38.4% of patients with colorectal cancer died from non-cancer disease, with cardiovascular disease being the most important cause, accounting for 20.3% of the total deaths. Cardiovascular toxicity associated with targeted therapy is not uncommon, most notably hypertension.

The study aimed to determine the overall incidence and risk of cardiovascular toxicity associated with fruquintinib in metastatic colorectal cancer.

We searched CNKI, Wanfang Data, CBM, PubMed, Embase, Web of Science and Cochrane Library databases for single-arm clinical trials and randomized controlled trials (RCTs) relevant to fuquintinib therapy in patients with metastatic colorectal cancer. The search time limit was from the establishment of the databases to May 2024. Literature screening, data extraction, and quality evaluation were performed independently by two investigators. The meta-analysis was conducted using R 4.3.3 software.

Eight articles involving six single-arm clinical trials and three randomized controlled trials were included. The meta-analysis results showed that the incidence rates of all-grade hypertension and hemorrhage were 35% (95%CI=0.25-0.45) and 24% (95%CI=0.10-0.37), respectively. For high-grade events, the rates were 15% for hypertension (95%CI=0.10-0.20), 1% for hemorrhage (95%CI=0-0.02), 3% for embolic and thrombotic events (95%CI=0.02-0.05), and 1% for cardiac diseases (95%CI=0-0.02). Fruquintinib was associated with increased risks for both all-grade and high-grade hypertension, as well as all-grade hemorrhage, with RR of 3.93 (95%CI=2.95-5.24), 12.33 (95%CI=5.31-28.63), and 1.84 (95%CI=1.36-2.50) respectively, but not for high-grade hemorrhage (RR=1.06, 95%CI=0.35-3.23), embolic and thrombotic events (RR=3.35, 95%CI=0.89-12.55), or cardiac diseases (RR=0.62, 95%CI=0.18-2.14) .

The use of fruquintinib is associated with a significantly increased risk of developing cardiovascular toxicity, primarily for lower-grade events, in patients with metastatic colorectal cancer.

Cardiometabolic multimorbidity (CMM) is one of the most common patterns of co-morbidity aggregated in middle-aged and older adults. It greatly increases the risk of disability and death in our country. Insulin resistance and obesity are closely related to the occurrence and development of cardiometabolic diseases (CMD). The correlation between obesity and various types of CMD has been previously confirmed. The risk of CMM in residents with varying types of obesity and gender may be different and still unclear.

To identify the correlation of the type of obesity and CMM in male and female middle-aged residents in Anhui Province.

The subjects of this study were derived from the Early Screening and Comprehensive Intervention Program for People at High Risk of Cardiovascular Disease carried out in Anhui Province from 2017 to 2021, with a total of 10 project sites involving community residents in 12 counties and cities. Finally, 70 812 permanent middle-aged residents (45-<65 years) were included. Surveying of the subjects was performed by pre-trained investigators, including the general information (age, gender, smoking, alcohol consumption, remarriage education level of high school and above, farmers), disease history (hypertension, heart disease, diabetes, stroke, dyslipidemia), physical examination (height, body mass index, waist circumference), and laboratory tests (blood glucose, blood lipids). Subjects were divided into male and female, and sub-divided into non-obese, peripheral obesity, central obesity, and compound obesity. Logistic regression analysis was conducted to explore the correlation of CMM with gender and type of obesity. The effect value in male and female groups with different types of obesity was compared by the Z-test in R package.

A total of 26 726 male and 44 086 female residents were included. The prevalence of CMM in the total population, male and female groups was 14.6% (10 361/70 812), 16.6% (4 445/26 726), and 13.4% (5 916/44 086), respectively. The prevalence of hypertension, diabetes mellitus, heart disease, stroke, and dyslipidemia among middle-aged residents of Anhui Province was 27.0%, 7.8%, 0.5%, 2.5%, and 29.5%, respectively. Logistic regression analysis showed that, after adjusting for age, smoking, alcohol consumption, remarriage, education level of high school and above, and occupation of farmers, the risk of CMD significantly increased in the peripheral obesity (OR=1.665, 95% CI=1.599-1.734), central obesity (OR=1.788, 95% CI=1.656-1.930), and compound obesity subgroups (OR=3.020, 95% CI=2.913-3.131) than the non-obesity subgroup (P<0.05). In either the male or female group, the risk of CMM increased sequentially in the peripheral obesity, central obesity, and compound obesity subgroups. In the male group, the OR (95%CI) of an increased risk of CMM in peripheral obesity, central obesity, and compound obesity subgroups compared to the non-obese subgroups was 2.008 (1.822-2.213), 2.281 (1.875-2.774), and 4.137 (3.799-4.504), respectively; while in the female group, it was 1.574 (1.443-1.717), 1.727 (1.509-1.976), and 2.916 (2.721-3.126), respectively (P<0.05). The Z-test results showed a significant difference among the peripheral obesity, central obesity, and compound obesity subgroups in male and female residents (P<0.05). After adjusting for the blood lipids and other related indexes, the risk of CMM in the peripheral obesity, central obesity, and compound obesity subgroups in male and female residents increased sequentially with a significant difference (P<0.05). Z-test showed a significant difference in the risk of CMM in the compound obesity subgroup of male and female residents (Z=2.258, P<0.05) .

The risk of CMM varies in middle-aged residents of Anhui Province with different types of obesity, showing the highest risk in those with compound obesity, followed by central obesity. Male middle-aged residents with compound obesity have a higher risk of CMM than females, serving as a highly concerned population.

With the progression of aging in China and the increase in the population with multiple coexisting diseases, the high risk associated with cardiovascular-metabolic multimorbidity (CMM) has made it a focal point for research. However, most studies have concentrated on individual cardiovascular metabolic diseases rather than exploring the comprehensive correlations within CMM.

To investigate the relationship between the triglyceride-glucose (TyG) index and the risk of CMM in middle-aged and elderly Chinese populations, and to evaluate the role of TyG in the prevention and control of CMM.

Participants were derived from the Anhui Province High-Risk Population Early Screening and Comprehensive Intervention Project for Cardiovascular Diseases conducted between 2017 and 2021. A total of 94 455 subjects were included based on inclusion and exclusion criteria. Baseline characteristics and laboratory examination indices were collected, and the TyG index was calculated. Multivariate logistic stepwise regression analysis was used to explore the impact factors of CMM by TyG as both a continuous variable and different quartiles. Z-tests were applied to compare odds ratio (OR) between groups. Restricted cubic spline (RCS) analysis was employed to assess potential non-linear associations, RCS curves were plotted, and the cutoff point where OR=1 was calculated.

Among the participants, 1 456 cases (664 males, 792 females) were identified with CMM, while 92 999 cases (38 313 males, 54 686 females) did not have CMM. In males, patients with CMM had higher age, BMI, mean arterial pressure (MAP), fasting plasma glucose (FPG), triglycerides (TG), proportion of individuals with high school education or above, diabetes, ischemic heart disease, stroke, hypertension, and TyG index compared to those without CMM (P<0.05) ; they also had lower rates of smoking, drinking, farmer occupation, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) (P<0.05). Men and women were stratified into quartiles based on their TyG index values. For men, the groups were T1 (TyG 6.90-8.33, n=9 745), T2 (TyG 8.34-8.67, n=9 744), T3 (TyG 8.68-9.08, n=9 744), and T4 (TyG 9.09-11.60, n=9 744). For women, the groups were F1 (TyG 7.07-8.49, n=13 870), F2 (TyG 8.50-8.82, n=13 870), F3 (TyG 8.83-9.21, n=13 869), and F4 (TyG 9.22-11.60, n=13 869). Multivariable Logistic stepwise regression analysis demonstrated that after adjusting for age, marital status, smoking, alcohol consumption, educational level (high school or above), occupation (farmer), TC, HDL-C, LDL-C, BMI, hypertension, and MAP, he odds of CMM were 9.045 times higher in T4 than in T1 (OR=9.045, 95%CI=6.372-13.169, P<0.001) and 7.442 times higher in F4 than in F1 (OR=7.442, 95%CI=5.576-10.080, P<0.001). The Z-test indicated no statistically significant difference in the extent of OR elevation between genders (Z=0.824, P=0.410). For each unit increase in TyG, the risk of CMM increased by 3.960 times in males (OR=3.960, 95%CI=3.388-4.620, P<0.001) and by 4.447 times in females (OR=4.447, 95%CI=3.845-5.137, P<0.001), with no statistically significant difference in OR elevation between genders (Z=-1.216, P=0.224). RCS analysis revealed a significant non-linear relationship between TyG index and CMM risk after adjusting for confounders (P_nonlinear<0.05), indicating an increased risk when TyG>8.82 with a notably steeper slope.

The TyG index is closely related to the risk of CMM occurrence in both genders and exhibits similar predictive power. Individuals with a TyG>8.82 should be particularly monitored, and proactive preventive and intervention measures should be implemented to reduce the risk of CMM.

Cardiovascular disease (CVD) is a global health problem, and it is not known whether socioeconomic status (SES) and healthy lifestyle (HL) have an impact on CVD onset.

To understand the relationship between SES, HL and CVD, and to provide a basis for the prevention and control of CVD in the population.

A multi-stage cluster random sampling method was employed to select 9 280 residents aged 18 and above from 12 counties and districts in Guizhou Province as the baseline sample in 2010. In 2016-2020 follow the cohort, face to face interview by unified training and qualified personnel, including basic situation, lifestyle (smoking, drinking, vegetables and vegetables, etc.), previous disease history, according to the survey was divided into CVD group (123) and non-CVD group (4 025) ; we used COX proportional hazard regression models were used to analyze the effect of SES and HL on CVD incidence. Additionally, an accelerated failure time model was utilized to assess the impact of different SES and HL at the time of CVD onset.

After excluding baseline CVD patients, lost-to-follow-up and missing information, the valid sample size included in the analysis was 4 148, CVD onset 123, and the incidence density was 4.13 / 1 000 person-years. The results of multivariate analysis showed that compared with low SES (≤7 points), the risk of CVD in high SES (>7 points) decreased by 40.60% (HR=0.594, 95%CI=0.402-0.878). Compared with 6 HL populations, the population with 8 and 9 HL decreased by 44.40% (HR=0.556, 95%CI=0.320-0.968) and 49.20% (HR=0.508, 95%CI=0.284-0.912). Compared with the population in the low SES group and with HL ≤ 6 conditions, there was no statistically significant risk of CVD incidence in the population in the low SES group with HL of 7, 8, or ≥ 9 conditions (P>0.05) ; those with high SES (>7 points) and HL of 8 or 9 decreased CVD risk by 61.80% (HR=0.382, 95%CI=0.163-0.894) and 70.20% (HR=0.298, 95%CI=0.119-0.748, respectively), showing a decreasing trend. The results of the accelerated failure time model showed that those with high SES (>7 points), those with 8 species and 9 HL were delayed by 1.148 years (95%CI=0.049-2.287) and 1.407 (95%CI=0.227-2.588) .

Different SES and HL are negatively associated with CVD onset; in high SES population, the duration of CVD onset increases with increasing HL species. Low SES population is the key population of CVD prevention and control in Guizhou Province, so measures should be taken to improve their health literacy, and the health education and health promotion of CVD should be carried out accordingly.

Type 2 diabetes (T2DM) and metabolism-associated fatty liver disease (MAFLD) interact with each other, and the coexistence of the two further increases the risk of adverse outcomes such as cardiovascular disease (CVD) and liver fibrosis. Therefore there is a need for MAFLD screening and liver fibrosis risk stratification in patients with T2DM, especially those with multiple cardio-metabolic risks.

To investigate the clinical metabolic characteristics of T2DM patients with different risk of liver fibrosis and CVD risks.

A total of 1 425 T2DM patients admitted to our department from July 2020 to June 2023 were included in the study. All patients underwent liver transient elastography (FibroTouch) examination. According to the 2023 American Diabetes Association (ADA) Standards of Medical Care in Diabetes, the population is classified based on the FIB-4 index and liver stiffness measurement (LSM) into three groups: low-risk group (n=1 235), intermediate-risk group (n=110), and high-risk group (n=80). The clinical characteristics among the groups were compared, and the Framingham Risk Score (FRS) was utilized to assess the 10-year risk of CVD. Furthermore, the different populations at varying risks of liver fibrosis were stratified based on CVD risk into three groups: Low-CVD Low hepatic risk Group (n=214), High-CVD Low hepatic risk Group (n=1 021), High-CVD High hepatic risk Group (n=178), Low-CVD High hepatic risk Group (n=12). The clinical characteristics of T2DM patients were compared in the first 3 groups.

The results showed that inclusion 5.6% of the 1, 425 patients with T2DM were at high risk of liver fibrosis.Age, alanine aminotransferase (ALT), direct bilirubin (DBIL), glycosylated hemoglobin (HbA_1c), fat attenuation parameter (UAP), LSM, FIB4, muscle mass loss, diabetic peripheral neuropathy, lipid-lowering therapy were higher in patients in the high-risk group than in the low-risk group of hepatic fibrosis, and platelets (PLT), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and skeletal muscle mass index (SMI) were lower than those in the low-risk group for liver fibrosis, and aspartate aminotransferase (AST) and diabetic retinopathy were higher than those in the low-risk group for liver fibrosis and the intermediate-risk group for liver fibrosis (P<0.05). Stratified analysis showed that T2DM patients with age>60 years, HbA_1c>9%, abnormal liver enzymes, and combined muscle mass loss were at higher risk of liver fibrosis (P<0.05). Comparison of the incidence of CVD risk in patients with different risks of liver fibrosis showed a progressive increase in the incidence of high CVD risk as the risk of liver fibrosis increased (χ²_trend=35.900, P<0.001). Age, AST, DBIL, UAP, LSM, FIB4, FRS, diabetic peripheral neuropathy, and lipid-lowering therapy were higher and PLT was lower in patients in the High-CVD High hepatic risk Group than in the the Low-CVD Low hepatic risk Group and the High-CVD Low hepatic risk Group (P<0.05) .

Patients with T2DM are at high risk of developing liver fibrosis and CVD, in which advanced age, poor glycemic control, combination of multiple diabetic complications, liver enzyme abnormalities, increased hepatic lipid deposition, or decreased muscle mass increase the risk of CVD and hepatic fibrosis, and early monitoring and preventive management should be strengthened in this group of patients.

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been proven to effectively improve the prognosis of patients with heart failure, chronic kidney disease, and diabetes in the context of cardiovascular-renal-endocrine coordinated management. However, the clinical benefits of SGLT2i in patients with acute myocardial infarction (AMI) remain controversial.

To investigate the impact of SGLT2i on the incidence of major cardiovascular adverse events (MACEs) in AMI patients after percutaneous coronary intervention (PCI) .

Relevant studies on the use of SGLT2i in AMI patients post-PCI were identified through a search of the PubMed, Web of Science, and Embase databases. Two researchers independently screened the studies, extracted data, and assessed the risk of bias. Meta-analysis was conducted using STATA 16.0 software.

A total of 8 studies involving 16 643 AMI patients were included in this analysis. Compared to conventional secondary prevention after PCI, the addition of SGLT2i did not reduce the all-cause mortality (OR=0.88, 95%CI=0.61-1.29, P=0.052), cardiovascular mortality (OR=1.04, 95%CI=0.83-1.30, P=0.735), all-cause readmission rate (OR=1.00, 95%CI=0.91-1.14, P=0.952), or the incidence of revascularization (OR=0.87, 95%CI=0.58-1.30, P=0.486). However, it significantly reduced the rate of heart failure-related readmission in AMI patients (OR=0.71, 95%CI=0.60-0.83, P<0.01) and did not increase the incidence of severe drug-related adverse reactions (OR=0.99, 95%CI=0.91-1.09, P=0.903) .

The addition of SGLT2i can safely and effectively reduce the incidence of heart failure-related readmission in AMI patients post-PCI. However, its impact on other MACEs still requires further high-quality randomized controlled trials for validation.

With the aggravation of population aging, the prevalence of cognitive disfunction is increasing year by year. Cardiovascular metabolic diseases, as an important influencing factor, are closely related to cognitive function. At present, there are few studies on the association between duration of cardiovascular metabolic diseases and mild cognitive impairment (MCI), which lack comprehensive consideration of lifestyle factors and large-scale surveys of elderly people in Chinese communities. The comprehensiveness and reliability of the research need to be further verified.

To explore the association between the duration of cardiovascular metabolic diseases and MCI in the elderly, and to evaluate the potential role of lifestyle factors in MCI, so as to provide scientific basis for the prevention and intervention of MCI.

The data from Hubei Memory and Aging Cohort Study (HMACS), a cluster sampling method was used to select the elderly aged 65 and over in 3 communities and 48 villages in Dawu County, Wuhan City, Hubei Province from 2018 to 2023. The standardized scale was used to evaluate the cognitive function. Six factors including smoking, drinking, eating habits, physical exercise, intellectual activity and body mass index (BMI) were used for lifestyle assessment to analyze the prevalence of MCI and its influencing factors. Multivariate Logistic regression analysis was used to analyze the correlation between the duration of cardiovascular metabolic diseases and MCI, the effect of lifestyle on the correlation between the duration of disease and MCI .

A total of 8 635 subjects were included, and the prevalence of MCI was 26.9%. Multivariate Logistic regression analysis showed that among hypertension (OR=1.263, 95%CI=1.093-1.458, P=0.002), diabetes (OR=1.907, 95%CI=1.476-2.463, P<0.001), coronary heart disease (OR=1.550, 95%CI=1.173-2.047, P=0.002), cerebrovascular disease (OR=2.129, 95%CI=1.627-2.786, P<0.001) the duration of illness was influencing factors for MCI in the elderly. Duration of hypertension >10 years (General: OR=1.367, 95%CI=1.086-1.720, P=0.008; Unhealthy: OR=2.377, 95%CI=1.560-3.623, P<0.001), diabetes duration >10 years (General: OR=1.688, 95%CI=1.134-2.514, P=0.010; Unhealthy: OR=2.083, 95%CI=1.035-4.194, P=0.040) duration of coronary heart disease≤10 years (General: OR=1.495, 95%CI=1.030-2.169, P=0.034; Unhealthy: OR=2.062, 95%CI=1.155-3.682, P=0.014), life style was the influencing factor of MCI. In patients with diabetes duration ≤10 years, general lifestyle (OR=1.611, 95%CI=1.065-2.437, P=0.024) was the influencing factor for MCI. Duration of coronary heart disease >10 years (OR=2.859, 95%CI=1.118-7.307, P=0.028), duration of cerebrovascular disease ≤10 years (OR=1.778, 95%CI=1.079-2.930, P=0.024), duration of cerebrovascular disease >10 years (OR=2.589, 95%CI=1.056-6.345, P=0.038), unhealthy lifestyle was the influencing factor for MCI.

The longer the duration of cardiovascular disease in the elderly, the higher the risk of MCI and the unhealthy lifestyle exacerbates this risk. It is recommended to reduce the incidence of MCI early by improving lifestyle and effectively managing chronic cardiovascular disease.

Cardiometabolic multimorbidity (CMM) was one of the most common comorbidity aggregation patterns in different regions and populations, with a high risk of mortality. However, studies on the clinical and medication characteristics of CMM were limited.

To study the clinical characteristics and medication patterns of patients with CMM in the real world, and provide reference basis for the prevention and management of CMM.

Outpatient patients who were diagnosed with CMM in the hospital information system (HIS) of the First Affiliated Hospital of Ningbo University from January 2023 to June 2023 were selected. Basic prescription information was collected and analyzed using frequency analysis and association rule analysis methods.

A total of 7 059 patients with CMM were included, of which 3 960 (56.1%) were male and 3 099 (43.9%) were female, with an age range of 18 to 97 years and a mean age of (58.1±13.7) years. The results showed that 3 910 patients with less than 5 types of medication, accounting for 55.4%; 2 740 patients with 5-9 types of medication, accounting for 38.8%; and 409 patients with more than 10 types of medication, accounting for 5.8%. Hypertension, dyslipidemia, and diabetes were the core diseases of CMM. Among the comorbidities of cardiovascular metabolic diseases, chronic gastritis, renal insufficiency, and hyperuricemia were more common. In the prescription of patients with CMM, statins, calcium channel blockers (CCB), angiotensin receptor blockers (ARB), metformin, and sodium-dependent glucose transporters 2 inhibitors (SGLT2i) were the core medications.

Our findings suggest chronic gastritis, renal insufficiency, and hyperuricemia are more common diseases in patients with CMM. Screening and prevention should be strengthened and treatment strategies should be adjusted. In the CMM drug prescription, lipid-lowering, antihypertensive, and hypoglycemic drugs are the core drugs used.

As the aging of the population, the burden of chronic diseases in China has increased significantly. The majority of chronic disease patients suffer from cardiometabolic diseases (CMD) like hypertension and diabetes. The health-related quality of life (HRQoL) is a subjective evaluation index that reflects both the physical health level and mental health of patients with chronic diseases. Existing research on HRQoL in patients with CMD primarily focuses on influencing factors and the assessment of their current status. Compared to the research on the static status of HRQoL, research on its dynamic trends over time, however, remains somewhat limited.

To analyze the development trajectory of HRQoL in middle-aged and elderly patients with CMD and influencing factors, as well as to explore the contribution of each influencing factor, thus providing a scientific basis for improving HRQoL in patients with CMD.

Using time-series data from field surveys, a baseline survey in 2016 (T0) was conducted using a typical sampling in eligible patients with primary hypertension or type 2 diabetes mellitus (T2DM) from 3 urban communities and 2 rural communities in a certain division of the Xinjiang Production and Construction Corps. Four follow-up surveys were conducted in 2017 (T1), 2018 (T2), 2019 (T3), and 2021 (T4). A total of 1 599 subjects were surveyed in the baseline period, and 565 subjects completed the follow-up visits. Of them, 389 had hypertension, and 176 had T2DM. After excluding samples with missing data like HRQoL and demographic characteristics, data from 563 subjects were included in the analysis. A self-designed questionnaire was used for the survey, composing of five parts of personal basic information, social and psychological status, lifestyle, disease status, and health service utilization. The HRQoL of patients was measured using the European Quality of Life 5-Dimension 5-Level version (EQ-5D-5L). The heterogeneous HRQoL development trajectories were explored using a growth mixture model, and the influencing factors and evaluation of the development trajectories were analyzed using a logistic regression model and Shapley value decomposition, respectively.

Three distinct types of heterogeneous development trajectories were identified, including a 452 (80.28%) cases in the significant growth group, 81 (14.39%) cases in the moderate decline group, and 30 (5.33%) cases in the significant attenuation group. Multivariate Logistic regressions analysis indicated that, patients who do not engage in physical exercise, possess impaired self-care abilities, experience deteriorating health conditions, have non-urban employee medical insurance, and express dissatisfaction with the outpatient chronic disease policy were more likely to enter the moderate decline group (P<0.05) ; patients who do not participate in physical exercise and express general satisfaction with the outpatient chronic disease policy were more likely to belong to the significant attenuation group (P<0.05). The Shapley value decomposition results revealed that the contribution of each influencing factor to the prediction of HRQoL varied among the different trajectory groups. In the significant growth group, the factors with the greatest contribution were changes in health status and self-care ability. In the moderate decline group, the predominant influencing factors were physical exercise and self-care ability. In the significant attenuation group, satisfaction with the outpatient chronic disease policy ranked first in the contribution analysis, followed by physical exercise.

Patients with CMD exhibit varying trajectories in HRQoL, which are influenced by distinct factors associated with each trajectory. Intervention measures can be dynamically tailored in response to the evolving HRQoL trajectories and their influencing factors, thereby offering more precise medical and health services to patients with CMD. We should concentrate on CMD patients whose health status has deteriorated, whose self-care ability has impaired, and who do not engage in physical exercise. Concurrently, efforts should be made to promote awareness of chronic disease policies, medical insurance, and other pension policies. Additionally, it is essential to continue enhancing the quality of outpatient chronic disease medical services and to improve patient satisfaction with the outpatient chronic disease policies, thereby further enhancing HRQoL.

At present, FFR is the ＂gold standard＂ index for evaluating the function and physiology of coronary blood flow. CT-fractional flow reserve (CT-FFR) reflects the hemodynamic changes of coronary artery lesions, it has higher diagnostic and differential ability in distinguishing lesion-specific ischemia compare with FFR.

To evaluate the value of CT-FFR in predicting the incidence of MACE in patients with stable chest pain caused by coronary artery obstruction.

This study included 116 patients who underwent coronary CT angiography (CCTA) examination for stable chest pain in the General Hospital of Ningxia Medical University from January 2017 to June 2021, and were followed up for a median of 2 (0, 25) months. The subjects were divided into MACE group (n=55) and non-MACE group (n=61) according to whether occurred major adverse cardiovascular events (MACE) during the follow-up period. The differences of the degree of coronary artery stenosis and CT-FFR between the two groups were compared, and the patients were classified according to the median of degree of coronary artery stenosis and CT-FFR, and compared the total incidence of MACE and the incidence of MACE within 3 months, 3 to 6 months and after 6 months. Spearman rank correlation analysis was used to analyze the correlation between the degree of coronary artery stenosis and CT-FFR, and multivariate Logistic regression analysis was used to explore the influencing factors of MACE. The ROC curves of stenosis degree, CT-FFR and the combination of the two index on the occurrence of MACE in patients with stable chest pain caused by coronary artery obstruction were drawn, and compared the predictive performance of different indexes according to the area under ROC curve (AUC) .

The median degree of coronary lumen stenosis in 116 patients was 70% (60%, 80%), and the median CT-FFR was 0.79 (0.74, 0.85). The degree of coronary lumen stenosis in the MACE group was higher than that in the non-MACE group (Z=-4.41, P<0.001), and CT-FFR was lower (Z=-5.54, P<0.001). The incidence of MACE in patients with coronary artery stenosis between 70% and 90% was higher than that in patients with coronary artery stenosis between 50% and 69% (χ²=19.221, P<0.001). The incidence of MACE in CT-FFR≤0.8 patients was higher than that in CT-FFR>0.8 (χ²=30.025, P<0.001). The incidence of MACE in patients with different degrees of coronary artery stenosis combined with different CT-FFR was significantly different (χ²=37.789, P<0.001). The incidence of MACE was higher in patients with stenosis between 70% and 90% within 3 months than that in patients with stenosis between 50% and 69%, and the incidence of MACE in patients with CT-FFR≤0.8 within 3 months was higher than that in patients with CT-FFR>0.8. The incidence of MACE in patients with stenosis between 70% and 90% and CT-FFR≤0.8 within 3 months of follow-up was higher than that in other categories (P<0.05). Spearman rank correlation analysis showed that the degree of coronary lumen stenosis was negatively correlated with CT-FFR (r_s=-0.532 6, P<0.001). Multivariate Logistic regression analysis showed that the degree of coronary lumen stenosis between 70% and 90% (OR=3.085, 95%CI=1.147-8.298, P=0.026), CT-FFR≤0.8 (OR=6.527, 95%CI=2.560-16.641, P<0.001) were risk factors for MACE. The value of coronary lumen stenosis combined with CT-FFR in predicting MACE was higher (AUC=0.812, 95%CI=0.731-0.892, P<0.001) .

The degree of coronary artery stenosis between 70% and 90%, CT-FFR≤0.8 may be the risk factors of MACE in patients. Compared with the degree of stenosis, CT-FFR has a beneficial value in predicting the incidence of MACE in patients with stable chest pain caused by coronary artery obstruction, and the prediction performance is better when the degree of stenosis is combined with CT-FFR.

Cardiovascular disease (CVD) is one of the major chronic diseases that cause death and disability, and is an important public health problem in China. At present, there are few studies on the effect of ethnic minority speciality diets on CVD.

To analyse the current situation of CVD prevalence among ethnic minorities in Guizhou Province, and to explore the relationship between ethnic speciality diets and the risk of CVD.

The data were obtained from the epidemiological survey database of the＂Cohort Study of Natural Populations Living in Ethnic Minority Aggregation Areas in the Southwest Region＂from July 2018 to August 2019. Multi-stage stratified sampling was adopted. A baseline survey was conducted on 18 790 Dong, Miao and Bouyei residents aged 30 to 79 in Qiandongnan Miao and Dong Autonomous Prefecture and Qiannan Bouyei Miao Autonomous Prefecture of Guizhou Province. A total of 17 085 people were included in the analysis. According to whether the survey subjects suffered from CVD, they were divided into two groups: CVD group (530 participants) and non-CVD group (16 555 participants). Face-to-face interviews were conducted by professional investigators using a special electronic questionnaire developed by the project team, which included surveys on basic information, living habits, disease history, and diet. As known from the study of ethnic minority dietary culture, the respondents were asked to recall the frequency (times/month) of eating 11 food items in the past 1 year: pickled vegetables, glutinous rice and its products, pickled fish/meat, preserved/smoked meat, white sour soup, red sour soup, cow/sheep deflated, purple-blooded meat, heartleaf houttuynia herb, fern, and oil tea. Unconditional Logistic regression model and restricted cubic spline were used to analyze the relationship between ethnic diet and CVD.

The total prevalence of CVD among ethnic minorities in Guizhou province was 3.20% (530/17 085), and the prevalence of CVD among each ethnic group was 3.14% (207/6 599) for the Dong, 3.13% (158/5 043) for the Miao, and 3.03% (165/5 443) for the Bouyei. The prevalence of CVD among males (3.68%) was higher than that among females (2.80%). Multivariate Logistic regression analysis showed that glutinous rice and its products were protective factors for CVD in the general population 1 to 3 times/month (OR=0.720, 95%CI=0.553-0.937, P=0.015). In the Dong population, fern≤1 time/month (OR=2.172, 95%CI=1.162-4.059, P=0.015) was a risk factor for CVD. In the Miao population, glutinous rice and its products <1 time/month (OR=0.563, 95%CI=0.340-0.933, P=0.026) and oil tea >1 time/month (OR=0.442, 95%CI=0.202-0.967, P=0.041) were protective factors for CVD. In the Bouyei population, cow/sheep deflated≤1 time/month (OR=1.935, 95%CI=1.046-3.579, P=0.035) was a risk factor for CVD. Subgroup analyses showed that in the male population, glutinous rice and its products 1-3 times/month (OR=0.639, 95%CI=0.427-0.957, P=0.030) reduced the risk of CVD. In people <60 years old, glutinous rice and its products 1-3 times/month (OR=0.656, 95%CI=0.443-0.971, P=0.035) and heartleaf houttuynia herb <1 time/month (OR=0.642, 95%CI=0.418-0.986, P=0.043) reduced the risk of CVD, while fern >1 time/month (OR=1.655, 95%CI=1.011-2.709, P=0.045) increased the risk of CVD. In the population with normal body mass, glutinous rice and its products <1 time/month (OR=0.584, 95%CI=0.393-0.868, P=0.008) and 1-3 times/month (OR=0.666, 95%CI=0.452-0.981, P=0.039) could reduce the risk of CVD; in the overweight population, purple-blooded meat ≤1 time/month (OR=0.658, 95%CI=0.453-0.955, P=0.027) could reduce the risk of CVD; in obese population, red sour soup 1-3 times/month (OR=0.592, 95%CI=0.360-0.973, P=0.039) could reduce the risk of CVD. In non-smokers, glutinous rice and its products <1 time/month (OR=0.716, 95%CI=0.532-0.965, P=0.028) and 1-3 times/month (OR=0.711, 95%CI=0.530-0.955, P=0.023) reduced the risk of CVD, and in those who had quit smoking, fern >1 time/month (OR=7.507, 95%CI=1.324-42.556, P=0.023) increased the risk of CVD, while oil tea >1 time/month (OR=0.319, 95%CI=0.103-0.990, P=0.048) decreased the risk of CVD; among people who had quit smoking, glutinous rice and its products were consumed 1-3 times/month (OR=0.710, 95%CI=0.531-0.948, P=0.020) and red sour soup 1-3 times/month (OR=0.775, 95%CI=0.613-0.980, P=0.033) could reduce the risk of CVD, while preserved/smoked meat 1-3 times/month (OR=1.400, 95%CI=1.040-1.884, P= 0.027) could increase the risk of CVD. Glutinous rice and its products, pickled fish/meat and purple-blooded meat were all associated with the risk of developing CVD in a non-linear quantitative manner (P<0.05, P_nonlinear<0.05) .

The prevalence of CVD in ethnic minority populations in Guizhou Province is low. The consumption frequency of glutinous rice and its products, oil tea, heartleaf houttuynia her, purple-blooded meat, red sour soup, fern, fern, cow/sheep deflated, and preserved/smoked meat may affect the prevalence risk of CVD. Knowledge of the intake frequency of ethnic minority speciality diets should be publicized, and dietary interventions should be made to prevent and control CVD in ethnic minority populations in Guizhou Province.

Cardiovascular disease (CVD) is the primary cause of death in patients undergoing peritoneal dialysis (PD) , with malnutrition being one of the significant risk factors for both CVD and mortality. The prognostic nutritional index (PNI) serves as a comprehensive indicator of a patient's immune, inflammatory, and nutritional status. Due to its convenience and reliability, PNI has been widely used in prognostic assessments across various diseases, including cancer. Recent studies have indicated that PNI not only reflects the prognosis of PD patients but is also closely related to their cardiovascular health. However, the relationship between nutritional status at different time points and the prognosis of PD patients requires further exploration.

To explore the relationship between first-year PNI and CVD mortality in PD patients.

This multicenter, retrospective observational cohort study included 1 640 PD patients who initiated treatment between January 1, 2000, and July 1, 2019, at four medical centers: Nanfang Hospital, Southern Medical University, Shunde Hospital of Southern Medical University, the First People's Hospital of Foshan, and Ganzhou People's Hospital. Patients were followed up until July 1, 2021, with the primary endpoint being CVD mortality. A restricted cubic spline (RCS) was used to further examine the non-linear association between PNI and the risk of CVD mortality. Survival curves were generated using the Kaplan-Meier method, and receiver operating characteristic (ROC) curves for predicting CVD mortality based on PNI were analyzed, with an optimal cut-off of 40.46 dividing patients into low PNI (703 patients) and high PNI (937 patients) groups. The impact of PNI on CVD mortality was assessed using Log-rank tests and Cox regression analysis.

The median follow-up period was 30 months, during which 148 patients died, 73 of whom from CVD (49.32%) . RCS results indicated a linear association between PNI and CVD mortality events (P for Nonlinear=0.655) . The area under the ROC curve (AUC) for PNI predicting CVD mortality was 0.717 (95%CI=0.659-0.775, P<0.001) , with a sensitivity of 74.0% and a specificity of 58.6%. Kaplan-Meier analysis showed statistically significant differences in CVD survival curves between the low and high PNI groups (χ²=26.685, P<0.001) . Multivariable Cox regression analysis, adjusted for gender, age, and history of CVD, indicated that a low PNI remains an independent predictor of CVD mortality (HR=7.76, 95%CI=1.72-35.06, P=0.008) . Subgroup analysis confirmed the robustness of these findings without significant interaction effects.

A reduced PNI is an independent factor influencing CVD mortality in PD patients, making the first-year PNI score a valuable tool for prognostic assessment in PD management.

The prevalence of cardiovascular disease (CVD) in China is on the rise. It is estimated that there are 330 million people with CVD, including 13 million cases of stroke, 11.39 million cases of coronary heart disease (CHD), 8.9 million cases of heart failure (HF), 5 million cases of pulmonary heart disease, 4.87 million atrial fibrillation, 2.5 million cases of rheumatic heart disease, 2 million cases of congenital heart disease, 45.3 million cases of peripheral arterial disease (PAD), and 245 million cases of hypertension. In 2021, the total number of discharges of patients with cardiovascular and cerebrovascular diseases in China was 27 649 800, accounting for 15.36% of the total number of discharges (including all inpatient diseases) in the same period, including 14 872 300 CVDs, accounting for 8.26%, and 12 777 500 cerebrovascular diseases, accounting for 7.10%. The economic burden of CVD on residents and society still increases, and the inflection point of CVD prevention and treatment has not yet arrived.

Remnant cholesterol (RC) is considered a significant risk factor for atherosclerotic cardiovascular diseases, and the progression of non-culprit coronary lesions (NCCLs) is also a prominent issue affecting the prognosis of patients with coronary artery disease. However, the relationship between residual cholesterol and vulnerable plaques in NCCLs that progress to major adverse cardiovascular events (MACE) is not well understood.

To explore the predictive value of RC for vulnerable plaques in NCCLs that develop MACE and its correlation with long-term prognosis.

A total of 488 patients with coronary artery disease admitted to the Cardiac Center of the First Affiliated Hospital of Xinjiang Medical University from February 2015 to February 2022 were selected as the study subjects. Baseline data of the patients were collected through the electronic medical record system, and coronary angiography and optical coherence tomography (OCT) were performed. Enrolled patients received scheduled follow-up at 1, 3, 6, and 12 months after discharge. Spearman's rank correlation test was used to explore the correlation between RC and the characteristics of thin-cap fibroatheroma (TCFA) plaques in NCCLs. Multiple Logistic regression analysis was used to explore the influencing factors of MACE in TCFA of NCCLs. The receiver operating characteristic curve (ROC curve) was plotted, and the area under the ROC curve (AUC) was calculated to explore the predictive value of RC for MACE in TCFA of NCCLs.

A total of 488 coronary artery disease patients were included, and patients were divided into MACE group (n=38) and non-MACE group (n=450) based on whether NCCLs developed MACE. Plaque characteristics of NCCLs were identified by OCT, and a total of 749 NCCL plaques were analyzed, with 304 NCCL plaques having a minimum lumen area (MLA) <3.5 mm². During the follow-up period, 38 patients (7.8%) experienced 41 MACE events caused by NCCL plaques, 18 patients (3.7%) developed in-stent restenosis, and 15 patients (3.1%) had deaths due to uncertain factors. The proportion of patients with hypertension, diabetes, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), RC, glycated hemoglobin (HbA_1c), TCFA, and MLA <3.5 mm² in the MACE group was higher than that in the non-MACE group (P<0.05). TCFA was detected in 105 patients, of which 22 cases developed MACE (TCFA MACE group), and 83 cases did not develop MACE (non-TCFA MACE group). The proportion of diabetes and RC in the TCFA MACE group was higher than that in the non-TCFA MACE group (P<0.05). The results of Spearman's rank correlation analysis showed that RC was negatively correlated with the thinnest fibrous cap thickness and MLA (r_s=-0.665、-0.771, P<0.05), and positively correlated with the maximum lipid arc and macrophage infiltration (r_s=0.806、0.481, P<0.05). The results of Multiple Logistic regression analysis showed that diabetes (OR=3.410, 95%CI=1.165~9.988, P=0.025) and high level of RC (OR=5.879, 95%CI=1.436-24.073, P=0.014) was a risk factor for MACE in TCFA of NCCLs. The ROC curve for predicting MACE in TCFA of NCCLs by RC showed an AUC of 0.695 (95%CI=0.571-0.819, P=0.005), with the optimal cutoff value of 0.606 mmol/L, and sensitivity and specificity of 0.818 and 0.518, respectively.

Elevated levels of RC may be a risk factor for the development of MACE in vulnerable plaques of NCCLs in patients with coronary artery disease, and it has certain predictive value for MACE in TCFA of NCCLs.

Percutaneous coronary intervention (PCI) is the main treatment for acute coronary syndrome (ACS), but some patients may experience recurrent major cardiovascular events (MACE) after the treatment. Recent studies have shown that lysophospholipid metabolites such as lysophosphatidylcholine (LPC) and lysophosphatidic acid (LPA), which are important components of oxidized low-density lipoprotein and low-density lipoprotein, can promote the formation and rupture of atherosclerotic plaques. However, it remains unclear whether lysophospholipid metabolites can be used to predict the occurrence of MACE following PCI in patients with ACS.

To investigate the predictive value of lysophospholipids for MACE following PCI in patients with ACS.

The study included patients with ACS who underwent PCI at Beijing Anzhen Hospital, Capital Medical University from June 2017 to September 2019. Baseline data of the patients were collected, and targeted metabolomics was performed to detect phospholipids and lysophospholipids. Patients were followed up at 1, 3, 6, 9, and 12 months post-enrollment, and then every 6 months thereafter, through outpatient visits and telephone consultations to record the occurrence of MACE. Principal component analysis (PCA) score plots were used to analyze the metabolic profiles and inter-group distributions of lysophospholipids between the non-MACE and MACE groups. A partial least squares-discriminant analysis (PLS-DA) with variable importance in projection (VIP) plots was utilized to assess the differential metabolites of lysophospholipids between the groups. The importance of each phospholipid and lysophospholipid metabolite was ranked using the random forest accuracy decrease diagram. Monte Carlo cross-validation was applied to construct the receiver operating characteristic (ROC) curve for the multivariable random forest models composed of different numbers of metabolites, and the area under the curve (AUC) was calculated to select key lysophospholipid metabolites associated with MACE. The accuracy of the predictive models was assessed using permutation tests.

Participants included 212 cases of patients, with an average follow-up of 3 years. Patients were divided into the MACE group (n=29) and the non-MACE group (n=183) based on whether MACE occurred during the follow-up period. There was no statistically significant difference in baseline data between the two groups (P>0.05). The PCA score plot revealed a distinct distribution of MACE and non-MACE group samples, indicating significant differences in the lysophospholipid metabolite profiles. Integrated analysis identified significant changes in LPA, oxidized lysophosphatidylcholine (LPC-O), LPE, LPI, and LPS. Monte Carlo cross-validation was used to construct a predictive model for MACE using the top 13 ranked lipid metabolites [mainly including 10 lysophospholipid metabolites (LPA 16: 0, LPA 18: 1, LPC-O 16: 0, LPC 16: 0, LPG 18: 2, LPC 18: 0, LPE 20: 3, LPE 22: 6, LPG 18: 1, LPS 20: 4) and 3 phospholipid metabolites (PA 16: 0-18: 0, PA 16: 0-20: 4, PA 16: 0-18: 1) ]. The ROC curve indicated that the model had an AUC of 0.934 (95%CI=0.793-0.998) for predicting MACE.

Abnormal expression of lysophospholipids metabolites in preoperative serum is closely correlated with the risk of recurrent MACE following PCI in patients with ACS. This exhibits significant predictive efficacy and clinical value for MACE following PCI in patients with ACS.

Lipoprotein (a) [Lp (a) ] is significantly related to atherosclerotic cardiovascular disease (ASCVD), but it is unclear whether clinical agents that lower Lp (a) can reduce the risk of ASCVD. Here, we systematically reviewed the structure, function, genetic characteristics and detection status of Lp (a), discussed the relationship of Lp (a) with ASCVD, aortic valve stenosis and other cardiovascular diseases, and summarized new advance of Lp (a) -lowering therapies. The structural composition of Lp (a) indicates that Lp (a) may promote atherosclerosis, inhibit fibrinolytic reaction and promote inflammation. Multiple evidence from genetic studies and epidemiological studies supports that Lp (a) is significantly associated with an increased risk of ASCVD and major adverse cardiovascular events. In addition, Lp (a) is also associated with other cardiovascular diseases such as aortic valve stenosis. At present, several emerging drugs that lower Lp (a) are in clinical trials and may further reduce residual cardiovascular risk. This paper hopes to offer new thought for the study of Lp (a), and provide a basis for the monitoring and management of blood lipids.

Statins are the cornerstone of lipid-lowering therapy and moderate-dose statin therapy is the preferred treatment strategy for lipid management in the Chinese population. Despite the widely recognized efficacy of statins in reducing cholesterol levels and preventing cardiovascular diseases, there are significant differences in treatment responses among patients from different ethnic groups.

To explore the differences in therapeutic efficacy between Han and Uyghur patients under moderate-dose statin therapy to guide the formulation of individualized treatment plans.

A total of 780 patients diagnosed with atherosclerotic cardiovascular disease (ASCVD) by coronary angiography at the First Affiliated Hospital of Xinjiang Medical University's Cardiac Center from 2012 to 2022 were included in the study. Baseline data and laboratory examination results of the patients were collected.

A total of 780 ASCVD patients were included, with 408 Han and 372 Uyghur patients. The mean age and gender composition of the two groups were statistically significant (P<0.05). Prior to statin therapy, Han patients had higher levels of total bilirubin (Tbil), albumin (ALB), glycated hemoglobin (HbA_1c), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), and proportions of hypertriglyceridemia and hypercholesterolemia compared to Uyghur patients. Conversely, Han patients had lower levels of alanine aminotransferase (ALT), hypoalphalipoproteinemia, hypoapolipoproteinemia A1, and hyperlipoproteinemia a compared to Uyghur patients (P<0.05). After statin therapy, Han patients had higher levels of Tbil, aspartate aminotransferase, ALB, HbA_1c, HDL-C, ApoA1, and lower levels of ALT, TC, low-density lipoprotein cholesterol (LDL-C), ApoB, hypoalphalipoproteinemia, hypoapolipoproteinemia A1, and hyperapolipoproteinemia B compared to Uyghur patients (P<0.05). After medium-dose statin therapy, the reduction levels of TC, HDL-C, LDL-C, and ApoB in Han patients were higher than those in Uyghurs (P<0.05) ; the reduction levels of TC, LDL-C, and ApoB were higher in Han patients than those in Uyghurs, and the increase level of HDL-C was lower in Han patients than those in Uyghurs (P<0.05). Patients were categorized into sensitive group (n=124), resistant group (n=104), and Intermediate group (n=552) based on the reduction in LDL-C. The resistant group consisted of 42 Han and 62 Uyghur patients, the sensitive group of 78 Han and 46 Uyghur patients, and the intermediate group of 288 Han and 264 Uyghur patients. The distribution of ethnicities among the three groups was statistically significant (χ²=11.511, P=0.030) .

Han patients showed a significantly better lipid-lowering effect following moderate-dose statin therapy compared to Uyghur patients. Uyghur patients may require more frequent monitoring of lipid levels and consideration of increased statin dosage or early combination with other lipid-lowering drugs to improve therapeutic efficacy.

As the leading cause of death in the world, cardiovascular diseases pose a serious threat to human health. Diet has attracted much attention as an important intervention, but the effect of carbohydrates on cardiovascular disease is unknown.

To analyze the evidence of the correlation between carbohydrate intake and cardiovascular disease risk.

Wanfang Data, CNKI, VIP, SinoMed, PubMed, Cochrane Library and Embase were searched by computer for randomized controlled trials on the risk of carbohydrates and cardiovascular disease published from inception to January 2023. Two researchers performed literature screening, data extraction, and quality evaluation separately. RevMan 5.3 was used for data analysis.

A total of 16 randomized trials were included. Carbohydrate could significantly reduce triglyceride level by 0.17 mmol/L (95%CI=-0.24--0.10, P<0.000 01). The level of triglyceride decreased by 0.25 mmol/L (95%CI=-0.33--0.17, P<0.000 01) in carbohydrate diet intervention for less than 6 months, and 0.15 mmol/L (95%CI=-0.29--0.01, P=0.04) in 12-23 months group. Plasma HDL-C level increased by 0.09 mmol/L (95%CI=0.07-0.10, P<0.000 01), and plasma LDL-C level increased by 0.10 mmol/L (95%CI=0.02-0.17, P=0.01) .

The overall effect of low carbohydrate diet on cardiovascular risk factors is more favorable below 6 months and 6-11 months, but it has no significant effect on cardiovascular risk factors after 2 years, and its long-term effect needs further study.

Artificial Intelligence (AI) is an emerging technology to improve healthcare services. With the joint promotion of government agencies and academic departments around the world, a large number of studies have demonstrated that AI can improve the diagnosis, treatment and prevention of cardiovascular disease. However, there are still some limitations in its development and application, and it has not yet been widely used in clinical practice. Based on this, the American Heart Association (AHA) published the Use of Artificial Intelligence in Improving Outcomes in Heart Disease: a Scientific Statement from the American Heart Association in Circulation on April 2, 2024. This statement reviews the research progress of AI in the diagnosis, classification and treatment of cardiovascular disease, puts forward the existing problems and potential solutions, and builds a framework for the future application of AI in the cardiovascular disease. This article aims to interpret the statement for providing advice and direction for the application and research of AI in cardiovascular disease in China.

Neighborhoods and Cardiovascular Health was drafted by a writing group of experts in cardiology, epidemiology, and preventive medicine and has been published in December 2023 in Circulation: Cardiovascular Quality and Outcomes, the official journal of the American Heart Association (AHA). The American Heart Association provides a roadmap on how to use current knowledge about neighborhoods influence on cardiovascular disease to develop and implement effective interventions to improve cardiovascular health at the population, health system, neighborhoods, and individual levels. Reducing the inequity burden of cardiovascular disease among deprived populations by influencing and improving the neighborhoods environment where possible. Our country is also faced with the problem of imbalance of neighborhoods infrastructure between urban and rural areas as well as between urban and rural areas. The interpretation of this scientific statement may provide new perspectives and ideas for the prevention and control of cardiovascular diseases in China at the community level, which will help to improve the prevention and control of cardiovascular diseases and the cardiovascular health of the public.

Carotid atherosclerosis (CAS) is often considered an early warning signal for cardiovascular diseases (CVD). The diagnostic technique of carotid artery Doppler ultrasonography has not been included in public health service programs, and the Framingham Risk Score (FRS) lacks accuracy in assessing CAS risk, hindering the identification of CAS by primary healthcare personnel. Currently, there is a lack of research on machine learning methods to identify CAS in the medium-high risk population assessed by FRS.

To construct a CAS risk prediction model for the medium-high risk population assessed by FRS using machine learning methods, compare its discriminative efficacy, select the optimal model, and assist primary healthcare personnel in identifying CAS more conveniently and accurately.

Using convenience sampling method, a total of 674 local residents from two townships in Liuzhou City, Guangxi Zhuang Autonomous Region, who met the inclusion criteria from 2019 to 2021 and 2023, were selected as the study subjects. Relevant information was collected, and biochemical indicators were measured in fasting blood and urine samples. FRS was used to assess the risk of CVD occurrence, and carotid ultrasound was used to diagnose CAS. Among the 517 subjects from 2019 to 2021, a random 8∶2 split was used to create a training set and a validation set. The training set was used to build Logistic regression, Random Forest (RF), Support Vector Machine (SVM), Extreme Gradient Boosting (XGBoost), and Gradient Boosting Decision Tree (GBDT) models, while the validation set was used for internal validation. The 157 subjects from 2023 served as the test set for external validation. Feature variables were selected using Lasso regression analysis, and discriminative efficacy was evaluated using sensitivity, specificity, accuracy, F1 score, and area under curve (AUC) value. External validation assessed the generalization ability of the optimal model using AUC value, and the Shapley Additive exPlanation (SHAP) method explored the important variables influencing the optimal model's identification of CAS.

Lasso regression analysis identified 15 feature variables: age, BMI, systolic blood pressure (SBP), smoking, drinking, hypertension, total cholesterol, high density lipoprotein cholesterol, C-reactive protein (CRP), fasting plasma glucose, apolipoprotein B (ApoB), lipoprotein a (LPA), aspartate aminotransferase (AST), AST/ alanine aminotransferase, urinary microalbumin creatinine ratio. The constructed Logistic regression, RF, SVM, XGBoost, and GBDT models exhibited high AUC values, with the GBDT model showing the best discriminative performance. Its sensitivity, specificity, accuracy, F1 score, and AUC value were 0.755 1, 0.836 4, 0.798 1, 0.778 9, and 0.834 9, respectively, and the external validation AUC value was 0.794 0. The SHAP method revealed that age, SBP, CRP, LPA, and ApoB were the top five factors influencing the GBDT model's identification of CAS.

Logistic regression, RF, SVM, XGBoost, and GBDT models for identifying CAS based on machine learning all demonstrated high discriminative performance, with the GBDT model exhibiting the best comprehensive discriminative efficacy and strong generalization ability.

Cardiovascular disease (CVD) is a major cause of human mortality worldwide, characterized by its insidious onset, intricate and variable course, and poor prognosis. Early identification and active intervention of potentially critically ill patients is essential to improve their prognosis.

To conduct a scoping review of the research on early warning assessment tools for cardiovascular disease risk at home and abroad, summarize and analyze their assessment content and application, ultimately providing reference for the selection of appropriate early warning tools for cardiovascular disease patients in China.

CNKI, Wanfang Data, VIP, CBM, PubMed, Web of Science, Cochrane Library, Embase, CINAHL, and Scopus were systematically searched from inception to May 2023. Two investigators independently screened literature and extracted data, analyzed in terms of assessment content, study subjects, validation method, reliability and validity, and predictive efficacy.

A total of 16 papers were included, comprising 7 papers on the development and validation of assessment tools and 9 papers on the localized application of these tools, involving 20 early warning assessment tools for cardiovascular disease risk. The results of the analysis showed that each assessment tool contained 3 to 17 assessment items, with the most frequently mentioned items of age, systolic blood pressure, respiratory rate, oxygen saturation, heart rate, comorbidities, level of consciousness, and gender. The results of the reliability and validity tests for 2 papers indicated robust reliability and validity, while all other studies lacked reliability and validity evaluations. Ten papers reported the area under the curve (AUC), with values ranging from 0.550 to 0.926 9.

Diverse early warning assessment tools for cardiovascular disease risk are available, however, their overall quality remains to be improved and there is a lack of specific assessment tools. In the future, it is imperative to conduct further validations of the reliability and validity of the existing tools, and develop localized early warning assessment tools specialized for cardiovascular diseases considering the unique characteristics of the disease, which exhibit robust reliability and validity.

The outbreak of COVID-19 has had a huge impact globally. After the infection, a considerable number of patients have been affected by a series of lingering symptoms or sequelae with strong heterogeneity, which we temporarily refer to as long COVID. Compared to the well-studied cardiovascular complications caused by COVID-19 during the acute phase, the cardiovascular sequelae in long COVID require greater attention. This review includes the clinical manifestations, mechanisms, and principles of diagnosis and management of cardiovascular sequelae in long COVID, aiming to improve the disease's understanding and reduce its harm scientifically.

Pharmacotherapy is the cornerstone of primary and secondary prevention of atherosclerotic cardiovascular diseases (ASCVD), but the values and preferences of community patients for pharmacotherapy remain unclear.

To understand the values and preferences surrounding pharmacotherapy among community patients at risk of or undergoing treatment for ASCVD, which would help clarify the individualized treatment burden and provide patient-centered clinical practice.

This study employed a sequential exploratory mixed-methods design. Firstly, we recruited eligible patients in West China Hospital of Sichuan University and Yulin Community Health Service Center in Wuhou District, Chengdu City from November 2021 to January 2022. for a focus group discussion, aiming to collect qualitative insights into their experience, values, and preferences for medication use. The software MAXQDA 2020 was used to support qualitative data analysis, and Colaizzi's seven-step approach was further used to identify themes. After completing the qualitative phase, a questionnaire was designed based on the emergent themes to further quantitatively analyze the values and preferences regarding pharmacotherapy.

Four themes emerged from the qualitative data, including knowledge and use of medications, barriers of medication use, facilitators of medication use, and need for medical services. A total of 186 valid questionnaires were collected in the quantitative study (response rate of 93.5%). The quantitative data showed a commonality in missed dose and confirmed the existence of social stigma and treatment burden in this group of participants. Although preferences in medication use were highly heterogeneous, participants generally preferred taking fewer medications with less frequency, and were less likely to use injectable medications.

The study suggests that it may be appropriate to increase the use of compound preparations, and make treatment plans in accordance with patients' daily lives and work to reduce the treatment burden of pharmacotherapy. In addition, we should be active in managing the misconceptions and improper practices in pharmacotherapy in order to improve patients' medication adherence.

High prevalence and low control rate of hypertension have brought a significant disease burden globally. In order to improve the level of hypertension prevention and treatment, remote healthcare and digital medicine have been rapidly developed and widely used worldwide. Currently, there are no relevant regulations in China for these technologies. In 2023, the Italian Society of Arterial Hypertension issued a position statement to guide the development, validation, and clinical use of remote medicine and digital healthcare. This article will interpret this position paper, focusing on the forms of application of telemedicine and digital healthcare in managing hypertension and its related cardiovascular diseases, key research evidence, existing advantages, as well as current opportunities and challenges. The aim is to guide general practitioners in China on how to utilize these technologies in managing hypertension and related cardiovascular conditions.

Cardiovascular diseases seriously threaten the health of the elderly in our country and bring a huge economic burden to our country. Accurate screening of risk assessment tools for early cardiovascular diseases can specifically prevent and delay the development of cardiovascular diseases, studies have suggested that commonly used cardiovascular risk scoring tools are not effective in predicting risk in the elderly, but there is a lack of relevant external validation experimental studies, and there is no well-recognized effective risk prediction tool for elderly patients.

To independently validate and compare the efficacy of five commonly used cardiovascular risk assessment tools in China and abroad in predicting 10-year cardiovascular disease risk in our community elderly population, to explore the cardiovascular disease risk assessment tools suitable for our community elderly population, and to provide theoretical basis and support for the prevention and treatment of cardiovascular disease at the grass-roots level.

From January 2012 to December 2013, more than 20 000 people in the Liuyuan Community Health Service Centre and Runda Community Health Service Centre in Suzhou Province took part in community medical examinations. According to the inclusion and exclusion criteria, three hundred and forty-four people were identified, data on age, sex, region of residence, systolic blood pressure, diastolic blood pressure, BMI, waist circumference, total cholesterol, high-density lipoprotein cholesterol, triglyceride, atrial fibrillation, Left ventricular hypertrophy, cardiovascular disease, hypertension, diabetes, and smoking were collected from the start-up medical examination system In the follow-up survey of chronic diseases, the current smoking status and smoking age, whether taking antihypertensive drugs, family history of cardiovascular disease, prevalence of hypertension and drug use of hypertension, prevalence of diabetes mellitus, and whether and when cardiovascular disease occurred from January 2014 to December 2022 were improved. The outcome events were stroke and coronary heart disease, and were divided into positive group and negative group, all subjects were assessed with the Framingham Heart Risk Score (FRS-CVD) , the modified Framingham Stroke Scale (R-FSRS) , the European systemic coronary risk assessment scale 2019 (SCORE) , Chinese 10-year ischemic cardiovascular disease risk (ICVD) , and the China-PAR cardiovascular disease risk assessment, concordance Index (C-index) , Hosmer-Lemeshow χ² and calibration chart were used to evaluate the relationship between the results and actual cardiovascular disease incidence.

Of the 344 enrolled investigators, with a mean age of 62 (56, 68) years, as of December 2022, 169 had developed cardiovascular disease and 175 had not. Two groups of people were carried out 5 kinds of cardiovascular disease risk score, cardiovascular disease risk assessment tool forecast and the actual incidence of the comparative analysis results are as follows, discrimination test: C-index of FRS-CVD was 0.711 (95%CI=0.658-0.764) , C-index of R-FSRS was 0.728 (95%CI=0.675-0.781) , SCORE: C-index was 0.724 (95%CI=0.671-0.777) , ICVD: C-index was 0.727 (95%CI=0.674-0.779) , China-PAR: C-index was 0.735 (95%CI=0.682-0.788) ; Hosmer-Lemeshow test calibration status: FRS-CVD: χ² =16.789 (P=0.032) , R-FSRS: χ²=11.019 (P=0.201) , SCORE: χ²=20.396 (P=0.002) , ICVD: χ²=24.311 (P=0.001) , China-PAR: χ²=15.149 (P=0.056) ; R-FSRS is the best calibration. In men, model discrimination: FRS-CVD: C-index was 0.642 (95%CI=0.577-0.707) , R-FSRS: C-index was 0.646 (95%CI=0.581-0.710) , SCORE: C-index was 0.646 (95%CI=0.581-0.711) , ICVD: C-index was 0.628 (95%CI=0.563-0.693) , China-PAR: C-index was 0.636 (95%CI=0.571-0.700) ; Hosmer-Lemeshow test calibration status: FRS-CVD: χ²=7.371 (P=0.288) , R-FSRS: χ²=8.470 (P=0.293) , SCORE: χ²=5.146 (P=0.525) , ICVD: χ²=6.103 (P=0.412) , China-PAR: χ²=9.555 (P=0.298) , SCORE was calibrated best in the calibration diagram. Model discrimination among women: FRS-CVD: C-index was 0.698 (95%CI=0.633-0.762) , R-FSRS: C-index was 0.731 (95%CI=0.666-0.795) , SCORE: C-index was 0.733 (95%CI=0.668-0.798) , ICVD: C-index was 0.747 (95%CI=0.682-0.811) , China-PAR: C-index was 0.754 (95%CI=0.689-0.818) ; Hosmer-Lemeshow test calibration status: FRS-CVD: χ²=14.515 (P=0.069) , R-FSRS: χ²=12.175 (P=0.032) , SCORE: χ²=9.611 (P=0.022) , ICVD: χ²=19.349 (P=0.007) , China-PAR: χ²=12.372 (P=0.135) , China-PAR calibration is the best in calibration chart.

R-FSRS model has a good performance in predicting the risk of cardiovascular disease in the elderly, especially in the elderly population. SCORE model did better in predicting cardiovascular disease risk in older men, while China-PAR model did better in predicting cardiovascular disease risk in older women. Therefore, the application of these assessment tools will help doctors to accurately predict the risk of cardiovascular disease in the elderly, and formulate corresponding prevention and treatment strategies.

Non-alcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease worldwide, its close correlation with metabolic disorders has been demonstrated in numerous studies in recent years and an expert panel has proposed renaming it metabolic-associated fatty liver disease (MAFLD). NAFLD/MAFLD may not only increase the incidence and mortality of liver-related diseases but also relate to the incidence and mortality of cardiovascular diseases. This article compares the diagnostic criteria of NAFLD/MAFLD and reviews the research progress in the correlation of non-alcoholic fatty liver disease and metabolic-associated fatty liver disease with cardiovascular diseases. The results show that both NAFLD/MAFLD are significantly associated with the increased incidence of cardiovascular diseases and independent risk factors for cardiovascular diseases. Furthermore, MAFLD patients have a higher risk of developing cardiovascular diseases than NAFLD patients. This article provides clinical physicians with the basis for cardiovascular risk assessment and management in NAFLD/MAFLD patients, emphasizing that in addition to the treatment of liver disease, clinical physicians should also focus on the risk of cardiovascular disease in NAFLD/MAFLD patients.

With the prevalence of unhealthy lifestyles and the accelerated trend of population aging, the mortality rate of cardiovascular diseases remains high in China. A timely understanding of the current and future trends of cardiovascular disease mortality in China, as well as exploring potential influencing factors and solutions, can provide a reference for formulating cardiovascular disease prevention and control measures.

To analyze the trend of cardiovascular disease mortality in China from 2009 to 2021 and predict the future trends from 2022 to 2030.

Cardiovascular disease mortality data were selected and analyzed based on gender, urban-rural areas, regions, and age groups from the "China Death Surveillance Data Set (2009-2021) " published by the Chinese Center for Disease Control and Prevention. The Joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to analyze the changing trends. Additionally, a GM (1, 1) model was established using R (4.3.1) software to predict the crude mortality rate of cardiovascular diseases in China from 2022 to 2030.

From 2009 to 2021, the crude mortality rate of cardiovascular diseases in China increased from 235.83/100 000 in 2009 to 353.31/100 000 in 2021, with the AAPC of 3.3% (95%CI=2.8% to 3.8%, P<0.001). The age-standardized mortality rate decreased from 281.82/100 000 in 2009 to 221.24/100 000 in 2021, with the AAPC of -1.9% (95%CI=-2.6% to -1.2%, P<0.001). During this period, the standardized mortality rate for cardiovascular diseases in China showed a decreasing trend across different genders (AAPC for males=-2.0%, AAPC for females=-2.1%; P<0.05), urban and rural areas (AAPC for urban=-1.3%, AAPC for rural=-2.4%; P<0.05), and regions (AAPC for eastern region=-2.1%, AAPC for central region=-2.2%, AAPC for western region=-1.0%; P<0.05). Notably, the mortality rate decline was greater in females than males, in rural areas than urban areas, and the central region than the eastern and western regions. The results of the GM (1, 1) model showed that the crude mortality rate of cardiovascular diseases in China will continue to rise to 461.57/100 000 from 2022 to 2030.

From 2009 to 2021, the overall crude mortality rate of cardiovascular disease in China has shown a continuous upward trend, while the overall standardized mortality rate has shown a downward trend. The burden of cardiovascular disease mortality in China still faces severe challenges. The GM (1, 1) model predicts a continuous increase in the crude mortality rate of cardiovascular diseases in China from 2022 to 2030. Therefore, it is necessary to formulate and implement scientifically effective measures for the prevention and control of cardiovascular diseases, with a focus on male, elderly and rural residents.

In 2022, the U.S. Preventive Services Task Force (USPSTF) updated its recommendations, reviewing the evidence of the benefits and harms of behavioral counseling interventions aimed at promoting healthy behaviors in adults without cardiovascular disease risk factors. The conclusions of this review align with the 2017 guidelines. Behavioral counseling interventions in adults without cardiovascular disease risk factors result in minimal net benefits. Therefore, it is recommended that clinicians make individualized decisions on whether to provide or recommend behavioral counseling interventions to adults without cardiovascular disease risk factors to promote a healthy diet and physical activity (Grade C). This article provides a comprehensive interpretation of the guidelines in the context of the current status of cardiovascular disease prevention in China, offering valuable insights into cardiovascular disease prevention practices among Chinese adults.

The most effective prevention strategy for atherosclerotic cardiovascular disease (ASCVD) is primary management, with the core measure of risk assessment. The existing prediction models for ASCVD for the elderly are not able to guide TCM primary management well. Therefore, it is necessary to integrate TCM elements into the development of prediction models to guide the primary management of ASCVD with combined traditional Chinese and western medicine.

To construct and validate the ASCVD prediction model for the elderly based on TCM constitution.

A total of 1 418 elderly people who underwent physical examination at Huayuan Street Community Health Service Center, Chentangzhuang Street Community Health Service Center, Xiangyang Road Street Community Health Service Center and Daqiuzhuang Town Central Health Center in 2017 were included as the study subjects. General data of the study subjects were collected and constitution identification was performed. The incidence of ASCVD (clinical outcome) was followed up from 2017 to 2022. The follow-up will end at 2022-11-30. The data of the subjects were randomly divided into a training set (n=1 127) and validation set (n=291) according to 8∶2. In the training set, the conventional ASCVD prediction model for the elderly (model 1) and the conventional ASCVD+constitution prediction model for the elderly (model 2) were constructed by using the forward stepwise method. The nomogram of ASCVD prediction model for the elderly based on TCM constitution was plotted. The calibration curve was plotted and the Hosmer-Lemeshow goodness of fit test was performed to determine the calibration of the model. The receiver operating characteristic curve was plotted and the area under the curve (AUC) was calculated to determine the discrimination of the model. AUC, Net Reclassification Index (NRI), Integrated Discrimination Improvement (IDI), and Decision Curve Analysis (DCA) were used to compare model 2 with model 1 to evaluate the improvement efficacy of model 2.

There was no significant difference in the general data between the training set and validation set (P>0.05). The results of multivariate analysis showed that model 1 included 7 predictors of gender, age, waist circumference, systolic blood pressure, triacylglycerol (TG), BMI, systolic blood pressure×hypertension medication history. model 2 included 8 predictors of gender, age, waist circumference, systolic blood pressure, TG, BMI, systolic blood pressure×hypertension medication history, and constitution type. Hosmer-Lemeshow goodness-of-fit test showed good fit of model 2; Delong test results showed that AUC of model 2 was higher than that of model 1 (Z=2.741, P=0.006), NRI=0.511 (95%CI=0.359-0.663, P<0.001), IDI=0.038 (95%CI=0.024-0.051, P<0.001), suggesting that the addition of constitution predictors could improve the accuracy of model prediction. The clinical utility comparison results showed that the net benefit of model 2 to predict severe ASCVD events in the elderly was better than model 1 at a threshold probability of 5% to 74%.

In this study, a ASCVD prediction model for the elderly was constructed including 8 predictor variables of gender, age, waist circumference, systolic blood pressure, TG, BMI, systolic blood pressure×hypertension medication history, and constitution type. After testing, the differentiation and calibration performed well, which was better than the conventional prediction model, and can be applied to the individualized risk assessment of ASCVD in the elderly and guide the primary management of ASCVD with combined traditional Chinese and western medicine.

The prevalence of diabetes and cardiovascular diseases in China has been increasing annually, and it has been demonstrated that diabetes can exacerbate the adverse effects of cardiovascular diseases through nutritional and inflammatory pathways. The prognostic nutritional index (PNI) is a marker of immunonutrition that reflects the inflammation, immune status and nutritional status of an individual. Due to its advantages of simplicity, rapidity, accessibility, and reliability, research on PNI has been increasing, yet its role in cardiovascular diseases has been less explored.

To investigate the relationship between PNI and major in-hospital adverse cardiovascular events (MACE) in patients with acute ST-elevation myocardial infarction (STEMI) complicated by type 2 diabetes mellitus (T2DM) following percutaneous coronary intervention (PCI) .

A retrospective analysis of 1 053 STEMI patients with T2DM who underwent PCI at the First Affiliated Hospital of Xinjiang Medical University from January 2015 to June 2023 was conducted. The patients were divided into the MACE (n=177) and non-MACE (n=876) groups according to the occurrence of MACE during hospitalization, and further categorized into the high PNI (n=686) and low PNI (n=367) groups according based on the cutoff value of PNI to predict the occurrence of in-hospital MACE after PCI in patients with STEMI and T2DM. Univariate and multivariate Logistic regression analyses identified factors influencing in-hospital MACE after PCI in patients with STEMI and T2DM. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of PNI for in-hospital MACE, and the area under the curve (AUC) was calculated. Pearson correlation analysis or Spearman rank correlation analysis was used to explore the correlation between PNI and cardiovascular disease risk factors.

The differences between the MACE and non-MACE groups in gender, age, history of hypertension, serum glucose, Killip classification, lactate dehydrogenase, heart rate, myoglobin, creatine kinase-MB isoenzyme (CK-MB), white blood cell count, brain natriuretic peptide (BNP), PNI, Global Registry of Acute Coronary Events (GRACE) score, hemoglobin, platelet count, lymphocyte count, albumin, total protein, creatinine, urea nitrogen and triacylglycerol were statistically significant (P<0.05). The results of multivariate Logistic regression analysis showed that elevated serum glucose (OR=1.055, 95%CI=1.002-1.112, P=0.044) and higher GRACE score (OR=1.034, 95%CI=0.876-0.939, P<0.001) were risk factors for in-hospital MACE, while increased PNI (OR=0.907, 95%CI=1.017-1.050, P<0.001) was a protective factor. The AUC of PNI for predicting in-hospital MACE was 0.734 (95%CI=0.694-0.773). A predictive model was constructed by Logistic regression analysis, and the model predicted an AUC of 0.791 (95%CI=0.753-0.858) for the occurrence of in-hospital MACE after PCI in patients with STEMI complicated by T2DM. The low PNI group showed higher incidence of MACE and proportion of intra-aortic balloon counterpulsation, longer hospitalization duration, higher levels of serum glucose, troponin T, CK-MB, myoglobin, BNP, C-reactive protein, creatinine, and urea nitrogen than those in the high PNI group; and lower optical coherence tomography ratio, total cholesterol, triacylglycerol, HDL-C, and hemoglobin levels than those in the high PNI group (P<0.05). The results of correlation analysis showed that PNI was positively correlated with hemoglobin, HDL-C, total cholesterol, and triacylglycerol (P<0.05) ; PNI was negatively correlated with serum glucose, creatinine, urea nitrogen, BNP, troponin T, CK-MB, myoglobin, and C-reactive protein (P<0.05) .

PNI is an independent predictive factor for in-hospital MACE in STEMI patients with T2DM after PCI, which can serve as an auxiliary indicator for monitoring patients' immunonutritional status and predicting their short-term prognosis.

Patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) face a significant risk of long-term major adverse cardiovascular events (MACEs). Accurate early risk stratification is crucial for managing post-PCI MACEs in STEMI patients, as highlighted in clinical guidelines. Existing risk scoring systems, including the Age, Creatinine, and Ejection Fraction (ACEF) score, Thrombolysis in Myocardial Infarction (TIMI) score, Zwolle score, Primary Angioplasty in Myocardial Infarction (PAMI) score, and Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) score, vary in their predictive utility for the long-term prognosis post-PCI in STEMI patients.

This study aims to analyze the risk factors for long-term MACEs post-PCI in STEMI patients in China and compare the predictive value of the commonly used ACEF, TIMI, Zwolle, PAMI, and CADILLAC risk scoring systems.

A retrospective cohort of 687 STEMI patients who underwent their first PCI between June 2016 and June 2020 at Gansu Provincial Hospital was selected. Patient demographics, laboratory, and imaging results were collected, and risk scores were assigned using the ACEF, TIMI, Zwolle, PAMI, and CADILLAC systems. Patients were followed up annually via phone or clinic visits until August 2023, with a focus on the occurrence of MACEs. Multivariable Logistic regression analysis was used to explore the factors influencing the occurrence of MACEs post-PCI. Receiver operating characteristic (ROC) curves for the different risk scoring systems were plotted, and their areas under the curve (AUC) were compared using the DeLong test.

Out of the 687 patients who underwent PCI, 44 were excluded due to incomplete data, leaving 643 for analysis. The median follow-up period was 37 (range 25-49) months. By the end of the follow-up, 134 patients had experienced MACEs, representing a 20.8% incidence rate. The MACEs group differed significantly from the non-MACEs group in terms of age, hospital stay duration, Killip class, N-terminal pro b-type natriuretic peptide, fibrinogen, anemia, left ventricular ejection fraction, estimated glomerular filtration rate, and creatinine levels (P<0.05). Multivariable Logistic regression revealed prolonged hospital stay (OR=1.071, 95%CI=1.012-1.134, P=0.018), elevated creatinine (OR=1.018, 95%CI=1.006-1.030, P=0.003), and increased fibrinogen (OR=1.226, 95%CI=1.066-1.409, P=0.004) as risk factors for MACEs, while higher left ventricular ejection fraction (OR=0.980, 95%CI=0.960-1.000, P=0.045), mild (OR=0.377, 95%CI=0.151-0.938, P=0.036), and moderate regurgitation (OR=0.164, 95%CI=0.051-0.522, P=0.002) were protective. The ACEF, TIMI, Zwolle, PAMI, and CADILLAC scores were significantly higher in the MACEs group (P<0.05). The ROC curves for predicting MACEs post-PCI in STEMI patients showed no significant differences among the five risk scoring systems (P>0.05) .

Hospital stay duration, creatinine levels, fibrinogen, left ventricular ejection fraction, and valvular regurgitation status are significant factors affecting the occurrence of long-term MACEs post-PCI in STEMI patients. While all five risk scoring systems—ACEF, TIMI, Zwolle, PAMI, and CADILLAC—can predict the occurrence of long-term MACEs in these patients, the CADILLAC score is recommended for its distinctiveness and sensitivity.

Cardiovascular disease is the primary cause of death and Disease burden of Chinese residents, and the situation of prevention and control is grim. Management of risk factors for cardiovascular disease is an important foundation for preventing cardiovascular disease. However, there is currently limited research on the influencing risk factors of cardiovascular disease risk in elderly patients with chronic disease in primary care using single lead wearable electrocardiogram devices both domestically and internationally, and previous studies have not ranked the importance of variables containing different quantities of risk in patients from a holistic perspective.

The aim of this study is to analyze the influencing factors of the comprehensive risk of cardiovascular disease in elderly patients with chronic disease aged 65 and above in primary care in Ningxia, and to provide objective basis and assistance for the comprehensive prevention and control of cardiovascular disease in primary care.

From December 2021 to September 2022, totally 3 039 patients over 65 years old with hypertension, diabetes and coronary heart disease, including at least one chronic disease, from 26 primary care health center in Ningxia were selected as the research subjects. According to the analysis of the 72 hour electrocardiogram, there were 632 cases in the normal group and 2 407 cases in the risk group. Analyze the basic information of two groups of patients to determine the best λ Value, draw a model, and use LASSO regression and multivariate Logistic regression to analyze the comprehensive risk factors of cardiovascular disease in elderly patients with chronic diseases; and rank the variables that affect the overall risk of cardiovascular disease and include different numbers of risks among patients.

The differences in age, gender, BMI, education level, occupation, urban-rural distribution, smoking, exercise, coronary heart disease combined with diabetes, hypertension combined with coronary heart disease and diabetes between the two groups of patients were statistically significant (P<0.05) ; optimum λvalue was 0.015 685 31. LASSO regression and multivariate logistic regression model analysis showed that age, BMI, urban-rural distribution, smoking Hypertension combined with coronary heart disease and diabetes is a influencing factor for cardiovascular disease (P<0.05). Auc was 0.650 (95%CI=0.627-0.673, P<0.001) The top five variables that affect comprehensive risk and different types of risk are age, BMI, urban-rural distribution, tea drinking, and exercise; Age, hypertension combined with coronary heart disease, gender, urban-rural distribution, smoking; Age, hypertension combined with coronary heart disease, gender, BMI, urban-rural distribution; Diabetes combined with coronary heart disease, age, hypertension combined with coronary heart disease, hypertension combined with coronary heart disease and diabetes, hypertension combined with diabetes.

Age, BMI, urban and rural distribution, smoking, hypertension with coronary heart disease and diabetes are the influencing factors of cardiovascular disease risk in patients over 65 years old with chronic diseases. In addition to age, BMI and lifestyle habits have a significant impact on the overall risk of cardiovascular disease. As the number of comorbidities increases, the impact of chronic diseases, especially chronic disease comorbidities, increases. Primary care medical teams should regularly conduct comprehensive CVD risk management for elderly patients with multiple chronic diseases using single lead wearable devices. This not only enables efficient and low-cost implementation of primary and secondary prevention and health management of CVD risks, but also accelerates the transformation of primary medical services from inconsistent diagnosis and treatment services to full process health management.

Against the backdrop of global aging, the number of patients with chronic diseases is increasing, and the multimorbidity is becoming more severe. Traditionally, cardiovascular diseases and type 2 diabetes are mostly considered diseases of the elderly. However, with changes in lifestyle patterns such as the pace of life and diet, many diseases are showing a trend of rejuvenation. Recent studies have also shown that individuals who develop diabetes at a young age have an increased relative risk of developing cardiovascular diseases and higher mortality rates compared to the general population.

To investigate the burden of cardiovascular diseases attributed to diabetes among Chinese adults from 1990 to 2019, so as to provide evidence for comorbidity prevention.

Based on the 2019 Global Burden of Disease (GBD) study data, indicators such as mortality rates, disability-adjusted life years (DALY) rates, and estimated annual percentage change (EAPC) were used to assess the burden of cardiovascular diseases in China (including ischemic heart disease, stroke, and peripheral arterial disease) attributed to diabetes. The analysis was stratified by age group (25-49 years, 50-69 years, ≥70 years) and gender, and the temporal trends in disease burden were finally analyzed.

The number of cardiovascular disease deaths attributable to diabetes increased from 298 050 in 1990 to 700 340 in 2019 among people aged 25 years and older in China. The age-standardized mortality rate for CVD attributed to diabetes increased for males compared to 1990, while it decreased for females, with males consistently having higher rates than females. In 2019, the DALY for CVD attributed to diabetes was 13 585 850 person-years. The age-specific mortality rate and DALY rate increased with age. The downward trend in standardized DALY rate was more pronounced in females (EAPC=-0.32%, 95%CI=-0.49% to -0.11%) than in males (EAPC=-0.01%, 95%CI=-0.26% to 0.29%). The mortality and DALY rates for ischemic heart disease and peripheral arterial disease attributed to diabetes increased in the three age groups from 1990 to 2019, while the mortality rates for stroke attributed to diabetes declined in all three age groups in 2019 compared to 1990. The percentage of standardized DALY rates attributable to diabetes for the 3 cardiovascular diseases in cardiovascular disease fluctuated from 1990 to 2019. However, the percentage of standardized DALY rates for all 3 cardiovascular diseases attributable to diabetes was higher in 2019 than in 1990.

From 1990 to 2019, there has been an overall increasing trend in the mortality and DALY rates of cardiovascular diseases attributed to diabetes among adults in China. Population is at greater risk for comorbidities of diabetes and CVD, emphasizing the need to focus on screening for CVD among individuals with diabetes or those at high risk of developing CVD. Emphasis should be placed on males, the elderly, and younger individuals with unhealthy lifestyle habits for early health interventions to reduce the burden of comorbidities.

The prevalence of atrial fibrillation (AF) has continued to rise globally in recent years, and AF increases the risk of stroke, heart failure, myocardial infarction, chronic kidney disease, and other diseases. Studies have identified hypertension, diabetes, smoking, obstructive sleep apnea, obesity and sedentary lifestyle as risk factors for AF. And most of these factors are within the scope of the "Life's Essential 8" (LE8) proposed by the American Heart Association.

To investigate the relationship between cardiovascular health (CVH) score based on the LE8 and AF.

A study was conducted in which 91 131 employees of Kailuan Group in Tangshan, Hebei Province were selected for physical examination from June 2006 to October 2007, and the LE8 score was evaluated according to the algorithm developed by the American Heart Association, and combined with the actual situation of the Kailuan study to form the Kailuan study version of LE8, including 4 health behaviors (diet, physical activity, tobacco exposure, and sleep) and 4 health factors (BMI, blood lipids, blood glucose, and blood pressure). The study subjects were divided into the three groups of the low CVH group (n=8 407) with a LE8 score less than 50, the medium CVH group (n=73 493) with a LE8 score of 50 or more but less than 80, and the high CVH group (n=9 231) with a LE8 score of 80 or more. The follow-up visit was performed per year with the time of the study subject's first Kailuan physical examination as the starting point, the occurrence of AF as the endpoint event, the end of AF and follow-up (2020-12-31) as the endpoint time. Kaplan Meier survival curve was used to analyze the cumulative incidence of new-onset AF in different groups, and log rank test was used to compare the differences between groups; Cox proportional hazards regression analysis was used to investigate the impact of different LE8 score groups and single factor scores on the risk of new-onset AF.

There were significant differences in age, gender, education level, monthly per capita household income, history of alcohol consumption, and LE8 scores among the three groups of subjects (P<0.001). During follow-up, 1 088 cases of new-onset AF were identified, including 133 cases (1.58%) in the low CVH group, 883 cases (1.20%) in the medium CVH group, and 72 cases (0.78%) in the high CVH group. The median follow-up time was 15.0 (14.7, 15.2) years; there was statistically significant difference in the comparison of cumulative incidence rate of new-onset AF in the three groups (P<0.000 1). Cox proportional hazards regression analysis after adjusting for age, gender, education level, monthly per capita household income, and history of alcohol consumption showed that, compared with the low CVH group, both the medium CVH group (HR=0.697, 95%CI=0.579-0.841, P<0.001) and the high CVH group (HR=0.609, 95%CI=0.454-0.816, P=0.001) reduced the risk of new-onset AF. An increase in LE8 score could reduce the risk of new-onset AF (HR=0.859, 95%CI=0.804-0.918, P<0.001). The individual factors of LE8, including BMI score (HR=0.762, 95%CI=0.717-0.809, P<0.001) and blood pressure score (HR=0.824, 95%CI=0.776-0.876, P<0.001), were negatively correlated with the risk of new-onset AF.

The LE8 score of CVH is negatively correlated with the risk of new-onset AF, and the individual factors of LE8, including BMI score and blood pressure score, are negatively correlated with the risk of new-onset AF.

Cardiovascular disease (CVD) is one of the leading causes of death worldwide. In April 2022, the U.S. Preventive Services Task Force (USPSTF) updated and published recommendations on aspirin use to prevent CVD based on the latest evidence-based research results. The USPSTF recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults aged 60 years and above. The decision to initiate low-dose aspirin use for the primary prevention of CVD in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk should be an individual one based on shared decision-making between clinicians and patients about the potential benefits and harms. This paper aims to interpret the latest recommendations in the context of China's actual situation, providing a reference on aspirin use to prevent CVD in China.

Cardiovascular disease (CVD) is the leading cause of death. It is well known that statins can reduce the risk of CVD and CVD-related death through lipid-lowering, anti-inflammatory, and plaque-stabilizing effects. In August 2022, the U.S. Preventive Services Task Force (USPSTF) conducted an updated recommendations statement on statins for primary prevention of CVD based on new evidence on the benefits and potential harms of statins in reducing CVD morbidity/mortality and all-cause mortality. The USPSTF recommends statins for the primary prevention of CVD for adults aged 40 to 75 years with 1 or more CVD risk factors and an estimated 10-year CVD risk of 10% or greater (B recommendation). The USPSTF recommends that clinicians selectively offer statins for the primary prevention of CVD in adults aged 40 to 75 years who have 1 or more of CVD risk factors and an estimated 10-year CVD risk of 7.5% to less than 10% (C recommendation). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of using statins for primary prevention of CVD events and mortality in adults aged 76 years and above (I statement). This article interprets the latest recommendations in the context of China to provide reference for the use of statins for the primary prevention of CVD in China.

With the change of lifestyle, atherosclerotic cardiovascular disease (ASCVD) is showing a younger trend as an important component of ASCVD. Snoring as a common health problem related to sleep breathing, which is a characteristic indicator of obstructive sleep apnea-hypopnea syndrome (OSAHS) . However, there are few studies on the correlation between snoring and ASCVD, and it is still necessary to identify this factor to provide scientific basis for early intervention.

To investigate the correlation between snoring frequency and 10-year risk of ASCVD in middle-aged and elderly population.

From 2018 to 2021, a multi-stage stratified cluster sampling method was adopted to investigate the permanent residents aged 35-75 in Jing'an District. General information of the subjects was collected through questionnaire survey, and laboratory tests were used to collect total cholesterol (TC) , triacylglycerol (TG) , low-density lipoprotein cholesterol (LDL-C) , and high-density lipoprotein cholesterol (HDL-C) . Snoring frequency: snoring 1-2 times per week was considered as mild snoring, snoring 3-4 times per week was considered as moderate snoring, and snoring 5-7 times per week was considered as severe snoring; the 10-year risk of ASCVD <5%, 5%-<10%, and≥10% were defined as low-risk group, intermediate-risk group, and high-risk group, respectively. Multilevel ordinal Logistic regression analysis was used to explore the correlation of snoring with the 10-year risk of ASCVD and ASCVD risk factors.

A total of 10 898 residents participated in the study, excluding 1 079 who were unclear about their individual snoring status, for a total of 9 819 residents included in the study. The risk assessment results of ASCVD showed 5 930 in the low-risk group, 1 804 in the intermediate-risk group and 2 085 in the high-risk group. In the general population, Model 1 with multilevel ordinal Logistic regression analysis showed that both moderate and severe snoring were risk factors for the 10-year risk of ASCVD compared with no snoring (P<0.05) . Model 2 adjusted for age based on Model 1, and Model 3 adjusted for hypertension, diabetes, overweight or obesity, smoking, alcohol consumption, and educational factors based on Model 2, the results showed that increasing snoring frequency would cause an increase in the 10-year risk level of ASCVD. After further dividing the total population into males and females by gender, severe snoring was associated with a 10-year risk level of ASCVD compared with the no snoring (P<0.05) , and severe snoring in males has a greater risk than in females, but mild and moderate snoring was not associated with ASCVD risk (P>0.05) . Further analysis of the relationship between snoring and ASCVD risk factors showed that severe snoring was a risk factor for hypertriglyceridemia, hypercholesterolemia, hyper-low-density lipoproteinemia and hypo-high-density lipoproteinemia, and moderate snoring was a risk factor for hyper-low-density lipoproteinemia and hypo-high-density lipoproteinemia compared with no snoring (P<0.05) . Mild snoring was not associated with ASCVD risk factors.

The frequency of snoring is correlated with the 10-year risk and risk factors of ASCVD, and it is concentrated in moderate and severe snoring population. People with mild and moderate snoring should be regarded as the focus of early intervention to promote the early prevention and treatment of ASCVD.

At present, there has been a dramatic increase in the number of obese children and adolescents globally, among which the prevalence of obesity in children aged 5 to 19 years has increased by about 8 times, and the prevalence of obesity in children aged 2 to 4 years has increased by about 1 times. Exercise intervention has an important effect on improving obesity and enhancing cardiorespiratory fitness. However, studies on the effects of combined motion intervention on obese female adolescents aged 14-16 years have not been addressed.

To investigate the effects of 12-week combined motion intervention on body composition, cardiovascular risk factors and cardiopulmonary fitness in obese female adolescents.

From May to July 2022, 48 obese female adolescents aged 14 to 16 years old in Qufu City, Shandong Province were selected as research objects, numbered and divided into the experimental group (n=24) and control group (n=24) using random numbers. The experimental group finally included 20 female adolescents based on the inclusion and exclusion criteria, and the whole intervention lasted for 12 weeks, including rope skipping intervention and taekwondo intervention; while the control group did not perform any exercise intervention and other dietary or pharmacological interventions throughout the 12 weeks. The indicators such as height, body mass, body fat rate (BFR) , waist circumference, BMI, blood pressure (BP) , fasting plasma glucose (FPG) , insulin, insulin resistance index (HOMA-IR) and maximal oxygen uptake (VO_2max) were detected before and after the 12-week combined motion intervention and compared between the two groups, as well as before and after the intervention. Pearson correlation analysis was used to explore the correlation of BFR and waist circumference with VO_2max in obese female adolescents.

Before the intervention, there was no significant difference in age, height, body mass, BFR, waist circumference, BMI, systolic blood pressure (SBP) , diastolic blood pressure (DBP) , pulse pressure difference, FPG, insulin, HOMA-IR, maximal number of completions (Laps) , maximal aerobic speed (MAS) , and VO_2max between the two groups (P>0.05) . After 12-week combined motion intervention, BFR, waist circumference, SBP, DBP, FPG, insulin and HOMA-IR in the experimental group were lower than the control group, while Laps, MAS, VO_2max was significantly higher than the control group (P<0.05) . Compared with pre-intervention, the BFR, waist circumference, SBP, DBP, FPG, insulin and HOMA-IR were decreased and Laps, MAS, VO_2max were increased after 12-week combined motion intervention (P<0.05) . The results of correlation analysis showed that body fat percentage and circumference were negatively correlated with VO_2max in obese female adolescents (r=-0.55, P<0.001; r=-0.41, P<0.001) .

The 12-week combined motion intervention can improve body composition and cardiovascular risk factors in obese female adolescents, and also enhance cardiopulmonary fitness by increasing VO_2max.