BMC Cardiovascular Disorders最新文献

{"title":"Association between soluble suppression of tumorigenicity 2 and risk and severity of coronary artery disease: a case control study.","authors":"Shuai Zhang, Lu Qian, Shibao Li, Zhijian Liu","doi":"10.1186/s12872-025-04787-5","DOIUrl":"https://doi.org/10.1186/s12872-025-04787-5","url":null,"abstract":"<p><strong>Background: </strong>To investigate the differential expression of soluble suppression of tumorigenicity 2 (sST2) in patients with coronary artery disease (CAD) and healthy controls, and the correlation between sST2 and the severity of coronary artery atherosclerosis.</p><p><strong>Methods: </strong>A total of 911 CAD patients were selected as the CAD group, and 322 healthy people were selected as the control group. We measured serum sST2 level by chemiluminescence immunoassay, and applied the Gensini scoring system to quantify the severity of coronary artery atherosclerosis. We utilized Mann-Whitney U test to assess the difference of sST2 level between the two groups, and adopted Spearman correlation test to evaluate the correlation between sST2 level and Gensini score and inflammatory indexes.</p><p><strong>Results: </strong>Compared with the control group, the expression level of sST2 in CAD group was significantly increased [29.20 (20.67, 46.34) vs. 19.69 (15.97, 25.02), P < 0.001]. Logistic regression showed that sST2 expression could increase CAD risk (OR = 1.099, 95%CI: 1.080 ~ 1.119, P < 0.001). Analysis of variance revealed that the sST2 expression level increased gradually in unstable angina pectoris group (UA), non-ST elevation myocardial infarction group (NSTEMI) and ST elevation myocardial infarction group (STEMI) [UA: 23.05 (17.54, 30.75), NSTEMI: 30.71 (21.31, 42.97), STEMI: 51.05 (32.85, 80.04), P < 0.001]. Spearman correlation analysis demonstrated significantly positive associations between sST2 expression level and Gensini score (r = 0.137, P < 0.001), and systemic inflammatory indexes MHR (r = 0.188, P < 0.001), NLR (r = 0.469, P < 0.001), PLR (r = 0.285, P < 0.001) and MLR (r = 0.368, P < 0.001), but negatively correlated with AFR (r=-0.135, P < 0.001). By receiver operating characteristic (ROC) curve analysis, the sST2 expression level had excellent predictive effect in STEMI with the area under the curve (AUC) value of 0.926 (95%CI: 0.903-0.948, P < 0.001) and sensitivity and specificity of 72.3% and 99.7% respectively, superior to NSTEMI with an AUC of 0.760 (95%CI: 0.719-0.802, P < 0.001) and UA with an AUC of 0.616 (95%CI: 0.576-0.656, P < 0.001).</p><p><strong>Conclusions: </strong>sST2 could not only serve as a biomarker for the clinical auxiliary diagnosis of CAD, but also act as a potential indicator for disease progression or risk stratification. Dynamic monitoring of sST2 levels might assist in evaluating treatment efficacy.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"334"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975454","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":"Association between Hemoglobin-albumin-lymphocyte-platelet score and all-cause or cardiovascular mortality in patients with diabetes or prediabetes: mediated effects of renal function.","authors":"Pingping Zhao, Zhuang Zhang, Ming Li, Jingqi Hao, Yirong Wang","doi":"10.1186/s12872-025-04791-9","DOIUrl":"https://doi.org/10.1186/s12872-025-04791-9","url":null,"abstract":"<p><strong>Objective: </strong>Hemoglobin-albumin-lymphocyte-platelet (HALP) score is considered to be a comprehensive indicator of inflammation and nutrition. We aimed to investigate the relationship of HALP score and the risk of all-cause and cardiovascular disease (CVD) mortality in patients with diabetes (DM) or prediabetes (PDM).</p><p><strong>Methods: </strong>6,869 participants with DM or PDM from the National Health and Nutrition Examination Survey (NHANES) 2005 to 2018 were enrolled. The colleration of HALP score with all-cause and CVD mortality was evaluated using Kaplan-Meier, Cox regression and restricted cubic spline (RCS) methods. The predictive value of HALP score for mortality was evaluated by time-dependent-receiver-operating-characteristic (ROC) curves. Finally, subgroup and interaction analysis were performed.</p><p><strong>Results: </strong>1203 deaths from all-cause and 399 deaths from CVD were observed. Cox regression analyses showed that the HALP score was negatively correlated with both all-cause and CVD mortality risk. RCS curves showed a nonlinear relationship between HALP score and all-cause or CVD mortality risk, and both the dose-response curves are L-shaped. For all-cause mortality risk, the AUC was 0.805, 0.799, and 0.816 for 3, 5, and 10 years survival, respectively, and for CVD mortality risk, the AUC was 0.839, 0.850, and 0.837 for 3, 5, and 10 years of survival, respectively. Mediation analysis showed that serum creatinine and urea nitrogen partially mediate the relationship between HALP and mortality risk.</p><p><strong>Conclusion: </strong>HALP score is negatively correlated with all-cause and CVD mortality risk, and serves as a valuable predictor of all-cause and CVD mortality risk in patients with DM or PDM.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"331"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963832","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":"Research on noninvasive electrophysiologic imaging based on cardiac electrophysiology simulation and deep learning methods for the inverse problem.","authors":"Yi Chang, Ming Dong, Lihong Fan, Bochao Kang, Weikai Sun, Xiaofeng Li, Zhang Yang, Ming Ren","doi":"10.1186/s12872-025-04728-2","DOIUrl":"https://doi.org/10.1186/s12872-025-04728-2","url":null,"abstract":"<p><strong>Background: </strong>The risk stratification and prognosis of cardiac arrhythmia depend on the individual condition of patients, while invasive diagnostic methods may be risky to patient health, and current non-invasive diagnostic methods are applicable to few disease types without sensitivity and specificity. Cardiac electrophysiologic imaging (ECGI) technology reflects cardiac activities accurately and non-invasively, which is of great significance for the diagnosis and treatment of cardiac diseases. This paper aims to provide a new solution for the realization of ECGI by combining simulation model and deep learning methods.</p><p><strong>Methods: </strong>A complete three-dimensional bidomain cardiac electrophysiologic activity model was constructed, and simulated electrocardiogram data were obtained as training samples. Particle swarm optimization-back propagation neural network, convolutional neural network, and long short-term memory network were used respectively to reconstruct the cardiac surface potential.</p><p><strong>Results: </strong>The correlation coefficients between the simulation results and the clinical data range from 75.76 to 84.61%. The P waves, PR intervals, QRS complex, and T waves in the simulated waveforms were within the normal clinical range, and the distribution trend of the simulated body surface potential mapping was consistent with the clinical data. The coefficient of determination R² between the reconstruction results of all the algorithms and the true value is above 0.80, and the mean absolute error is below 2.1 mV, among which the R² of long short-term memory network is about 0.99 and the mean absolute error about 0.5 mV.</p><p><strong>Conclusions: </strong>The electrophysiologic model constructed in this study can reflect cardiac electrical activity, and contains the mapping relationship between the cardiac potential and the body surface potential. In cardiac potential reconstruction, long short-term memory network has significant advantages over other algorithms.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"335"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954577","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 frequencies of CYP2C19*2, *3, and *17 alleles and their impact on the clinical efficacy of doubled maintenance dose of clopidogrel in Syrian patients with coronary artery disease.","authors":"Nour Haj Saleh, Lama A Youssef","doi":"10.1186/s12872-025-04768-8","DOIUrl":"https://doi.org/10.1186/s12872-025-04768-8","url":null,"abstract":"<p><strong>Background: </strong>Genetic variations in the CYP2C19 gene, which encodes the major enzyme responsible for activating clopidogrel, may influence response to Clopidogrel antiplatelet therapy. This study aimed to assess the prevalence of CYP2C19 variants in Syrian patients with coronary artery disease (CAD) and evaluate the impact of these variants on the clinical efficacy of a doubled maintenance dose of clopidogrel following percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>This study included 50 Syrian CAD patients on dual antiplatelet therapy (DAPT) with a doubled maintenance dose of clopidogrel. CYP2C19 genotypes were determined by PCR, followed by Sanger sequencing. Clinical outcomes, including major acute cardiovascular events (MACE) and bleeding events, were monitored over 18-24 months.</p><p><strong>Results: </strong>The allele frequencies were 8% for CYP2C19*2, 0% for CYP2C19*3, and 17% for CYP2C19*17. The distribution of our study population by CYP2C19 genotype-predicted metabolizer phenotypes was 56% for normal metabolizers (NMs), 26% for intermediate metabolizers (IMs), 12% for rapid metabolizers (RMs), and 2% for ultra-rapid metabolizers (UMs). No association was found between the CYP2C19*2 allele and recurrent ischemic events or between the CYP2C19*17 allele and bleeding complications in patients treated with a doubled maintenance dose of clopidogrel.</p><p><strong>Conclusions: </strong>In Syrian patients undergoing PCI, a doubled maintenance dose of clopidogrel (150 mg/day) may help mitigate variability in response due to CYP2C19*2 carrier status, offering potential benefits in optimizing antiplatelet therapy. However, given the study's limited sample size, these findings should be interpreted with caution, and larger studies are needed to confirm this potential benefit.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"330"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969679","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":"Association of dietary index of gut microbiota with cardiovascular disease risk: new evidence from NHANES 2007-2018.","authors":"Jiameng Jin, Xingang Sun, Lihong Wang","doi":"10.1186/s12872-025-04776-8","DOIUrl":"https://doi.org/10.1186/s12872-025-04776-8","url":null,"abstract":"<p><strong>Background: </strong>The dietary index of gut microbiota (DI-GM) is a newly proposed index for assessing dietary quality, and studies on its association with cardiovascular disease (CVD) are limited. This study aimed to investigate the association between DI-GM and the prevalence of CVD.</p><p><strong>Methods: </strong>We utilized data from the National Health and Nutrition Examination Survey (NHANES). Logistic regression analyses were performed to examine the association between DI-GM and CVD. Smoothed curve fitting was employed to explore potential nonlinear relationships. Additionally, subgroup analyses were conducted to assess the stability of the results.</p><p><strong>Results: </strong>The study included 22,590 participants, of whom 20,216 had no CVD and 2,374 had CVD. After adjusting for all covariates, the DI-GM score was significantly negatively associated with CVD risk, with a 4% reduction in CVD risk for each unit increase in DI-GM score (OR = 0.96, 95% CI: 0.94-0.99, P = 0.015). Notably, the highest DI-GM score group (6-12) had a 13% lower risk of CVD compared to the lowest DI-GM score group (0-3) (OR = 0.87, 95% CI: 0.76-1.00, P = 0.048).</p><p><strong>Conclusion: </strong>The research results indicate that a higher DI-GM score protects against CVD, providing crucial empirical support for dietary intervention strategies based on gut microbiota modulation.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"332"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964920","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":"Nonlinear relationship between triglyceride-glucose index and cardiovascular mortality with competing risk analysis on populations aged 18-80 years.","authors":"Jianchun Yao, Jinping Lu, Linfen Li, Liangping Huang","doi":"10.1186/s12872-025-04778-6","DOIUrl":"https://doi.org/10.1186/s12872-025-04778-6","url":null,"abstract":"<p><strong>Background: </strong>The existing evidence regarding the relationship between the triglyceride-glucose index (TyG index) and cardiovascular mortality risk remains relatively limited and controversial, particularly within the context of competing risk scenarios. This study seeks to investigate this relationship, while further incorporating the impact of non-cardiovascular mortality as a competing risk event to this association.</p><p><strong>Methods: </strong>Data of eligible participants were extracted from National Health and Nutrition Examination Surveys (NHANES) 1999-2018. Traditional Cox proportional hazards regression and Fine-Gray sub-distribution hazard models were applied to assess the TyG index and cardiovascular mortality relationship. Restricted cubic splines were used to estimate possible non-linearity, while segmented regression and log-likelihood ratio tests were used to identify threshold values and model fit.</p><p><strong>Results: </strong>The final analysis compromised a number of 23,800 participants, with a mean age of 47.75 ± 18.06 years, and female prominent (51.72%). After fully adjusted, it revealed a positive relationship between the TyG index and cardiovascular mortality risk (HR = 1.24, 95%CI 1.08-1.41, P = 0.0017). Furthermore, upon considering non-cardiovascular mortality as competing risk event, the result of Fine-Gray sub-distribution hazard model analysis attenuated but remained significantly positive (sHR = 1.11, 95%CI 1.11-1.11, P < 0.0001). Besides, a non-linear reversed L-shaped relationship was revealed, with a cutoff value determined as 9.4. Below 9.4, the relationship was insignificant (HR = 1.10, 95%CI 0.92-1.31, P = 0.2866), whereas beyond 9.4, the relationship became positive (HR = 1.64, 95%CI 1.21, 2.22, P = 0.0014), and the log-likelihood ratio test confirmed the threshold effect (P = 0.049). Significant interaction was observed in age and body mass index (BMI) subgroups, respectively, with individuals ≤ 65 years and normal BMI category exhibited higher risk in the relationship (P for interaction < 0.05).</p><p><strong>Conclusions: </strong>The present study reveals a robust positive relationship between the TyG index and cardiovascular mortality among individuals aged 18-80 years despite the influence from non-cardiovascular mortality event. Additionally, the relationship was non-linear with the risk intensifying when TyG index beyond a specific threshold. Besides, individuals younger than 65 years old with normal BMI may be more susceptible in this relationship.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"326"},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961479","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 cardioprotective effects of acteoside in myocardial ischemia reperfusion injury and the underlying mechanism.","authors":"Jing Li, Yuxin Guo, Yang Yang, Qing Xue, Hong Cao, Guangyuan Yang, Zhiqi Sun, Lin-Lin Jia, Hai-Bo Yu","doi":"10.1186/s12872-025-04762-0","DOIUrl":"https://doi.org/10.1186/s12872-025-04762-0","url":null,"abstract":"<p><strong>Introduction: </strong>We observed the cardioprotective effects of Acteoside (AC) on myocardial ischemia reperfusion injury (MIRI) and discussed the possible mechanisms.</p><p><strong>Methods: </strong>Before MIRI model was established successfully, AC was administrated to SD rats by gastric route for 7 d. Punctuate paw withdrawal threshold (PWT) was recorded to reflect the pain threshold. Blood samples were collected to measure the levels of oxidative stress, myocardial enzymes and Norepinephrine (NE). Hematoxylin and eosin (HE) staining was performed to observe the pathological changes of myocardial tissues. Apoptosis of myocardial cell was determined by transferase-mediated dUTP nick end labeling (TUNEL) assay, and the expressions of Bcl-2 and Bax were determined by Western blotting. Using network pharmacological analysis, the PI3K/Akt signaling pathway was screened to be associated with both AC and MIRI. Subsequently, the expressions of PI3K, p-Akt and caspase-3 were detected by immunochemistry in myocardial tissues.</p><p><strong>Results: </strong>We found that pre-administration of AC improved pain threshold and pathological change of myocardial structure caused by MIRI. AC reduced serum levels of myocardial enzymes and NE in MIRI. Compared with the Sham group, rats in MIRI group showed enhanced oxidative stress levels. These changes were partly reversed by AC. In addition, AC inhibited apoptosis, regulated the expression of apoptosis-related proteins. Immunochemistry analysis confirmed that AC increased the expressions of PI3K and p-Akt in myocardial tissue.</p><p><strong>Conclusion: </strong>The cardioprotective effects of AC in MIRI were related with pain alleviation, oxidative stress, apoptosis and sympathetic nerve activity inhibition, the PI3K/Akt signal pathway activation.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"329"},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975083","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":"Temporal dynamics and clinical correlates of ischemic J waves in the early phase of acute myocardial infarction.","authors":"Huanhuan Hu, Lu Huang, Dewen Zhu, Mingwei Wang, Deye Yang, Hongyu Wang, Lina Chen","doi":"10.1186/s12872-025-04766-w","DOIUrl":"https://doi.org/10.1186/s12872-025-04766-w","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore the temporal relationship between ischemic J waves and the progression of chest discomfort in patients experiencing acute myocardial infarction (AMI) during its earliest phase.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 466 AMI cases, each reporting chest discomfort lasting no longer than 4 h. The cohort was divided into four subgroups based on the duration of pain, and electrocardiographic (ECG) alterations were compared across these groups. Patients were categorized based on the presence or absence of J waves on their initial ECG, and a comprehensive analysis was performed comparing patient demographics, ECG characteristics, echocardiographic data, and coronary angiography results.</p><p><strong>Results: </strong>J waves were most prominent within the first hour of chest pain onset (p < 0.05). Patients with J waves had higher rates of ST-segment elevation myocardial infarction (STEMI) (91.4% vs. 50.4%, p < 0.001), lower heart rates (74.22 ± 9.49 vs. 80.43 ± 13.80 bpm, p < 0.001), elevated fasting glucose (8.50 ± 3.12 vs. 6.99 ± 2.20 mmol/L, p = 0.011), increased QT dispersion (90.48 ± 9.12 ms vs. 66.29 ± 11.84 ms, p < 0.001), and prolonged TpTe interval (the time interval from the peak of the T wave to its end point) (131.88 ± 19.81 ms vs. 96.99 ± 11.29 ms, p < 0.001). Multivariate analysis identified five independent factors linked to J wave presence: ST-segment elevation myocardial infarction (STEMI), reduced heart rate, elevated glucose, increased QT dispersion, and prolonged TpTe. J waves were also more frequent in patients with multi-vessel disease and right coronary artery involvement.</p><p><strong>Conclusion: </strong>Ischemic J waves are most detectable within the first hour of chest discomfort in AMI patients and are independently associated with STEMI, bradycardia, hyperglycemia, and specific ECG changes.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"328"},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976459","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":"Correction: HACE1 protects against myocardial ischemia-reperfusion injury via inhibition of mitochondrial fission in mice.","authors":"Bang-Xia Liu, Juan Zheng, Zhan-Wei Tang, Lei Gao, Meng Wang, Ying Sun, Chen Chen, Heng-Chen Yao","doi":"10.1186/s12872-025-04761-1","DOIUrl":"https://doi.org/10.1186/s12872-025-04761-1","url":null,"abstract":"","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"327"},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973564","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":"Clinical characteristics and outcomes of acute coronary syndrome patients in a PCI-Limited setting: a prospective study from Bhutan.","authors":"Chempay, Yeshey Dorjey, Ugyen Tshering, Melanie R Watts","doi":"10.1186/s12872-025-04782-w","DOIUrl":"https://doi.org/10.1186/s12872-025-04782-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Coronary artery disease is the most prevalent heart condition and a leading cause of mortality worldwide. Acute coronary syndrome (ACS) encompasses ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina (UA). ACS has become an increasingly concerning health issue in Bhutan. Currently, no baseline data exists on ACS in the country. This study aims to assess the burden of ACS by analyzing the clinical characteristics and outcomes of patients diagnosed with ACS who presented to the National Referral Hospital in Bhutan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective cohort study was conducted at the Emergency Department of Jigme Dorji Wangchuk (JDW) National Referral Hospital from October 1, 2022, to September 30, 2023. All patients diagnosed with ACS who presented to the Emergency Department were included in the study. Demographic and clinical presentations were recorded. Electrocardiogram (ECG) recordings were performed for all patients with ACS and categorized into STEMI, NSTEMI, and UA. Appropriate treatments were initiated, and patients were closely monitored. Depending on the severity, patients were either admitted to the medical ward or intensive care unit, while some were discharged home. All data were recorded using a standard pro forma developed for the study. Data analysis was performed using SPSS version 23.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During the study period, 67 patients were diagnosed with ACS. Of these, over 58% (39/67) had NSTEMI, while approximately 33% (22/67) had STEMI. The mean age ± SD of ACS patients was 63.5 ± 16.8 years, with the majority being male (67.2%, 45/67). More than half of the ACS patients presented to the hospital within 24 h of symptom onset, with chest pain (29.7%) and shortness of breath (26.4%) being the most common complaints. Among STEMI patients, over 60% exhibited ST elevation in the anterior and septal leads on ECG, and more than two-thirds required thrombolytic therapy (77.3%, 17/22). Among thrombolytic agents, alteplase was the most commonly used (70%), followed by streptokinase (17.6%). Of the 67 ACS patients, over 46% (31/67) developed complications, with more than one-fourth experiencing heart failure (26.9%). Complications were significantly more common in STEMI patients compared to those with NSTEMI (p &lt; 0.001). The majority (61.2%, 41/67) were discharged home after improvement, while one-third required referral overseas for cardiac interventions. Older age (≥ 60 years) was independently associated with ACS (OR 9.5, 95% CI 1.1-86.9, p = 0.046). Other medical conditions, including hypertension, diabetes, dyslipidemia, and smoking, increased the likelihood of ACS; however, these associations were not statistically significant (p &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Among the cases of acute coronary syndrome, 58% were classified as NSTEMI and 33% as STEMI. A majority of patients presented to the hospita","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"324"},"PeriodicalIF":2.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961478","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}