Angiology最新文献

Artificial Intelligence (AI) has brought new opportunities in medicine, with a great potential to improve care provided to patients. Given the technical complexity and continuously evolving field, it can be challenging for vascular specialists to anticipate and foresee how AI will shape their practice. The aim of this review is to provide an overview of the current landscape of applications of AI in clinical practice for the management of non-cardiac vascular diseases including aortic aneurysm, peripheral artery disease, carotid stenosis, and venous diseases. The review describes and highlights how AI has the potential to shape the three pillars in the management of vascular diseases including clinical practice, medical research and education. In the limelight of these results, we show how AI should be considered and developed within a responsible ecosystem favoring transdisciplinary collaboration, where multiple stake holders can work together to face current challenges and move forward future directions.

Toll-like receptor 5 (TLR5), integral to the immune system as a primary sensor for flagellin, is central to the link between innate and adaptive immunity, modulating immune responses and cytokine production essential for defense against flagellated pathogens and immune tolerance. This review consolidates the understanding of TLR5's structural and signaling mechanisms and its interactions with flagellin, shedding light on its dual role in immune responses and its promise as a therapeutic target. It highlights TLR5's intricate role in the pathogenesis of obesity-related hypertension, a growing global health concern that correlates with rising obesity rates and is characterized by a complex interplay of immune responses and metabolic dysregulation. Despite the current understanding, the impact of TLR5 on obesity-related hypertension is marked by conflicting findings, indicating a need for further exploration. The review critically analyzes the existing literature, providing novel insights from rodent models and human studies that underscore TLR5's therapeutic potential, setting the stage for transformative research in managing obesity-related hypertension. It calls for deeper investigation into TLR5's multifaceted role, emphasizing its promise as a target for managing obesity-related hypertension and the necessity for future research to clarify its complexities and to innovate treatment strategies.

Chronic kidney disease (CKD) is prevalent among patients with coronary artery disease (CAD) and exacerbates myocardial ischemia. However, the survival benefit of percutaneous coronary intervention (PCI) across different stages of CKD remains controversial. CAD patients (n = 17,418) with CKD (mean age, 69.5 ± 9.9 years; 70.9% male) were included in the Cardiorenal Improvement II cohort from 2007 to 2020. Patients were grouped by PCI or medical treatment and further categorized by stages 3a-5 CKD. Multivariable Cox regression was performed to investigate the associations of cardiovascular- and all-cause mortality with PCI and CKD stage, and to compare predictors of outcomes in patients stratified by advanced CKD. During a median follow-up of 4.2 years, 4605 (26.4%) participants died. Compared with medical treatment, PCI was not associated with improved survival benefit among patients with stage 3b-5 CKD (all P > .05). Among patients with advanced CKD, hypertension, hyperfibrinogenemia and moderate-severe malnutrition were more significantly associated with increased cardiovascular mortality with relatively high attributable risk. PCI was not associated with a survival advantage among patients with advanced CKD. Hypertension, hyperfibrinogenemia and malnutrition may contribute to poor prognosis in patients with advanced kidney disease.

Contrast-induced nephropathy (CIN), which can develop after procedures involving contrast agents, is a significant cause of patient morbidity and mortality. This study aims to investigate the role of pre-procedural pan-immune-inflammation value (PIV) in predicting CIN development in patients undergoing percutaneous coronary intervention (PCI) due to non-ST segment elevation myocardial infarction (NSTEMI). A total of 1006 NSTEMI patients were included in the study. CIN was defined as an increase of at least 0.5 mg/dl or 25% in serum baseline creatinine level 72 h after the procedure. Patients were divided into two groups: those with and without CIN. NSTEMI patients who developed CIN, glucose level (P = .01), platelet count (P < .01), monocyte count (P < .001), neutrophil-to-lymphocyte ratio (NLR) (P < .001), systemic immune inflammation index (SII) score (P < .001), and PIV (P < .001) were higher compared with those without CIN. In the multivariate analysis of all these parameters, the Odds ratios of PIV and SII were similar and slightly lower than NLR. Receiver operating characteristic curve analysis (ROC) showed a PIV cut-off value of 448.43 with a sensitivity of 83.1% and a specificity of 72.8% in patients with CIN. Our study demonstrated an independent relationship between PIV at admission and CIN development in NSTEMI patients.