Dyslipidemia is one of the most important factors for coronary artery disease (CAD). The atherogenic index of plasma (AIP), a new comprehensive lipid index, might be a strong marker for predicting the risk of CAD. A hospital-based case–control study including 2936 CAD patients and 2451 controls was conducted in a Chinese population. Traditional lipid parameters were detected, and nontraditional lipid comprehensive indexes were calculated. Compared with controls, CAD patients had higher levels of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C). By contrast, the level of high-density lipoprotein cholesterol (HDL-C) was lower in CAD patients. The values of nontraditional lipid profiles, including non-HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HDL-C/HDL-C (atherogenic index, AI), TC*TG*LDL/HDL-C (lipoprotein combine index, LCI), and lg (TG/HDL-C) (AIP), were all significantly higher in the cases than in the controls. The results of Pearson correlation analyses indicated that AIP was positively and significantly correlated with TC (r = 0.125, P < .001), TG (r = 0.810, P < .001), LDL-C (r = 0.035, P < .001), non-HDL-C (r = 0.322, P < .001), TC/HDL-C (r = 0.669, P < .001), LDL-C/HDL-C (r = 0.447, P < .001), AI (r = 0.669, P < .001), and LCI (r = 0.688, P < .001) and was negatively correlated with age (r = −0.122, P < .001) and HDL-C (r = −0.632, P < .001). In the univariate logistic regression analysis, AIP was the lipid parameter that was most strongly associated with CAD, with an unadjusted odds ratio of 1.782 (95% confidence interval: 1.490–2.131, P < .001), for an increase of 1-SD. Multivariate logistic regression analyses revealed that AIP was an independent risk factor for CAD. AIP might be a strong and independent predictor for CAD in the Chinese Han population.

Background: Dyslipidaemia plays an important role in coronary atherosclerotic disease (CAD). The relationship between the atherogenic index of plasma (AIP) and CAD in elderly individuals was explored in this study. Methods: Elderly individuals (age ≥ 65 years) who underwent coronary angiography from January 2016 to October 2020 were consecutively enrolled in the study. Results: A total of 1313 individuals, including 354 controls (non-CAD) and 959 CAD patients, were enrolled. In univariate analysis of all populations, the adjusted AIP (aAIP) in the CAD group was 1.13 (0.96, 1.3), which was significantly higher than that in the controls [1.07 (0.89, 1.26)]. However, in subgroup analyses, this phenomenon was only present in males. In addition, further study showed that aAIP was positively related to CAD severity. In binary logistic regression analyses, after adjusting for sex, age, smoking status, primary hypertension (PH), type 2 diabetes mellitus (T2DM), heart rate (HR), white blood cell (WBC) and platelet (PLT), AIP remained independently related to CAD in elderly individuals and was superior to traditional and other nontraditional lipid indices. Subgroup analyses showed that AIP independently influenced CAD risk in males. Ultimately, sensitivity analyses were performed excluding all coronary emergencies, and the final results were similar. Conclusions: AIP was positively related to the risk and severity of CAD in elderly individuals and was superior to traditional and other nontraditional lipid profiles. However, this association only exists in elderly males.

Background: Transradial access (TRA) has been considered as the default choice in cardiac catheterization. Although infrequent, vascular complications of this approach remain. Recently, the distal transradial approach (dTRA) in cardiac catheterization was reported by interventionalists. Methods: We retrieved the relevant literatures and reviewed the safety and feasibility of this novel approach in cardiac catheterization. Results: The dTRA for cardiac intervention has superior safety and satisfaction. As a novel approach for cardiac catheterization, access related complications should also be considered by operators, such as RAO, radial spasm, bleeding and haematoma, and injury of the superficial branch of the radial nerve. Conclusions: The dTRA in cardiovascular angiography and intervention was safe and feasible.

Background: The distal transradial access (dTRA) has become an attractive and alternative access to the conventional transradial access (TRA) for cardiovascular interventional diagnosis and/or treatment. There was a lack of randomized clinical trials to evaluate the effect of the dTRA on the long-term radial artery occlusion (RAO).Methods: This was a prospective, randomized controlled study. The primary endpoint was the incidence of long-term RAO at 3 months after discharge. The secondary endpoints included the successful puncture rate, puncture time, and other access-related complications.Results: The incidence of long-term RAO was 0.8% (3/361) for dTRA and 3.3% (12/365) for TRA (risk ratio = 0.25, 95% confidence interval = 0.07–0.88,P = 0.02). The incidence of RAO at 24 h was significantly lower in the dTRA group than in the TRA group (2.5% vs. 6.7%,P < 0.01). The puncture success rate (96.0% vs. 98.5%,P = 0.03) and single puncture attempt (70.9% vs. 83.9%,P < 0.01) were significantly lower in the dTRA group than in the TRA group. However, the number of puncture attempts and puncture time were higher in the dTRA group. The dTRA group had a lower incidence of bleeding than the TRA group (1.5% vs. 6.0%,P < 0.01). There was no difference in the success rate of the procedure, total fluoroscopy time, or incidence of other access-related complications between the two groups. In the per-protocol analysis, the incidence of mEASY type ≥ II haematoma was significantly lower in the dTRA group, which was consistent with that in the as-treated analysis.Conclusions: The dTRA significantly reduced the incidence of long-term RAO, bleeding or haematoma.Trial registration: ClinicalTrials.gov identifer: NCT05253820.

Studies had investigated the associations between proprotein convertase subtilisin/kexin type 9 (PCSK9) E670G polymorphism and coronary artery disease (CAD) and lipid levels, but the results were controversial. Thus, we performed this meta-analysis to investigate the association between PCSK9 E670G polymorphism and lipid levels and the susceptibility to CAD. All relevant articles according to the inclusion criteria were retrieved and included in the present meta-analysis. Odds ratios (ORs) with 95 % confidence interval (CI) were used to analyze the strength of the association between PCSK9 E670G polymorphism and the susceptibility to CAD. At the same time, the pooled standardized mean difference (SMD) with 95 % CI was used for the meta-analysis of PCSK9 E670G polymorphism and lipid levels. The publication bias was examined by using Begg’s funnel plots and Egger’s test. A total of seventeen studies met the inclusion criteria. For CAD association, the pooled effects indicated that the G allele carriers had higher risk of CAD than non-carriers in dominant genetic model (OR:1.601, 95 % CI: 1.314–1.951, P < 0.001), as well as in allelic genetic model (OR: 1.546, 95 % CI: 1.301–1.838, P < 0.001). When the subgroup analysis stratified by ethnicity and HWE was performed, the positive result existed in most of the subgroups. For lipid levels association, the pooled effects indicated that the G allele carriers had higher TC and LDL-C levels than the non-carriers (for TC, SMD: 0.126, 95 % CI: 0.023–0.229, P = 0.016; for LDL-C, SMD: 0.170, 95 % CI: 0.053–0.287, P = 0.004, respectively). There was no difference in the levels of TG and HDL-C between the G carriers and the non-carriers in the whole population (SMD: 0.031, 95 % CI: −0.048–0.110, P = 0.440; SMD: −0.123, 95 % CI: −0.251–0.006, P = 0.061, respectively). When the studies were stratified by ethnicity and type of study, the G carriers had higher TC levels than the non-carriers (SMD: 0.126, 95 % CI: 0.014–0.238, P = 0.027) in the non-Asian subgroup. The similar results existed in cohort subgroup. The association between PCSK9 E670G polymorphism and LDL-C levels was significant in all subgroups. Meanwhile, the G carriers had higher TG levels than the non-carriers (SMD: 0.113, 95 % CI: 0.012–0.214, P = 0.028) in the case–control subgroup. AG + GG genotypes had lower HDL-C levels than AA genotype in Asian subgroup (SMD: −0.224, 95 % CI: −0.423– −0.025, P = 0.027) and in case–control subgroup (SMD: −0.257, 95 % CI: −0.467–−0.048, P = 0.016). The present meta-analysis concluded that PCSK9 E670G polymorphism was associated with CAD risk and lipid levels.

Dipeptidyl peptidase-4 inhibitors (DPP-4i) are emerging glucose-lowering agents through interacting with DPP-4 substrate, impact of which on systemic inflammation in type 2 diabetes mellitus (T2DM) remains unknown. This study aimed to evaluate the effect of DPP-4i on modulating serum levels of C-reactive protein (CRP) in T2DM. PubMed, Cochrane library and Embase databases were searched. Randomized controlled trials (RCTs) with comparators were selected. A random-effects model was used for quantitative data analysis. Heterogeneity was evaluated with I2 index. Sensitivity analysis was performed using the one-study remove approach. Sixteen trials with 1607 patients with T2DM were included. Pooled analysis of DPP-4i demonstrated a significant decrease in serum CRP concentrations (− 0.86 mg/L, 95% CI, − 1.36 to − 0.36). No significant difference was found between DPP-4i and active comparators on serum CRP concentrations (0.64 mg/L, 95% CI, − 0.10 to 1.37). Pooled analysis proved to be stable and credible by sensitivity analysis. In subgroup analysis, changes in serum concentrations of CRP were significantly associated with short diabetes duration (− 0.23 mg/L, 95% CI, − 0.41 to − 0.05). DDP-4i effectively reduced serum CRP levels and showed no stronger effect than traditional oral antidiabetic agents. International Prospective Register for Systematic Review (PROSPERO) number: CRD42017076838.