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Background: The association between plasma free fatty acid (FFA) and the outcomes in the heart failure (HF) patients remains unclear. Methods: A cohort study among HF patients was performed. Plasma FFA was analyzed as both a continuous and a categorical variable (grouped by tertiles) to assess its association with composite cardiovascular (CV) death and HF hospitalization (CV death & HHP), CV death alone, and all-cause mortality (ACM) using Cox regression models. Subgroup analyses of HF patients with preserved ejection fraction (HFpEF) and mildly reduced/reduced ejection fraction (HFmrEF/HFrEF) were performed. This work also assessed the effectiveness of combining FFA and NT-pro BNP biomarkers for risk stratification by calculating the concordance index (C-index). Results: Among the 4,109 HF patients, FFA levels exceeding 0.4–0.42 mmol/L were associated with increased risks of the three outcomes. Patients in the highest FFA tertile faced greater risks than those in the lowest tertile. Adjusted hazard ratios were 1.32 (95% CI: 1.11–1.58) for CV death & HHP, 1.45 (95% CI: 1.16–1.82) for CV death, and 1.39 (95% CI: 1.15–1.68) for ACM, with a maximum follow-up of 8 years (median: 25 months). Subgroup analyses revealed that elevated FFA levels consistently predicted worse outcomes in both HFmrEF/HFrEF and HFpEF patients. The C-index for predicting outcomes was significantly greater when NT-pro BNP and FFA were combined than when NT-pro BNP was used alone (P < 0.01). Conclusion: Increased plasma FFA concentrations were independently associated with greater risks of CV death & HHP, CV death, and ACM among HF patients, irrespective of the ejection fraction. The combination of FFA and NT-pro BNP biomarkers significantly improved risk stratification in HF patients. [ABSTRACT FROM AUTHOR]

Background Marital status is associated with cardiovascular disease (CVD) incidence and overall mortality, yet limited research on this topic in elderly individuals is available. Our aim was to comprehensively assess the impact of marital status and other family factors on CVD incidence and long-term mortality among elderly people. Methods Data from the Chinese Longitudinal Healthy Longevity Survey (2002/2005/2008–2018) for participants aged ≥60 years were analysed. A cross-sectional study initially examined the correlation between spouses, offspring, living arrangements, and CVD using logistic regression. Subsequently, a retrospective cohort study investigated the long-term associations of these factors with overall mortality via Kaplan–Meier and Cox regression analyses. Results The study involved 48 510 subjects (average age: 87 years). The cross-sectional analysis revealed a correlation between living with a spouse and an increased incidence of heart disease (adjusted OR 1.27, 95% CI 1.04–1.55) and cerebrovascular disease/stroke (adjusted OR 1.26, 95% CI 1.11–1.42). According to the retrospective cohort analysis, living with a spouse significantly reduced overall mortality (adjusted HR 0.84, 95% CI 0.80–0.87), irrespective of marital relationship quality. Conversely, living with offspring (adjusted HR 1.12, 95% CI 1.08–1.16), having more children (adjusted Pnonlinearity = 0.427) or cohabitants (adjusted Pnonlinearity < 0.0001) were associated with increased overall mortality. Conclusion In the elderly population, being married and living with a spouse were not significantly associated with a decrease in CVD incidence but were associated with a reduction in long-term overall mortality. Living with offspring, having more children, or having a larger family size did not replicate the protective effect but indicated greater overall mortality. Key message What is already known on this topic Being married is associated with a decrease in cardiovascular disease (CVD) and overall mortality in the general population. What this study adds Among the elderly, living with a spouse was associated with lower long-term mortality rates but not with the occurrence of CVD. Conversely, living with offspring, having more children, or a larger family size did not provide the same protective effect and instead indicated higher overall mortality. How this study might affect research, practice, or policy Cohabiting with a spouse might contribute to extending the lifespan of elderly people. For widowed or divorced elderly individuals, remarriage could be beneficial. [ABSTRACT FROM AUTHOR]

Background and Aims: The clinical effects of multivessel interventions in patients with unstable angina/non‐ST‐segment elevation myocardial infarction (UA/NSTEMI), multivessel disease (MVD) and chronic kidney disease (CKD) remain uncertain. This study aimed to investigate the safety and effectiveness of intervention in non‐culprit lession(s) among this cohort. Methods: We consecutively included patients diagnosed with UA/NSTEMI, MVD and CKD between January 2008 and December 2018 at our centre. After successful percutaneous coronary intervention (PCI), we compared 48‐month overall mortality between those undergoing multivessel PCI (MV‐PCI) through a single‐procedure or staged‐procedure approach and culprit vessel‐only PCI (CV‐PCI) after 1:1 propensity score matching. We conducted stratified analyses and tests for interaction to investigate the modifying effects of critical covariates. Additionally, we recorded the incidence of contrast‐induced nephropathy (CIN) to assess the perioperative safety of the two treatment strategies. Results: Of the 749 eligible patients, 271 pairs were successfully matched. Those undergoing MV‐PCI had reduced all‐cause mortality (hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.48–0.67). Subgroup analysis showed that those with advanced CKD (estimated glomerular filtration rate (eGFR) ≤ 30 mL/min/1.73 m2) could not benefit from MV‐PCI (P = 0.250), and the survival advantage also tended to diminish in diabetes (Pinteraction < 0.01; HR = 0.95, 95% CI = 0.65–1.45). Although the staged‐procedure approach (N = 157) failed to bring additional survival benefits compared to single‐procedure MV‐PCI (N = 290) (P = 0.460), it showed a tendency to decrease the death risk. CIN risks in MV‐PCI and CV‐PCI groups were not significantly different (risk ratio = 1.60, 95% CI = 0.94–2.73). Conclusion: Among patients with UA/NSTEMI and non‐diabetic CKD and an eGFR > 30 mL/min/1.73 m2, MV‐PCI was associated with a reduced risk of long‐term death but did not increase the incidence of CIN during the management of MVD compared to CV‐PCI. And staged procedures might be a preferable option over single‐procedure MV‐PCI. [ABSTRACT FROM AUTHOR]