Objective To investigate the relationship between estimated glucose disposal rate (eGDR) and the incidence of cardiovascular disease (CVD) in individuals without diabetes and those with diabetes. Methods Participants were drawn from the China Health and Retirement Longitudinal Study from 2011 to 2018. Participants were divided into four subgroups based on quartiles of baseline eGDR. In this study, data were analyzed using Kaplan-Meier survival curves, Cox proportional hazards models, restricted cubic spline curves, subgroup analyses, and receiver operator characteristic curves. Results A total of 6 283 participants were included. Among them, 47.2% are male, with an average age of (59.6±9.5) years; 285 cases (4.5%) had diabetes; there were 1 571 cases in Q1 group, 1 572 cases in Q2 group, 1 583 cases in Q3 group, and 1 557 cases in Q4 group. A total of 761 CVD events occurred. According to the multivariate-adjusted model, baseline eGDR levels were significantly associated with the risk of CVD events (P<0.05). Baseline eGDR was associated with the risk of CVD events in individuals without diabetes (P<0.05), but the results were not entirely consistent for those with diabetes [CVD: hazard ratio (HR)=0.85, 95% confidence interval (CI) (0.75, 0.96), P=0.012; heart disease: HR=0.91, 95%CI (0.78, 1.06), P=0.211; stroke: HR=0.74, 95%CI (0.58, 0.93), P=0.012]. Restricted cubic spline curves revealed significant negative linear relationships between baseline eGDR and CVD, heart disease, and stroke. Subgroup analyses with interaction testing revealed that the association between baseline eGDR and CVD was not modified by age, sex, smoking status, alcohol consumption, or dyslipidemia. Receiver operator characteristic curves further demonstrated that baseline eGDR exhibited significantly better predictive performance than the triglyceride-glucose (TyG) index, obesity indices, and the TyG index-obesity composite. Conclusions Low level baseline eGDR is associated with an increased risk of CVD in individuals without diabetes. This finding may help improve risk stratification to guide preventive measures and enhance the prognosis of CVD.
In June 2022, the American Lipid Society released "NLA scientific statement on statin intolerance: a new definition and key considerations for ASCVD risk reduction in the statin intolerant patient", which provides the latest definition, modifiable factors, and treatment strategies of statin intolerance. According to the guidelines, for statin intolerance, the statin medication regimen should be adjusted first (reducing the dose, switching to another statin, reducing the frequency of medication), and if the patient is still intolerant, non-statin drugs should be considered to reduce the risk of ASCVD in the patient. The interpretation of this guideline will help clinicians and researchers identify, manage and intervene in the statin intolerance syndrome.
Cardiovascular diseases are the leading cause of death and their diagnosis and treatment rely heavily on the variety of clinical data. With the advent of the era of medical big data, artificial intelligence (AI) has been widely applied in many aspects such as imaging, diagnosis and prognosis prediction in cardiovascular medicine, providing a new method for accurate diagnosis and treatment. This paper reviews the application of AI in cardiovascular medicine.
With the heavier burden of cardiovascular disease, an abundance of papers emerge every year in the research hotspots, which cover a wide range of types and content. In order to let readers interested in the cardiovascular field quickly understand the research hotspots and research frontier, it is necessary to sort out and summarize the research topic in time. According to the discipline classification, we screened papers in cardiovascular field from the Essential Science Indicators (ESI) hot papers published in 2019. Methods such as bibliometrics, statistical description, hierarchical induction, analysis and interpretation were used a step further to reveal the context and characteristics of research in the field of cardiovascular diseases, summarize the latest progress and development direction in this field, and provide information and hints for the expansion of future research directions. A total of 297 papers were finally included, which were mainly in the field of clinical medicine; The country with the most publications was the United States, while China ranked the fifth in terms of contribution; the research institution with the highest number of published papers was Harvard University; the New England Journal of Medicine (NEJM) has published the most papers, with contribution also from journals such as Circulation, Europe Heart Journal, JAMA, and Lancet. All the papers were categorized into disease burden, disease risk, drug treatment, device treatment and surgical treatment, clinical diagnosis, basic research and others, so as to review and summarize the research front in the field of cardiovascular diseases.
With the discovery of cardiac stem cell, the conception of the heart considered to be a terminally differentiated organ was changed. Cardiac stem cells possess the common characteristics of self-renew, clone formation and differentiating into cardiomyocyte, smooth muscle cell, and endothelial cell. Because of the properties of tissue specificity and lineage commitment, cardiac stem cells are considered to have great advantages over other stem cells in the treatment of cardiovascular disease. However, the low rate of engraftment still remains a problem to be solved. In recent years, people attempted to combine stem cell therapy with other ways, such as tissue engineering, gene therapy, exosome therapy, to cure cardiovascular diseases, aiming at finding better ways to treat the cardiovascular disease. This article is mainly for the reviewing of the mechanisms underlying the stem cell therapy and the combinatory use of new technology emerged these years.
Circular RNA (circRNA) is a non-coding RNA which exists widely in eukaryotic cells with a structure of covalently closed continuous loop. Its generation, characteristics and functions have received extensive attention, making it one of the hot spots in the field of non-coding RNA research. Many studies have found that circRNA plays an important role in the development of various diseases including cardiovascular disease, nervous system disease and cancer. Cardiovascular disease is a worldwide common disease with high incidence and poor prognosis. Its exact pathogenesis has not been found, which blocks the development of cardiovascular disease treatment. In this review, we summarize the loop-forming mechanisms, the functions and the progress of current researches of circRNA in cardiovascular diseases.
Cardiovascular disease is a leading cause of death in Chinese population. It is of great significance to further explore the pathogenesis of cardiovascular diseases. Ferroptosis is a recently discovered iron-dependent and non-apoptotic form of regulated cell death, which exerts a regulatory role in a variety of biological events. Some studies have shown that ferroptosis plays an important role in the development of cardiovascular diseases. According to newly scientific reports, we summarized the mechanism and regulation in ferroptosis, and reviewed the results of ferroptosis in common cardiovascular diseases such as cardiac ischemia-reperfusion/myocardial infarction, cardiomyopathy, cardiac hypertrophy, atherosclerosis and abdominal aortic aneurysm.
Cardiovascular disease is one of the diseases with the highest morbidity and mortality in the world. Tanshinone ⅡA is one of the main active components of Salvia miltiorrhiza, which can significantly improve heart function. In this paper, the mechanisms of cardiovascular protection by tanshinone ⅡA are reviewed, including reducing myocardial apoptosis, inhibiting inflammatory reaction, improving atherosclerosis, and inhibiting myocardial fibrosis and antioxidant stress, and the related clinical research of tanshinone ⅡA is evaluated, so as to provide reference for the following research and clinical application of tanshinone ⅡA in cardiovascular system.
This paper tried to address how to apply the relative concepts and methods of evidence-based medicine in clinical practice of cardiology, especially in diagnosis and treatment, with an aim to promote the cardiovascular evidence-based medicine in China.
The randomized controlled trial is the best evidence in the evidence-based medicine. The cardiovascular disease internal department is the typical example of the evidence-based medicine. A serial large-scale randomized controlled trials provided the evidence and improved clinical treatment level. For normal development of a large-scale randomized controlled trials need to enhance the standard management.