Objective The relationship between the Cholesterol, High-density lipoprotein, and Glucose (CHG) index and stroke has been investigated in only a limited number of studies, and the findings remain inconsistent. This prospective cohort study aims to provide further evidence on the association between the CHG index and stroke risk in patients with hypertension. Methods A total of 6725 elderly subjects (≥ 60 years) were enrolled in this prospective cohort analysis. The CHG index was calculated, and incident stroke was identified as the outcome. Cox proportional hazards models were employed to examine the association between the CHG index and stroke risk. Restricted cubic splines (RCS) were used to evaluate the dose-response relationship. Results Over a mean follow-up of 3.92 (0.58) years, 319 (4.7%) patients developed new-onset stroke. After multivariate adjustment, each 1-unit increase of CHG index was associated with a 268% higher risk of stroke (HR = 3.68, 95% CI: 2.03, 6.65). Compared with participants in the lowest quartile (Q1) of the CHG index, those in Q2, Q3, and Q4 had fully adjusted HRs (95% CI) for stroke of 1.89 (1.35, 2.65), 2.20 (1.52, 3.18), and 3.11 (2.03, 4.76), respectively. RCS analysis revealed a positive linear association between the CHG index and stroke risk, and this association remained consistent across subgroups, with no significant interactions. Conclusions An elevated CHG index is significantly and linearly associated with increased stroke risk in hypertensive patients. The CHG index may serve as a useful early indicator for stroke risk assessment in this population. Trial registration : the China Hypertension Registry Study (registration number: ChiCTR1800017274; registered on July 20, 2018; available at http://www.chictr.org.cn/).

The association between serum uric acid (SUA) and cognitive function is controversial in previous studies. Hypertension group are prone to cognitive decline. We aimed to investigate the correlation between serum uric acid levels and cognitive function among Chinese hypertensive patients using the Chinese adapted version of Mini-Mental State Examination (CAMSE). We included 9,471 subjects from the China Hypertension Registry study. Serum uric acid was measured using biochemical analysis instruments. The CAMSE assessment was performed to evaluate the cognitive function. Participants with different educational backgrounds used different CAMSE score cutoffs to define cognitive impairment (CI): < 24 for participants with junior high school education or above (≥ 7 years of schooling), < 20 for those with primary school education (1–6 years), and < 17 for illiterate participants. We enrolled 9,471 hypertensive participants (mean age 63.6 ± 9.8 years; 47.9

There is a paucity of data regarding the association between malnutrition and mortality in China. This study aimed to explore the association between the geriatric nutritional risk index (GNRI) and all-cause and cardiovascular mortality in Chinese adults with hypertension. A total of 14,221 participants with hypertension (mean age, 63.8 ± 9.4 years; 47.2

Background:Vitamin D is essential for calcium homeostasis, bone health, and immune function, yet its association with serum uric acid (UA) remains uncertain. This study evaluates vitamin D status in Chinese adults and explores its sex- and age-specific relationships with UA and hyperuricemia (HUA). Methods:We conducted a cross-sectional analysis of 15,116 males and 25,895 females from The China Precision Nutrition and Health KAP Real World Study (CPNAS). Restricted cubic spline (RCS) visualized dose-response relationships, while multivariate regression assessed associations between vitamin D and UA/HUA. Subgroup analyses (age < 70 vs. ≥70, male vs. female) explored potential variations. Results:The study revealed a high prevalence of vitamin D deficiency (33.5%) and insufficiency (53%) in Chinese adults. Among males under 70 years, we observed an inverse J-shaped relationship between vitamin D and serum UA levels (P-non-linear = 0.046). Compared to those with vitamin D < 22 ng/ml, participants with moderate levels (22-30 ng/ml) showed significantly lower UA (β = -5.40 to -4.36, all P < 0.05), while no significant reduction occurred at higher concentrations (≥25.8-30 ng/ml, P > 0.05). Notably, this association was absent in males ≥70 years. In contrast, females exhibited a consistent positive linear relationship between vitamin D and UA. These patterns were similarly observed for hyperuricemia risk in both sexes. Conclusion:Vitamin D levels are differentially associated with UA and HUA based on sex and age, highlighting the need for personalized approaches in managing vitamin D and UA metabolism. Clinical trial registration:This trial was registered at https://www.chictr.org.cn/hvshowproject.html?id=178499&v=2.2, as ChiCTR2100051983.

Triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance and has been linked with cardiovascular outcomes. However, its association with arterial stiffness is understudied, particularly among hypertensive adults. To explore the association between TyG index and arterial stiffness, assessed by carotid-femoral pulse wave velocity (cfPWV), among a group of rural dwelling hypertensive adults. A total of 12,751 hypertensive participants from the Hypertension and Stroke Prevention and Control Project (HSPCP) were analyzed. cfPWV was measured noninvasively using a PulsePen device (WPP001-ET, DiaTecne s.r.l.). TyG index was calculated as ln [fasting triglycerides (mg/dL) ×fasting glucose (mg/dL)/2]. Multivariate linear regression and log-binomial regression were used to explore the cross-sectional association between TyG index and cfPWV. Subgroup analyses were applied to identify potential effect modifiers. The mean age was 59.8 years, with 37.3

BACKGROUND:Sodium-glucose cotransporter 2 (SGLT2) inhibitors have established long-term cardiorenal benefits in patients with type 2 diabetes mellitus. However, their short-term peri-procedural role in preventing contrast-induced acute kidney injury (CI-AKI) after coronary computed tomographic angiography (CCTA) remains uncertain, and their acute effects on renal oxygenation may be complex. METHODS:This prospective, randomized, double-blind, placebo-controlled single-center study screened 352 diabetic patients scheduled for CCTA. A total of 335 patients were randomized, and 322 patients with complete baseline and post-CCTA creatinine assessment were included in the modified intention-to-treat analysis. Participants received dapagliflozin 10 mg once daily or matched placebo beginning 3 days before CCTA and continuing through the 72-hour post-CCTA follow-up. CI-AKI was defined according to prespecified serum creatinine-based criteria within 72 hours after contrast exposure. Serial renal indices and exploratory biomarker variables were summarized at available time points, and logistic regression was restricted to a parsimonious covariate set because of the limited number of events. RESULTS:The modified intention-to-treat analysis included 322 patients, with 161 patients assigned to each group. CI-AKI occurred in 29 patients overall (9.0%), with a significantly lower incidence in the dapagliflozin group than in the placebo group (6/161 [3.7%] vs. 23/161 [14.3%]; odds ratio, 0.23; 95% confidence interval, 0.09-0.59; P = 0.001 by Fisher exact test). Baseline renal indices, including serum creatinine, estimated glomerular filtration rate, blood urea nitrogen, neutrophil gelatinase-associated lipocalin, and baseline eGFR category distribution, were comparable between groups. At 72 hours after CCTA, the dapagliflozin group had lower serum creatinine and higher eGFR than the placebo group. KDIGO creatinine-based AKI stage distribution did not differ significantly between groups (P = 0.064), and no patient required new dialysis or kidney replacement therapy during the 72-hour follow-up. Exploratory secondary biomarker analyses showed lower blood urea nitrogen and neutrophil gelatinase-associated lipocalin levels at 72 hours in the dapagliflozin group. CONCLUSION:In diabetic patients undergoing CCTA, short-term peri-procedural dapagliflozin was associated with a lower incidence of creatinine-defined CI-AKI and improved early post-contrast renal function profiles. By focusing on a noninvasive CCTA population, this study expands the potential application of SGLT2 inhibition from invasive coronary procedures to intravenous contrast-enhanced cardiac CT, suggesting a novel adjunctive approach for renal risk reduction in selected diabetic patients. Larger multicenter trials are needed to validate these findings and define the patients most likely to benefit.

Blood homocysteine (Hcy) concentrations have become a sensitive predictor of the development of cardiovascular disease. Few studies have reported the relationship between plasma vitamin E and Hcy. We aim to conduct an sex- and age-stratified investigation of the association between vitamin E status and Hcy concentrations in a large nationwide sample in China. We conducted a cross-sectional study including 15,842 Chinese adults. The exposure variable was plasma vitamin E. The outcome variables included Hcy concentrations and hyperhomocysteinemia. Multiple linear models and multivariable logistic regression were performed to evaluate the relation between plasma vitamin E and Hcy. Restricted cubic spline was conducted to examine the non-linear relationship. In men, the association between plasma vitamin E and Hcy concentrations suggested an approximately U-shaped pattern (p for nonlinearity < 0.001). Compared with men aged < 65 years with plasma vitamin E concentrations of 8.5–15.9 µg/mL, those with concentrations below 8.5 µg/mL or above 15.9 µg/mL had higher odds of hyperhomocysteinemia (OR: 1.33 (1.10,1.60), p = 0.002; OR: 1.77 (1.25, 2.50), p = 0.001, respectively). In men ≥ 65 years old, plasma vitamin E < 8.4 µg/mL was not significantly associated with hyperhomocysteinemia (OR: 1.06(0.86,1.30), p = 0.589). Among women, age-stratified spline curves generally suggested an L-shaped pattern, with higher plasma vitamin E concentrations associated with lower Hcy concentrations, followed by a plateau in the association. Sex-specific associations between plasma vitamin E and Hcy concentrations or hyperhomocysteinemia were found. The spline analyses suggested an approximately U-shaped pattern in men and an L-shaped pattern in women. In contrast to the sex-specific patterns, the association between vitamin E and Hcy were generally consistent across age groups.

Background and purpose: Matching the anti-proliferative drug effect with endothelial healing after drug-eluting stent (DES) implantation may help reduce cardiac events, especially stent thrombosis. A previous PIONEER II optical coherence tomography (OCT) sub-study demonstrated significantly better 1-month strut coverage with the novel healing-targeted BuMA Supreme DES, which was designed with a drug elution period of 4 to 6 weeks after implantation, compared with the XIENCE everolimus eluting stent (EES). This clinical trial aimed to evaluate whether the early endothelial healing observed in previous OCT sub-study would translate into improved intermediate-term angiographic and short-term clinical outcomes. Methods: PIONEER II was a multicenter, prospective, tandem clinical trial conducted in China. It was part of a series of clinical investigations of the BuMA Supreme DES, together with PIONEER I in Europe and PIONEER III in the United States, Canada, Europe, and Japan. The efficacy and safety of the BuMA Supreme DES were evaluated in patients with de novo coronary artery lesions. Results: From December 2015 to March 2018, 459 patients were randomly assigned to the randomized controlled trial (RCT) arm and received either the BuMA Supreme DES (n = 226) or the BuMA biodegradable polymer sirolimus-eluting stent (BP-SES; n = 233). In addition, 819 patients were enrolled in the objective performance criteria (OPC) arm. In the RCT arm, the BuMA Supreme DES was non-inferior to the BuMA BP-SES with respect to 9-month in-stent late lumen loss (LLL), with values of 0.23 ± 0.37 mm and 0.27 ± 0.36 mm, respectively (difference: −0.046 mm, 95% confidence interval: −0.107 to 0.015; P < 0.001 for non-inferiority). Furthermore, the BuMA Supreme DES demonstrated significantly lower values for secondary angiographic endpoints, including in-segment LLL and in-stent/in-segment diameter stenosis, compared with the BuMA BP-SES. In the OPC arm analysis, which combined patients from the BuMA Supreme group of the RCT arm with patients enrolled in the single-arm cohort, the 1-year target lesion failure rate was 4.17%. Both primary endpoints met the pre-specified non-inferiority criteria. Conclusion: The BuMA Supreme DES was non-inferior to the BuMA BP-SES with respect to 9-month in-stent LLL and was associated with the expected target lesion failure rate and a low incidence of stent thrombosis at 1-year follow-up.

Purpose Blood homocysteine (Hcy) levels have become a sensitive predictor of the development of cardiovascular disease. Few studies have reported the relationship between plasma vitamin E and Hcy. We aim to conduct an age- and sex-stratified investigation of the association between vitamin E status and Hcy levels in a large nationwide sample in China. Methods We conducted a cross-sectional study including 15,842 Chinese adults. The exposure variable was plasma vitamin E. The outcome variables included homocysteine level and hyperhomocysteinemia. Multiple linear models and multivariable logistic regression were performed to evaluate the relation between plasma vitamin E and homocysteine. Restricted cubic spline was conducted to examine the non-linear relationship. Results In men, the association between plasma vitamin E and homocysteine level followed a U-shape ( p for nonlinearity < 0.001). Compared with plasma vitamin E value of 8.5 ~ 15.9 ug/ml, the risk of hyperhomocysteinemia increased for values lower than 8.5 ug/ml (OR: 1.33 (1.10,1.60), p = 0.002) or higher than 15.9 ug/ml (OR: 1.77 (1.25, 2.50), p = 0.001) in < 65 year-old adults. In men ≥ 65 years old, participants with plasma vitamin E less than 8.3 ug/ml had no significantly associated with hyperhomocysteinemia (OR: 1.22 (1.04,1.43), p = 0.015). Among women, however, no nonlinear relationship was found regardless of age. ( p for nonlinearity > 0.05), the dose-response relationship between vitamin E and homocysteine showed an L-shape. Conclusions Sex-specific associations between plasma vitamin E and homocysteine levels or hyperhomocysteinemia were found. The relationship was U-shaped in men and L-shaped in women. In contrast to the differences observed between sexes, the association between vitamin Eand homocysteine remained consistent across age groups.

Abnormal lipid metabolism plays a critical role in the development of cardiovascular diseases. However, limited evidence is available for the association between lipid and zinc levels in hypertensive population. This study aims to investigate the relationship between plasma zinc concentration and serum lipid levels among a group of rural Chinese hypertensive adults. This study is a pre-specified sub-study of China Stroke Primary Prevention Trial (CSPPT), conducted in multiple Chinese communities, from May 2008 to August 2013. Multivariable linear regression models, adjusted for demographics, lifestyle factors, cardiometabolic indices, and trial design variables, were used to examine associations between plasma zinc concentration and lipid biomarkers (LDL-C, HDL-C, TG, and TC). Stratified analyses and interaction tests were performed to evaluate potential effect modification. Non-linear relationships were explored using smoothing techniques. 1121 participants with mean age 60.15 ± 7.64 years and 59.68

Cardiovascular implantable electronic device (CIED) pocket infections represent a grave threat to the survival quality and life safety of patients with cardiovascular diseases, while also imposing a substantial economic burden on healthcare systems. However, the efficacy of current approaches employed for preventing CIED pocket infections remains suboptimal. In this study, an injectable antibacterial hydrogel was successfully constructed by physically crosslinking carboxyl groups on the surface of hyaluronic acid microspheres (HAG) with amino groups on poly-l-lysine (PLL). The developed HAG/PLL hydrogel exhibited not only non-toxicity toward L929 cells but also excellent cytocompatibility, accompanied by a low hemolysis rate when tested with red blood cells. Furthermore, in vivo experiments demonstrated that the HAG/PLL hydrogel showed no toxicity to vital organs (including the heart, liver, and kidney) as well as local tissues at the implantation site. Moreover, the HAG/PLL hydrogel effectively eliminated Staphylococcus aureus and Escherichia coli bacteria by promoting ROS production, thereby inducing bacterial cell membrane disruption. In conclusion, HAG/PLL hydrogels were simply and conveniently prepared and showed considerable potential in the prevention of CIED infections owing to their excellent biocompatibility and antimicrobial properties.

The purpose of this study is to study the relationship between serum uric acid to high-density lipoprotein cholesterol ratio (UHR) and atrial fibrillation (AF) in elderly patients with hypertension. To provide a scientific basis for the correlation between UHR and AF, which is of great significance to the prevention and control of AF. The cross-sectional study utilized data collected from the hypertension registration cohort study. The exposure factor of this study was UHR, and the outcome was AF, defined as AF or atrial flutter captured by standard 12-lead ECG. The association between UHR and AF was evaluated using the logistics regression analysis and the method of penalty spline. This cross-sectional study included 9902 elderly hypertensive patients (4685 males), with an average age of 68.7 ± 6.1 years. The multivariate logistic regression analysis presented a linearly positive relationship between UHR and AF. For per 1 SD increase in UHR, the prevalence of AF was increased by 33

Hyperuricemia (HUA) is a major public health concern that is closely linked to obesity. The novel visceral adiposity index (METS-VF) demonstrates significant associations with multiple chronic diseases, yet its association with HUA risk in hypertensive patients remains unclear. This study aimed to investigate this association in a Chinese hypertensive population. This study utilized data from the Chinese Hypertension Registry Study, including 13,341 hypertensive patients. Data collection was conducted through standardized questionnaires, physical examinations, and laboratory tests. We evaluated the association between METS-VF and HUA using multivariate logistic regression models. Robustness was assessed via multivariable-adjusted models and subgroup analyses. The overall prevalence of HUA was 55.3

Pulsed field ablation (PFA) is an emerging innovative technology for treating paroxysmal atrial fibrillation (PAF), featured by its superior speed, accuracy, and reduced risk to adjacent tissues. The NOVA-AF study aimed to evaluate the efficacy and safety of a novel PFA system equipped with two PFA catheters: a circular PFA catheter and a linear PFA catheter integrating contact force-sensing capability, in patients with symptomatic PAF. This prospective, multicenter, single-arm study enrolled 161 patients with symptomatic PAF from seven medical centers in China. The composite primary effectiveness endpoint was defined as freedom from atrial tachyarrhythmia recurrence, device failure, multiple ablations during the blanking period, or antiarrhythmic drug failure during the evaluation period. The primary safety endpoint was the incidence of major adverse events (MAEs) related to the devices or procedures within three months of the procedure. All the ablated lesions (100 www.chictr.org.cn ), TRN: ChiCTR2400091941, Registration date: Nov 6 2024 (retrospectively registered).

Uric acid to high-density lipoprotein cholesterol ratio (UHR) is a novel index of metabolism and inflammation proposed by recent studies. The predictive value of UHR has been validated in non‑alcoholic fatty liver disease. However, the association of UHR is undetermined in patients with hypertension. The aim of this study was to investigate the association of UHR with all-cause mortality and CVD mortality in patients with hypertension. This study was conducted in a real-world setting using data from a large-scale, population-based registry in China. The outcome was all-cause and CVD mortality. Cox proportional hazards models were used to investigate the associations between UHR and mortality from all-causes and cardiovascular. Penalized spline method, the Kaplan-Meier method, and subgroup analyses were also used. 13719 patients with hypertension were included in the study. During a median follow-up of 4.3 years,772 all-cause mortality occurred, with 378 CVD mortality. The mean baseline UHR was 12.53 ± 5.34. Overall, higher UHR was conspicuously associated with an elevated risk of CVD mortality and all cause mortality. Accordingly, compared with participants in quartiles 1, a conspicuous higher risk of all-cause mortality (HR = 1.52, 95

AIMS:The pulse pressure index, derived on a theoretical basis from arterial elasticity characteristics, represents an optimized metric calculated by determining the ratio of pulse pressure to systolic blood pressure. Previous studies have confirmed the association between pulse pressure index and cardiovascular diseases. However, research on the relationship between pulse pressure index and atrial fibrillation remains insufficient. METHODS:This study had a total of 9091 hypertensive patients in the final analysis, including 245 patients with new-onset atrial fibrillation. Cox proportional hazards regression models and restricted cubic spline were applied to explore the association between pulse pressure index and atrial fibrillation. RESULTS:After adjusting for potential confounding factors, the analysis revealed a positive association between pulse pressure index and atrial fibrillation (HR 1.20, 95% CI 1.05-1.38). A gender-stratified analysis showed that this association was statistically significant in women (HR 1.28, 95% CI 1.04-1.57) but not in men (HR 1.14, 95% CI 0.95-1.37). Further subgroup analyses indicated that the relationship between pulse pressure index and atrial fibrillation remained consistent across different subgroups (all interaction P values >0.05). CONCLUSIONS:Our findings suggest that the pulse pressure index may assist in identifying patients at high risk of atrial fibrillation. Additionally, it could help hypertensive patients implement stricter blood pressure management to reduce their risk of atrial fibrillation.

Background:The Metabolic Score for Visceral Fat (METS - VF), a novel metric for evaluating visceral adipose tissue, has been demonstrated to exhibit a significant correlation with an elevated cardiovascular risk. Nevertheless, its relationship with peripheral artery disease (PAD) remains ambiguous. Consequently, the present study aimed to explore the association between METS-VF and PAD. Methods and results:This prospective study was based on a Chinese H-type hypertension cohort, comprising 6,452 patients. The association between METS-VF and PAD was evaluated using the Cox proportional hazards regression analysis and the method of restricted cubic splines (RCS). During an median follow-up time of 3.9 years, 266 PAD events occurred. The mean age of all participants was 63.20 ± 8.38 years. In the fully adjusted model, each 1-unit increase of METS-VF raised the risk of PAD by 21.0% (HR = 1.21, 95%CI: 1.07, 1.37). There was a saturation effect of METS-VF with an inflection point of 8.63 on PAD. For METS-VF < 8.63, each unit increase was associated with a 69.0% higher risk of PAD (HR=1.69, 95%CI: 1.32-2.16), while for METS-VF ≥8.63, there was no significant association between them (HR=0.93, 95%CI: 0.73-1.19) (P for log-likelihood ratio test= 0.002). Subgroup analysis further showed a significant interaction between METS-VF and current smoking status (P for interaction<0.05), with a stronger association observed in non-smokers. Conclusion:METS-VF exhibited a saturation effect on PAD in hypertensive adults in China. Increased METS-VF was positively associated with a higher risk of PAD among hypertensive adults with METS-VF < 8.63, and this association was more pronounced in non-smokers.

This study aimed to investigate the association between remnant cholesterol (RC) levels and arterial stiffness in hypertensive patients and to explore potential effect modifiers. A cohort of 18,152 individuals diagnosed with hypertension was analyzed. RC was calculated using the Martin-Hopkins method, i.e., RC = total cholesterol (TC)—high-density lipoprotein cholesterol (HDL-C)—low-density lipoprotein cholesterol (LDL-C). Multivariate logistic regression models were employed to mitigate the influence of potential confounding factors and assess the association between RC and arterial stiffness (baPWV ≥ 1800 cm/s). Mediating analysis was conducted to determine the extent to which systolic blood pressure (SBP) mediates the correlation between RC and arterial stiffness. Among 18152 study participants, 50.0

Introduction : Notably, SGLT2 inhibitors are renowned for their renal protective properties. However, empirical evidence regarding their efficacy in mitigating CI-AKI risk during Coronary computed tomographic angiography(CCTA) in diabetic cohorts remains scarce. Methods : This research conducted a double blind randomized clinical trial involving 352 patients undergoing CCTA. Participants were randomly assigned to receive SGLT2i (treatment group) or a placebo（control group）, starting 3 days before CCTA. The patients’ serum creatinine levels were evaluated at before and after the procedure. Univariate and multivariate logistic regression analyses were performed to assess the associations of demographic, clinical, and procedural characteristics with CI-AKI. Results: Finally, 161 patients entered each group, two groups patients had no significant demographic and clinical data differences before CCTA. We showed that the incidence of CI- AKI was meaningfully lower in the treatment group (5.15%) than in the control group (13.88%, P = 0.024).Univariate and multivariate regression analysis showed that SGLT2i significantly lowered the rate of CI-AKI [odds ratio(OR)=0.242], increasing Age (OR=1.070), high BNP level (OR=1.001), and high homocysteine values (OR=1.053) were positively correlated with CI- AKI (all p<0.05). Conclusion : Observations obtained from this investigation indicate that the use of SGLT2 inhibitors could be protective against the occurrence of CI-AKI in diabetic patients undergoing CCTA.

BACKGROUND:Hyperhomocysteinemia (HHcy) is known to exacerbate coronary microvascular dysfunction in patients experiencing acute myocardial infarction (AMI). However, the precise mechanisms underlying the exacerbation of injury by HHcy remain to be fully elucidated. METHODS:HHcy models were established in C57/BL6 mice and human coronary artery endothelial cells (HCAECs). Transcriptome sequencing identified differentially expressed non-coding RNAs (ncRNAs) and proteins in myocardial infarction (MI) mice with HHcy. Cardiac function and tissue morphology were assessed using small animal ultrasound imaging and hematoxylin-eosin (H&E) staining. CD31 immunofluorescence staining and ink staining were employed to evaluate microvascular density and microcirculatory function. The scratch wound healing assay was utilized to determine endothelial cell migration capacity. Quantitative real-time PCR and Western blot analysis was performed to investigate the impact of HHcy on the long non-coding RNAs (lncRNA) MEG3/microRNA-223/NLRP3 signaling pathway in vivo and in vitro. RESULTS:Both in vivo and in vitro studies demonstrated that HHcy could exacerbate cardiac and endothelial cell injury following MI or hypoxia through the lncRNA MEG3/microRNA-223/NLRP3 signaling pathway. HHcy suppressed miR-223 expression by upregulating lncRNA MEG3 levels, which subsequently increased NLRP3 expression and aggravated cell pyroptosis. Microcirculatory disorders arising from impaired coronary microvascular function significantly contributed to the decline in cardiac function. Targeting lncRNA MEG3 silencing or NLRP3 inhibition could attenuate the exacerbation of cardiac damage and microcirculatory dysfunction induced by HHcy after myocardial infarction. CONCLUSION:HHcy exacerbates cardiac injury and microcirculatory dysfunction post-myocardial infarction through the lncRNA MEG3/microRNA-223/NLRP3 signaling pathway.