OBJECTIVE: To investigate the relationship between C-reactive protein and albumin ratios (CAR) and all-cause and cardiovascular disease(CVD)-specific mortality in individuals with coronary heart disease(CHD).
METHODS: The data from 1895 patients were extracted from the National Health and Nutrition Examination Survey (NHANES) database from 1999-2010. We used weighted COX regression analyses to explore the association between CAR, all-cause, and CVD-specific mortality. Restricted cubic spline(RCS) regression models and threshold effects analysis were used to analyze nonlinear relationships. Subgroup analyses were also performed to explore these relationships further.
RESULTS: During a mean follow-up of 115.78 months, 61.48% of deaths occurred, and 21.85% were due to CVD. After adjusting for potential confounders, each 1-unit increase in CAR was associated with a 65% increase in all-cause mortality and a 67% increase in CVD-specific mortality. The RCS model revealed a non-linear association between CAR and the risk of all-cause mortality and CVD-specific mortality in CHD patients (all non-linear P < 0.001). Threshold effects analysis identified inflection points in regression models of all-cause mortality (0.04, P < 0.001) and CVD-specific mortality (0.05, P = 0.0024). The interaction tests found sex, smoking and diabetes influenced the association between CAR and all-cause mortality and sex, smoking and HF influenced its association with CVD-specific mortality (all P < 0.05).
CONCLUSIONS: There was a nonlinear association between CAR and all-cause mortality and CVD mortality in patients with CHD, with a higher hazard ratio before the inflection point. Sex, smoking, diabetes, and HF might have an effect on the associations between CAR and death risks.

UNASSIGNED: At present, no consensus is reached among articles that investigate the relationship of paraoxonase 1(PON1) -108C/T polymorphism with susceptibility of coronary heart disease (CHD) so far. In this regard, the present meta-analysis was conducted to comprehensively review existing articles related to the relationship of PON1 -108C/T polymorphism with CHD susceptibility. It was preregistered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY)-INPLASY202430117.
UNASSIGNED: Articles that explored the relationship between PON1 -108C/T polymorphism and CHD incidence were searched from electronic databases according to our preset study selection criteria. Thereafter, we adopted stata 12.0 software to analyze our screened studies. At the same time, odds ratios (ORs) and related 95% confidence intervals (95% CIs) were determined for evaluating association strength.
UNASSIGNED: At last, this meta-analysis selected altogether 13 case-control studies that involved 2,979 cases and 2,887 control subjects. We found that the PON1 -108C/T polymorphism displayed marked relationship with CHD susceptibility (T vs. C: OR = 1.24, 95% CI 1.07-1.45; CT vs. CC: OR = 1.33, 95% CI 1.17-1.52; TT vs. CC: OR = 1.51, 95% CI 1.09-2.09; Recessive model: OR = 1.16, 95% CI 0.93-1.45; Dominant model: OR = 1.45, 95% CI 1.16-1.81). Moreover, subgroup analysis showed that race and sample size had no impact on the results. Bioinformatics analysis showed that -108C>T polymorphism was relation to PON1 gene expression (https://gtexportal.org/home/).
UNASSIGNED: The PON1 -108T allele is identified as the possible low-penetrant risk factor of CHD, as suggested by our present meta-analysis.Systematic Review Registration: https://inplasy.com/inplasy-2024-3-0117/, Identifier INPLASY202430117.

UNASSIGNED: Rs1333040 is the single-nucleotide polymorphisms (SNP) related with coronary heart disease (CHD). The aim of the present study is to examine the association between rs1333040 polymorphism genotypes and CHD and to further explore the molecular mechanism in Chinese population.
UNASSIGNED: A case-control study was used in this study, including 500 CHD patients and 500 control subjects. CHD patients and controls were distinguished by coronary angiography. Genotypes of rs1333040 were determined on the Agena MassARRAY system. Statistical analysis was conducted by SPSS (Ver 16.0) and plink (Ver. 1.07, Shaun Purcell).
UNASSIGNED: Fisher\'s exact test by plink indicated a significant difference in the allele distribution between cases and controls, the allele T may be associated with a higher risk of CHD (p = 0.012, odds ratio (OR) = 1.258). The serum levels of low-density lipoprotein cholesterol (LDL-C) (p = 0.029) and Gensini score (p = 0.008) distributed differently in patients with various alleles. In the recessive model, the levels of high-density lipoprotein (HDL) and apolipoprotein A (ApoA) were higher in the TC + CC genotype than in the TT genotype. The TC + TT genotype was found to be risk factors against CHD in a dominant model (OR = 1.278, p = 0.014). The TC + TT genotype along with multiple risk factors significantly positively correlated with the risk of CHD.
UNASSIGNED: The present study investigates the association between the rs1333040 polymorphism genotypes and CHD. The T allele of rs1333040 is the susceptibility site of CHD. The interaction between SNP and various risk factors plays an important role in the development of CHD.

UNASSIGNED: Rapid progression of coronary non-target lesions is essential for the determination of future cardiovascular events. Clinical factors that predict rapid progression of non-target lesions are unclear. The purpose of this study was to identify the clinical predictors of rapid progression and revascularization of coronary non-target lesions.
UNASSIGNED: Consecutive patients with coronary heart disease who had undergone two serial coronary angiograms were enrolled. All coronary non-target lesions were identified and evaluated at both procedures. Multivariable Cox regression analysis was used to investigate the clinical risk factors associated with rapid progression or revascularization of coronary non-target lesions.
UNASSIGNED: A total of 1255 patients and 1670 lesions were enrolled. In this cohort of patients, 239 (19%) had rapid progression and 186 (14.8%) underwent revascularization. At the lesion level, 251 (15.0%) had rapid progression and 194 (11.6%) underwent revascularization. The incidence of lesion revascularization and myocardial infarction was significantly higher in patients with rapid progression. In multivariable analyses, hypertension (hazard ratio [HR], 0.76; 95% confidence interval [95% CI], 0.58-1.00; p = 0.049), ST-segment elevation myocardial infarction (STEMI) (HR, 1.46; 95% CI, 1.03-2.07; p = 0.035), glycosylated hemoglobin (HR, 1.16; 95% CI, 1.01-1.33; p = 0.039) and lesion classification (B2/C versus A/B1) (HR, 1.73; 95% CI, 1.27-2.35; p = 0.001) were significant factors associated with rapid progression. The level of triglycerides (HR, 1.10; 95% CI, 1.00-1.20; p = 0.040) and lesion classification (B2/C versus A/B1) (HR, 1.53; 95% CI, 1.09-2.14; p = 0.014) were predictors of lesion revascularization.
UNASSIGNED: Hypertension, STEMI, glycosylated hemoglobin and lesion classification may be used as predictors of rapid progression of coronary non-target lesions. The level of triglyceride and lesion classification may predict the revascularization of non-target lesions. In order to prevent future cardiovascular events, increased attention should be paid to patients with these factors.

UNASSIGNED: The efficacy of bioresorbable vascular scaffolds (BVS) compared to metallic stents for the treatment of coronary heart disease remains controversial. The analysis of clinical outcomes at five years following the initial treatment has yet to be reviewed. This study sought to assess the five-year outcomes in randomized controlled trials of BVS in the treatment of coronary heart disease using a systematic review and meta-analysis.
UNASSIGNED: A systematic database search was conducted from their inception to June 30th, 2023 using various Medical Subject Headings (MeSH) terms including: \"Coronary Disease\", \"Bioresorbable stent\", \"Randomized controlled trials\".
UNASSIGNED: After a rigorous selection process, a total of five high-quality articles were finally included in this study. Each trial demonstrated a low risk of bias. After 5 years, bioresorbable stents showed outcomes similar to conventional metal stents in terms of cardiac mortality. However, they were inferior in terms of lesion revascularization rates, in-stent thrombosis rates, target lesion failure, target vessel failure, and myocardial infarction.
UNASSIGNED: While bioresorbable stents are comparable to metallic stents in terms of cardiac mortality rates, they exhibit significant drawbacks that warrant clinical consideration.

BACKGROUND: Coronary computed tomography angiography (CCTA) has become a central tool for the primary diagnosis of stable coronary artery disease (CAD). Its integration into the service catalog of the German statutory health insurance will not only transform the way patients are examined and treated but also enhance the collaboration between nonradiologists and radiologists.
OBJECTIVE: This article explores the requirements nonradiologists have for CCTA and identifies ways to promote successful interdisciplinary communication.
METHODS: The study addresses criteria for proper patient selection and preparation for CCTA. It considers the perspectives and needs of patients and various medical specialties, highlighting essential aspects of interdisciplinary communication.
RESULTS: CCTA enables precise clarification of CAD and should be used for patients with a pretest probability of chronic CAD between 15 and 50%. Clear action plans in the diagnostic report are crucial to assist general practitioners and cardiologists in treatment planning. Patients expect clear information about the procedure, possible risks, and results.
CONCLUSIONS: Close collaboration between various medical disciplines is essential for the successful implementation of CCTA. Clear, structured diagnostic reports with annotated images, along with regular case discussions and feedback loops, can improve report interpretation and interdisciplinary communication. Patient-friendly reports can make diagnostic results more understandable and enhance patient adherence.
UNASSIGNED: HINTERGRUND: Die Computertomographie-Koronarangiographie (CCTA) ist eine wichtige Methode in der Primärdiagnostik der stabilen koronaren Herzkrankheit (KHK). Ihre Integration in den Leistungskatalog der gesetzlichen Krankenversicherung verändert künftig nicht nur die Art und Weise, wie Patienten untersucht und behandelt werden, sondern erfordert auch eine enge Zusammenarbeit zwischen Nicht-Radiologen und Radiologen.
UNASSIGNED: Welche Anforderungen Nicht-Radiologen an die CCTA stellen und welche Wege es gibt, um eine erfolgreiche interdisziplinäre Kommunikation zu fördern, wird im folgenden Artikel detailliert erörtert.
METHODS: Die Arbeit thematisiert Kriterien der Patientenselektion und Patientenvorbereitung für eine CCTA. Sie berücksichtigt Perspektiven und Bedürfnisse des Patienten sowie verschiedener medizinischer Fachrichtungen und beleuchtet wesentliche Aspekte der interdisziplinären Kommunikation.
UNASSIGNED: Die CCTA ermöglicht eine präzise KHK-Abklärung und sollte bei einer Vortestwahrscheinlichkeit für eine chronische KHK zwischen 15 und 50 % eingesetzt werden. Klare Handlungsanweisungen im Befundbericht sind entscheidend, um Hausärzte und Kardiologen bei der Therapieplanung zu unterstützen. Patienten erwarten verständliche Informationen zum Untersuchungsablauf, möglichen Risiken und Ergebnissen.
CONCLUSIONS: Die enge Zusammenarbeit zwischen verschiedenen medizinischen Disziplinen ist für die künftig erfolgreiche Implementation der CCTA entscheidend. Durch klar strukturierte Befundberichte mit annotierten Bilddaten sowie regelmäßige Fallbesprechungen und Feedbackschleifen kann die Befundinterpretation verbessert und die interdisziplinäre Kommunikation gefördert werden. Durch patientengerechte Befundzusammenfassungen können Befunde verständlicher gemacht und die Patientenadhärenz verbessert werden.

OBJECTIVE: Coronary heart disease (CHD) is a prevalent cardiovascular disease with high mortality rates worldwide. Patients with CHD often experience adverse psychological stress related to the disease\'s diagnosis, treatment and recovery phases. This stress can hurt sleep quality and overall quality of life. Mindfulness-based interventions (MBIs) have been studied as a psychotherapeutic approach to alleviating the psychological stress associated with CHD. This study aimed to determine the effectives of MBIs for health outcomes in patients with CHD.
METHODS: A total of eight English-language databases were searched, and eight relevant studies were included in the analysis. The included studies were assessed for literature quality, and data were extracted and analysed using Review Manager 5.3.
RESULTS: A total of eight studies involving 802 participants were included in the analysis. Compared to control groups, MBIs significantly reduced anxiety, depression, perceived stress, and systolic blood pressure. However, there was no significant effect on diastolic blood pressure, quality of life or body mass index. One study reported that MBIs significantly improved sleep quality in patients with acute myocardial infarction after percutaneous coronary intervention but had no significant effect on body mass index.
CONCLUSIONS: MBIs had significant effects on anxiety and depression in patients with CHD, reduced perceived stress and were associated with reductions in systolic blood pressure and improvements in sleep quality. However, they did not significantly affect diastolic blood pressure, quality of life or body mass index.

BACKGROUND: Prior researches have highlighted inverse associations between levels of circulating very-long chain saturated fatty acids (VLCSFAs) and coronary heart disease (CHD). However, the intricate links involving VLCSFAs, gut microbiota, and bile acids remain underexplored.
OBJECTIVE: This study examined the association of erythrocyte VLCSFAs with CHD incidence, focusing on the mediating role of gut microbiota and fecal bile acids.
METHODS: This 10-year prospective study included 2383 participants without CHD at baseline. Erythrocyte VLCSFAs (arachidic acid [C20:0], behenic acid [C22:0], and lignoceric acid [C24:0]) were measured using gas chromatography at baseline and 274 CHD incidents were documented in triennial follow-ups. Gut microbiota in 1744 participants and fecal bile acid metabolites in 945 participants were analyzed using 16S rRNA sequencing and UPLC-MS/MS at middle-term.
RESULTS: The multivariable-adjusted HRs (95%CI) for CHD incidence in highest vs. lowest quartiles were 0.87 (0.61, 1.25) for C20:0, 0.63 (0.42,0.96) for C22:0, 0.59 (0.41,0.85) for C24:0, and 0.57 (0.39, 0.83) for total VLCSFAs. Participants with higher total VLCSFA levels exhibited increased abundances of Holdemanella, Coriobacteriales Incertae Sedis spp., Ruminococcaceae UCG-005 and UCG-010, and Lachnospiraceae ND3007 group. These five genera generated microbial score (ODMS) that accounted for 11.52% of the total VLCSFAs-CHD association (Pmediation =0.018). Bile acids tauro_α_ and tauro_β_muricholic acid (T_α_ and T_β_MCA) were inversely associated with ODMS and positively associated with incident CHD. Opposite associations were found for glycolithocholic acid (GLCA), glycodeoxycholic acid (GDCA). Mediation analyses indicated that GLCA, GDCA, and T_α_ and T_β_MCA explained 56.40%, 35.19%, and 26.17% of the ODMS-CHD association, respectively (Pmediation =0.002, 0.008, and 0.020).
CONCLUSIONS: Elevated erythrocyte VLCSFAs are inversely associated with CHD risk in the Chinese population, with gut microbiota and fecal bile acid profiles potentially mediating this association. The identified microbiota and bile acid metabolites may serve as potential intervention targets in future studies.
BACKGROUND: NCT03179657.

Cardiovascular disease (CVD) is the most common cause of death worldwide, with coronary atherosclerotic heart disease (CHD) accounting for the majority of events. Evidence demonstrates that inflammation plays a vital role in the development of CHD. The association between C-reactive protein (CRP), a representative inflammatory biomarker, and atherosclerosis (AS), CHD, and inflammation has attracted attention. Therefore, we conducted an extensive search on PubMed using the aforementioned terms as search criteria and identified a total of 1246 articles published from January 2000 to April 2024. Both review and research-based articles consistently indicate CRP as a risk enhancer for CVD, contributing to the refinement of risk stratification and early identification of apparently healthy at-risk populations. Additionally, CRP reflects disease progression and predicts the prognosis of recurrent cardiovascular events. Anti-inflammatory therapeutic strategies targeting CRP also provide new treatment options for patients. This review focuses on the link between CRP and CHD, highlighting how CRP is involved in the pathological progression of AS and its potential value for clinical applications.

Background: Glycosylated hemoglobin (HbA1c) variability is a risk factor for cardiovascular complications in patients with Type 2 diabetes mellitus (T2DM), but its relationship with the severity of coronary artery disease (CAD) is unclear. Methods: Patients with T2DM who underwent coronary angiography due to angina were enrolled. HbA1c variability was expressed as coefficient of variation (CV), standard deviation (SD), variability independent of mean (VIM), and time in range (TIR). The severity of CAD was expressed by the number of involved vessels and Gensini score. Multivariate regression models were constructed to test the relationship between HbA1c variability, number of involved vessels, and the Gensini score, followed by linear regression analysis. Results: A total of 147 patients were included. In multivariate analysis, VIM-HbA1c (OR = 2.604; IQR: 1.15, 5.90; r = 0.026) and HbA1cTIR (OR = 0.13; IQR: 0.04, 0.41; r < 0.001) were independent risk factors for the number of involved vessels. After adjustment, HbA1cTIR (OR = 0.01; IQR: 0.002, 0.04; r < 0.001), SD-HbA1c (OR = 4.12, IQR: 1.64, 10.35; r = 0.001), CV-HbA1c (OR = 1.41, IQR: 1.04, 1.92; r = 0.007), and VIM-HbA1c (OR = 3.26; IQR: 1.43, 7.47; r = 0.003) were independent risk factors for the Gensini score. In the linear analysis, the Gensini score was negatively correlated with HbA1cTIR (β = -0.629; r < 0.001) and positively correlated with SD-HbA1c (β = 0.271; r = 0.001) and CV-HbA1c (β = 0.176; r = 0.033). After subgroup analysis, HbA1cTIR was a risk factor for the number of involved vessels. The Gensini score was negatively correlated with HbA1cTIR and positively correlated with SD-HbA1c at subgroups of subjects with a mean HbA1c ≤ 7%. Conclusions: Our analysis indicates that HbA1c variability, especially HbA1cTIR, plays a role for the severity of CAD in patients with T2DM. HbA1c variability may provide additional information and require management even at the glycemic target. Translational Aspects: Studies have shown that HbA1c variability is related to cardiovascular complications. Further, we explore the correlation between HbA1c variability and the severity of CAD. HbA1c variability is a risk factor for coronary stenosis in T2DM. It may be a potential indicator reflecting glycemic control for the prevention and treatment of cardiovascular complications.