American journal of preventive cardiology最新文献

{"title":"AJPC family heart summit special issue: guest editor overview / message","authors":"Laurence S. Sperling , Martha Gulati","doi":"10.1016/j.ajpc.2025.101331","DOIUrl":"10.1016/j.ajpc.2025.101331","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101331"},"PeriodicalIF":5.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of coronary artery calcium scoring in low-risk patients: The Multi-Ethnic Study of Atherosclerosis (MESA)","authors":"Jonathan R. Davis ,&nbsp;Alexander C. Razavi ,&nbsp;Charlotte C. Ellberg ,&nbsp;Michael J. Blaha ,&nbsp;Michael H. Criqui ,&nbsp;Harpreet S. Bhatia","doi":"10.1016/j.ajpc.2025.101329","DOIUrl":"10.1016/j.ajpc.2025.101329","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines recommend consideration of coronary artery calcium (CAC) scoring in intermediate atherosclerotic cardiovascular disease (ASCVD) risk patients, but its utility in lower-risk individuals is less clear.</div></div><div><h3>Methods</h3><div>Data from 6712 participants from MESA was used with 10-year ASCVD risk defined by the pooled cohort equations (PCE) and AHA PREVENT equations. The association between CAC, CHD and ASCVD risk was evaluated using Cox proportional hazard models. Risk prediction improvement was evaluated using Harrell’s C-index and net reclassification improvement (NRI).</div></div><div><h3>Results</h3><div>Amongst all participants (mean age 62.2 ± 10.2 years, 52.8 % women), the ASCVD event rate per 1000 person years was 14.3 vs. 4.1 with and without CAC over a median of 16.7 years. CAC score was most strongly associated with increased ASCVD risk in low and borderline-risk individuals (HR 1.35, 95 % CI 1.22–1.50 and 1.30, 1.16–1.46). Among these individuals, addition of the Agatston score to the PCE improved the C-index (SE) for ASCVD from 0.593(0.029) to 0.640(0.031) and 0.558(0.037) to 0.663(0.036), respectively. Category-free NRI was also significant in low (0.3268, 95 % CI 0.0960–0.5408) and borderline (0.4283, 0.2319–0.7332) risk individuals with similar results using the AHA PREVENT equations. Using a statin eligibility threshold of 7.5 %, the addition of CAC correctly reclassified a net of 10.1 % of low/borderline risk individuals vs the PCE and 16.7 % vs. PREVENT.</div></div><div><h3>Conclusions</h3><div>CAC is associated with increased ASCVD risk in lower-risk individuals. The addition of CAC scoring to the PCE and AHA PREVENT equations improved risk prediction, suggesting potential utility in this population.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101329"},"PeriodicalIF":5.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erectile dysfunction and cardiovascular-kidney-metabolic syndrome: Insights from the all of us research program","authors":"Cameron M. Blazoski ,&nbsp;Zhiqi Yao ,&nbsp;Tobias S. Kohler ,&nbsp;Martin M. Miner ,&nbsp;John Erhabor ,&nbsp;Michael J. Blaha","doi":"10.1016/j.ajpc.2025.101332","DOIUrl":"10.1016/j.ajpc.2025.101332","url":null,"abstract":"<div><h3>Introduction</h3><div>Erectile dysfunction (ED) is associated with cardiovascular disease (CVD) risk factors and is a potential indicator for future CVD events, but ED’s association with cardiovascular-kidney-metabolic (CKM) syndrome has not been systematically studied.</div></div><div><h3>Methods</h3><div>This study used data from the <em>All of Us</em> Research Program covering 2017 to 2023. The primary exposure was prevalence of electronic health record-diagnosed ED with cross-sectional analyses measuring the association between prevalent ED and prevalent CKM conditions. In participants without CKM conditions at baseline, we performed survival analyses to evaluate the association between prevalent ED and the development of future CKM conditions with a follow up period ranging from a median of 2.1–4.0 years.</div></div><div><h3>Results</h3><div>Of the 97,475 male participants in this study, 5,575 (5.7 %) had a documented baseline ED diagnosis. The highest prevalence by race was white individuals (7.2 %) and by age range was 75–80 (12.7 %). Participants with ED versus those without ED had a higher rate of CKM conditions including diabetes mellitus (T2DM) (19.3 % vs 7.3 %), hypertension (HTN) (47.6 % vs 18.8 %), chronic kidney disease (CKD) (10.3 % vs 2.8 %), heart failure (HF) (5.7 % vs 2.0 %), atherosclerotic cardiovascular disease (ASCVD) (3.0 % vs 1.3 %), and atrial fibrillation (AF) (7.3 % vs 2.5 %). Baseline prevalent ED was associated with higher risks of developing CKM conditions of CKD, HF, AF, ASCVD, and HTN but not the development of T2DM.</div></div><div><h3>Conclusion</h3><div>A diagnosis of ED was significantly associated with both the prevalence and future development of cardiovascular and metabolic conditions, suggesting that ED assessment should be incorporated into routine cardiometabolic risk evaluation.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101332"},"PeriodicalIF":5.9,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Over-the-counter access to combined oral contraceptives for individuals with hypertension: an expert review","authors":"Kate Grindlay ,&nbsp;Katherine Key ,&nbsp;Raegan McDonald-Mosley ,&nbsp;Melissa Kottke ,&nbsp;Dázon Dixon Diallo ,&nbsp;Martha Gulati ,&nbsp;Daniel Grossman","doi":"10.1016/j.ajpc.2025.101328","DOIUrl":"10.1016/j.ajpc.2025.101328","url":null,"abstract":"<div><div>Efforts are underway to move a combined oral contraceptive over the counter in the United States. However, hypertension is an important contraindication and questions exist regarding how users should screen for it in an over-the-counter setting. An expert panel convened in April 2022 to review the literature related to hypertension and an over-the-counter switch for combined oral contraceptives and vote on a set of blood pressure screening recommendations for future over-the-counter combined oral contraceptives. Research indicates that people can accurately self-screen for contraindications to combined oral contraceptives using simple checklists, and the absolute risk of adverse events is low among people with hypertension who use combined oral contraceptives and must be balanced against substantially higher risks of pregnancy as well as benefits of increased contraceptive access. Based on these data, the panel concluded that 1) individuals who have not had their blood pressure checked in the last year or do not know their blood pressure should be advised in product labeling to get it checked prior to purchase; 2) blood pressure documentation should not be required to purchase over-the-counter combined oral contraceptives, provided over-the-counter switch behavioral studies demonstrate individuals can correctly self-screen for use; and 3) blood pressure screening should be made more accessible and affordable. Over-the-counter combined oral contraceptives may increase access to the most commonly used reversible contraceptive method. They may also provide an opportunity for enhanced education and awareness of hypertension and preventive cardiovascular screenings among people of reproductive age, particularly young people and people of color.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101328"},"PeriodicalIF":5.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Greater amount of lying and reclining associate with cardiovascular disease risk score and several risk factors, while short sitting bouts and standing have opposite relation","authors":"Pauliina Husu ,&nbsp;Henri Vähä-Ypyä ,&nbsp;Kari Tokola ,&nbsp;Harri Sievänen ,&nbsp;Onni Niemelä ,&nbsp;Tommi Vasankari","doi":"10.1016/j.ajpc.2025.101327","DOIUrl":"10.1016/j.ajpc.2025.101327","url":null,"abstract":"<div><div>Excess sedentary behavior (SB) seems to be harmful for health, whereas the effects of standing can be opposite. The present study aimed at 1) describing different components of SB (lying, reclining, sitting) and standing accumulating from different bout lengths in a population-based sample and 2) analyzing their associations with indicators of cardiometabolic health. The study is based on cross-sectional accelerometer-measured data on 24/7 physical behavior among 20–69-year-old Finns. Outcomes were Framingham score for cardiovascular disease (CVD) risk, serum high (HDL)- and low-density lipoprotein (LDL) and total cholesterol, triglycerides, and waist circumference. Participants (<em>n</em> = 4298) mean age was 51 years (SD=13) and 61 % were female. More lying and reclining, regardless of bout length, were associated with higher CVD-score (<em>p</em> ≤ 0.001), lower HDL-cholesterol (<em>p</em> &lt; 0.001), higher triglycerides (<em>p</em> &lt; 0.001) and larger waist circumference (<em>p</em> &lt; 0.001). Longer sitting time accumulating from &lt;30 min bouts was associated with lower CVD-score (<em>p</em> &lt; 0.001), higher HDL- (<em>p</em> &lt; 0.001), lower LDL- (<em>p</em> = 0.004) and total cholesterol (<em>p</em> = 0.009), lower triglycerides (<em>p</em> &lt; 0.001) and smaller waist circumference (<em>p</em> &lt; 0.001). Longer sitting accumulating from bouts exceeding 20 min was associated with larger waist circumference (<em>p</em> &lt; 0.001) indicating that health associations of sitting may depend on bout length. More standing regardless of bout length was associated with lower CVD-score (≤0.001), higher HDL-cholesterol (<em>p</em> &lt; 0.001), lower triglycerides (<em>p</em> &lt; 0.001) and smaller waist circumference (<em>p</em> &lt; 0.001). These associations were mostly independent of moderate-to-vigorous physical activity. Lying and reclining had negative associations with CVD-score and risk factors while short sitting bouts and standing had positive associations, underpinning the importance of evaluating the different components of stationary behavior separately without combining them to overall SB.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101327"},"PeriodicalIF":5.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global trends in cardiovascular mortality attributable to high body mass index: 1990–2021 analysis with future projections","authors":"Parisa Fallahtafti ,&nbsp;Hamidreza Soleimani ,&nbsp;Shaghayegh Khanmohammadi ,&nbsp;Amirhossein Habibzadeh ,&nbsp;Morvarid Taebi ,&nbsp;Alireza Azarboo ,&nbsp;Amirhossein Shirinezhad ,&nbsp;Aysan Valinejad ,&nbsp;Michael J. Blaha ,&nbsp;Sadeer Al-Kindi ,&nbsp;Khurram Nasir","doi":"10.1016/j.ajpc.2025.101326","DOIUrl":"10.1016/j.ajpc.2025.101326","url":null,"abstract":"<div><h3>Objective</h3><div>Cardiovascular disease (CVD) remains a major global cause of death, with high body mass index (BMI) as a key modifiable risk factor. This study examines global and regional patterns of CVD mortality attributable to high BMI from 1990 to 2021, with projections to 2032.</div></div><div><h3>Methods</h3><div>Using Global Burden of Disease 2021 data from 204 countries, we analyzed age-standardized mortality rates (ASMRs) and population-attributable fractions by sex, age, socio-demographic index (SDI), and region. Future trends were estimated using a Bayesian age-period-cohort model, with uncertainity intervals from 1000 posterior simulations.</div></div><div><h3>Results</h3><div>High BMI-related deaths due to CVD rose from 0.9 million in 1990 to 1.9 million in 2021, with ASMR declining from 24.43 to 22.77 per 100,000 (-6.83 %). High-middle SDI regions had the highest ASMR, while low-middle SDI regions saw the largest increase. Mortality rose for hypertensive heart disease and atrial fibrillation and flutter, but declined for ischemic heart disease and stroke. Older adults accounted for most deaths, though ASMR increased among those aged 15–49. By 2032, deaths are projected to reach 2.5 million (+33 %), with ASMR dropping to 22.06.</div></div><div><h3>Conclusion</h3><div>Despite modest ASMR declines, high-BMI-related CVD deaths are rising, especially in low-SDI regions, underscoring the need for targeted prevention.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101326"},"PeriodicalIF":5.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of self-assessment tools for cardiovascular risk behaviors: A systematic review","authors":"Wilhelmina F. Goevaerts ,&nbsp;Joyce M. Heutinck ,&nbsp;Mayke M.C.J. Van Leunen ,&nbsp;Wessel W. Nieuwenhuys ,&nbsp;Lonneke A. Fruytier ,&nbsp;Cyrille Herkert ,&nbsp;Jos J. Kraal ,&nbsp;Ilse A.G. Rongen ,&nbsp;Willem J. Kop ,&nbsp;Yuan Lu ,&nbsp;Hareld M.C. Kemps ,&nbsp;Rutger W.M. Brouwers","doi":"10.1016/j.ajpc.2025.101316","DOIUrl":"10.1016/j.ajpc.2025.101316","url":null,"abstract":"<div><h3>Background</h3><div>A healthy lifestyle is crucial in mitigating cardiovascular disease risk. Numerous tools for cardiovascular risk behaviors have been developed that people can use for self-assessment purposes. However, the validity of these tools is insufficiently understood in the context of self-assessment. This systematic review examines the validity of self-assessment tools for cardiovascular risk behaviors, including lack of physical activity (PA), tobacco smoking, excessive alcohol consumption, unhealthy diet, and chronic psychological stress.</div></div><div><h3>Methods</h3><div>The PubMed, Ovid Embase, and the Cochrane Library databases were searched. Studies investigating the validity of tools in the context of self-assessment (i.e., without active involvement of a healthcare professional) were included. We investigated criterion validity (i.e., comparison to a gold standard), convergent validity (comparison to similar measures), face and content validity, and reliability.</div></div><div><h3>Results</h3><div>Thirty-one unique articles reporting on 37 separate validation studies were included, which examined a total of 49 distinct self-assessment tools (with tools for PA (<em>n =</em> 40), nutritional intake (<em>n =</em> 7), psychological stress (<em>n =</em> 1), and multiple domains (<em>n =</em> 1)). No validation studies were found for self-assessment of tobacco smoking or alcohol consumption. All wearable PA intensity assessment–energy expenditure studies demonstrated weak validity, both in laboratory and free-living conditions. Criterion validity was examined for only two nutritional intake tools, showing weak to moderate validity. For psychological stress and tools measuring multiple domains, only convergent validity was examined.</div></div><div><h3>Discussion</h3><div>Behavioral self-assessment tools are predominantly focused on PA and nutritional intake, with limited evidence for good validity. There is a pressing need for developing and validating comprehensive and accurate self-assessment tools.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101316"},"PeriodicalIF":5.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in utilization and cost of triglyceride-lowering therapies among Medicare beneficiaries: An analysis from the Medicare part D database","authors":"Kabir Malkani ,&nbsp;Ruina Zhang ,&nbsp;Navjot Sobti ,&nbsp;Krista Zachariah ,&nbsp;Jacob Groenendyk ,&nbsp;Subhanik Purkayastha ,&nbsp;Xiaohan Ying ,&nbsp;Danielle Newbury ,&nbsp;Diala Steitieh ,&nbsp;Sonika Patel ,&nbsp;Vinay Kini","doi":"10.1016/j.ajpc.2025.101318","DOIUrl":"10.1016/j.ajpc.2025.101318","url":null,"abstract":"<div><h3>Background</h3><div>Approximately 14 million U.S. adults may benefit from treatment of hypertriglyceridemia to reduce risk of atherosclerotic cardiovascular disease (ASCVD). While the evidence base for treatment of hypertriglyceridemia has significantly changed over time, patterns of utilization and spending on triglyceride-lowering therapies in the U.S. are not well-understood.</div></div><div><h3>Methods</h3><div>We used the Medicare Part D Prescriber dataset from 2013 to 2021 to identify all generic and brand name formulations of triglyceride-lowering therapies (fibrates, omega-3 acid ethyl esters, and niacin). We assessed annual expenditures and number of beneficiaries, evaluated trends and assessed potential savings to Medicare if generic medications were used in place of brand names.</div></div><div><h3>Results</h3><div>We identified seventeen oral triglyceride-lowering medications used from 2013–2021. There was a 22 % decline in beneficiaries receiving any triglyceride-lowering therapy and a 32 % reduction in Medicare spending over the study period. For fibrates, overall use declined by 21 % (from 1.6 million to 1.3 million beneficiaries) and spending declined by 67 % (from $735 million to $243 million). For omega-3 acid ethyl esters, overall use increased by 47 % (from 389k to 571k beneficiaries) and spending increased by 101 % (from $461 million to $925 million). For niacin, overall use declined by 87.3 % (from 445k to 56k beneficiaries) and spending declined by 92.9 % (from $431 million to $31 million). When generics became available, expenditure on and number of beneficiaries receiving brand name medications decreased. During the study period, $5.0 billion (41 %) was spent on brand name triglyceride-lowering therapies, and $1.5 billion could have been saved by switching to their respective generic versions when available.</div></div><div><h3>Conclusions</h3><div>Among Medicare Part D beneficiaries, use and spending on fibrates and niacin declined, while use and spending on omega-3 acid ethyl esters increased. These trends likely reflect changes in the evidence base and guideline recommendations for hypertriglyceridemia treatment. While most beneficiaries received generic medications when available, substantial spending on brand name medications persists, indicating potential missed opportunities for cost savings.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101318"},"PeriodicalIF":5.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between artificial sweeteners and cardiovascular disease, stroke, and diabetes: A Mendelian randomization study","authors":"Jinming Fan ,&nbsp;Yifei Hu ,&nbsp;Junzhu Zhang ,&nbsp;Jiawen Chen ,&nbsp;Yajun Yuan ,&nbsp;Benshuai Yu","doi":"10.1016/j.ajpc.2025.101325","DOIUrl":"10.1016/j.ajpc.2025.101325","url":null,"abstract":"<div><h3>Background</h3><div>Erythritol is a widely used artificial sweetener, yet its long-term impact on cardiometabolic health remains debated. This study aimed to investigate the genetic associations of erythritol with cardiovascular disease (CVD), stroke, and diabetes using a two-sample Mendelian randomization (TSMR) approach.</div></div><div><h3>Methods</h3><div>We utilized single-nucleotide polymorphisms (SNPs) associated with erythritol levels from genome-wide association studies (GWAS) as instrumental variables (IVs). The primary analysis employed the inverse-variance weighted (IVW) method. Robustness was assessed using multiple sensitivity analyses (including MR-Egger, weighted median, weighted multitude, and simple mode). Heterogeneity test, pleiotropy test, and sensitivity analysis were also conducted to further ensure the accuracy and stability of the research results.</div></div><div><h3>Results</h3><div>Erythritol showed positive associations with coronary heart disease (CHD) (OR = 1.0020, 95% CI: 1.0007–1.0034, <em>P</em> = 0.0034), myocardial infarction (MI) (OR = 1.0015, 95% CI: 1.0004–1.0026, <em>P</em> = 0.0090), and stroke (OR = 1.0463, 95% CI: 1.0010–1.0937, <em>P</em> = 0.0449) according to the IVW method. There was suggestive evidence of a positive association between erythritol and CHD, MI, and stroke. No significant causal association was observed between erythritol with heart failure (HF) and diabetes.</div></div><div><h3>Conclusions</h3><div>This TSMR study provides genetic evidence suggesting erythritol is associated with an increased risk of CHD, MI, and stroke, but not with HF or diabetes. Our findings could further clarify the effect of erythritol on CVD, stroke and diabetes, and thus be more beneficial in reducing the risk of disease. Clinical trial number: not applicable.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101325"},"PeriodicalIF":5.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic inflammation modulates lipoprotein(a)-associated coronary stenosis in the chronic coronary syndromes","authors":"Lu Shen ,&nbsp;Wenqing Zhai ,&nbsp;Ping Jiang ,&nbsp;Feng Liang ,&nbsp;Ruonan Li ,&nbsp;Dongju Xu ,&nbsp;Qingna Zhang ,&nbsp;Jing Zhang ,&nbsp;Xingyong Tao","doi":"10.1016/j.ajpc.2025.101324","DOIUrl":"10.1016/j.ajpc.2025.101324","url":null,"abstract":"<div><h3>Background</h3><div>Recent researches highlight the interdependence of lipoprotein(a) [Lp(a)] and Lp(a)-associated cardiovascular risk with the background inflammatory burden. This study aimed to investigate whether systemic inflammation modulates Lp(a)-associated coronary stenosis in chronic coronary syndromes (CCS).</div></div><div><h3>Methods</h3><div>A total of 1513 participants undergoing angiography at a tertiary cardiology center in China were included in our retrospective, cross-sectional study. Participants were categorized into normal, mild, and severe groups based on the Gensini Scores, which quantitatively assess stenosis severity. Multinomial logistic models were calculated according to accompanying systemic inflammation concentration.</div></div><div><h3>Results</h3><div>Participants with elevated Lp(a) levels had a high coronary stenosis risk: fully adjusted model odds ratios (ORs) [95% confidence intervals (CIs)] for the mild vs. normal and severe vs. normal groups were 1.47 (1.11-1.96) and 1.68 (1.21-2.33). Notably, the strongest Lp(a)-coronary stenosis associations after multi-variable adjustment persisted only in low inflammation concentration [systemic inflammation response index (SIRI) &lt; 0.64)] [mild vs. normal, OR 2.03, 95% CI 1.17-3.54, <em>P</em> = 0.012; severe vs. normal, OR 2.34, 95% CI 1.24-4.44, <em>P</em> = 0.009], with no associations in moderate (0.64 ≤ SIRI &lt; 1.41) and high (SIRI ≥ 1.41) state. Identical analysis across the systemic immune-inflammation index (SII) and neutrophil to lymphocyte ratio (NLR) yielded consistent results.</div></div><div><h3>Conclusions</h3><div>Elevated Lp(a) correlates with coronary stenosis only in low inflammation concentration. Considering systemic inflammation in personalized Lp(a)-lowering therapies is more conducive for CCS managements.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101324"},"PeriodicalIF":5.9,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}