BMC Cardiovascular Disorders最新文献

Background: Coronary heart disease (CHD) was a leading cause of death worldwide, and the offspring of patients with early-onset CHD faced an elevated risk of cardiovascular disease (CVD). Identifying modifiable short-term risk factors in this high-risk population and developing individualized interventions were crucial for early prevention. This study aimed to clarify the independent risk factors for CVD among the offspring of CHD patients and construct a personalized health education pathway integrated with digital health technologies.

Methods: This study was a retrospective analysis that enrolled 88 offspring of CHD patients, who were divided into an intervention group (IG, n = 52) and a control group (CG, n = 36). Baseline physiological indicators, laboratory test results, and follow-up data at 3 and 6 months were collected. Univariate analysis and multivariate Logistic regression analysis were used to screen for independent risk factors, and a targeted health management pathway was constructed accordingly.

Results: Univariate analysis showed significant differences between the IG and CG in age, height, weight, waist circumference, and blood lipid levels (P < 0.05). Multivariate regression analysis identified the 3-month changes in weight and waist circumference, as well as the 3-month levels of low-density lipoprotein cholesterol (LDL-C) and total cholesterol (CHOL), as independent risk factors for CVD. Reductions in weight and waist circumference exerted a protective effect, while elevated LDL-C and CHOL levels increased the risk of CVD.

Conclusion: This study clarified the key short-term independent cardiovascular risk factors in the offspring of CHD patients. The constructed personalized health pathway focused on weight/waist circumference control and blood lipid regulation, integrating diet, exercise, medication, psychological support, and digital health technologies. It provided a feasible and targeted intervention framework for the early prevention of CVD in this high-risk population, addressing the limitations of generalized interventions in existing studies.

Background: Patients with cardio-kidney-metabolic (CKM) disease are at high risk of long-term mortality. While several metabolic and inflammatory biomarkers have been investigated, their relative prognostic value in real-world CKM populations remains uncertain. We aimed to develop and internally validate a Cox-based prognostic model for long-term all-cause mortality, with a particular focus on serum albumin and inflammatory markers.

Methods: We conducted a prospective cohort study including 480 patients across the CKM spectrum. Participants were followed for up to 11 years, with all-cause mortality as the primary outcome. Cox proportional hazards models were constructed using prespecified clinical variables, including age, sex, estimated glomerular filtration rate (eGFR), serum albumin, high-sensitivity C-reactive protein (hs-CRP), body mass index, hypertension, coronary artery disease, and diabetes mellitus defined by laboratory criteria (HbA1c ≥ 6.5% and/or fasting plasma glucose ≥ 126 g/dL). Model performance was assessed using Harrell's C-index with internal validation by bootstrap resampling. Proportional hazards assumptions were evaluated using Schoenfeld residuals, with sensitivity analyses addressing time-varying effects.

Results: Among 480 participants, 114 deaths (23.8%) occurred during a median 10-year follow-up. In multivariable Cox models, age and coronary artery disease were consistently associated with higher all-cause mortality across all model specifications. Higher serum albumin levels were independently protective in models including laboratory-defined diabetes (HR 0.52 per 1 g/dL, 95% CI 0.30-0.93) and clinical history of diabetes (HR 0.49, 95% CI 0.28-0.86). Laboratory-defined diabetes mellitus was associated with an increased mortality risk (HR 2.24, 95% CI 1.36-3.69), whereas clinically documented diabetes mellitus showed an inverse association (HR 0.17, 95% CI 0.08-0.35). Measures of renal function, inflammatory burden assessed by log-transformed hs-CRP, body mass index, hypertension, and sex were not independently associated with mortality.

Conclusions: In this real-world cohort spanning the cardiorenal-metabolic spectrum, serum albumin emerged as a robust and independent protective prognostic marker for long-term all-cause mortality, even after adjustment for age, comorbidities, renal function, and inflammatory burden. Age and coronary artery disease consistently predicted mortality across all model specifications. These findings highlight the value of serum albumin as an integrative biomarker reflecting nutritional status, systemic inflammation, and disease severity, with potential implications for refined risk stratification in patients with complex cardiorenal-metabolic conditions. Routine assessment of serum albumin may support pragmatic prognostic stratification in cardiorenal-metabolic populations.

Background: This study was designed to investigate the impact of the serum free triiodothyronine to free thyroxine ratio (FT3/FT4) on both the incidence and long-term prognosis of contrast-induced nephropathy (CIN) following elective percutaneous coronary intervention (PCI).

Methods: This retrospective study was conducted among patients who underwent elective PCI at the Second Hospital of Tianjin Medical University from January 1, 2019, to March 31, 2022. The diagnosis of CIN was established when serum creatinine (SCr) level increased by more than 44.2 mol/L (0.5 mg/dL) or 25% compared to baseline within 48-72 h post-PCI. Logistic regression analysis was employed to identify independent predictors of CIN. Cox regression and survival analysis were utilized to assess factors influencing all-cause and cardiovascular mortality. Furthermore, the correlation between FT3/FT4 and the occurrence of CIN was examined via restricted cubic spline (RCS) analysis.

Results: The study encompassed a cohort of 1,390 patients, out of whom 173 (12.4%) experienced CINs. Patients diagnosed with CIN exhibited advanced age, a greater prevalence of acute myocardial infarction (AMI) and chronic renal dysfunction, along with a lower level of FT3/FT4 (all P < 0.001). Stratification based on FT3/FT4 quartile resulted in four distinct patient groups. Notably, significant distinctions emerged among the groups in terms of CIN occurrence, all-cause mortality, cardiovascular mortality. RCS analysis depicted a J-shaped relationship between FT3/FT4 levels and the incidence of CIN. The curve showed an inflection point at an FT3/FT4 ratio of approximately 0.306. CIN risk initially decreases and then increases with the increase of FT3/FT4 ratio. Several factors were identified as risk factors for all-cause mortality, including age, myocardial infarction, LVEDD, SCr before PCI, diuretic usage, left main coronary artery disease, and left circumflex artery disease. Conversely, diastolic blood pressure, serum albumin, post ballooning, statin usage, and FT3/FT4 demonstrated protective effects.

Conclusion: The FT3/FT4 level was significantly associated with both incidence of CIN and long-term all-cause mortality in patients undergoing elective PCI.