Background: Many studies have shown that glycated hemoglobin (HbA1c) is associated with coronary artery disease (CAD). HbA1c was independently related to angiographic severity in Chinese patients with CAD after adjusting for other covariates. Some traditional cardiovascular drugs may have an impact on this relationship. Methods: This retrospective study enrolled a total of 572 CAD patients who underwent their coronary angiography and had their HbA1c levels measured at the Chinese Hospital. The complexity of the coronary artery lesions was evaluated using the Syntax score, and the subjects were divided into 4 inter quartiles according to HbA1c levels. Covariates included history of traditional cardiovascular drugs. Results: The average age of selected participants was 61.00 ± 9.15 years old, and about 54.72% of them were male. Result of fully adjusted linear regression showed that HbA1c was positively associated with Syntax score after adjusting confounders (β = 1.09, 95% CI: 0.27, 1.91, P = 0.0096). By interaction and stratified analyses, the interactions were observed based on our specification including with the medication history of statins and angiotensin receptor blockers (ARBs) (P values for interaction < 0.05). Conclusion: In this study, we found a positive correlation between the HbA1c levels and the SYNTAX score among CAD individuals, and oral statins and ARBs medication could affect the correlation. Thus, HbA1c measurement could be used for the evaluation of the severity and complexity of coronary lesions among CAD patients.

Objectives Identifying high-risk paediatric patients with a poor prognosis and providing timely and adequate treatment are critical. This study aimed to evaluate the effects of different types of cardiac enzyme spectrum within 24 hours of admission on the short-term prognosis of patients in paediatric intensive care units. Design A retrospective study. Setting A single-centre, tertiary care hospital in China, with patient data from 2010 to 2018. Participants A total of 4343 critically ill children were enrolled. Intervention None. Primary and secondary outcome measures The main outcome measure was in-hospital mortality, which was defined as death from any cause during hospitalisation. The secondary outcome was 30-day mortality, intensive care unit (ICU) length of stay (LOS) and total LOS. Results Using the local polynomial regression fitting method, an approximately linear increase in in-hospital mortality was detected for creatine kinase (CK), creatine kinase MB (CK-MB), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH). Among the different types of cardiac enzyme spectrum, LDH had the highest area under the curve value (0.729), followed by AST (0.701), CK-MB (0.613) and CK (0.557). The Kaplan‒Meier analysis showed that the patients in the high LDH group had higher 30-day mortality. The multivariate logistic regression revealed that high LDH was independently associated with in-hospital mortality (OR 2.45, 95% CI 1.84 to 3.24). After propensity score matching (PSM) and sensitivity analysis, the results remained consistent. Conclusions LDH is a reliable outcome predictor in critically ill children, including those with various comorbidities.

Serum uric acid(SUA) is proinflammatory and increases the risk of cardiovascular events in patients with coronary artery disease. SUA levels differ between men and women, and it is unclear whether there are gender differences in the correlation between SUA levels and major adverse cardiovascular events (MACE) in patients with acute coronary syndromes (ACS). In this paper, we analyze the correlation between SUA and MACE in men and women with ACS respectively, to achieve a more accurate prognosis prediction and to determine the optimal level of SUA control in ACS patients of different genders. This was a retrospective cohort study that ultimately selected 2799 ACS patients who were hospitalized in the Department of Cardiology of the Affiliated Hospital of Jining Medical College from May 2013 to October 2015, and grouped the patients according to the gender-specific criteria for hyperuricemia(HUA). With a mean follow-up of 4.42 years after discharge, MACE were collected, and the correlation between SUA and MACE risk in patients of different genders was investigated using the Cox proportional risk regression model. Smooth curve fitting was used to analyze the nonlinear relationship between SUA and MACE, and sensitivity and subgroup analyses were performed to investigate further the correlation between SUA and MACE in different populations. A total of 309 patients developed MACE during the follow-up period. Kaplan-Meier curves showed that patients with HUA had a higher risk of MACE (p < 0.01). Multivariate Cox proportional risk regression modeling analysis revealed a significant correlation between SUA and MACE risk. In crude Cox analyses, SUA levels were associated with higher risk of MACE (total: HR 1.22,95% CI 1.13, 1.31, p < 0.0001, men: HR 1.24, 95% CI 1.14, 1.35, p < 0.0001, women: HR 1.16, 95% CI 1.00, 1.34, p = 0.0477). However, after adjusting for various covariates including SYNTAX scores(SS), the prediction of MACE risk by SUA was clinically significant only in men (HR 1.21, 95% CI 1.03, 1.42, p = 0.0191), and the incidence of MACE events was elevated with elevated uric acid in women but was not clinically significant (HR 1.06, 95% CI 0.82, 1.38, p = 0.6633). In addition, when results were analyzed according to SUA tertiles and gender, men with higher SUA tertiles had a higher risk of MACE (p < 0.0001). After adjusting for variables, smoothed-fit curve analysis similarly showed a trend toward higher MACE occurrence with elevated uric acid in a variety of populations. The inflection points present in the threshold effect analysis in the whole population, men and women curve fits were 7.11 mg/dL, 7.13 mg/dL, and 6.31 mg/dL, respectively, and for every 1-unit increase in uric acid to the right of the inflection point, the risk of MACE increased by 1.48-fold, 1.24-fold, and 1.48-fold, respectively. (( HR (95%) CI: 2.48 (1.57, 3.90) p < 0.0001, in total; 2.24 (1.37, 3.65) p = 0.0013, in men; 2.48 (1.02, 6.01) p = 0.0442, in women)). Subgroup analyses and interaction tests showed that the association between uric acid and MACE was more significant in men in the high triglyceride and high LDL population, whereas in women it was more significant in patients with high BMI, mild coronary artery stenosis, high creatinine, and normoglycemia (interaction p-value < 0.05). There is a gender difference in the risk of MACE and uric acid levels in patients with ACS, with elevated uric acid levels being more likely to lead to cardiovascular events in men patients, whereas there was no significant difference in women patients.

Myocardial infarction (MI) is an important pathological event in cardiovascular disease and the heterogeneous changes in cardiomyocytes and non‑cardiomyocytes that occur following its occurrence have a profound effect on cardiac repair and functional recovery. Single‑cell sequencing, a novel technology for the analysis of tissues at the single‑cell level, permits a comprehensive insight into the heterogeneity of different cell populations. The current review presented a summary of the application of single‑cell sequencing to detect the heterogeneity of cardiomyocytes and non‑cardiomyocytes following MI. It focused on the classification and changes of cell clusters and explored the mechanisms of post‑infarction cardiac regeneration and remodeling with the aim of providing a theoretical foundation for identifying potential targets to enhance the diagnosis and treatment of post‑infarction cardiac remodeling.

Coronary heart disease (CHD) is associated with increased morbidity and mortality. Acute cardiovascular events frequently occur in patients with coronary artery stenoses exceeding 70%. Although coronary revascularization can significantly improve ischemic symptoms, the inflection point for reducing mortality from CHD has yet to be reached. Therefore, the prevention and treatment of mild-to-moderate coronary artery stenosis should be given significant attention to more effectively reduce the incidence and mortality of acute events from CHD. Subsequently, a stenosis of less than 70% is used to characterize the incidence of mild to moderate coronary artery stenosis. While acute cardiovascular events caused by soft plaque and plaque rupture may not have a significant impact on hemodynamics, these events are detrimental and result in increased mortality. This review summarizes the methods available for detecting mild-to-moderate coronary artery stenoses, assessing risk, and understanding the mechanisms underlying adverse events. Moreover, this review proposes intervention strategies for preventing and treating mild to moderate coronary stenosis.