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Backgrounds This study aimed to investigate the cross-sectional association between social risk profile (SRP) and the strict control of cardiovascular risk factors, and the prospective association between cardiovascular risk factors controlled and cardiovascular mortality in different SRP grades. Methods Data from 12,695 participants of the National Health and Nutrition Examination Surveys (NHANES) (2005–2018) were included in the analysis. Logistic analysis was performed to assess the relationships between SRP and the strict control of cardiovascular risk factors. Kaplan–Meier curves and Cox regression models were used to analyze the associations between the number of cardiovascular risk factors controlled and outcomes incidence in different SRP grades. Results Compared to individuals with low SRP, those with high SRP had greater odds of strict control of blood pressure (OR = 1.996, 95% CI: 1.733–2.299) and glucose (OR = 1.797, 95% CI: 1.556–2.074), but lower odds of lipid control (OR = 0.810, 95% CI: 0.717–0.915,). Controlling two or three risk factors significantly reduced all-cause and cardiovascular mortality risk compared to no controlled risk factors ( P  < 0.05). Conclusions SRP grades were positively related to the strict control of blood pressure and glucose; and negatively related to the strict control of lipids. Controlling more risk factors is associated with a lower mortality risk. The lower the SRP grades, the greater the reduction in all-cause and cardiovascular mortality risk due to cardiovascular risk factor control.

This study aimed to evaluate the association between conventional and unconventional lipid parameters and the risk of future chronic kidney disease (CKD) and progression of renal function decline. Data from 4,542 participants who were free of CKD at baseline were analyzed using information from the China Health and Retirement Longitudinal Study (2011-2015). The follow-up period was four years. The primary endpoints were incident CKD and rapid progression of renal function decline. The associations between lipid parameters and the risk of CKD and rapid progression of renal function decline were assessed using restricted cubic splines (RCS) and logistic regression analysis. Logistic regression analysis showed that high-density lipoprotein cholesterol (HDL-C) was negatively associated with CKD risk, while remnant cholesterol (RC) and the atherogenic index of plasma (AIP) were positively associated. Triglycerides (TG), RC, and AIP were positively correlated with rapid renal function decline, whereas low-density lipoprotein cholesterol (LDL-C) and HDL-C were negatively correlated. Among these parameters, AIP was the most strongly associated with CKD [adjusted odds ratio (OR) (95% CI): 2.091 (1.199, 3.649),  = 0.009] and rapid progression of renal function decline [adjusted OR (95% CI): 3.996 (2.632, 6.068),  < 0.001]. LDL-C and HDL-C were negatively associated with rapid progression of renal function decline, while TG, RC, and AIP were positively associated with this outcome. Among the lipid parameters examined, AIP was the most strongly associated with CKD and rapid progression of renal function decline.

Background The combination of hemoglobin, albumin, lymphocytes, and platelets (HALP) is a comprehensive index of nutrition and systemic inflammation. This study aimed to assess the association between HALP score and major adverse cardiovascular events (MACEs) in patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI). Methods 2182 patients with AF and ACS or undergoing PCI were recruited and followed up for a median survival time of 1128 (807–1391) days. The endpoint was the incidence of MACEs including all-cause death, myocardial infarction, stroke, non-central nervous system embolism, and ischemia-driven revascularization. Kaplan-Meier curve was used to compare the MACEs risk in four groups divided by the HALP quartile. Cox analysis was performed to assess the relationships between HALP and MACE risk. Restricted cubic spline (RCS) was used to clarify the non-linear correlation of HALP with MACEs risk. Results The Kaplan-Meier curves showed statistically significant differences in outcomes among the four groups (log-rank P  < 0.01). The results of Cox analysis demonstrated that compared with participants with low HALP scores, participants with the highest HALP score had a lower MACE risk [adjusted HR: 0.61 (95% CI (0.45–0.81), P  < 0.01]. The RCS curve revealed that the HALP was non-linearly and L-shaped correlated with MACEs (P for overall = 0.02, P for nonlinear = 0.02). Two-stage Cox analysis showed that in patients with HALP scores < 44.95, for every 1-unit decrease in HALP, the risk of MACEs increased by 1.8%. Adding the HALP score into the GRACE model or CHA2DS2-VASc model significantly increased the original predictive value on MACEs or all-cause death. Conclusions High HALP was associated with a reduced risk of MACEs risk in patients with AF and ACS or undergoing PCI. HALP may be a potential marker for independently predicting MACEs in patients with AF and ACS or undergoing PCI.

Objective There is limited evidence on the relationship between remnant cholesterol (RC) and low-density lipoprotein cholesterol (LDL-C) discordance and type 2 diabetes or prediabetes. This study aimed to investigate the association between RC and LDL-C discordance and type 2 diabetes or prediabetes in the general US adult population. Methods Data from 19,604 participants in the National Health and Nutrition Examination Surveys (NHANES) (2005–2018) were analyzed. The percentile difference between RC and LDL-C was used to define discordance. Logistic regression models were performed to assess the relationships between RC, LDL-C, RC and LDL-C percentile difference, LDL-C and RC discordant. Nonlinear relationships were explored using restricted cubic splines. Mediation analysis was conducted to evaluate the direct and indirect relationships between abdominal obesity and type 2 diabetes through RC. Results RC was non-linearly and J-shaped correlated with type 2 diabetes and prediabetes, whereas LDL-C was non-linearly and U-shaped correlated with type 2 diabetes and was S-shaped correlated with prediabetes. Compared to concordant participants, those with discordantly low RC population had lower type 2 diabetes odds, while those with the discordantly high RC population had higher type 2 diabetes and prediabetes odds. When a clinical LDL-C cut-off of 2.60 mmol/L was applied, participants in the high LDL-C and low RC group had the lowest odds of type 2 diabetes, while those in the low LDL-C and high RC group had the highest odds. Significant interactions between LDL-C and RC discordance and factors such as age, MetS, and lipid-lowering medications were observed in relation to type 2 diabetes odds. RC was found to mediate 15.86% of the association between abdominal obesity and type 2 diabetes, and 16.22% of the association between abdominal obesity and prediabetes in the non-diabetes population. Conclusions Discordantly high RC was associated with higher odds of type 2 diabetes and prediabetes, while discordantly low RC was associated with lower odds of type 2 diabetes.

Background The triglyceride-glucose body mass index (TyG-BMI) is a reliable marker of insulin resistance and has been linked to cardiovascular outcomes. However, data on the relationship between TyG-BMI and prognosis in patients with atrial fibrillation (AF) complicated by acute coronary syndrome (ACS) are limited. This study aimed to evaluate the association between baseline TyG-BMI and prognosis in AF-ACS patients. Methods We conducted a single-center prospective analysis of 832 AF-ACS patients hospitalized at Fuwai Hospital from January 2017 to December 2019. The primary outcome was the incidence of major adverse cardio-cerebrovascular events (MACCEs) during the 1-year follow-up. Kaplan-Meier curves compared MACCE risk across four TyG-BMI quartiles. Cox proportional hazards regression and restricted cubic spline (RCS) analyses assessed the relationship between TyG-BMI and patient outcomes. Results The mean age of participants was 68.15 ± 9.59 years, with 569 (68.39%) being male. Kaplan-Meier analysis showed significant differences in 1-year MACCE risk between the four groups. Cox regression revealed that patients in the lowest TyG-BMI quartile had a significantly higher 1-year MACCE risk. RCS analysis indicated a linear increase in MACCE risk with decreasing TyG-BMI. Conclusion TyG-BMI is closely associated with the prognosis of AF-ACS patients. Lower TyG-BMI is significantly linked to a higher risk of MACCEs in this population.

Background The purpose of this study was to assess the relationship between admission inflammatory indexes neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII), and the risk of in-hospital all-cause mortality in acute aortic dissection (AAD) patients. Methods A retrospective analysis was conducted on 597 AAD patients (Stanford classification: Stanford type A 365 patients, Stanford type B 232 patients) at a single center. Outcomes were the incidence of in-hospital all-cause mortality. The risk of all-cause death was compared between the groups with low and high inflammatory indexes using the Kaplan-Meier curve. The association between admission inflammatory indexes and outcomes was evaluated using the Cox regression model and restricted cubic splines (RCS). Stratified analysis was performed based on AAD type, age (< 50 years or ≥ 50 years), and gender. Results The Kaplan-Meier curves revealed statistically significant differences in outcomes among the low and high inflammatory indexes groups. Cox regression analysis revealed that the in-hospital mortality risk was significantly high in the high inflammatory index groups. MLR was the strongest associated with in-hospital mortality risk. The RCS curve revealed that NLR was non-linearly and J-shaped correlated with in-hospital mortality, and MLR and SII were linearly correlated with in-hospital mortality. Stratified analysis showed interactions between NLR, MLR, and SII and AAD type and age for the risk of in-hospital mortality. Conclusion Admission high inflammatory indexes were independently associated with an increased risk of in-hospital all-cause mortality in AAD patients. The inflammatory indexes NLR, MLR, and SII may be useful indicators for predicting in-hospital all-cause mortality in AAD patients.

Background Current evidence on relationships between serum lipid biomarkers and the risk of gastrointestinal cancers remains controversial, with no consensus reached. Methods We conducted a prospective cohort study within the Kailuan Cohort wherein 88,225 individuals with baseline information on triglyceride (TG), total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐C), and high‐density lipoprotein cholesterol (HDL‐C) was followed from 2006 to 2021 for the incidence of esophageal cancer (EC), gastric cancer (GC), and colorectal cancer (CRC). Cox proportional hazards models and restricted cubic spline (RCS) analysis were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results Increased EC risk was associated with high HDL‐C levels (HRQ4vs.Q1 = 2.50, 95% CI: 1.57–3.98), while a U‐shaped relationship between HDL‐C and EC risk was revealed in the RCS analysis (poverall ≤ 0.0001, pnonlinear = 0.02). No robust association was identified between lipid biomarkers and GC risk. In multivariable analysis, increased CRC risk was positively associated with high TC levels (HRQ4vs.Q1 = 1.42, 95% CI: 1.11–1.83, ptrend = 0.03), dose–responsely negatively associated with LDL‐C levels over quartiles (HRQ2vs.Q1 = 0.83, 95% CI: 0.66–1.02; HRQ3vs.Q1 = 0.86, 95% CI: 0.69–1.07; HRQ4vs.Q1 = 0.68, 95% CI: 0.53–0.86, ptrend = 0.02), and showed a diminished negative association with HDL‐C levels over quartiles (HRQ2vs.Q1 = 0.75, 95% CI: 0.60–0.94; HRQ3vs.Q1 = 0.76, 95% CI: 0.61–0.95; HRQ4vs.Q1 = 0.91, 95% CI 0.74–1.13, ptrend = 0.02). The subsequent RCS analysis revealed a linear negative relationship of LDL‐C (poverall = 0.004, pnonlinear = 0.67) and a U‐shaped relationship of HDL‐C (poverall = 0.05, pnonlinear = 0.02) with CRC risk. Competitive risk analysis and sensitivity analysis confirmed the stability of our results. Conclusion We observed a U‐shaped relationship regarding HDL‐C levels with EC and CRC risk, and a linear inverse relationship between LDL‐C levels and CRC risk. Relevant serum lipid levels should be properly managed in high‐risk individuals of certain gastrointestinal cancers.

In this study, a novel mitovirus, tentatively designated as \"Alternaria alternata mitovirus 2\" (AaMV2), was isolated from the fungus Alternaria alternata f. sp. mali causing apple leaf blotch disease. The complete genome of AaMV2 is 3,157 nucleotides in length, with an A+U content of 68.10%. The genome has a single large open reading frame (ORF) encoding an RNA-dependent RNA polymerase (RdRp) protein with a molecular mass of 98.10 kDa. BLAST analysis revealed that AaMV2 has the highest sequence identity to Leptosphaeria biglobosa mitovirus 6, with 79.76% and 82.86% identity at the amino acid and nucleotide level, respectively. Phylogenetic analysis suggested that AaMV2 is a new member of the genus Duamitovirus within the family Mitoviridae. This is the first report of the complete genome sequence analysis of a mitovirus in A. alternata.

Background Small cell lung cancer (SCLC) is an extremely malignant subtype of lung cancer because of its high potential for metastases. Cardiac invasion of SCLC is a serious concern that may lead to systemic embolism or tract obstruction. It has aroused much concern that cardiovascular comorbidities may significantly affect the survival of SCLC patients and their treatment decisions. Methods We consecutively recruited 772 small cell lung cancer (SCLC) patients between January 2011 and December 2018 from 4 cancer specialty hospitals in China. Only newly diagnosed primary cancer inpatients were included. Univariable and multivariable adjusted Cox proportional hazard models were conducted to evaluate the risk factors associated with mortality. Hazard ratios (HRs) for mortality and corresponding 95% confidence intervals (95% CIs) were calculated. Results The prevalence of cardiovascular diseases (CVDs) was 34.6% in all SCLC patients. Log-rank analysis presented statistically significant differences in median survival time (MST) between patients with CVD and without CVD in all SCLC patients (9.0 months vs. 15.0 months, P  = 0.005) and patients with chemotherapy only (12.0 months vs. 18.0 months, P  = 0.048). Pericardial effusion (HR 1.671, 95% CI 1.082–2.580, P  = 0.021) and heart failure (HR 1.752, 95% CI 1.290–2.379, P  < 0.001) were independent risk factors associated with mortality in all SCLC patients. VTE is related to poorer prognosis in patients with chemotherapy only (HR 5.558, 95% CI 1.335–23.135, P  = 0.018) and chemoradiotherapy (HR 3.057, 95% CI 1.270–7.539, P  = 0.013). Conclusions Comprehensive management of CVD comorbidities is of vital importance for the long-term prognosis of SCLC patients.

The management of the coexistence of chronic obstructive pulmonary disease (COPD) and atrial fibrillation (AF) remains unclear due to a lack of evidence. This study aimed to find the effect of beta-blockers and renin-angiotensin-aldosterone system inhibitors (RAASi) in this special population. We designed an observational real-world study that included 2016 AF patients from 20 hospitals across the country. The diagnosis of COPD was extracted from case report forms and confirmed by specialists. The study endpoint was all-cause mortality. Kaplan-Meier curves and Log rank test were used to analyse the prognosis of different treatments. Several multivariable Cox regression models were performed to identify the independent prognostic value of the medications. Approximately 30% of patients were prescribed beta-blockers or RAASi. Survival curves showed that beta-blockers did not affect all-cause mortality in AF patients with COPD ( =0.130). Patients with RAASi had a better prognosis than those without ( =0.011). After multivariable Cox regression analysis adjusting for demographics, other comorbidities and treatments, beta-blockers and angiotensin II receptor blockers (ARB) did not independently affect the endpoint. Angiotensin converting enzyme inhibitors (ACEI) remained a protective factor for overall survival in AF patients with COPD (model 1: HR=0.45, 95% CI 0.21-0.98, =0.045; model 2: HR=0.41, 95% CI 0.18-0.93, =0.034; model 3: HR=0.38, 95% CI 0.16-0.89, =0.026). Beta-blockers did not affect overall survival in patients with AF and COPD, whereas ACEI may be protective.