Background: The risk of coronary artery disease (CAD) in different valve dysfunction has been unclear. Methods: We reviewed patients, who underwent valve heart surgery and coronary angiography from 2008 to 2021, at our center. Results: A total of 7,932 patients were included in the present study, and 1,332 (16.8%) had CAD. The mean age of the study cohort was 60.5±7.9 years, and 4,206 (53.0%) were male. CAD was 21.4% in aortic disease, 16.2% in mitral valve disease, 11.8% in isolated tricuspid valve disease, and 13.0% in combined aortic and mitral valve disease. Patients with aortic stenosis were older than those with regurgitation (63.6±7.4 years vs. 59.5±8.2 years, P < 0.001), and the CAD risks also were higher (28.0% vs. 19.2%, P < 0.001). The age difference was minimal (60.6±8.2 years vs. 59.5±6.7 years, P = 0.002) between patients with mitral valve regurgitation and stenosis, but the risks of CAD were twice high in regurgitation (20.2% vs. 10.5%, P < 0.001). When the type of valve impairment was not considered, non-rheumatic etiology, advanced age, male sex, hypertension, and diabetes were independent predictors of CAD. Conclusion: In patients undergoing valve surgery, the prevalence of CAD was influenced by conventional risk factors. Importantly, CAD also was associated with the type and etiology of valve diseases.

Neointimal hyperplasia persists as a barrier following vascular interventions. Forkhead Box O1 (FoxO1) is a transcription factor that possesses a distinctive fork head domain and indirectly contributes to various physiological processes. FoxO1 expression and signaling also impact the energy metabolism of vascular smooth muscle cells, potentially influencing neointimal hyperplasia. Our hypothesis is that FoxO1 inhibits neointimal hyperplasia in a rat patch angioplasty model. Four groups were compared in a rat aorta patch angioplasty model: the control group without treatment, patches coated with AS184286 (a FoxO1 inhibitor) in a PLGA matrix, patches coated with FoxO1 in a PLGA matrix, and patches coated with MLN0905 (a PLK1 inhibitor) in a PLGA matrix. The patches were harvested on Day 14 and subjected to analysis. FoxO1-positive and p-FoxO1 cells were observed after patch angioplasty. The addition of FoxO1 through patches coated with exogenous FoxO1 protein in a PLGA matrix significantly inhibited neointimal thickness (p = 0.0012). The treated groups exhibited significantly lower numbers of CD3 (p = 0.0003), CD45 (p < 0.0001), and PCNA (p < 0.0001)-positive cells. PLK1 is an upstream transcriptional regulator of FoxO1, governing the expression and function of FoxO1. MLN0905 PLGA-coated patches exhibited comparable reductions in neointimal thickness and inflammatory cell accumulation. FoxO1 represents a promising therapeutic strategy for inhibiting neointimal hyperplasia.

Background: Traditional sutures often fail to meet the complex demands of wound closure across diverse anatomical environments. This study introduces a novel drug-eluting, multiscene absorbable biological suture derived from decellularized fish swim bladder, designed to address limitations in mechanical performance, pH resistance, and foreign body reactions. Methods: Swim bladders were decellularized, microdissected into 0.3-mm strips, and functionalized with rapamycin (RAPA) or necrostatin-1 (NEC-1) via hyaluronic acid/polyvinyl alcohol coatings. Sutures were evaluated for cytotoxicity [human umbilical vein endothelial cell (HUVEC) assays], mechanical properties (tensile/acid/alkali resistance), and efficacy in rat models of venous/arterial, intestinal, gastric, and abdominal wall closures ( n = 3/group). Histological (hematoxylin and eosin, immunofluorescence) and scanning electron microscopy analyses were performed. Results: The NEC-1 sutures demonstrated superior tensile strength (hydrated: 2.1 ± 0.3 N vs. RAPA: 1.8 ± 0.2 N, CTL: 1.5 ± 0.2 N; P <0.05) and maintained structural integrity in both acidic (pH 1.0) and alkaline (pH 8.0) environments for 7 days. In vitro , drug-loaded sutures significantly inhibited HUVEC proliferation by 40% ( P = 0.0096) without inducing apoptosis. In vivo evaluations across venous, arterial, intestinal, gastric, and abdominal wall closures revealed that NEC-1 sutures markedly reduced foreign body reactions, exhibiting the smallest capsule area (0.12 ± 0.03 mm ² vs. CTL: 0.35 ± 0.05 mm ² ; P <0.0001) and 58% fewer CD68 + macrophages compared to controls ( P = 0.0015). All suture types achieved successful leak-free wound closures, with NEC-1 showing particularly strong suppression of neovascularization (CD31 + vessels: 12 ± 3 vs. CTL: 28 ± 5; P = 0.0001). The RAPA sutures also showed significant improvements over controls but were intermediate in performance between NEC-1 and uncoated CTL sutures. Mechanical testing confirmed that both drug-loaded variants (RAPA and NEC-1) maintained higher strength than CTL sutures under both dry and hydrated conditions, while histological analyses demonstrated progressive reductions in inflammatory markers (CD45 +, PCNA +, cleaved caspase 3 + cells) with drug-functionalized sutures. Conclusion: Swim bladder-derived sutures demonstrate universal applicability, staged drug release, and significant reductions in inflammatory responses, offering a promising alternative for multitissue surgical repairs. Graphic The process of making suture and summarizing the cross-tissue analysis protocol. A: Surgical extraction and processing workflow. ① Tissue harvest from fish. ② The swim bladder undergoes decellularization treatment. ③ Microdissection into standardized strips. ④ The swim bladder is processed to create a drug-carrying, multiscene, absorbable biological suture. B: Fish swim bladder suture is used to stitch various organs. (i) Inferior vena cava and infrarenal abdominal aorta. (ii) Small intestine. (iii) Stomach. (iv) Abdominal wall.

Background: Blood troponin I (TnI) concentrations, the reasons for increases in TnI after coronary artery bypass grafting (CABG) and the effects of TnI on short- and long-term outcomes are not well understood. Methods: Patients undergoing off-pump CABG at Anzhen Hospital between 2011 and 2022 were reviewed. Data on peak postoperative TnI and high-sensitivity (hs) TnI were collected, and patients were divided into a high TnI group (TnI ≥10 μg/l or hsTnI ≥10,000 pg/ml) and low TnI group. Baseline characteristics, graft flow, perioperative outcomes and long-term mortality were compared between the two groups. Results: In all, 19,196 patients were included in the study (median age 63 years; interquartile range [IQR] 57–68 years; 14,423 (75.1%) male). Compared with the low TnI group, patients in the high TnI group were more likely to have an intra-aortic balloon pump inserted (17.8% vs. 2.9%; p<0.001), receive extracorporeal membrane oxygenation support (3.6% vs. 0.1%; p<0.001), and undergo early revascularisation (2.81% vs. 0.12%; p<0.001); the high TnI group also had more in-hospital deaths (2.7% vs. 0.2%; p<0.001). After propensity score matching, patients in the high TnI group had fewer grafts to the left circumflex artery (LCX; 0.71 ± 0.58 versus 0.81 ± 0.57; p<0.001) and right coronary artery (RCA; 0.89±0.53 versus 0.95±0.53; p=0.011), as well as less graft flow to the LCX (median 33 [IQR 21–55] versus 41 [IQR 25–67] ml/min; p<0.001) and RCA (30 [IQR 18–50] versus 35 [IQR 22–55] ml/min; p<0.001) than patients in the low TnI group. Patients with high postoperative TnI also had reduced long-term survival (HR 2.59; 95% CI [1.76–3.82]; p<0.001). Conclusion: Elevated TnI following off-pump CABG may be associated with incomplete revascularisation in the LCX and RCA. It is also associated with increased early and late mortality.

Central adiposity and metabolic dysfunction are associated with adverse cardiovascular outcomes, but their associations with incident infective endocarditis (IE) remain unclear. We compared conventional anthropometric and TyG-based indices in relation to incident IE in UK Biobank participants. We analysed 386,859 participants recruited between 2006 and 2010. A 2-year landmark design was applied. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), the triglyceride-glucose (TyG) index, and TyG-based composite indices were assessed. Cox proportional-hazards models with multiple imputation estimated associations with incident IE. Cubic spline, competing-risk, and additional sensitivity analyses evaluated dose–response patterns and robustness. Over 5.55 million person-years of follow-up (median, 14.88 years), 1,124 participants developed incident IE, corresponding to an incidence rate of 20.24 per 100,000 person-years. In the primary adjusted model, each standard-deviation increase in WC and WHtR was associated with incident IE, with HRs of 1.31 (95% CI, 1.23–1.40) and 1.29 (95% CI, 1.22–1.37), respectively. BMI and TyG-based composite indices were also positively associated with incident IE, whereas the association for TyG alone was more modest. WC and WHtR showed positive dose–response associations with incident IE. Higher central adiposity, assessed by WC and WHtR, was consistently associated with a higher long-term hazard of incident IE.

Prolonged mechanical ventilation (PMV) is a serious complication after coronary artery bypass grafting (CABG), yet the association between preoperative pul