British journal of hospital medicine最新文献

{"title":"Relationship Between Dietary Inflammatory Index With Biochemical Markers and Atherogenic Risk in Patients With Atherosclerotic Heart Disease.","authors":"Hikmet Nur Yemlihalıoğlu, Aslı Gizem Çapar, Abdurrahman Oğuzhan","doi":"10.31083/BJHM50330","DOIUrl":"https://doi.org/10.31083/BJHM50330","url":null,"abstract":"<p><strong>Aims/background: </strong>The relationship between cardiovascular disease and the inflammatory potential of diet has been recently reported. This study aimed to investigate the relationship between a pro-inflammatory diet, as assessed by the dietary inflammatory index (DII), and the atherogenic index of plasma (AIP) and biochemical markers in patients with atherosclerotic heart disease.</p><p><strong>Methods: </strong>This study was conducted with 100 patients with atherosclerotic heart disease who were admitted or hospitalised at the Department of Cardiology, Erciyes University Faculty of Medicine between March and September 2024. Participants' sociodemographic variables, anthropometric measurements, and biochemical markers were recorded. Their AIP and DII values were calculated. The 14-item Mediterranean Diet Adherence Tool and the Global Physical Activity Questionnaire were administered to them.</p><p><strong>Results: </strong>In our study, DII scores ranged from (-0.50) to (+12.20). Patients were divided into three groups based on their DII scores; T1 and T3 represented lower and higher DII scores, respectively. There were no significant differences in AIP values among the groups (<i>p</i> > 0.05). There were also no differences among the groups in serum Na, K, Ca, fasting blood glucose (FBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and C-reactive protein (CRP) values (<i>p</i> > 0.05 for all); only Hemoglobin (Hb) value was higher in the T1 group compared to the other groups (<i>p</i> = 0.014). Participants in the T1 group had higher intakes of energy, total fat, carbohydrates, protein, monounsaturated fat, polyunsaturated fat, fiber; beta-carotene, thiamine, riboflavin, niacin, folic acid, and vitamins A, E, C, and B6; and iron and zinc (<i>p</i> < 0.001 for all). Significant differences were observed among the groups in the intake of saturated fat (<i>p</i> = 0.020), vitamin B12 (<i>p</i> = 0.030), magnesium (<i>p</i> < 0.001), garlic (<i>p</i> = 0.004), onion (<i>p</i> < 0.001), and pepper (<i>p</i> < 0.001), whereas no significant differences were found for cholesterol, vitamin D, selenium, and tea consumption (<i>p</i> > 0.05). No associations were observed between DII and HDL-C, LDL-C, TG, TC, CRP, AIP, Global Physical Activity Questionnaire (GPAQ) score, or the 14-item Mediterranean Diet Adherence score after adjustment for confounders in the whole cohort (<i>p</i> > 0.05 for all).</p><p><strong>Conclusion: </strong>This study demonstrates that patients with atherosclerotic heart disease tend to have more pro-inflammatory dietary habits, which are significantly correlated with energy intake and various macronutrient and micronutrient levels. Although there is no direct association between DII and AIP or key biochemical markers, continued pro-inflammatory dietary habits in patients may increase inflammation, potentially affecting th","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 7","pages":"50330"},"PeriodicalIF":1.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Intratumoral and Peritumoral Ultrasound Radiomics Models for Breast Nodule Diagnosis Using Machine Learning.","authors":"Xinru Yang, Jiaxin Zuo, Cuiping Liu, Huihong Zhou, Ping Xiong","doi":"10.31083/BJHM56311","DOIUrl":"https://doi.org/10.31083/BJHM56311","url":null,"abstract":"<p><strong>Aims/background: </strong>The differentiation of benign and malignant breast nodules, particularly those categorized as Breast Imaging Reporting and Data System (BI-RADS) 3-4, remains a clinical challenge due to the subjectivity and operator dependence of conventional ultrasound assessment. This study aimed to evaluate the diagnostic value of intratumoral and peritumoral ultrasound radiomics features in distinguishing benign from malignant BI-RADS 3-4 breast nodules and to construct interpretable machine learning models.</p><p><strong>Methods: </strong>Ultrasound images and parameters (BI-RADS classification) of breast nodules were retrospectively collected from female patients at two institutions between January 2021 and June 2024: 571 patients (880 nodules) from Institution 1 (Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine) and 333 patients (351 nodules) from Institution 2 (Shanghai Second People's Hospital). Included patients had BI-RADS 3-4 nodules confirmed by pathology or, for BI-RADS 3 nodules, stable findings on follow-up for at least 2 years. Nodules from Institution 1 were randomly divided into a training set (n = 615) and an internal validation set (n = 265) at a 7:3 ratio, while patients from Institution 2 constituted an external test set (n = 351). Radiomics features of intratumoral and peritumoral regions (3 and 5 pixels wide) were extracted using PyRadiomics. Features were screened using the independent <i>t</i>-test, Spearman correlation, and least absolute shrinkage and selection operator (LASSO) regression. Machine learning models-including random forest (RF), multilayer perceptron (MLP), extra trees (ET), support vector machine (SVM), logistic regression (LR), k-nearest neighbor (KNN), eXtreme Gradient Boosting (XGBoost), Adaptive Boosting (AdaBoost), Gradient Boosting Decision Tree (GBDT), and Light Gradient Boosting Machine (LightGBM)-were trained and compared using area under the curve (AUC) and other metrics. The best-performing model was then used to compare intratumoral versus peritumoral regions. SHapley Additive exPlanations (SHAP) was applied to interpret feature importance.</p><p><strong>Results: </strong>Across the training, internal validation, and external test sets, SVM demonstrated the most stable and balanced performance. The 3 pixels transitional zone region of interest support vector machine (EI3_SVM) model achieved a higher AUC than the tumor core region of interest (T) model in the external test set (0.875 vs. 0.787, <i>p <</i> 0.01), with accuracy 78.1%, sensitivity 42.2%, specificity 97.0%, and Brier score 0.166, outperforming other peritumoral models. Most models incorporating peritumoral features demonstrated AUCs that were higher than or comparable to those of the T model. SHAP analysis indicated that the high specificity was mainly driven by texture and shape features.</p><p><strong>Conclusion: </strong>Integrating intratumoral and peritumoral radiomics fe","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 7","pages":"56311"},"PeriodicalIF":1.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Serum IL-6, TNF-α, and HIF-1α Levels With Respiratory Tract Infection in Patients With Ischemic Stroke.","authors":"Wenwen Wu, Qing Gao","doi":"10.31083/BJHM56310","DOIUrl":"https://doi.org/10.31083/BJHM56310","url":null,"abstract":"<p><strong>Aims/background: </strong>Patients with ischemic stroke are prone to developing respiratory tract infections, which can seriously affect prognosis. The objective of this study was to assess the association of the serum levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and hypoxia-inducible factor-1 alpha (HIF-1α) with the occurrence of respiratory tract infection, and to determine whether these biomarkers are independently associated with infection risk.</p><p><strong>Methods: </strong>A total of 140 patients with ischemic stroke admitted to The Fifth People's Hospital of Jinan between January 2024 and September 2025 were enrolled. Based on the presence or absence of respiratory tract infection, patients were divided into an infection group (<i>n</i> = 41) and a non-infection group (<i>n</i> = 99). Blood samples were collected within 24 hours after admission. Serum IL-6, TNF-α, and HIF-1α levels were measured using enzyme-linked immunosorbent assay (ELISA). Baseline characteristics were compared between the two groups. Point-biserial correlation and univariate logistic regression were used to assess the relationships between inflammatory markers (IL-6, TNF-α, HIF-1α) and respiratory tract infection, followed by multivariate logistic regression to identify independent influencing factors.</p><p><strong>Results: </strong>There were no significant differences between the two groups in terms of age, gender, body mass index, smoking and drinking history, hypertension, diabetes, coronary heart disease, hyperlipidemia, infarction site, National Institutes of Health Stroke Scale (NIHSS) score, Glasgow Coma Scale (GCS) score, mean respiratory rate, or mean oxygen saturation (<i>p</i> > 0.05). Serum levels of IL-6, TNF-α, and HIF-1α were significantly higher in the infection group than in the non-infection group (<i>p</i> < 0.001). Point-biserial correlation analysis revealed that IL-6, TNF-α, and HIF-1α were positively correlated with respiratory tract infection (r = 0.695, 0.738, and 0.655, respectively; <i>p</i> < 0.001). Univariate logistic regression indicated that all three biomarkers were influencing factors of respiratory tract infection (<i>p</i> < 0.001), and multivariate logistic regression confirmed them as independent influencing factors (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Elevated serum levels of IL-6, TNF-α, and HIF-1α are significantly associated with respiratory tract infection in patients with ischemic stroke. However, this association does not imply a causal relationship, and the observed increases in these inflammatory markers may reflect a consequence of infection rather than independent risk factors. Early monitoring of these biomarkers may help identify patients with increased risk of developing infection and facilitate timely clinical assessment and intervention to improve outcomes.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 7","pages":"56310"},"PeriodicalIF":1.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Safely Anticoagulate Patients With Renal Impairment.","authors":"Nadir Aziz, Robyn Haysom, Jecko Thachil, Dawn Swan","doi":"10.31083/BJHM49737","DOIUrl":"https://doi.org/10.31083/BJHM49737","url":null,"abstract":"<p><p>Chronic kidney disease (CKD), a highly prevalent condition worldwide, is associated with increased thrombotic and bleeding risks. Thrombotic risks include heightened cardiovascular risk and that of venous thromboembolism, driven by endothelial dysfunction, and inflammation. Conversely, platelet dysfunction and vascular abnormalities elevate the bleeding risk. This complex interplay of bleeding and thrombosis highlights the challenges faced in anticoagulant prescribing in CKD. Although warfarin and low-molecular-weight heparin are currently recommended in the guidelines, direct oral anticoagulants (DOACs) may offer a favourable profile in mild-to-moderate CKD based on the decreased incidence of thrombotic events and lower bleeding risk reported in studies. There remains a paucity of studies on DOAC use in severe CKD and end-stage renal disease (ESRD). In this article we discuss different options of anticoagulant use in the setting of CKD for venous thromboembolism (VTE) treatment and prophylaxis in atrial fibrillation (AF), highlighting the need for further clinical trials in this patient population.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 7","pages":"49737"},"PeriodicalIF":1.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research in Emergency Medicine Is Not Optional - Why We Must Generate Our Own Evidence.","authors":"Matthew J Reed","doi":"10.31083/BJHM54690","DOIUrl":"https://doi.org/10.31083/BJHM54690","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 7","pages":"54690"},"PeriodicalIF":1.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Methotrexate Failure and Tubal Rupture in Patients With Tubal Ectopic Pregnancy: A Retrospective Cohort Study.","authors":"Eda Güner Özen, Süleyman Özen, Handan Semiz Sağir, Begüm Köse Kinci, Şükran Büşra Tanyeri, Ahkam Göksel Kanmaz, Yaşam Kemal Akpak","doi":"10.31083/BJHM56309","DOIUrl":"https://doi.org/10.31083/BJHM56309","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims/background: &lt;/strong&gt;Tubal ectopic pregnancy remains a potentially life-threatening condition despite advances in early diagnosis and management. Although methotrexate (MTX) is widely used in clinically stable patients, treatment escalation and tubal rupture may still occur. This study primarily aimed to evaluate MTX treatment outcomes and identify pretreatment clinical, laboratory, and ultrasonographic factors associated with tubal rupture during MTX therapy in tubal ectopic pregnancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-center retrospective cohort study included women with confirmed tubal ectopic pregnancy managed between October 2023 and June 2025. According to the pre-established institutional protocol, patients received either primary surgical treatment or first-line systemic methotrexate treatment. Only cases with tubal localization confirmed by follow-up transvaginal ultrasonography and/or intraoperative findings were included. MTX was administered using a single-dose regimen (50 mg/m&lt;sup&gt;2&lt;/sup&gt;), with a second dose given in clinically stable patients when indicated. Requirement for a second MTX dose was considered treatment escalation rather than treatment failure; MTX failure was defined as the need for surgical intervention. Demographic, clinical, laboratory, and ultrasonographic variables were analysed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of baseline β-human chorionic gonadotropin (β-hCG) levels and ectopic mass size for tubal rupture during MTX therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 194 women were included; 54 (27.8%) underwent primary surgery and 140 (72.2%) received MTX as initial treatment. Among MTX-treated patients, single-dose MTX was successful in 94 patients (67.1%), 24 (17.1%) required a second dose, and tubal rupture requiring surgical intervention occurred in 22 (15.7%). Patients who developed rupture had significantly higher baseline, day-4, and day-7 β-hCG levels, larger ectopic mass size, and a markedly higher frequency of free intraperitoneal fluid compared with those successfully treated with MTX (all &lt;i&gt;p&lt;/i&gt; &lt; 0.05). The decline in β-hCG levels between days 4 and 7 was significantly lower in patients requiring treatment escalation or developing rupture (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Although fetal cardiac activity was numerically more frequent in the MTX-related rupture subgroup, this difference was not statistically significant after analysis with the Fisher-Freeman-Halton exact test. Gestational age at presentation was significantly greater in patients who later developed MTX-related rupture than in those who underwent primary surgery (&lt;i&gt;p&lt;/i&gt; = 0.009). Receiver operating characteristic analysis demonstrated excellent discriminative performance for baseline β-hCG (area under the curve [AUC] = 0.869; 95% confidence interval [CI], 0.769-0.970; &lt;i&gt;p&lt;/i&gt; &lt; 0.001; cut-off = 1670 mIU/mL; sensitivity 95.2%, specificity 77.1%) and","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 7","pages":"56309"},"PeriodicalIF":1.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatocellular Carcinoma Presenting With Extensive Portal Vein Tumour Thrombus Without Evidence of Underlying Liver Cirrhosis or Steatosis: A Case Report.","authors":"Ami Schattner, Livnat Uliel, Itzhak Schechtman, Ina Dubin","doi":"10.31083/BJHM56026","DOIUrl":"10.31083/BJHM56026","url":null,"abstract":"<p><strong>Aims/background: </strong>Most cases of hepatocellular carcinoma (HCC) develop in the setting of chronic liver disease (CLD), usually with chronic inflammation, fibrosis, or cirrhosis. The case aims to highlight a rare presentation without evidence of prior CLD.</p><p><strong>Case presentation: </strong>An older adult patient with no risk factors for CLD other than type 2 diabetes, overweight, and hypertension presented with high-gradient ascites, splenomegaly and hypersplenism due to portal hypertension.</p><p><strong>Results: </strong>Imaging identified an extensive tumour thrombus extending from the portal vein and hepatic veins to the inferior vena cava and right atrium-adjacent to a liver mass. Alpha-fetoprotein was extremely elevated. Ultrasound-guided core liver needle biopsy of the mass was diagnostic of HCC. Biosynthetic liver functions were preserved, liver imaging did not show cirrhosis or steatosis, and liver tissue adjacent to the tumour showed no CLD.</p><p><strong>Conclusion: </strong>HCC may rarely present with tumour thrombus-associated portal hypertension and ascites, and very rarely arise with no demonstrable background of liver pathology. Absence of demonstrable CLD does not rule out HCC and its complications.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 7","pages":"56026"},"PeriodicalIF":1.7,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Inflammatory and Immune Markers for Acute Respiratory Failure in Patients With Community-Acquired Pneumonia.","authors":"Jinping Sun, Jun Zhao","doi":"10.31083/BJHM56282","DOIUrl":"https://doi.org/10.31083/BJHM56282","url":null,"abstract":"<p><strong>Aims/background: </strong>Acute respiratory failure (ARF) may develop in some patients with community-acquired pneumonia (CAP), resulting in a significantly increased mortality rate. Early identification of high-risk patients is essential for improving prognosis. This study aimed to investigate the predictive value of inflammatory and immune markers for acute respiratory failure in patients with community-acquired pneumonia.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 334 patients with community-acquired pneumonia admitted at Zhuji Sixth People's Hospital, between January 2021 and December 2024. Patients were divided into a CAP-only (non-event) group and a CAP-ARF (event) group based on the development of acute respiratory failure. Inflammatory markers (white blood cell count, neutrophil count, tumor necrosis factor-α, etc.) and immune markers (complement components 3 and 4[C3andC4], immunoglobulins A and G [IgAand IgG], etc.) were collected within 24 hours of admission. Univariate and multivariate logistic regression analyses were performed to identify independent predictive factors, and the predictive performance of individual and combined indicators was evaluated using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>Multivariate analysis showed that elevated white blood cell count, neutrophil count, and tumor necrosis factor-α levels were independent risk factors for acute respiratory failure, while decreased levels of complement C3 and C4, and IgA and IgG, were independent protective factors. The combined predictive model incorporating these indicators demonstrated excellent predictive performance for acute respiratory failure, with an area under the curve (AUC) of 0.853.</p><p><strong>Conclusion: </strong>In patients with community-acquired pneumonia, inflammatory and immune markers exhibit significant predictive value for the development of acute respiratory failure. A combined assessment of white blood cell count, neutrophil count, tumor necrosis factor-α, complement C3 and C4, and IgA and IgG may facilitate early identification of high-risk patients and inform clinical decision-making.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 7","pages":"56282"},"PeriodicalIF":1.7,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extending Value-Based Healthcare Into Population Health.","authors":"Hao Yi Tan","doi":"10.31083/BJHM53727","DOIUrl":"https://doi.org/10.31083/BJHM53727","url":null,"abstract":"","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 7","pages":"53727"},"PeriodicalIF":1.7,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal Association Between Idiopathic Pulmonary Fibrosis and Coronary Artery Disease: A Bidirectional Two-Sample Mendelian Randomization.","authors":"Lirui Yang, Xin Zhao, Tingting Feng, Jiang Li","doi":"10.31083/BJHM56025","DOIUrl":"https://doi.org/10.31083/BJHM56025","url":null,"abstract":"<p><strong>Aims/background: </strong>Coronary artery disease (CAD) has been epidemiologically linked to idiopathic pulmonary fibrosis (IPF); however, the genetic basis of this association remains unclear. Therefore, this study aims to investigate the potential causal relationships between IPF and CAD using a bidirectional two-sample Mendelian randomization (MR) strategy.</p><p><strong>Methods: </strong>Inverse-variance weighted (IVW), MR-Egger, weighted median, and weighted mode approaches were applied to summary statistics obtained from CAD and IPF genome-wide association studies. Heterogeneity among instrumental variables was assessed using Cochran's Q test. Pleiotropy was assessed using MR-Egger regression and MR pleiotropy residual sum and outlier (MR-PRESSO) analyses. Additionally, the robustness and reliability of the findings were validated by applying a leave-one-out analysis.</p><p><strong>Results: </strong>The forward MR analysis revealed no evidence supporting a genetic causal association between IPF and CAD (odds ratio [OR] = 0.989, 95% confidence interval [CI]: 0.967-1.010, <i>p</i> = 0.305) after excluding an outlier single-nucleotide polymorphism (SNP) (rs7725218). However, reverse MR analysis demonstrated a significant negative genetic causal association between CAD and IPF (OR = 0.832, 95% CI: 0.711-0.975, <i>p</i> = 0.023). Sensitivity analysis revealed heterogeneity in the forward MR analysis, which was resolved after excluding an outlier SNP, with no evidence of horizontal pleiotropy detected.</p><p><strong>Conclusion: </strong>This study demonstrates a potential negative genetic influence of CAD on the risk of IPF, providing valuable insights that may guide the development of more enhanced preventive and therapeutic strategies. Future research should further assess the interactions between CAD and IPF to improve disease management and patient outcomes.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"87 7","pages":"56025"},"PeriodicalIF":1.7,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}