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Few studies have investigated the association between herbal medicine consumption and coronary artery disease severity. This cross‐sectional study aimed to investigate the association between the frequency of medicinal herbs consumption and coronary artery stenosis (CAS), lipid profile, fasting blood sugar (FBS), and blood pressure level in participants undergoing coronary angiography. This study was conducted on 662 participants aged 35–75 years. Serum cardiometabolic markers were measured using standard kits. The extent and severity of CAS were evaluated using the Gensini score (GS) and syntax score (SS). Higher consumption of Thymus vulgaris and Sumac was associated with decreased odds of artery‐clogging according to the GS. A higher intake of Thymus vulgaris and Mentha was associated with lower levels of serum cholesterol and triglyceride. Monthly intake of Thymus vulgaris, and weekly/daily intake of Mentha, Nigella Sativa, and Cuminum Cyminum were associated with lower low‐density lipoprotein. Weekly/daily intake of Turmeric and Thymus vulgaris were associated with lower high‐density lipoprotein levels and monthly intake of Mentha was related to lower serum FBS levels. Higher consumption of Mentha, Mentha pulegium L, Lavandula angustifolia, and Nigella Sativa was associated with lower levels of systolic blood pressure. According to the results of the present study, herbs consumption might be related to a reduction in CAS risk factors. [ABSTRACT FROM AUTHOR]

Context: More positive global longitudinal strain (GLS) and higher epicardial fat thickness (EFT) correlate with coronary artery disease (CAD) severity. Aim: The aim of the study was to assess the combined efficacy of GLS and EFT measurement in predicting severity of CAD measured by coronary angiography. Study and Design: Prospective, observational study conducted in Government Medical College, Kottayam, Kerala, for 2 years. One thousand patients with ≥50% coronary stenosis were grouped as cases and 500 patients who had normal coronaries or

Abstract Background The purpose of this study was to explore the expression of miR-665 in acute myocardial infarction (AMI) and evaluate its significance in the diagnosis and prognosis of AMI. Methods 100 patients with AMI were selected as the study group and 80 healthy subjects were chosen as the control group. The levels of miR-665 were detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR) in the two groups. The diagnostic value of miR-665 expression level in AMI was analyzed by the receiver operator characteristic (ROC) curve. Kaplan-Meier curve and Cox regression were used to evaluate the predictive value of miR-665 for major adverse cardiovascular events (MACEs) in patients with AMI within 30 days after percutaneous coronary intervention (PCI). Results The serum miR-665 level of the study group was significantly lower than that of the control group. The level of miR-665 was significantly correlated with clinical indicators of patients with AMI. ROC curve showed that miR-665 has a high diagnostic value for AMI. Survival analysis showed that Gensini score and miR-665 were independent risk factors for the occurrence of MACEs within 30 days after PCI in patients with AMI. Conclusions Abnormal decrease of serum miR-665 expression level in patients with AMI may increase the risk of MACEs occurrence after PCI.

Introduction: This study investigates the relationship between serum TWEAK levels and the degree of vascular involvement in patients with stable angina pectoris, offering insights beyond conventional cardiovascular risk factors. Materials and Methods: This study involved 88 patients (33 women, 55 men) diagnosed with stable angina pectoris. Patients were classified based on angiographic findings. Comprehensive demographic and medical history data were collected, and morning blood samples were analyzed, focusing on TWEAK and IL-6 levels. To assess the severity of coronary artery lesions, a modified version of the Gensini scoring system was employed. Results: Analyses revealed no significant correlation between TWEAK levels and the severity of coronary artery disease. Although some variations in biochemical markers were observed based on gender and diabetic status, these differences did not exhibit a statistically significant relationship with the degree of vascular involvement. Conclusion: The findings indicate that serum TWEAK levels do not have a significant association with the severity of vascular involvement in patients with stable angina pectoris. These results highlight the limited efficacy of TWEAK as a sole biomarker in assessing the severity of coronary artery disease, emphasizing the complexity of its role.

Context: Acute coronary syndrome (ACS) encompasses a range of conditions associated with sudden, reduced blood flow to the heart, typically due to an acute blockage of a coronary artery. The severity and specific location of the blockage determine the type of ACS and its consequences. Menopause, marked by a significant decline in estrogen levels, is known to negatively impact circulatory function and metabolism, potentially increasing the risk of ACS. However, there is a lack of studies comparing the burden of cardiovascular disease between pre- and postmenopausal women. Aim: This study seeks to bridge the knowledge gap regarding the impact of menopausal status on the presentation and severity of ACS in women. Setting and Design: This retrospective observational study was conducted in a single center, India, over 7 months. Materials and Methods: The study included 250 patient populations among which 120 were premenopausal and 130 were postmenopausal women. The subjects were evaluated for their clinical and angiographic profile. Statistical Analysis Used: Differences between pre- and postmenopausal women were compared using the two-sample t-test for continuous variables and the Chi-square test for categorical variables. Results: In this study, the mean ± standard deviation number of stenotic vessels and Gensini score was significantly higher in postmenopausal patients (2.46 ± 0.74 and 47.35 ± 20.92, respectively) than in premenopausal patients (1.30 ± 0.27 and 13.13 ± 4.43, respectively) which indicate the severity of coronary artery disease in postmenopausal women. Conclusion: Menopausal status significantly impacts the severity of coronary artery disease (CAD) in women presenting with ACS, as demonstrated by the marked difference in Gensini scores.

Abstract Background Premature coronary artery disease (PCAD) is prevailing. We aimed to investigate the evaluation value of atherogenic index of plasma (AIP) and high-sensitivity C-reactive protein (hs-CRP) for the occurrence and severity of coronary artery lesion in PCAD patients. Methods PCAD (PACD group)/non-PCAD (control group) patients were enrolled. The coronary artery lesion degree was evaluated using Gensini score (GS). PCAD patients were allocated into the low/medium/high GS groups, with general clinical baseline data analyzed. Plasma hs-CRP/AIP levels were compared in PCAD patients with different disease degree. Correlations between plasma hs-CRP/AIP with Gensini score, independent risk factors affecting the occurrence of PCAD, and the predictive value of hs-CRP/AIP/their combination for the occurrence and degree of PCAD were evaluated by Spearman correlation analysis/Logistic multivariate regression/receiver operating characteristic (ROC) curve. The differences in the area under the curve (AUC) were compared using MedCalc-Comparison of ROC curves. Results Plasma hs-CRP/AIP levels in the PCAD group were increased. Plasma hs-CRP/AIP levels varied significantly among PCAD patients with different disease degree. Plasma hs-CRP/AIP levels were markedly positively correlated with the Gensini score. Smoking history/homocysteine/fasting blood-glucose/hs-CRP/AIP were all independent risk factors affecting PCAD occurrence. The AUC of hs-CRP and AIP combination predicting the occurrence of PCAD was 0.950 (90.80% sensitivity/93.33% specificity). hs-CRP/AIP combination assisted in predicting the disease degree in PCAD patients. Conclusions AIP and hs-CRP are independent risk factors for the occurrence of PCAD, and their combination has high predictive value for PCAD occurrence and disease degree, which are both positively correlated with coronary artery lesion degree.

Siyu Pan,1 Yixiao Wang,1 Yuchen Zhang,1 Xiaoyu Ma,1 Jingfeng Peng,1 Fangfang Li,1,2 Wenhao Qian,1,2 Jing Zong1,2 1Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, People’s Republic of China; 2Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of ChinaCorrespondence: Jing Zong, Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of China, Tel +8618205000580, Email xyfyzongjing@126.comObjective: To investigate the Levels of Nucleotide-binding, leucine-rich repeat and pyrin domain-containing protein 3 (NLRP3) and Adiponectin (APN) and their relationship with the severity of coronary artery disease in patients with Unstable Angina (UA) and Type 2 Diabetes (T2D).Methods: Two hundred and thirty-one patients with UA were diagnosed by CAG in the Department of Cardiology of the Affiliated Hospital of Xuzhou Medical University from July 2022 to May 2023 were included, and 74 healthy subjects were included as the control group. The levels of NLRP3 and APN in each group were detected by ELISA and the Gensini score in each patient according to the results of CAG. The correlations between NLRP3, APN, and Gensini score were analyzed. According to whether complicated with T2D or not, we further analyze the effect of NLRP3 and APN levels of patients with UA and T2D on the severity of coronary artery stenosis.Results: The levels of NLRP3 in UA with T2D group were the highest, followed by simple UA group, and the lowest in the control group, and the level of APN was the opposite. Spearman Correlation analysis showed that the level of NLRP3 was positively correlated with Gensini score (ρ1=0.688, P

Background: The purpose of this study was to explore the expression of miR-665 in acute myocardial infarction (AMI) and evaluate its significance in the diagnosis and prognosis of AMI. Methods: 100 patients with AMI were selected as the study group and 80 healthy subjects were chosen as the control group. The levels of miR-665 were detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR) in the two groups. The diagnostic value of miR-665 expression level in AMI was analyzed by the receiver operator characteristic (ROC) curve. Kaplan-Meier curve and Cox regression were used to evaluate the predictive value of miR-665 for major adverse cardiovascular events (MACEs) in patients with AMI within 30 days after percutaneous coronary intervention (PCI). Results: The serum miR-665 level of the study group was significantly lower than that of the control group. The level of miR-665 was significantly correlated with clinical indicators of patients with AMI. ROC curve showed that miR-665 has a high diagnostic value for AMI. Survival analysis showed that Gensini score and miR-665 were independent risk factors for the occurrence of MACEs within 30 days after PCI in patients with AMI. Conclusions: Abnormal decrease of serum miR-665 expression level in patients with AMI may increase the risk of MACEs occurrence after PCI. [ABSTRACT FROM AUTHOR]

• Reduced HDL-2b and HDL-3 correlate with coronary stenosis risk, which is modified by age. • HDL-3 significantly impacts stenosis severity in individuals <75 years of age and in men. • HDL-2b notably affects stenosis severity in individuals ≥75 years of age. Past research has shown an inverse correlation between high-density lipoprotein (HDL) and coronary heart disease (CHD), while recent studies have shown that extremely high or low HDL levels increase the risk of cardiovascular death. To explore the relationships between HDL subtypes and the degree of coronary artery stenosis in patients with acute myocardial infarction (AMI). This was a single-center cross-sectional study. Ultimately, we included 1,200 adult participants with AMI hospitalized from 2017 to 2023. Patients were classified into mild and moderate-severe groups according to their Gensini score. Restricted cubic spline and multivariate logistic regression models were used to explore the associations between HDL subclasses and the severity of coronary stenosis. The adjusted odds ratios (ORs), 95% confidence intervals (CIs), and p values for HDL subclasses in the multivariate logistic model (adjusted for age, gender, hypertension status, diabetes status, stroke status, and kidney disease status) were as follows: HDL-2b: 0.97 (0.95–1.00, p = 0.018) and HDL-3: 0.98 (0.97–0.99, p = 0.008). Subgroup analysis revealed that HDL-3 exhibited a statistically significant impact on the severity of coronary stenosis among individuals <75 years of age and among men, and the influence of HDL-2b on the severity of coronary stenosis was statistically significant only in individuals aged ≥75 years. The relationship between reduced levels of HDL-2b and HDL-3 and the risk of coronary stenosis exhibited a linear pattern and was significantly modified by age. Subgroup analysis identified specific populations that warrant attention regarding HDL-2b and HDL-3. [ABSTRACT FROM AUTHOR]

Background: Premature coronary artery disease (PCAD) is prevailing. We aimed to investigate the evaluation value of atherogenic index of plasma (AIP) and high-sensitivity C-reactive protein (hs-CRP) for the occurrence and severity of coronary artery lesion in PCAD patients. Methods: PCAD (PACD group)/non-PCAD (control group) patients were enrolled. The coronary artery lesion degree was evaluated using Gensini score (GS). PCAD patients were allocated into the low/medium/high GS groups, with general clinical baseline data analyzed. Plasma hs-CRP/AIP levels were compared in PCAD patients with different disease degree. Correlations between plasma hs-CRP/AIP with Gensini score, independent risk factors affecting the occurrence of PCAD, and the predictive value of hs-CRP/AIP/their combination for the occurrence and degree of PCAD were evaluated by Spearman correlation analysis/Logistic multivariate regression/receiver operating characteristic (ROC) curve. The differences in the area under the curve (AUC) were compared using MedCalc-Comparison of ROC curves. Results: Plasma hs-CRP/AIP levels in the PCAD group were increased. Plasma hs-CRP/AIP levels varied significantly among PCAD patients with different disease degree. Plasma hs-CRP/AIP levels were markedly positively correlated with the Gensini score. Smoking history/homocysteine/fasting blood-glucose/hs-CRP/AIP were all independent risk factors affecting PCAD occurrence. The AUC of hs-CRP and AIP combination predicting the occurrence of PCAD was 0.950 (90.80% sensitivity/93.33% specificity). hs-CRP/AIP combination assisted in predicting the disease degree in PCAD patients. Conclusions: AIP and hs-CRP are independent risk factors for the occurrence of PCAD, and their combination has high predictive value for PCAD occurrence and disease degree, which are both positively correlated with coronary artery lesion degree. [ABSTRACT FROM AUTHOR]

Sarcopenia is accepted as an indicator of subclinical atherosclerosis. However, its effects on clinical coronary atherosclerotic burden and lesion complexity and major adverse cardiovascular events (MACE) in elderly patients with non-ST elevation myocardial infarction (NSTEMI) are unknown. Therefore, we evaluated these possible effects. Coronary artery disease (CAD) burden and complexity were assessed using the Gensini and TAXus and cardiac surgery (SYNTAX) score, respectively. MACE involving nonfatal myocardial infarction, rehospitalization, ischemic stroke, and total mortality were evaluated after 1 year of the index NSTEMI event. The study included 240 elderly patients; of these, 60 (25%) patients had sarcopenia. The SYNTAX score and Gensini score were similar in both groups (16.8 ± 8.7 vs 17.3 ± 9.2, P =.63 and 67.7 ± 43.9 vs 73.9 ± 45.5, P =.31, respectively). The total MACE rate was significantly higher in patients with sarcopenia than in those without sarcopenia (31.7 vs 14.4%, P =.003). In the multivariate model, age [odds ratio (OR) 1.112, 95% CI: 1.006–1.228, P =.04)], ejection fraction (OR:.923, 95% CI:.897–.951, P <.001), and sarcopenia (OR: 2.262, 95% CI: 1.039–4.924, P =.04) were independently associated with MACE. Sarcopenia was independently associated with MACE but not with CAD burden or complexity in elderly patients with NSTEMI. [ABSTRACT FROM AUTHOR]

ObjectiveTo investigate the correlation between remnant cholesterol (RC) and premature coronary artery disease (PCAD) and the severity of coronary artery lesions in men.MethodsA total of 630 male subjects who underwent coronary angiography were included in the study. The general data, laboratory tests, and coronary angiography data of each group were statistically analyzed, and RC levels were calculated. According to the Gensini score, PCAD was divided into mild and severe lesion groups. The relationship between RC and PCAD and coronary artery lesions was analyzed using multivariate logistic regression and spearman correlation analysis, and the predictive value of RC for coronary artery lesions was evaluated using receiver operating characteristic (ROC) curves.ResultsThe RC levels in the PCAD group were significantly higher than those in the non-PCAD group (p

Abstract Background The neutrophil percentage-to-albumin ratio (NPAR), which is defined as the percentage of neutrophils divided by the concentration of albumin, is a cost-effective and readily available biomarker of inflammation. This study aimed to evaluate the association between the NPAR and the severity of coronary atherosclerosis in patients with chronic kidney disease (CKD). Methods A total of 280 CKD patients who underwent coronary angiography were retrospectively enrolled in this study. The severity of coronary atherosclerosis was evaluated using the Gensini score (GS). Patients were divided into low-, medium- and high-NPAR groups according to the tertiles of the NPAR values. Logistic regression analysis was conducted to analyze the relationship between the NPAR and the GS. The cutoff points for the sensitivity and specificity of the NPAR in predicting the GS were estimated via receiver operating characteristic (ROC) analysis. Results There was a higher prevalence of coronary artery disease (CAD) among CKD patients with higher NPARs (P =0.041). More patients in the high-NPAR group had complex CAD (triple-vessel disease and/or left main coronary artery stenosis) and chronic total occlusion lesions, and more of these patients required revascularization therapy (P60) in CKD patients was 1.91 (sensitivity 0.495, specificity 0.749), with an area under the curve (AUC) of 0.650 (95% CI 0.581-0.719, P

Background and objective: We are not aware of studies examining the association between dietary meal intake habits (DMIH) and severity of coronary artery stenosis (CAS). This study was conducted to investigate the relationship between DMIH and the severity of CAS as well as cardiometabolic risk factors in adults undergoing coronary angiography. Methods: This cross-sectional study was done on 720 patients undergoing coronary angiography (aged 35–75 years) who were admitted to Afshar Hospital, a referral hospital for cardiovascular diseases in Yazd, Iran. Data on DMIH were gathered by interview. Blood samples were taken for biochemical analysis. Blood pressure, anthropometric indices, and body composition were also evaluated. The relationship between DMIH and the severity of CAS [examined by angiography based on Gensini Score (GS) and Syntax Score (SS)] and cardiometabolic risk factors were assessed using logistic regression and the analysis of covariance (ANCOVA), respectively, in crude and multivariable adjusted models. Results: After adjustment for all possible confounding variables, the study revealed that people who ate 3 meals/day had a lower risk of severe CAS compared to people who ate 2 or fewer meals (OR = 0.48, 95% CI: 0.26, 0.88, P-trend = 0.02). There was an inverse association between the number of snacks /day and the severity of CAS (OR = 0.43, 95% CI: 0.22, 0.87, P-trend = 0.02). There was also an inverse relationship between breakfast frequency/week and the severity of CAS based on both GS and SS (P < 0.05). Breakfast consumption, meal frequency, lunch consumption, snack frequency, and more food consumption on holidays were also associated with different cardiometabolic markers and anthropometric measures (P < 0.05). Conclusion: According to the results of the present study, meal frequency and breakfast consumption might be inversely associated with CAS and cardiometabolic risk factors. [ABSTRACT FROM AUTHOR]

Purpose: Sleep apnea-specific hypoxic burden (SASHB) is a polysomnographic metric that comprehensively measures the degree of nocturnal desaturation caused by obstructive sleep apnea. This research was conducted to elucidate the relationship between SASHB and coronary artery disease (CAD) severity. Methods: We carried out a prospective study of hospitalized patients with CAD of unstable angina who were expected to undergo invasive coronary angiography at Beijing Anzhen Hospital from February to September 2023. SASHB values were calculated using a self-programmed C + + program. Multivariable logistic regression analysis was applied to identify the association between SASHB and the prevalence of severe CAD, documented by the Gensini Score, and the SYNTAX (Synergy between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) Score. Results: This study enrolled 137 patients with a median age of 59 years, 96 (70.1%) of whom were male. A total of 125 (91.2%) patients had coronary stenosis of ≥ 50% in at least one location. Patients with a high SASHB of ≥ 18% min/h had a significantly higher Gensini Score (32.0 vs. 18.5, P = 0.002) and SYNTAX Score (14.0 vs. 7.0, P = 0.002) than those with a low SASHB. After adjusting for multiple covariates, a high SASHB was significantly associated with the prevalence of severe CAD, determined by a Gensini Score ≥ 21 (OR 2.67, P = 0.008) or a SYNTAX Score > 22 (OR 4.03, P = 0.016). Conclusion: Our findings revealed a robust and independent association between SASHB and CAD severity in patients with unstable angina, highlighting the potential value of SASHB as a predictor of risk and a target for interventions aimed at preventing cardiovascular diseases. Trial registration: Chinese Clinical Trial Registry No. ChiCTR2300067991 on February 2, 2023. [ABSTRACT FROM AUTHOR]

Background and Aims: The aim of this study is to evaluate the association of coronary computed tomography angiography derived (CCTA) plaque characteristics and the left anterior descending coronary artery (LAD) and left circumflex coronary artery (LCX) bifurcation angle with severity of coronary artery disease (CAD). Methods: All the stable patients with suspected CAD who underwent CCTA between January to December 2021 were included. Correlation between CCTA‐derived aggregated plaque volume (APV), LAD‐LCX angle, remodeling index (RI), coronary calcium score with Gensini score in conventional angiography were assessed. One hundred and twenty‐two patients who underwent both CCTA and coronary angiography were analyzed. Results: Our analysis showed that the median (percentile 25% to percentile 75%) of the APV, LAD‐LCx angle, and calcium score were 31% (17%−47%), 58° (39°−89°), and 31 (0−186), respectively. Also, the mean ± SD of the RI was 1.05 ± 0.20. Significant correlation between LAD‐LCx bifurcation angle (0.0001−0.684), APV (0.002−0.281), RI (0.0001−0.438), and calcium score (0.016−0.217) with Gensini score were detected. There was a linear correlation between the mean LAD‐LCx bifurcation angle and the Gensini score. The sensitivity and specificity for the cut‐off value of 47.5° for the LAD‐LCX angle were 86.7% and 82.1%, respectively. Conclusion: There is a direct correlation between the LAD‐LCx angle and the Gensini score. In addition to plaque characteristics, anatomic‐based CCTA‐derived indices can be used to identify patients at higher risk for CAD. [ABSTRACT FROM AUTHOR]

Background: The neutrophil percentage-to-albumin ratio (NPAR), which is defined as the percentage of neutrophils divided by the concentration of albumin, is a cost-effective and readily available biomarker of inflammation. This study aimed to evaluate the association between the NPAR and the severity of coronary atherosclerosis in patients with chronic kidney disease (CKD). Methods: A total of 280 CKD patients who underwent coronary angiography were retrospectively enrolled in this study. The severity of coronary atherosclerosis was evaluated using the Gensini score (GS). Patients were divided into low-, medium- and high-NPAR groups according to the tertiles of the NPAR values. Logistic regression analysis was conducted to analyze the relationship between the NPAR and the GS. The cutoff points for the sensitivity and specificity of the NPAR in predicting the GS were estimated via receiver operating characteristic (ROC) analysis. Results: There was a higher prevalence of coronary artery disease (CAD) among CKD patients with higher NPARs (P =0.041). More patients in the high-NPAR group had complex CAD (triple-vessel disease and/or left main coronary artery stenosis) and chronic total occlusion lesions, and more of these patients required revascularization therapy (P<0.05). Multivariate logistic regression analysis revealed a significant positive correlation between the NPAR and the severity of coronary stenosis (adjusted OR 2.68, 95% CI 1.25-5.76, p=0.012), particularly among female and older (age ≥65) patients. The ROC analysis indicated that the optimal cutoff value for the NPAR in predicting severe coronary artery stenosis (GS>60) in CKD patients was 1.91 (sensitivity 0.495, specificity 0.749), with an area under the curve (AUC) of 0.650 (95% CI 0.581-0.719, P<0.001). A subgroup analysis according to sex revealed that the NPAR exhibited stronger predictive value in female patients (AUC 0.730, 95% CI 0.643-0.817) than in male patients (AUC 0.565, 95% CI 0.460-0.670) (P<0.001), and the optimal cutoff value for the NPAR in female patients was 1.80 (sensitivity 0.667, specificity 0.705). Conclusions: Our study demonstrated that the NPAR is independently associated with the severity of coronary atherosclerosis in CKD patients, especially in female and elderly patients (≥65 years old). Moreover, the NPAR can effectively predict the severity of coronary atherosclerosis, exhibiting greater predictive value in females than in males. [ABSTRACT FROM AUTHOR]

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[Objectives] This study was conducted to explore the relationship between neutrophil percentage-to-albumin ratio (NPAR) and coronary heart disease complicated with diabetes. [Methods] A total of 603 patients with coronary heart disease who underwent coronary angiography in Pingquan County Hospital from January, 2023 to December, 2023 and met the inclusion criteria were included as the research object. All the patients were divided into a coronary heart disease complicated with diabetes group (CAD +T2DM group) (n=298 cases) and a control group (CAD group) (n=305 cases), according to patients' medical history, heart color ultrasound and biochemical test results. The clinical data, biochemical test results and coronary artery imaging data of patients were recorded, and the Gensini score was calculated. The neutrophil percentage (NEUT% ) and albumin count were determined to calculate NPAR. [Results] The NPAR value of the coronary heart disease complicated with diabetes mellitus group was (1. 6 ± 0. 42), which was significantly higher than that of the control group (1.47 ±0.49), and the difference was statistically significant (P<0.05). The area under the ROC curve was 0.619 (95% CI: 0.591-0.675, P < 0. 05), and the prediction of coronary heart disease complicated with diabetes using NPAR showed a Youden index of 0. 31, a sensitivity of 60.4%, a specificity of 40.3%, and a best cut-off score of 1.450 6. [Conclusions] The neutrophil percentage-to-albumin ratio (NPAR) is closely related to coronary heart disease complicated with diabetes mellitus, and NPAR has clinical application value in the diagnosis of coro-nary heart disease complicated with diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: One of the strongest risk factors for coronary artery disease is diabetes mellitus. Therefore, it is crucial to identify CAD in diabetic patients as soon as feasible. This study aimed to assess the relation between microalbuminuria and the angiographic severity of CAD patients with type 2 DM by SYNTAX I, SYNTAX II and Gensini scores. Patients and Methods: The study comprised 82 type II DM patients who were referred for elective coronary angiography due to a suspected CAD. All patients had their urinary albumin-creatinine ratio (UACR) determined, and the Gensini, SYNTAX, and SYNTAX II scores were used to determine how severe each patient's CAD was. Results: There were 26 (31.7%) females and 56 (68.3%) males in the study population. They were 56.29 + 9.18 years old on average. According to the UACR level, patients were divided into two groups: group 1 included patients with UACR less than 30 mg/g (41 patients), and group 2 included patients with UACR greater than or equal to 30 mg/g (41 patients). According to the study, patients in group 2 had considerably higher Gensini scores than patients in group 1 (P=0.001) and significantly higher SYNTAX scores than patients in group 1 (P=0.001). Age and the duration of DM and UACR had a positive association (p=0.003), and hypertension (HTN) and the duration of DM and UACR had a positive correlation (p=0.049). Conclusion: In type II DM, microalbuminuria can be utilized to predict the presence and severity of CAD. [ABSTRACT FROM AUTHOR]

MicroRNA-33b (miR-33b) affected various biological pathways in regulating cholesterol homeostasis which may link to the pathogenesis of atherosclerotic lesions. However, whether this marker is associated with the presence and severity of coronary heart disease (CHD) is undetermined. We aim to explore the diagnostic value of circulating miR-33b level in the presence and severity of CHD. Altogether 320 patients were enrolled, including 240 patients diagnosed with CHD while 80 were classified as controls after CAG examination. Circulating miR-33b level was analyzed in all subjects, the Gensini score was calculated to assess the severity of stenotic lesions. The association between miR-33b and the presence and severity of CHD was analyzed, and the diagnostic potential of miR-33b of CHD was performed by the receiver operating characteristic (ROC) analysis. The CHD group had higher miR-33b levels (p < 0.001), and the miR-33b content significantly elevated following an increasing Gensini score (p for trend < 0.001). After adjustments for potential risk factors, such as several blood lipid markers, miR-33b remained a significant determinant for CHD (p < 0.001). ROC analysis disclosed that the AUC was 0.931. The optimal cutoff value of miR-33b was with a sensitivity of 81.3% and a specificity of 98.7% in differentiating CHD. It can prognosticate that the higher level of miR-33b was linked to increased severity of disease in CHD patients. Thus, the application of this marker might assist in the diagnosis and classification of CHD patients. Nevertheless, additional studies with larger sample sizes will be required to verify these results. [ABSTRACT FROM AUTHOR]

ObjectiveThis study aims to explore the association of methyltransferase-like protein 3 (METTL3) expression with severity of coronary artery stenosis in patients with coronary heart disease (CHD).MethodsA total of 100 patients administrated in the Fourth Affiliated Hospital of China Medical University between October 2022 and June 2023 with primary symptoms of chest pain or tightness, or cardiac discomfort, and who underwent coronary angiography for a definitive diagnosis, were included in the study. The baseline characteristics, including TG, TC, LDL-C, HDL-C, uric acid and past history were recorded. Peripheral blood samples were collected to assess the expression levels of METTL3, YT521-B homology domains 1 (YTHDF1), YT521-B homology domains 2 (YTHDF2), and YT521-B homology domains 3 (YTHDF3) using the PCR method. Relative expression levels of METTL3 protein were determined by Western blotting. Correlation analysis were conducted to evaluate the relationship between METTL3/YTHDF1 gene expression and clinical data. Receiver operating characteristic (ROC) curve analysis was employed to assess the predictive value of METTL3 and YTHDF1 for CHD. Binary logistic regression was used to determine whether the expression of METTL3 and YTHDF1 in peripheral blood were risk factors for CHD.ResultsThe study found no significant differences in baseline characteristics between CHD patients and controls, except for length of stay, Lymphocytes, Neutrophils, AST, HDL-C and modified Gensini score. The gene expression levels of METTL3 and YTHDF1 were significantly higher in CHD patients compared to controls (p 0.052. The AUC for YTHDF1 in CHD was 0.623, with a sensitivity of 47.4% and a specificity of 74.4% at a cut-off value of >0.027. Binary logistic regression revealed that only increased METTL3 expression in peripheral blood was an independent risk factor for CHD (p

Abstract Objective To evaluate the relationship between the ambulatory arterial stiffness index (AASI) and the degree of coronary stenosis, and assess its predictive value for the presence and severity of coronary artery disease (CAD). Materials and methods In total, 619 consecutive patients who presented with exertional anginal symptoms and/or acute coronary syndrome between January 2021 and December 2022 underwent elective non-urgent CAG with no emergency conditions and performed 24-h ambulatory blood pressure monitoring (ABPM) were included in this study and were divided into the control group (n = 68) and CAD group (n = 551) according to the angiography results. Ambulatory Arterial Stiffness Index (AASI) is obtained from the 24-h ABPM recordings, defined as 1 minus the regression slope of diastolic blood pressure on systolic blood pressure values. CAD complexity was determined by the Gensini score (GS). The patients with CAD were stratified according to the tertiles of the Gensini score (GS 48), and GS > 48 is considered severe coronary artery disease. To explore the relationship between AASI and the severity of CAD, Spearman correlation analysis was conducted. Logistic regression analysis was then performed to determine the influence of AASI on CAD as well as severe CAD. Moreover, a Receiver Operating Characteristic (ROC) curve was constructed to assess the predictive value of AASI for CAD and severe CAD. Results The CAD group had a substantially higher median AASI than the control group [0.47 (0.4, 0.58) vs.0.32 (0.24, 0.41), P

With the widespread adoption of electronic health records, the amount of stored medical data has been increasing. Clinical data, often in the form of semi-structured or unstructured electronic medical records (EMRs), contains rich patient information. However, due to the use of natural language by physicians when composing these records, the effectiveness of traditional methods such as dictionaries, rule matching, and machine learning in the extraction of information from these unstructured texts falls short of clinical standards. In this paper, a novel deep-learning-based natural language extraction method is proposed to overcome current shortcomings in data governance and Gensini score automatic calculation in coronary angiography. A pre-trained model called bidirectional encoder representation from transformers (BERT) with strong text feature representation capabilities is employed as the feature representation layer. It is combined with bidirectional long short-term memory (BiLSTM) and conditional random field (CRF) models to extract both global and local features from the text. The study included an evaluation of the model on a dataset from a hospital in China and it was compared with another model to validate its practical advantages. Hence, the BiLSTM-CRF model was employed to automatically extract relevant coronary angiogram information from EMR texts. The achieved F1 score was 91.19, which is approximately 0.87 higher than the BERT-BiLSTM-CRF model.

Abstract Background Systemic Inflammatory Response Index (SIRI), a composite inflammatory marker encompassing neutrophils, monocytes, and lymphocytes, has been recognized as a reliable marker of systemic inflammation. This article undertakes an analysis of clinical data from ST-segment Elevation Myocardial Infarction (STEMI) patients, aiming to comprehensively assess the relationship between SIRI, STEMI, and the degree of coronary stenosis. Methods The study involved 1809 patients diagnosed with STEMI between the years 2020 and 2023. Univariate and multivariate logistic regression analyses were conducted to evaluate the risk factors for STEMI. Receiver operating characteristic (ROC) curves were generated to determine the predictive power of SIRI and neutrophil-to-lymphocyte ratio (NLR). Spearman correlation analysis was performed to assess the correlation between SIRI, NLR, and the Gensini score (GS). Results Multivariate logistic regression analysis showed that the SIRI was the independent risk factor for STEMI (adjusted odds ratio (OR) in the highest quartile = 24.96, 95% confidence interval (CI) = 15.32–40.66, P

Rehua Wang,1,2,&ast; Yongjun Lin,3,&ast; Mao Chen,4 Wei Wang,5 Yongli Chen,6 Xiaoxia Qiu,7 Xing Miao1,2 1Department of Cardiology, Fujian Provincial Hospital, Fuzhou, 350001, People’s Republic of China; 2Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, People’s Republic of China; 3Department of General Medicine, the First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, 362000, People’s Republic of China; 4Department of Scientific Research, Fujian Provincial Hospital, Fuzhou, 350001, People’s Republic of China; 5Department of Psychiatry, Fuzhou Neuro-Psychiatric Hospital Affiliated to Fujian Medical University, Fuzhou, 350008, People’s Republic of China; 6Department of Cardiology, Fujian Provincial Hospital South Branch, Fuzhou, 350028, People’s Republic of China; 7Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, 350001, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xing Miao, Department of Cardiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, No. 134 East Street, Gulou District, Fuzhou, 350001, People’s Republic of China, Tel +86 13763810443, Email miaoxingph@outlook.comPurpose: Temperature changes unfavorably impact on cardiovascular disease. However, the association between temperature changes and coronary artery disease (CAD) is not well documented. This study aimed to explore the association between daily mean temperature and daily CAD hospital admissions on the southeast coast of China (Fuzhou City).Methods: A total of 1883 CAD patients who underwent percutaneous coronary intervention between 2017 and 2019 were obtained. The severity of CAD was evaluated by the Gensini score. Distributed lag non-linear model (DLNM) combined with a quasi-Poisson regression model was used to examine the delayed effect between daily mean temperature and daily CAD hospital admissions. Stratified analyses were performed by Gensini score and severity of lesions. The relative risk (RR) with a 95% confidence interval (CI) was used to assess the relationship.Results: Extreme cold (8°C) (RR=0.49, 95% CI: 0.25– 0.99) and moderate cold (10°C) (RR=0.56, 95% CI: 0.31– 0.99) daily mean temperature with a lag of 0– 20 days were correlated with lower risk of daily CAD hospital admissions. Moderate heat (30°C) (RR=1.80, 95% CI: 1.01– 3.20) and extreme heat (32°C) (RR=2.02, 95% CI: 1.01– 4.04) daily mean temperature with a lag of 0– 20 days related to a higher risk of daily CAD hospital admissions. Similar results were observed for daily mean temperature with a lag of 0– 25 days. Stratified analysis showed the lagged effect of daily mean temperature (lag 0, 0– 5, 0– 15, 0– 20, and 0– 25 days) on the daily CAD hospital admissions was observed only in patients with a Gensini score ≤ 39 (tertile 1).Conclusion: Cold temperatures may have a protective effect on daily CAD hospital admissions in the Fuzhou area, whereas hot temperatures can have an adverse effect.Keywords: temperature, coronary artery disease, gensini score, daily admissions, lag effect

Feyza Aksu, Said Abdirahman Ahmed Department of Cardiology, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, SomaliaCorrespondence: Said Abdirahman Ahmed, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia, Digfer Road, Mogadishu, Somalia, Tel +252615583381, Email saciidcabdi114@gmail.comAim: Coronary artery diseases (CAD) are chronic disorders in which atherosclerosis plays a major role in their pathogenesis. Their severity is directly related to cardiovascular outcomes. The assessment of Coronary Artery severity is quite complex, in which different parameters are used, such as the gensini score, syntax score, etc.Methods: This was a retrospective study of adult (≥ 18 years) patients who underwent angiography in Mogadishu Somali Türkiye Training and Research Hospital from June 2022 to September 2023. Gensini scores were calculated to determine the extent and severity of atherosclerosis among patients with coronary artery disease.Results: A total of 278 participants (78% male and 22%% women) were analyzed. Their risk factors were assessed with hypertension being the leading risk factor (48%). While a significant relationship was found between gensini score and dyslipidemia in patients with chronic ischemic heart disease (p 0.035), no significance was found with other risk factors On the other hand, the Gensini score had a significant correlation with the final decision of management (medical, PCI vs CABG).Conclusion: This study indicated that the Gensini score can be used as a guide for CAD decisions.Keywords: stable coronary artery disease, acute coronary syndrome, Gensini score

Purpose: The purpose of this study was to investigate the relationship between serum immunoglobulin M (IgM) and the severity of coronary artery disease in Chinese patients who underwent coronary angiography. Methods: A total of 2,045 patients who underwent coronary angiography (CAG) from March 2017 to March 2020 at Beijing Hospital were included in this study. Serum IgM concentration and biochemical indicators were measured before coronary angiography (CAG). The triquartile IgM levels at baseline in the population were analysed. Spearman rank correlation was used to analyse the association between IgM and traditional risk factors for coronary artery disease (CAD). CAD patients were divided into subgroups by affected area, number of affected vessels, and Gensini score to analyse the relationship between IgM and CAD severity. Multivariable logistic regression analysis was used to evaluate the association between IgM and CAD severity. Results: Serum IgM levels were significantly lower in the CAD group (63.5 mg/dL) than in the non-coronary artery disease (NCAD) group (72.3 mg/dL) (P < 0.001). Serum IgM levels were significantly associated with sex. Serum IgM levels were positively correlated with traditional CAD risk factors such as TG, TC and LDL-C (P < 0.05), and negatively associated with the number of obstructed vessels, the number of affected areas, and Gensini scores. After adjusting for age, sex, smoking status, hypertension, dyslipidaemia, diabetes, stroke, and statin use history, a high IgM level was independently negatively associated with the severity of CAD expressed by the Gensini score. Conclusion: We determined that serum IgM was independently negatively associated with the severity of CAD diagnosed by angiography in Chinese adults. [ABSTRACT FROM AUTHOR]

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Background: Large epidemiologic studies have shown that hyperuricemia is associated with an increased incidence of coronary artery disease. Aims: This study aims to explore the relationship between serum uric acid level and Gensini score, which in turn reflects the severity of coronary artery disease. Methods: A retrospective cohort study was conducted in patients presenting with ACS at tertiary care centre, Bagalkot. Hyperuricemia was defined as serum uric acid level > 6 mg/dl. Severity of coronary artery disease was assessed on the basis of Gensini score. Number of diseased vessels, critical lesions and total occlusions on coronary angiogram was taken into consideration Results: Mean uric acid levels of normouricemic and hyperuricemic groups were 4.7±1.1 and 7.53 ± 1.32 respectively with p value of 0.001. Mean Gensini score of normouricemic group was (20.56 ± 13.66) while hyperuricemic group was (35.53 ± 17.84). Chi square, independent t test was applied to compare the Gensini score of two groups and it resulted in p valve of 0.001 which is statistically significant. Spearman correlation revealed a positive correlation between serum uric acid level and Gensini score which was found to be statistically. Significant difference was observed in total occlusions (p=0.001) and left main coronary artery stenosis s (p=0.001) which were higher in the hyperuricemic group compared to normouricemic group. Conclusion: Hyperuricemia is associated with higher Gensini score and more frequency of total occlusions and left main coronary artery stenosis. It is an independent factor for evaluating the degree and severity coronary artery stenosis. [ABSTRACT FROM AUTHOR]

This study aims to analyze the correlation between Systemic Inflammatory Response Index (SIRI) and the severity of coronary artery stenosis in patients with coronary heart disease (CHD). It also aims to assess the predictive value of SIRI for the severity of coronary artery stenosis. A total of 2990 patients who underwent coronary angiography were included in this study. The Gensini score was used to estimate the severity of coronary vascular lesions. The predictive ability of SIRI for CHD was evaluated using receiver operating characteristic (ROC) curves. Binary multivariate logistic regression analysis was used to predict the likelihood of CHD based on the SIRI index. The results showed that people with higher SIRI index were more likely to have CHD (P < 0.001). After controlling for other risk factors, the highest quartile had a significantly higher incidence of coronary artery disease compared to the lowest quartile (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.73-3.92, P < 0.001). Furthermore, the Gensini score was significantly higher in the fourth quartile group (T4) compared to the first (T1) and second (T2) quartile groups (P < 0.001). Additionally, the SIRI index was significantly higher in the group with severe coronary artery lesions compared to the mild and moderate groups (P < 0.001). The SIRI index also showed a higher predictive ability for the extent of coronary lesions under the ROC curve compared to other commonly used markers, including platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR) (P < 0.001). Therefore, SIRI index positively correlates with coronary artery stenosis in CHD patients, serving as an effective early screening marker for assessing stenosis severity.

Abstract Background Chronic coronary syndrome (CCS) is a major public health burden; its pathogenesis involves atherosclerosis and endothelial dysfunction. Endothelin-1 (ET-1) and nitric oxide (NO) are vasoactive substances synthesized by endothelial cells that play a crucial role in CCS development. The Gensini score (GS) is used for evaluating CCS severity based on lumen segment changes, stenosis degree, and coronary stenosis site. Methods This prospective study included 71 patients with CCS; we evaluated the relationships between GS and ET-1 and NO serum levels were evaluated in these patients. The GS was calculated for all patients. Serum ET-1 & NO levels among other laboratory parameters were measured. Results The high GS group had higher ET-1 and relatively NO expressions in the than the low GS group. GS was positively correlated with ET-1 and negatively correlated with NO, T4, and TSH levels. The results of the multiple linear regression analysis showed that ET-1 had the most significant effect on GS. Conclusions We found a strong association between ET-1, NO, and CCS severity. A combination of ET-1, NO, and GS is an essential predictor of CCS disease severity.

Abstract Background and aims Recent studies have shown that the negative effect of uric acid (UA) on coronary arteries determines the severity of atherosclerotic disease. This study aims to explore the relationship between serum UA level and Gensini score, which reflects the severity of coronary artery disease. Methods A total of 860 patients with suspected coronary heart disease who were admitted to hospital due to angina pectoris or myocardial ischemia related symptoms and received coronary angiography were selected. Based on the findings of the angiography, they were categorized into two groups: the coronary heart disease (CHD) group (n = 625) and the control group (n = 235). The uric acid levels and other clinical data were compared between these groups. Additionally, the prevalence of coronary heart disease and Gensini score were compared between the groups, considering gender-specific quartiles of uric acid levels. The clinical baseline data were analyzed using appropriate statistical methods, and multivariate logistic regression analysis was conducted to identify independent risk factors for coronary heart disease. Results Of 860 patients (mean age, 63.97 ± 11.87 years), 528 were men (mean age, 62.06 ± 11.5 years) and 332 were women (mean age, 66.99 ± 10.11 years). The proportion of smoking, diabetes, hypertension, and hyperlipidemia in the coronary heart disease group was higher than that in the control group (P 0.05).Multivariate logistic regression analysis showed that age, hypertension, hsCRP and SUA levels increased the risk of coronary heart disease, and the difference was statistically significant(OR = 1.034,95%CI 1.016–1.052, P = 0.001; OR = 1.469,95%CI 1.007–2.142, P = 0.046;OR = 1.064,95%CI 1.026–1.105, P = 0.001; OR = 1.011,95%CI 1.008–1.014, P

Abstract Background Cytokines play a potential role in atherosclerosis pathogenesis and progression. We investigated the association of interleukin-6 (IL-6) with the angiographic severity of coronary artery disease (CAD). Methods Three hundred ten angiografically diagnosed CAD patients and 210 controls were enrolled in this study. CAD patients were stratified according to IL-6 cut-off value into high levels IL-6 group (≥ 9.5 pg/mL) and low levels IL-6 group ( 40) but not with stenosis degree and vessel score. GS levels were significantly more elevated in patients with high levels of IL-6 group than in low IL6 levels patients (60.6 ± 39.5 vs 46.7 ± 37.2; p = 0.027). The analysis of the ROC curve performed in myocardial infarction patients showed that IL-6 (AUC: 0.941 (CI 95% 0.886, 0.997; p

BACKGROUND: One of the common pathogenic links of diabetes mellitus type 2 (T2DM) and coronary artery disease (CAD) is chronic low-grade inflammation, restricted by FoxP3+ T-regulatory lymphocytes.AIM: To investigate the numbers of FoxP3+CD25hi and FoxP3+CD25lo T-lymphocytes, the subcellular localization of FoxP3 in them, and the production of the main cytokines in relation to clinical and metabolic parameters in patients with association of CAD and T2DM.MATERIALS AND METHODS: An observational single-center single-stage comparative study was conducted. The severity of atherosclerosis was assessed by calculating the Gensini Score index after coronary angiography. Absolute numbers and frequencies of CD4+CD25hiFoxP3+ and CD4+CD25loFoxP3+ T-lymphocytes were assessed in peripheral blood by flow cytometry. Imaging flow cytometry was used to determine the degree of FoxP3 translocation to the cell’s nucleus. Concentration of cytokines in blood serum and supernatants of mononuclear leukocytes’ cultures was determined by the multiplex analysis.RESULTS: We recruited 57 patients with chronic CAD. Of these, T2DM was diagnosed in 22 patients. In patients with CAD and T2DM, the absolute numbers and frequencies of FoxP3+CD25lo cells were increased compared to patients with CAD without diabetes (1.15 (0.98; 1.73) vs. 0.96 (0.60; 1.15)% (р=0.046); 1.48 (1.05; 1.97) vs. 1.07 (0.71; 1.42) x107/L (р=0.025)). Patients with T2DM also had a higher level of translocation of FoxP3 to the nucleus of FoxP3+CD25lo cells (92.0 (86.4; 95.0) vs. 88.7 (80.0; 91.4)%, р=0.040) and increased concentration of the chemokine CCL22 both in blood serum (912 (828; 1061) vs. 669 (585; 738) pg/mL, р=0.022) and supernatants of LPS-stimulated mononuclear leukocyte cultures (1189 (851; 1310) vs. 539 (437; 949) pg/mL, р=0.038), which correlated with the presence of CD4+CD25hiFoxP3+ cells (Rs=0.587; p=0.044) and the triglyceride/glucose index (Rs=0.587; p=0.044). The identified changes were most pronounced in patients with moderately elevated values on the Gensini Score (17–45 points).CONCLUSION: We are the first to show association between the numbers of FoxP3+CD25lo-lymphocytes in peripheral blood and an increase in the nuclear translocation of FoxP3 in them with the severity of atherosclerosis in patients with association of CAD and T2DM. These data justify the necessity of the further investigation of the diagnostic significance of FoxP3+CD25lo-cells as biomarkers of tissue inflammation.

ObjectiveAssessing the impact of lumbar disc herniation (LDH) on the plaque burden of coronary atherosclerosis is our objective.MethodsIn this study, a total of 212 patients (age 46–80 years) with unstable angina (UA) who underwent coronary angiography (CAG) in our hospital from January 2018 to July 2022 due to UA were included. Patients were divided into LDH group (n = 106) and no LDH group (n = 106). Gensini scores were calculated to assess the plaque burden of coronary. Logistic analysis was used to examine potential risk variables linked to the Gensini score. The association between lumbar disc lesions grading and coronary plaque burden was analysed by Spearman's correlation test. LDH patients with higher plaque burden (n = 56) were further divided into evolocumab treatment group (n = 28) and conventional treatment group (n = 28). Cox regression analysis were performed.ResultsPatients with LDH had higher Gensini scores (P

Objectives: In our study, we aimed to investigate the correlation between reduction in global longitudinal strain value and severity of coronary artery disease in Non-ST-Elevation Myocardial Infarction (NSTEMI) patients. Materials and Methods: Patients admitted with NSTEMI were underwent 2D echocardiography to evaluate LV global longitudinal strain and coronary angiography to evaluate severity of CAD. Data analysis was done to investigate the correlation between global longitudinal strain and severity of CAD. Results: In the present study we were able to demonstrate the correlation between reduction in global longitudinal strain value and severity of coronary artery disease in Non-ST-Elevation Myocardial Infarction (NSTEMI) patients. As the number of coronary arteries involved increases LVGLS reduces. Conclusions: 2D echocardiographic Global longitudinal strain can be used in initial diagnostic workup for early identification and revascularization of NSTEMI patients with severe CAD. [ABSTRACT FROM AUTHOR]

Background: Chronic coronary syndrome (CCS) is a major public health burden; its pathogenesis involves atherosclerosis and endothelial dysfunction. Endothelin-1 (ET-1) and nitric oxide (NO) are vasoactive substances synthesized by endothelial cells that play a crucial role in CCS development. The Gensini score (GS) is used for evaluating CCS severity based on lumen segment changes, stenosis degree, and coronary stenosis site. Methods: This prospective study included 71 patients with CCS; we evaluated the relationships between GS and ET-1 and NO serum levels were evaluated in these patients. The GS was calculated for all patients. Serum ET-1 & NO levels among other laboratory parameters were measured. Results: The high GS group had higher ET-1 and relatively NO expressions in the than the low GS group. GS was positively correlated with ET-1 and negatively correlated with NO, T4, and TSH levels. The results of the multiple linear regression analysis showed that ET-1 had the most significant effect on GS. Conclusions: We found a strong association between ET-1, NO, and CCS severity. A combination of ET-1, NO, and GS is an essential predictor of CCS disease severity. [ABSTRACT FROM AUTHOR]

Objective: To investigate coronary artery disease (CAD) and its correlation with the ambulatory arterial stiffness index (AASI) in patients with H-type hypertension (essential hypertension combined with hyperhomocysteinemia) and coronary heart disease (CHD). Methods: Patients with essential hypertension and CHD who were undergoing coronary angiography were enrolled. The general clinical data, biochemical indicators, ambulatory blood pressure monitoring results and coronary angiography results of the selected patients were collected, and the AASI and Gensini scores were calculated. According to homocysteine (Hcy) levels, the patients were divided into two groups: a study group and a control group. The differences in general clinical data, biochemical indexes, AASI scores and degree of coronary artery lesions between the two groups were compared. The correlation between the AASI and the Gensini score and the relationship between the AASI and the Gensini score of CAD and various factors were analyzed. Results: Compared with the control group, the Hcy level in the study group was significantly increased (8.16 ± 2.33 vs 19.20 ± 2.36, P = .001). The 24-h diastolic blood pressure (DBP) in the study group was significantly lower than that in the control group (76.38 ± 9.33 vs 79.91 ± 9.25, P = .002), and the AASI was significantly higher than in the control group (0.62 ± 0.81 vs 0.420 ± 0.70, P = .001). The number of patients having coronary stenoses with a Gensini score of ≤ 38 was significantly lower in the study group than in the control group (21.3% vs 49.4%, P < .001). The number of patients with a Gensini score of ≥ 51 in the study group was significantly higher than in the control group (22.0% vs 18.8%, P < .001). There was a significant positive correlation between the AASI and the Gensini score in the study group (R = 0.732, P < .001). Hypertension duration (β = 0.168), diabetes history (β = 0.236), 24-h SBP (β = 0.122), 24-h DBP (β = -0.131), low-density lipoprotein cholesterol (β = 0.134) and Hcy (β = 0.233) were the influencing factors for AASI (P < .05). Both Hcy * AASI (β = 0.356) and Hcy × 24-h HR (β = 0.331) had a synergistic effect on the Gensini score (P = .017), with Hcy * AASI having a more significant effect on the Gensini score (P < .001). Conclusion: The AASI was significantly increased in patients with H-type hypertension and CHD, which was associated with the severity of CAD. Therefore, Hcy levels and the AASI have a synergistic effect when evaluating the severity of CAD in patients with hypertensive CHD. [ABSTRACT FROM AUTHOR]

Background: ​Vascular endothelial growth factor A (VEGFA) is well acknowledged as a powerful angiogenesis-promoting agent mainly through its receptor VEGFR2. Ischemia stimulates VEGFA/VEGFR2 signaling pathway and elevated serum levels of VEGFA were detected in coronary heart disease (CHD) patients. The goal of the current study is to determine how four SNPs in the genes for VEGFA (rs3025039 and rs699947) and VEGFR2 (rs2305948 and rs1870377) contribute to the development of CHD. We also wanted to use the Gensini score to confirm if these four SNPs have an effect on the severity of coronary lesions. Methods: In this case-control research, we used the restriction fragment length polymorphism of the polymerase chain reaction to genotype 239 CHD patients and 200 controls. Age, sex, smoking behavior, and obesity were taken into account in the statistical analysis. Results: Two VEGFA/VEFGR2 signaling pathway SNPs (rs699947 and rs1870377) were found to be associated with CHD (C vs. A, P = 0.002; OR = 1.47 (1.12–1.93); A vs. T, P = 0.001; OR = 1.58 (1.17–2.13) respectively). The rs2305948 showed no allelic associations with CHD susceptibility, although we noticed a slight association under the recessive model of rs3025039 TT genotype (p = 0.023; OR = 6.41 (1.14–36.12)) only under adjusted analyses. In addition, both VEGFA SNPs (rs699947and rs3025039) were found to be associated with high Gensini score (p < 0.001). Conclusions: Our research helps to shed further light on the pathophysiology of CHD. The VEGFA/VEGFR2 signaling pathway may have been downregulated, increasing CHD susceptibility and risk. [ABSTRACT FROM AUTHOR]

Background: Cytokines play a potential role in atherosclerosis pathogenesis and progression. We investigated the association of interleukin-6 (IL-6) with the angiographic severity of coronary artery disease (CAD). Methods: Three hundred ten angiografically diagnosed CAD patients and 210 controls were enrolled in this study. CAD patients were stratified according to IL-6 cut-off value into high levels IL-6 group (≥ 9.5 pg/mL) and low levels IL-6 group (< 9.5 pg/mL). The severity of CAD was assessed according to Gensini score (GS), artery stenosis degree and the number of vessels involved. The mean age was 60.3 ± 11.0 years. Results: The level of IL-6 in patients was increased compared to controls and ranged from 1.5 to 3640.0 pg/mL. High levels of IL-6 were significantly associated with high levels of GS (> 40) but not with stenosis degree and vessel score. GS levels were significantly more elevated in patients with high levels of IL-6 group than in low IL6 levels patients (60.6 ± 39.5 vs 46.7 ± 37.2; p = 0.027). The analysis of the ROC curve performed in myocardial infarction patients showed that IL-6 (AUC: 0.941 (CI 95% 0.886, 0.997; p < 0.001) could be a powerful predictor marker in evaluating the infarct size after myocardial infarction when compared to myonecrosis biomarkers. Conclusions: IL-6 levels were associated with the severity of CAD assessed by the GS. Based on the highest levels of IL-6 measured in patients with STEMI, our study strongly suggests that IL-6 could be a powerful marker in evaluating the myocardial necrosis. Trial registration: ClinicalTrials.gov Number: NCT03075566 (09/03/2017). [ABSTRACT FROM AUTHOR]

Background: Assessment of risk factors is essential for clinical diagnosis and prevention in patients with both diabetes mellitus (DM) and coronary heart disease (CHD). In the present study we investigated correlation of the Gensini score with the incidence of major adverse cardiac and cerebrovascular events (MACCEs) in patients with DM and CHD. Methods: A total of 802 DM patients with CHD admitted to the First Affiliated Hospital of Zhengzhou University and who met the inclusion criteria were enrolled in the study. The median follow-up time for these patients was 3000 days (range 382.5–3000). Receiver operating characteristic (ROC) curves for the Gensini score were generated and the area under the curve (AUC) was calculated. Patients were divided into two groups based on the Gensini score cut-off value. Univariate and multivariate Cox proportional hazard regression analysis was used to identify the risk factors associated with MACCEs. The incidence of MACCEs in the two groups was compared using Kaplan-Meier analysis. Results: The AUC of the ROC curve was 0.675. The maximum Youden’s index was 0.248 at a Gensini score cut-off value of 74.8605. This gave a sensitivity and specificity for the prediction of MACCE of 68.8% and 56%, respectively. A high Gensini score was a risk factor for MACCEs, and the incidence of MACCEs was significantly greater in the high Gensini score group compared to the low Gensini score group. Conclusions: A high Gensini score is a risk factor for patients with DM and CHD and is associated with a high incidence of MACCEs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate gender difference in non-traditional cardiovascular risk factors among Saudi patients with angiographically defined coronary artery disease (CAD). METHODS: We recruited 144 (male=105, female=39) patients with CAD who underwent coronary angiography. Laboratory analysis of total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), lipoprotein(a) [Lp(a)], and high sensitivity C-reactive protein (hs-CRP) were performed along with echocardiographic evaluation. RESULTS: Systolic blood pressure (SBP) was significantly higher in females (138.65±18.67 vs 129.59±21.03 mmHg; p=0.0363). Although no significant difference was observed in TC (4.30±1.36 vs 4.67±1.07 mmol/L), however significantly higher levels of both HDL and LDL were seen in females (0.86±0.17 vs 0.70±0.23 mmol/L; p=0.0592 and 3.50±0.67 vs 2.72±1.13; p=0.0466 respectively). There were no significant differences in TG, Lp(a) and hs-CRP, however females had comparatively higher Lp(a) (30.43±28.89 vs 24.02±23.42 mg/dl) and hs-CRP (1.14±1.46 vs 0.95±1.25 mg/L). On angiography, greater extent of stenosis was observed in left anterior descending and right coronary arteries among males, while the left circumflex artery was affected more in the female patients without statistical significance (p=0.0797; 0.3890 and 0.5032 respectively). Gensini Score in males & females was 60.46±46.17 and 74.39±39.52 respectively (p=0.3013). Significantly narrower aortic root diameter (ARD) was observed among females (27.30±6.66 vs 29.73±3.40 mm; p=0.0293). CONCLUSION: Female patients have greater risk of cardiovascular diseases due to higher SBP and LDL levels which could lead to a greater Gensini score when compared to male patients. In addition, narrow ARD among females could also be a contributing factor to CAD.

Yang Gao,1,&ast; Yuguang Guo,2,&ast; Wenjun Hao,1 Jin Meng,1 Zhilin Miao,1 Aijie Hou,1 Bo Luan1 1Department of Cardiology, the People’s Hospital of Liaoning Province, Shenyang, People’s Republic of China; 2Department of Clinical Laboratory, the People’s Hospital of Liaoning Province, Shenyang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Bo Luan, Department of Cardiology, the People’s Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang, Liaoning Province, 110016, People’s Republic of China, Email Boluan369@hotmail.comBackground: Coronary angiography (CAG) is an invasive examination with high risks and costs and various complications may occur. It is necessary to find a diagnostic method, non-invasiveness, inexpensive with low risk. This study aims to analyze the correlation between the levels of serum homocysteine (Hcy), cystatin C (Cys C) and uric acid (UA) and Gensini score in patients with coronary heart disease (CHD) and assess their diagnostic value for CHD.Methods: A retrospective analysis was conducted on 1412 patients underwent CAG from October 2019 to December 2021, and we conducted this study from January to July 2022. A total of 765 patients with CHD confirmed by CAG were selected as the research group, while 647 patients revealed as non-obstructive stenosis by CAG as the control group. The serum Hcy, Cys C and UA levels were detected and the correlation between Gensini score and variables was analyzed. The receiver-operating characteristic (ROC) curve was performed to assess the diagnostic value of the Hcy, Cys C and UA for CHD.Results: The serum Hcy, Cys C and UA levels in the research group were higher as compared with the control group (p< 0.05). Spearman correlation and multivariate linear regression analysis showed that there was a significantly positive correlation between Gensini score and serum Hcy, Cys C and UA levels (p< 0.05). The ROC curve analysis presented the combined Hcy and Cys C with UA having the highest specificity of diagnostic value for CHD (area under the curve (AUC)=0.768, 95% CI 0.706– 0.823, specificity = 72.34%, sensitivity = 67.88%, Youden Index = 0.4022).Conclusion: The serum Hcy, Cys C and UA levels in patients with CHD were significantly increased, positive correlation with Gensini score. The combined Hcy and Cys C with UA could be used to assess the severity of coronary artery stenosis and provide predictive and early intervention treatment values for CHD and a new way of diagnosing CHD, which is cheap, safe, effective and deserving of clinical application.Keywords: serum homocysteine, cystatin C, uric acid, gensini score, correlation analysis, diagnostic value

Objective: We sought to evaluate the myocardial strain by four-dimensional speckle-tracking echocardiography (4D-STE) in patients with stable angina pectoris (SAP) to determine the severity of coronary artery disease (CAD) based on the Gensini score. Methods: The present study comprised of 150 patients with SAP. Patients with history of SAP, normal left ventricular ejection fraction, and without regional wall motion abnormalities (RWMA) were scheduled for elective coronary angiography. Based on Gensini score, there were two groups: non-critical stenosis group [Gensini score (0–19), n = 117] and critical stenosis group [Gensini score ≥20, n = 33]. Correlation between Gensini score and 4D-STE strain parameters were investigated. Results: Out of 150 patients, critical stenosis group had significantly depressed values of all 4D-STE strain parameters than non-critical stenosis group (p

Wanjiao Chen,1 Li Wang,1 Bin Hu,1 Ying Zheng,1 Shuya Zhang,1 Zhong Zhou,2 Yifeng Mai2 1Health Science Center, Ningbo University, Ningbo, 315020 People’s Republic of China; 2The First Affiliated Hospital of Ningbo University, Ningbo, 315020, People’s Republic of ChinaCorrespondence: Zhong Zhou; Yifeng Mai, The First Affiliated Hospital of Ningbo University, 247 Renmin Road, Jiangbei District, Ningbo, Zhejiang Province, 315020, People’s Republic of China, Tel +8613736099999, Email zhouz70@163.com; fymaiyifeng@nbu.edu.cnObjective: This study aimed to compare the predictive value of carotid or femoral artery ultrasound for coronary artery disease (CAD) in type 2 Diabetes mellitus (T2DM) patients free from known CAD, and to assess the relationship with the severity of coronary artery stenosis.Methods: Cross-sectional study in adults with a T2DM duration of at least 5 years and without established CAD. Carotid plaque score (CPS) and Gensini score were used to measure the severity of carotid and coronary artery stenosis, respectively, and patients were divided into no or mild group, moderate group, and severe group according to the tertile of the score. Univariate and multivariate logistic regression analysis was used to explore the possible risk factors for CAD. Receiver operating characteristic (ROC) curves were created to determine the most accurate assessment for detecting significant CAD (≥ 50% stenosis).Results: 245 patients (137 male) aged 68.21± 9.5 years (range: 36– 95 years), with T2DM duration 12.04± 6.17 years (range: 5– 34 years), and without CVD were included. CAD was diagnosed in 165 patients (67.3%). Multiple regression analysis showed that CPS, femoral plaque, and smoking were independently and positively correlated with CAD. CPS yielded the highest area under the curve for detecting significant coronary disease (AUC=0.7323). In contrast, the area under the curve of femoral artery plaque and carotid intima-media thickness was lower than 0.7, which was at a lower prediction level.Conclusion: In patients with long T2DM duration, CPS has a higher ability to predict the occurrence and severity of CAD. However, femoral artery plaque has special value in predicting moderate to severe coronary artery disease in patients with long-term T2DM.Keywords: peripheral atherosclerosis, coronary artery disease, type 2 diabetes mellitus, Gensini score, carotid plaque score, femoral artery plaque

This study aimed to find an association between ABO blood groups with presence and severity of Coronary artery disease (CAD) among Indian population. 1500 patients undergoing elective coronary angiogram (CAG) at a tertiary care hospital in Karnataka were enrolled in the study. Baseline demographic data and the presence of cardiac comorbidities were documented. Data from baseline echocardiography and angiographic studies were compiled. The incidence of CAD was higher among patients with blood group A. Blood group A also showed a higher incidence of acute coronary syndrome (ACS), left ventricular dysfunction, triple vessel disease, and severe CAD among the patients who underwent CAG.