induced acute kidney injury in STEMI patients undergoing percutaneous coronary intervention.","authors":"Lanqing Xiang, Bowen Qiu, Lei Chen, Chunyue Wang, Wen Zhang, Lu Liu, Guoqing Yin, Fuad A Abdu, Cailin Feng, Xian Lv, Jiasuer Alifu, Yuan Lu, Wenliang Che","doi":"10.1186/s12872-025-04522-0","DOIUrl":"10.1186/s12872-025-04522-0","url":null,"abstract":"<p><strong>Background: </strong>Contrast-induced acute kidney injury (CI-AKI) is a common complication of percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) patients. Our aim was to assess the lymphocyte to C-reactive protein ratio (LCR) to predict CI-AKI in patients with acute STEMI.</p><p><strong>Methods: </strong>A total of 777 patients with STEMI undergoing primary PCI were continuously included in this study. The occurrence of CI-AKI was monitored during the follow-up period for all patients. Logistic regression analysis was employed to assess the relationship between LCR and CI-AKI. Furthermore, ROC analysis was conducted to establish the optimal LCR cut-off value for the prediction of CI-AKI.</p><p><strong>Results: </strong>The incidence of CI-AKI after PCI was 12.2% (95/777). Univariate and multivariate analysis showed that LCR was an independent factor for CI-AKI after PCI. ROC curve analysis of LCR showed the optimal cut-off value of LCR identified for predicting CI-AKI was 7875.94, yielding the area under the curve of 0.626 (95% CI: 0.572-0.679; P < 0.001). The integration of the LCR could significantly improve the ability of the model to identify CI-AKI (IDI = 0.016[P < 0.001], and NRI = 0.137[P = 0.006]).</p><p><strong>Conclusion: </strong>LCR is an independent risk factor for CI-AKI in STEMI patients undergoing primary PCI. Integration of LCR can significantly improve the risk model for CI-AKI.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"140"},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery time of atrioventricular conduction and its influencing factors in patients presenting late with inferior wall acute myocardial infarction and atrioventricular block.","authors":"Jiahao Feng, Yiqiong Zhang, Xiaojuan Fan","doi":"10.1186/s12872-025-04589-9","DOIUrl":"10.1186/s12872-025-04589-9","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the recovery time of atrioventricular conduction and its influencing factors in patients presenting late and diagnosed with inferior wall acute myocardial infarction (AMI) and high-degree atrioventricular block (AVB) on admission.</p><p><strong>Methods: </strong>We conducted a retrospective study in patients presenting > 12 h after symptom onset and diagnosed with inferior wall AMI and new onset second-degree type 2 or third-degree AVB on admission. All of them underwent percutaneous coronary intervention (PCI). The clinical characteristics, time to PCI and time to AVB recovery after symptom onset were studied.</p><p><strong>Results: </strong>Among the 80 patients, 68 were male, aged 63 ± 10 years. The median admission time after symptom onset was 36 h. 10 patients presented with second-degree type 2 AVB and 70 patients with third-degree AVB. The median time of AVB recovery from AMI onset was 5d (Q1-Q3:4-7d; Min-max: 1-15d). Patients were divided into two groups according to the median AVB recovery time. Compared to the late recovery group (> 5 days), patients in the early recovery group (≤ 5 days) had shorter admission time after AMI onset (P < 0.001) and received PCI earlier (P < 0.001). Multivariate Logistic regression analysis showed that admission time from AMI onset (OR:1.032, 95%CI: 1.013-1.052, P = 0.001) and time from AMI onset to PCI (OR: 1.449, 95%CI: 1.163-1.804, P = 0.001) were independent factors for early AVB recovery.</p><p><strong>Conclusions: </strong>In patients presenting late with inferior wall AMI complicated with high-degree AVB, the median time of AVB recovery was 5 days. Shorter admission time from AMI onset and earlier PCI treatment were independently associated with earlier AVB recovery.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"138"},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of the CeRNA axis of circ_0000006/miR-483-5p/KDM2B in the progression of aortic aneurysm to aorta dissection.","authors":"Yong Liu, Xiong Tan, Liang Wang, Weitao Jin, Yangchen He, Yu Yan, Kai Hu, Hao Wang, Chaohu Xiang, Ming Hou, Yinglong Lai","doi":"10.1186/s12872-025-04598-8","DOIUrl":"10.1186/s12872-025-04598-8","url":null,"abstract":"<p><strong>Background: </strong>Aortic aneurysm (AA) and aortic dissection (AD) are serious cardiovascular disorders with a high risk of mortality. The molecular mechanisms underlying the progression from AA to AD are not well understood. This study aimed to identify the key circular RNA (circRNA)-microRNA (miRNA)-messenger RNA (mRNA) regulatory axis involved in this disease progression.</p><p><strong>Methods: </strong>CircRNA microarray, miRNA microarray, and mRNA sequencing were performed on plasma samples from healthy controls, AA patients, and AD patients. Bioinformatics analysis integrated the expression profiles to identify dysregulated circRNA-miRNA-mRNA networks. Key molecules were validated in vascular smooth muscle cells (VSMCs) and an AD mouse model. Cell proliferation, migration, and phenotypic transition assays were conducted after modulating the identified circRNA. The impact on AD progression was evaluated in mice upon circRNA knockdown.</p><p><strong>Results: </strong>A total of 12 circRNAs were found upregulated in AD compared to AA samples. miR-483-5p was downregulated while its targets KDM2B and circ_0000006 were upregulated in AD. Silencing circ_0000006 in VSMCs inhibited PDGF-induced phenotypic switching, proliferation, and migration by increasing miR-483-5p and decreasing KDM2B levels. In the AD mouse model, knockdown of circ_0000006 alleviated disease progression with similar molecular changes.</p><p><strong>Conclusion: </strong>The study identified a novel circ_0000006/miR-483-5p/KDM2B axis dysregulated during AD progression. Targeting this axis, especially circ_0000006, could be a potential strategy to mitigate the transition from AA to AD by modulating VSMC phenotype and function.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"141"},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of bleeding and performance of the PRECISE-DAPT score in predicting bleeding in patients on dual antiplatelet therapy after treatment for acute coronary syndrome in Kenya.","authors":"Peter Mugo, Mohamed Jeilan, Miriam Msunza, James Orwa, Mzee Ngunga","doi":"10.1186/s12872-024-04434-5","DOIUrl":"10.1186/s12872-024-04434-5","url":null,"abstract":"<p><strong>Introduction: </strong>Dual Antiplatelet Therapy (DAPT) plays an important role in the secondary prevention of ischemic events after treatment for acute coronary syndrome (ACS). The long-term use of DAPT is associated with an increased risk of bleeding, which affects morbidity and mortality. Risk stratification scores have been developed to predict this risk and provide a balance against the risk of ischemic events. The aim of this study was to determine the incidence of bleeding in a cohort of patients in Kenya on DAPT and assess the performance of the PRECISE-DAPT Score in predicting the risk of bleeding.</p><p><strong>Methods: </strong>This was a retrospective study conducted in three hospitals in Kenya among patients on DAPT after ACS between January 2019 and April 2022. We reviewed medical records for demographic and clinical characteristics and conducted telephone interviews to assess bleeding for patients on DAPT for a minimum period of one year. Bleeding events were categorized according to the TIMI criteria for bleeding, and the PRECISE-DAPT Score was calculated using an online calculator. The cumulative one-year incidence of bleeding was calculated and presented as frequencies and percentages. Receiver operating characteristic (ROC) analysis and C-statistics were used to quantify the ability of the PRECISE-DAPT Score to predict bleeding events, whereas calibration was estimated using the Hosmer‒Lemeshow goodness-of-fit test.</p><p><strong>Results: </strong>A total of 202 patients were enrolled in the study. The study population was predominantly male (n = 156, 77.2%) and African (n = 141, 69.8%), with a median age of 61 years (IQR 52-72). Majority were admitted with ST-Elevation Myocardial infarction (STEMI) (n = 126, 62.4%) and had a mildly reduced left ventricle ejection fraction (n = 124, 61.4%). Fourteen patients (6.9%) met the TIMI criteria for bleeding, of whom 11 (5.4%) had minimal bleeding and 3 (1.5%) had minor bleeding. There was no incidence of major bleeding. The discrimination and calibration of the PRECISE-DAPT Score was good {ROC curve 0.699 (95% CI: 0.564-0.835)} and the Hosmer-Lemeshow goodness-of-fit test (Chi-square, 6.53; p = 0.588), respectively.</p><p><strong>Conclusion: </strong>The incidence of bleeding was low, with the majority of patients having minimal bleeding that did not require medical intervention. The PRECISE-DAPT Score performed well in predicting bleeding in patients on DAPT.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"137"},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges faced by cardiac patients prior to coronary artery bypass grafting: a qualitative study.","authors":"Sajjad Ebrahimi, Tayebeh Hasan Tehrani, Azim Azizi, Hakimeh Vahedparast, Efat Sadeghian","doi":"10.1186/s12872-025-04577-z","DOIUrl":"10.1186/s12872-025-04577-z","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery bypass grafting (CABG) is one of the most effective treatments for improving the quality of life in patients with severe coronary artery disease. However, these patients face multiple challenges prior to surgery. This study aims to elucidate the challenges faced by cardiac patients before CABG.</p><p><strong>Methods: </strong>This qualitative study used a conventional content analysis approach. Data were obtained from 26 interviews with 23 individuals, including patients and their families, physicians, and nurses from hospitals in Bushehr and Hamadan, selected through purposive sampling. Data were collected through semi-structured interviews over ten months and analyzed using MAXQDA20 software.</p><p><strong>Results: </strong>A total of 575 initial codes were extracted from the interviews and categorized into 16 subcategories based on similarities and differences. After reviewing and comparing the subcategories, five main categories of challenges faced by cardiac patients prior to coronary artery bypass surgery were identified and conceptually named. These categories included psychological and social stress during the waiting period, financial resource management for treatment, quality of information and communication, heightened need for belonging, and spirituality.</p><p><strong>Conclusions: </strong>Patients prior to coronary artery bypass grafting encounter psychological, financial, social, and spiritual challenges. A precise understanding of these challenges and the provision of psychological and social counseling to patients and their families, financial support and facilitation of treatment costs, improvement of information quality and communication between patients and the healthcare team, strengthening emotional support from family and friends, and attention to patients' spiritual needs by the healthcare team can facilitate decision-making and enhance the quality of life and surgical outcomes.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"142"},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between insulin resistance and QT interval: A systematic review and Meta-Analysis.","authors":"Maryam Mobasheri-Shiri, Sina Bazmi, Mohammad Saeed Soleimani-Meigoli, Zeinab Karimimoghadam, Reza Tabrizi, Mojtaba Farjam","doi":"10.1186/s12872-025-04593-z","DOIUrl":"10.1186/s12872-025-04593-z","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) is a major health concern associated with various diseases, and prolonged QT interval can potentially lead to life-threatening arrhythmias and death. There are conflicting views on the relationship between IR and QT interval. This meta-analysis aims to comprehensively investigate the association between IR and QT interval.</p><p><strong>Methods: </strong>An extensive search in databases PubMed, Scopus, Cochrane Library, Embase, and Web of Science up to October 2024 was conducted. Cohort studies which reported means and standard deviations for the QTc interval across the case and control groups with and without insulin resistance based on HOMA-IR were eligible for inclusion. Research with partial or inaccessible primary data, those involving participants with pre-existing cardiac conditions, and those with ambiguous results were excluded. The evaluation of study quality utilized the Newcastle-Ottawa Scale. A random-effects model was applied for the meta-analysis, and Egger's test was used to assess publication bias. GRADEproGDT was used to evaluate the certainty of the evidence.</p><p><strong>Results: </strong>Five studies, encompassing 603 participants, met the inclusion criteria. A significant positive association was observed between IR and QT interval (Weighted Mean Difference [WMD] = 12.38, 95% Confidence Interval [CI]: 5.51, 19.25). All included studies demonstrated high methodological quality. Assessment for publication bias revealed no significant findings (p-value for Egger's test = 0.39). The quality of evidence for the main outcome was moderate. Subgroup analyses revealed a significant link between IR and QT interval in studies from Turkey and India, with samples over fifty, and involving adults.</p><p><strong>Conclusions: </strong>This meta-analysis highlights that IR is linked to an elevated risk of QT prolongation. Early identification of IR is crucial to mitigate the risk of QT prolongation and subsequent arrhythmias, thus emphasizing the importance of early intervention to prevent adverse cardiac outcomes and sudden cardiac death. Caution is needed when interpreting our results due to study heterogeneity, certainty of evidence, and sensitivity analysis findings. More rigorous research on this subject is required.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"139"},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}