Background: Associations between high serum uric acid (SUA) and cardiovascular diseases have been reported. However, few studies have been conducted to explore the relationship between SUA and long-term all-cause mortality in coronary artery disease (CAD) patients. Our study aims to investigate the relationship between SUA and long-term all-cause mortality in patients with CAD.Methods: From January 2007 to December 2018, we divided 33,034 patients with CAD admitted in the Guangdong Provincial People's Hospital into five groups (quintile 1: SUA <5.05 mg/dl, quintile 2: 5.05 mg/dl ≤ SUA <5.59 mg/dl, quintile 3:5.59 mg/dl ≤ SUA <6.8 mg/dl, quintile 4, 6.8 mg/dl ≤ SUA <7.93 mg/dl, and quintile 5, SUA ≥7.93 mg/d;). This study used Kaplan–Meier survival analysis to evaluate patient outcomes with different ranges of SUA. Cox proportional hazards regression models and restricted cubic spline were applied to determine the association between serum uric and long-term all-cause mortality.Results: A total of 33,034 participants were recruited, including 24,780 (75.01%) men and 8,254 (24.99) women in this cohort study. Median follow-up was 4.91 years. We found that SUA is an independent risk factor of long-term all-cause mortality according to the result of Cox proportional hazards models. This study also illustrated an approximate U-shape association between SUA and all-cause mortality when compared with 5.95 mg/lL ≤ SUA <6.8 mg/dl, SUA <5.0 5mg/dl (adjusted hazard ratio (aHR) =1.13, 95% CI: 1.01–1.26, p = 0.03), and SUA ≥8 mg/dL (aHR = 1.18, 95% CI: 1.06-1.32, p = 0.003).Conclusion: Our study indicated a U-shaped relationship between SUA and long-term all-cause mortality in patients with CAD. No matter whether SUA is too high or too low, it increased the all-cause mortality in the CAD population, which deserves to be closely monitored.

Background: Cognitive impairment, indicative of Alzheimer disease and other forms of dementia, significantly deteriorates the quality of life of older adult populations and imposes considerable burdens on families and health care systems worldwide. The early identification of individuals at risk for cognitive impairment through a convenient and rapid method is crucial for the timely implementation of interventions. Objective: The objective of this study was to explore the application of machine learning (ML) to integrate blood biomarkers, life behaviors, and disease history to predict the decline in cognitive function. Methods: This approach uses data from the Chinese Longitudinal Healthy Longevity Survey. A total of 2688 participants aged 65 years or older from the 2008‐2009, 2011‐2012, and 2014 Chinese Longitudinal Healthy Longevity Survey waves were included, with cognitive impairment defined as a Mini-Mental State Examination (MMSE) score below 18. The dataset was divided into a training set (n=1331), an internal test set (n=333), and a prospective validation set (n=1024). Participants with a baseline MMSE score of less than 18 were excluded from the cohort to ensure a more accurate assessment of cognitive function. We developed ML models that integrate demographic information, health behaviors, disease history, and blood biomarkers to predict cognitive function at the 3-year follow-up point, specifically identifying individuals who are at risk of experiencing significant declines in cognitive function by that time. Specifically, the models aimed to identify individuals who would experience a significant decline in their MMSE scores (less than 18) by the end of the follow-up period. The performance of these models was evaluated using metrics including accuracy, sensitivity, and the area under the receiver operating characteristic curve. Results: All ML models outperformed the MMSE alone. The balanced random forest achieved the highest accuracy (88.5% in the internal test set and 88.7% in the prospective validation set), albeit with a lower sensitivity, while logistic regression recorded the highest sensitivity. SHAP (Shapley Additive Explanations) analysis identified instrumental activities of daily living, age, and baseline MMSE scores as the most influential predictors for cognitive impairment. Conclusions: The incorporation of blood biomarkers, along with demographic, life behavior, and disease history into ML models offers a convenient, rapid, and accurate approach for the early identification of older adult individuals at risk of cognitive impairment. This method presents a valuable tool for health care professionals to facilitate timely interventions and underscores the importance of integrating diverse data types in predictive health models.