Ethnopharmacological relevance Myocardial ischemia/reperfusion injury (MI/RI) is a common complication of acute myocardial infarction, with significant effects on clinical outcomes. Tongmai Yangxin pill (TMYX), a traditional Chinese medicine formula, is approved by the National Medical Products Administration (NMPA) for treating cardiovascular and cerebrovascular diseases. While empirical evidence supports its therapeutic efficacy for MI/RI, the underlying mechanisms remain incompletely understood. Aim of the study This study aimed to determine the effects of TMYX on mitophagy during MI/RI and explore its potential mechanisms. Materials and methods A rat model of MI/RI and an H9c2 cell hypoxia/reoxygenation (H/R) model were established to evaluate the cardioprotective effects of TMYX. After identifying the drug components, serum and tissue samples post-administration, network pharmacology was combined with WGCNA to predict the mechanisms of TMYX in treating MI/RI. Additionally, gene silencing was employed to validate the mechanisms by which TMYX exerts its cardioprotective effects. Results TMYX treatment significantly reduced myocardial fibrosis and alleviated oxidative stress in MI/RI rats. A total of 148 compounds in TMYX were identified across different samples. Bioinformatics analysis identified estrogen receptor α (ERα) as a key factor in TMYX-mediated regulation of mitophagy. TMYX restored mitochondrial biogenesis and downregulated the genes associated with the PINK1/Parkin pathway. Silencing ERα in cardiomyocytes abolished the cardioprotective effects of TMYX. Conclusions TMYX regulates the PINK1/Parkin signaling pathway via ERα activation, restores mitophagy balance, and protects against MI/RI-induced cardiac injury. This study identifies potential new therapeutic targets for TMYX in MI/RI treatment. However, given the complex multi-component composition of traditional Chinese medicine formulas, additional studies are necessary to confirm the findings of this research.

ETHNOPHARMACOLOGICAL RELEVANCE:The Tongmai Yangxin Pill (TMYX) is derived from the Zhigancao decoction recorded in Treatise on Cold Damage Disorders (Shang Han Lun) by Zhang Zhongjing during the Han dynasty. The prescription of TMYX reflects a therapeutic rationale and efficacy unique to traditional Chinese medicine. TMYX is clinically effective in alleviating myocardial ischemia-reperfusion injury (MI/RI). However, the precise active ingredients and underlying mechanisms remain unclear. AIM OF THE STUDY:The primary objective of this study was to investigate the potential of TMYX in addressing MI/RI by activating the estrogen receptor ERα. We hypothesized that this action upregulates PGC-1α activity, subsequently promoting a balanced regulation of mitochondrial fusion and fission. MATERIALS AND METHODS:UPLC-Q-TOF-MS/MS was used to identify the active components of TMYX. Subsequently, a network pharmacology approach was used to uncover the therapeutic targets and underlying pharmacological mechanisms through which TMYX mitigates MI/RI. Lastly, the anticipated outcomes were confirmed through in vivo and in vitro experimental validations. RESULTS:Using UPLC-Q-TOF-MS/MS, we successfully identified 53 distinct compounds in TMYX. Network pharmacology analysis revealed 20 key TMYX targets associated with MI/RI. Enrichment studies using GO and KEGG analyses revealed that these targets were mainly associated with mitochondrial processes and estrogen signaling pathways. Both in vivo and in vitro studies confirmed that TMYX markedly improved mitochondrial function through the ERα/PGC-1α signaling cascade, leading to a reduction in the size of myocardial infarctions and the incidence of apoptosis. Notably, combining TMYX with siERα abolished the protective effect of TMYX on the mitochondria. CONCLUSION:TMYX therapy can improve cardiac function in MI/RI. This effect is likely mediated by the ERα/PGC-1α signaling pathway. However, given the complex multi-component composition of traditional Chinese medicine formulas, additional studies are necessary to confirm the findings of this research.

Nonalcoholic fatty liver disease frequently coexists with diabetes (DM), and both are associated with an increased risk of coronary heart disease (CHD). The effect of nonalcoholic fatty liver disease progression or regression on the severity of coronary artery disease (CAD) in patients with CHD or DM remains unclear. In this multicenter study, 3126 patients with CHD, hepatic steatosis and fibrosis were assessed using the hepatic steatosis index (HSI) and fibrosis-4 index. CAD severity was evaluated using coronary angiography. After adjusting for confounders, hepatic steatosis (HSI > 36) was found to be associated with an increased risk of multivessel CAD. In patients with both hepatic steatosis and significant fibrosis (HSI > 36, fibrosis-4 index ≥ 1.3), the risk was further elevated (odds ratio [OR]: 1.596; 95% confidence interval [CI]: 1.245-2.046), with a stronger association in patients with DM (OR: 1.988; 95% CI: 1.041-3.835). Hepatic steatosis and/or significant fibrosis were associated with CAD severity, especially in individuals with both CHD and DM.

Objective:To investigate the antidepressant mechanism of Jiaotaiwan (JTW), a classic Traditional Chinese Medicine formula, by examining its effects on the gut microbiota short-chain fatty acid (SCFA) neurotransmitter/immune axis in patients with depression.Methods:In this 8-week multicenter randomized controlled trial, 120 patients with depression were randomized to receive JTW, selective serotonin reuptake inhibitors (SSRIs), or JTW+SSRIs, and 30 healthy volunteers were enrolled as controls without intervention (healthy controls, n = 30). Gut microbiota profiling (16S ribosomal RNA [16S rDNA] gene sequencing), fecal SCFA quantification (gas chromatography-mass spectrometry), and plasma levels of neurotransmitters (5-hydroxytryptamine [5-HT], norepinephrine [NE], dopamine [DA]) and gut barrier/inflammatory markers (lipopolysaccharide [LPS], soluble zonula occludens-1 [sZO-1], high mobility group box 1 [HMGB1]) were assessed pre- and post-treatment. Correlations between brain gut peptides, gut flora, SCFAs, and gut barrier/inflammatory markers were analyzed using Spearman correlation analysis.Results:Treatment with JTW, particularly in combination with SSRIs, significantly modulated gut microbiota composition by reducing Bacteroidetes abundance and increasing Firmicutes. It selectively ameliorated SCFA metabolic disturbances, notably elevating fecal levels of branched-chain fatty acids, including isobutyric and isovaleric acids. These changes were accompanied by increased plasma levels of 5-HT and DA, and reduced levels of LPS and HMGB1, suggesting improved gut barrier integrity and attenuated systemic inflammation. Correlation analysis revealed a positive association between Firmicutes abundance and sZO-1 levels, and overall coordination among microbial shifts, metabolic changes, and neurotransmitter improvements.Conclusion:JTW may alleviate depressive symptoms through multitarget modulation of the microbiota-SCFA-neurotransmitter/immune axis, potentially involving the restoration of microbial composition, enhanced beneficial SCFA production, improved intestinal barrier function, reduced inflammation, and elevated monoamine neurotransmitters. Synergistic effects were observed when JTW was combined with SSRIs, thereby providing a mechanistic basis for using JTW in microbiota-directed approaches for treating depression.

The systemic inflammation response index (SIRI) is a novel inflammatory biomarker that reflects the chronic inflammatory status. This study aimed to evaluate its clinical utility in determining coronary heart disease (CHD) severity. Participants in this study, sourced from the Cohort Study on the Treatment of Cardiovascular Diseases with Traditional Chinese Medicine (CSCD-TCMplus), were divided into tertiles (T) based on their SIRI values. The number of diseased vessels (single- and multi-vessel CHD) was used as a measure of disease severity, assessed by coronary angiography. Logistic regression analysis was used to investigate the relationship between SIRI and the severity of CHD. Among the 7706 participants, 6215 (80.6%) had multi-vessel disease. Logistic regression analysis revealed a significant association between SIRI and CHD severity (odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.03-1.15). Compared with males, females had a higher risk of CHD severity at the SIRI T3 tertile (OR: 1.64; 95% CI: 1.28-2.10). Also, patients >55 years of age had a greater risk than those ≤55 years old (OR: 1.93; 95% CI: 1.67-2.01). The association between SIRI and CHD severity persisted even after adjusting for confounding factors.

Background The ratio of blood urea nitrogen(BUN)to serum albumin(ALB)(BAR)is an emerging biomarker that has been recently recognized to associate with adverse outcomes in a variety of cardiorespiratory disorders.However,the relationship between BAR and carotid plaque in patients with coronary heart disease(CHD)is currently unclear.Objective To investigate the correlation between BAR and carotid plaque in CHD patients.Methods Admission medical data of CHD patients hospitalized in six hospitals in Tianjin from January 2014 to September 2019 were retrospectively analyzed.BAR was calculated by dividing BUN by ALB.Logistic regression analysis was used to evaluate the correlation of BAR with the occurrence,number and characteristics of carotid plaque in CHD patients before and after adjusting for confounding factors.Drew a receiver operating characteristic(ROC)curve for diagnosing the risk of carotid plaque occurrence using BAR,and calculate the area under the ROC curve(AUC).Results A total of 10 808 cases of CHD were included.Among them,8 158 cases suffered from carotid plaque with a prevalence of 75.5%.The data of 10 808 CHD cases were divided into four groups by quartiles of BAR(Q1,Q2,Q3,Q4)for baseline analysis:Q1≤-0.395 4,-0.395 40.132 4.Compared with Q1,the correlation between BAR and carotid plaque formation was more significant in Q4 after multivariate adjustment(OR=1.512,95%CI=1.273-1.795,P<0.001).The AUC for diagnosing the risk of carotid plaque in CHD patients with BAR is 0.612(95%CI=0.600-0.624).The correlation between BAR and plaque was more significant in the female population.(OR=1.583,95%CI=1.260-1.989,P<0.001),the correlation between BAR and plaque was more significant in the older age group(OR=1.810,95%CI=1.459-2.246,P<0.001).The significant correlation between BAR and carotid plaque was not affected by diseases such as hypertension,hyperlipidemia and diabetes.Conclusion High-level BAR is associated with carotid plaque formation,and which is more significant in women and middle-aged and elderly people.High-level BAR is helpful in an early identification of carotid plaque formation in CHD patients,thus avoiding the occurrence of major adverse cardiovascular events(MACEs).

PurposeThe METS-IR index, a non-insulin-based metabolic score, represents a new marker closely linked to insulin resistance. This study aimed to evaluate the relationship between the METS-IR index and dyslipidemia in individuals diagnosed with Cardiovascular disease (CVD), as well as to delve deeper into how varying glucose metabolic conditions influence this relationship.MethodsThis multicenter retrospective investigation encompassed 214,717 individuals diagnosed with CVD across China, spanning from September 1, 2014, to June 1, 2022, ultimately incorporating 17,632 cases in the conclusive analysis. All cases were grouped according to quartiles of METS-IR. The American College of Cardiology classifies dyslipidemia into four distinct categories: hyper-triglyceridemia (hyper-TG), hyper-cholesterolemia (hyper-TC), hypo-high-density lipoprotein cholesterolemia (hypo-HDL), and hyper-low-density lipoprotein cholesterolemia (hyper-LDL). Dyslipidemia is diagnosed when any one of these conditions is present. Logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (CI), assessing the relationship between the METS-IR index and dyslipidemia risk in patients with CVD. To evaluate the precision of the METS-IR index in identifying dyslipidemia, receiver operating characteristic (ROC) curve was produced.ResultsThe results of the baseline analysis showed that 11,934 cases had dyslipidemia, with notable variations observed in the clinical and biological attributes among CVD cases (P < 0.05 to < 0.001). Logistic regression analysis showed that the METS-IR index was significantly associated with the risk of dyslipidemia (odds ratio [OR]: 1.14; 95% confidence interval [CI] 1.13-1.15; P < 0.001). The OR for dyslipidemia in Q4 of the METS-IR index was 11.94 (95% CI 10.60-13.45; p < 0.001) compared to Q1. ROC analysis revealing an area under the curve (AUC) of 0.747 (95% CI 0.739-0.754; P < 0.001). The association between the METS-IR index and dyslipidemia proved significant across all glycemic status groups, with the highest OR observed in the Q4 subgroup of cases with NGR (OR: 15.43; 95% CI 12.21-19.49).ConclusionThe risk of developing dyslipidemia is positively associated with heightened METS-IR levels in individuals afflicted with CVD, and these relationships hold significance across all glycemic metabolic conditions. METS-IR could potentially aid in forecasting the risk of dyslipidemia development in individuals diagnosed with CVD.

Objective Jiaotaiwan (JTW) is a classic traditional Chinese medicine (TCM) prescription for treating depression, but its potential mechanisms are not fully understood. The aim of this study is to detect the levels of serum Short-chain fatty acids (SCFAs) and cyclic adenosine monophosphate (cAMP)-protein kinase A (PKA)-cAMP-response element binding protein (CREB)-brain derived neurotrophic factor (BDNF) signaling pathway, further revealing the scientific connotation of the antidepressant effect of JTW. Methods In this multicenter, randomized, controlled study, 120 patients with depression were divided into the JTW (16.5 g/d) group, JTW (16.5 g/d) + selective serotonin reuptake inhibitors (SSRIs) group, and SSRIs group. Hamilton depression Scale-24 (HAMD-24) and Self-rating depression scale (SDS) were used for efficacy evaluation. Enzyme linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction (RT-PCR) were used to evaluate the expression levels of cAMP-PKA-CREB-BDNF signaling pathway. Serum SCFAs concentrations were analyzed using liquid chromatograph-mass spectrometer (LC-MS) targeted metabolomics. Results After eight weeks of treatment, HAMD score and SDS score were significantly decreased in the three groups, and HAMD score in JTW + SSRIs group was significantly lower than that in SSRIs group. After treatment, the expression levels of cAMP-PKA-CREB-BDNF signaling pathway were significantly increased in the three group, with the JTW + SSRIs group showing more significant increase. After treatment, the levels of isobutyric, butyric, isovaleric, and valeric acids in the JTW + SSRIs groups were significantly higher than that before treatment, and the levels of isobutyric, and isovaleric acids in the JTW + SSRIs group was significantly higher than that in the JTW group and SSRIs groups. Conclusion JTW can alleviate symptoms in patients with depression, and its antidepressant mechanism may be related to regulating serum SCFAs and cAMP-PKA-CREB-BDNF signaling pathway.

The present study explored the association between serum uric acid/albumin ratio (UAR) and carotid artery plaque (CAP) in cases (n = 12 481) with coronary heart disease (CHD). Participants were stratified by UAR quartiles. Logistic regression analysis was used to analyze the association between the UAR and CAP. The relationship between the UAR and carotid plaques according to sex, age, blood pressure, and blood lipid groups was also assessed. Results showed that UAR was significantly associated with CAP (odds ratio [OR]: 1.03; 95% confidence interval [CI]: 1.02-1.05). The correlation between UAR and the presence of carotid plaque was strong in both females (OR: 1.03; 95% CI: 1.01-1.06) and males (OR: 1.03; 95% CI: 1.00-1.06). Patients aged ≥60 (OR: 1.60; 95% CI: 1.34-1.90) had a higher risk for carotid plaque at the Q4 UAR level than those <60. Hypertensive patients showed higher carotid plaque risk at Q4 UAR (OR: 1.46; 95% CI: 1.20-1.78) than normotensives. The correlation between UAR and the presence of carotid plaque was greater in dyslipidemic patients (OR: 1.06; 95% CI: 1.02-1.10) than in normolipidemic patients (OR: 1.03; 95% CI: 1.01-1.05). These results confirm a significant association between UAR and CAP, most pronounced in patients aged ≥60 or with hypertension/dyslipidemia.

BACKGROUND:Anti-inflammatory therapy could become a new target for the treatment of heart failure (HF), and multi inflammatory index (MII) is a new index composed of an inflammatory index. Then, the relationship between MII and HF is not completely clear. OBJECTIVES:The aim of this study was to investigate the association of MII and HF in coronary heart disease (CHD) patients. METHODS:In a cohort of 17,937 patients with CHD, 6386 had HF. Logistic regression analysis was used to analyze the relationship between the MII and HF in CHD patients. The relationship between MII and HF was also assessed according to sex, blood pressure, and blood glucose. RESULTS:Compared with T1 of MII, MII-1 had the highest T3 (OR: 1.33; 95% CI: 1.23-1.45; P < 0.001), and MII-3 had the lowest T3 (OR: 1.25; 95% CI: 1.16-1.36; P < 0.001). In both sexes, MII-1 was more associated with HF than MII-2 and MII-3. In binary logistic regression analysis, when MII was treated as a continuous variable, MII-1 was significantly associated with HF risk in CHD patients with hypertension (OR: 1.06; 95% CI: 1.02-1.10; P = 0.002) and in CHD patients with diabetes (OR: 1.04; 95% CI: 1.00-1.08; P = 0.040). All MII were associated with HF. The MII-1 proved to be superior. CONCLUSION:In patients with CHD, the association between the MII and HF was stronger in female than in male. There was a association between MII and risk of HF in with CHD patients after multivariate adjustment.

Background: The triglyceride-glucose (TyG) index is a surrogate indicator of insulin resistance. Therefore, we aimed to determine the association between TyG index and heart failure (HF) with preserved ejection fraction (HFpEF) in patients with coronary heart disease (CHD) and to explore whether such associations would be modified by different metabolic states. Methods: Among 107,301 CHD patients, 62,794 were included to analyze the relationship between the TyG index and HF. Among them, 8,606 patients who had undergone echocardiography were included to identify different types of HF, including HF with reduced ejection fraction (HFrEF), HF with intermediate-range ejection fraction (HFmrEF), and HFpEF. Among them, 1896 patients were diagnosed with HFpEF. Logistic regression was used to analyze the relationship between the TyG index and HFpEF in CHD patients. In addition, the association between TyG index and HFpEF according to sex, age, blood lipids, and blood pressure was assessed. Results: A baseline analysis of CHD patients divided into four groups according to the tertile level of the TyG index showed significant differences in the related parameters between the groups. In the multi-adjusted models, the TyG index was significantly associated with the risk of HFpEF (odds ratio [OR]: 1.17; 95% confidence interval [CI]: 1.09-1.25). After adjustment for multivariates, TyG index levels for T2 (OR: 1.33; 95% CI: 1.16-1.52) and T3 (OR: 1.52; 95% CI: 1.32-1.74) were associated with increased OR in HFpEF. In addition, the TyG index of CHD patients was significantly associated with HFpEF in older adults aged > 60 years (OR: 1.20; 95% CI: 1.11-1.29), hypertension (OR: 1.27; 95% CI: 1.17-1.37), and dyslipidemia (OR: 1.15; 95% CI: 1.08-1.24). Moreover, the OR (OR: 1.23; 95% CI: 1.11-1.36) in women is higher than in men (OR: 1.17; 95% CI: 1.02-1.22, indicating a stronger association between TyG index and HFpEF in women. Conclusions: Our findings demonstrated a significant association between TyG index and HFpEF in CHD patients. Furthermore, TyG index was independently associated with HFpEF in hypertension, dyslipidemia, and older patients (aged > 60 years). In addition, the association between the TyG index and HFpEF in CHD patients differed according to sex.

BACKGROUND AND AIMS:Thyroid hormones (THs) will affect the occurrence and prognosis of stroke, and the research on THs sensitivity index and stroke in patients with coronary heart disease (CHD) is scarce. The goal of this study is to look into the relationship between central and peripheral THs sensitivity index and stroke in patients with CHD.METHODS:Between January 1, 2014, and September 30, 2020, 30,160 patients with CHD were enrolled in this study. By computing the thyroid feedback quantile index (TFQI), thyroid stimulating hormone index (TSHI), and thyrotropin thyroxine resistance index (TT4RI), the central sensitivity indexes to THs was assessed, and the ratio of serum free triiodothyronine (FT3) to serum free thyroxine (FT4) was used to assess peripheral THs sensitivity. The relationship between central and peripheral THs sensitivity index and stroke was investigated using logistic regression, especially in different types of stroke, ages, sexes, and blood glucose levels.RESULTS:Stroke risk is positive associated with TSHI, TFQI, and PTFQI. In subgroup analysis, the OR values of these relationships are higher in people younger than 65 years old, male, and diagnosed with diabetes. In addition, stroke risk was negatively associated with FT3/FT4, and the OR values of these relationships were lower in people older than 65 years, female, and diagnosed with prediabetes.CONCLUSIONS:This study demonstrates that the increase in the central THs sensitivity index and the decrease in the peripheral THs sensitivity index are associated with a higher risk of stroke in CHD patients, and provides new ideas for the assessment of stroke in patients with CHD.

BACKGROUND:The activation of the NLRP3 inflammasome has recently been revealed as a novel pathological mechanism of coronary heart disease (CHD). The Dan-Lou tablets (DLT) is widely used in the clinical treatment of CHD and prescription characterized by multi-component and multi-target regulation. However, the anti-inflammatory mechanism of DLT in the treatment of CHD remains unclear. PURPOSE:This study aimed to evaluate the effect of DLT in the treatment of CHD on the priming and activation of the NLRP3 inflammasome and to investigate the underlying anti-inflammatory mechanisms. METHODS:First, CHD rats model were established by a high-fat diet combined with left anterior coronary artery ligation (LADCA) followed by DLT intervention. The therapeutic effect of DLT was evaluated according to cardiac function, lipid level, and cardiac histopathology. Next, data-independent acquisition (DIA) proteomics was used to identify the key differential proteins of DLT intervention in CHD rats, and bioinformatics analysis was performed. Finally, the differentially expressed proteins in the NOD-like signaling pathway were verified based on bioinformatics results, and the priming and activation steps of the NLRP3 inflammasome were detected. RESULTS:In this study, a high-fat diet combined with LADCA was utilized to generate a CHD model, and DLT alleviated myocardial ischemia injury by inhibiting lipid deposition and inflammatory response. Proteomic studies observed that the RNF31, TXN2, and GBP2 of the NOD-like receptor signaling pathway were verified as the key targets of DLT in inhibiting myocardial injury in CHD rats. Furthermore, DLT in the treatment of CHD rats may function through the downregulation of P2X7R expression, thereby interfering with the priming (TLR4/MyD88/NF-κB) and activation (NLRP3/ASC/Caspase-1) of the NLRP3 inflammasome regulated by HSP90, and may then reduce the release of the IL-1β and IL-18 inflammatory factors to play an anti-myocardial injury effect. CONCLUSION:Our findings elucidate a novel mechanism of DLT and provide some new drug evaluation targets and therapeutic strategies for CHD. This study innovatively proposed that DLT further exerts an anti-myocardial injury effect by inhibiting P2X7R expression, thereby interfering with the priming (TLR4/MyD88/NF-κB) and activation (NLRP3/ASC/Caspase-1) of the NLRP3 inflammasome regulated by HSP90, and then downregulates the release of the IL-1β and IL-18 inflammatory factors.

Remnant cholesterol (RC) and non-high-density lipoprotein cholesterol (non-HDL-C) are associated with coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM). However, the association between RC, non-HDL-C, and CHD patients with T2DM has not been comprehensively investigated. We analyzed the association between RC, non-HDL-C, and cardiac function in CHD patients with T2DM. Of the 22 022 CHD patients from six hospitals in Tianjin, 5373 (24.4%) patients with T2DM had higher levels of RC and non-HDL-C ( P < .001) than those without T2DM. Among CHD patients with T2DM, RC and non-HDL-C were positively associated with New York Heart Association (NYHA) class Ⅱ [RC: odds ratio (OR), 1.74; 95% confidence interval (CI), 1.50–2.01; P < .01; non-HDL-C: OR, 1.23; 95% CI, 1.15–1.31; P < .01]. After adjusting for confounding factors, this association remained (RC: OR, 1.22; 95% CI, 1.03–1.45; P < .05; non-HDL-C: OR, 1.09; 95% CI, 1.02–1.17; P < .05). These findings provide evidence of an independent positive association between RC, non-HDL-C, and NYHA functional classes. More research is warranted to confirm these findings and determine the mechanisms involved.

Abstract Background and aims Haemoglobin A1c (HbA1c) levels have been shown to be related to carotid artery plaques. However, studies on the relationship between HbA1c levels and carotid artery plaques in patients with coronary heart disease (CHD) are limited and inconsistent. Our objective was to examine the correlation between HbA1c levels and carotid artery plaques in patients with CHD. Methods The study comprised 9275 Chinese adults with CHD from January 1, 2014, to September 30, 2020. HbA1c levels were assessed, and colour Doppler ultrasound was used to evaluate the carotid artery, including plaque presence, intima-media thickness, and plaque echo properties, to investigate the association between HbA1c and carotid plaque. A logistic regression model was used to assess the association between carotid artery plaques, carotid plaque echogenicity, and HbA1c. Results The HbA1c level of the plaque-present group was higher than that of the plaque-absent group [6.1 (5.6–7.2) vs. 5.8 (5.5–6.5), p < 0.001]. In multiple linear regression analysis, intima-media thickness was associated with HbA1c (p < 0.001). Logistic regression showed that a higher HbA1c level was associated with plaque incidence as well as hyperechoic and heterogeneous plaques (p < 0.001). These associations persist after adjusting for age, sex, blood pressure, lipid profiles, alcohol consumption, and tobacco exposure. Conclusion HbA1c levels are notably associated with carotid artery plaque incidence, intima-media thickness, and plaque echogenicity in patients with CHD. These findings show that different levels of HbA1c may be an indicator for carotid artery plaques and thus, should be observed in patients with CHD. Graphical abstract

We investigated the association between anemia status and the risk of heart failure (HF) in patients with coronary heart disease (CHD) based on a multi-center, large-sample and retrospective cross-sectional study including 89,207 patients. Heart failure was categorized as HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and HF with mid-range ejection fraction (HFmrEF). In multi-adjusted models, compared with patients without anemia, mild anemia (odds ratio [OR] 1.71; 95% confidence interval [CI] 1.53–1.91; P < .001), moderate anemia (OR 3.68; 95% CI, 3.25–4.17; P < .001), and severe anemia (OR 8.02; 95% CI, 6.50–9.88; P < .001) were associated with the risk of HF among CHD patients. Men aged <65 years were more likely to develop HF. In subgroup analyses, the multi-adjusted ORs and 95% CI of HFpEF, HFrEF, and HFmrEF related to anemia were 3.24 (95% CI 1.43–7.33), 2.22 (95% CI 1.28–3.84), and 2.55 (95% CI 2.24–2.89), respectively. These findings suggest that anemia might be associated with increased risk of different types of HF, especially HFpEF.

BACKGROUND AND AIM:Accumulating evidence suggests a potential link between thyroid function with hypertension. However, the research results are limited, and there is no research to explore the relationship between central and peripheral thyroid hormones (THs) sensitivity and different grades of hypertension in patients with coronary heart disease (CHD). This study aims to prove the complex interaction between thyroid system and blood pressure, and provides new ideas for the assessment of hypertension in patients with CHD. METHODS AND RESULTS:Calculate parameters representing central and peripheral sensitivity to THs. Logistic regression analysis was used to analyze the relationship between central and peripheral THs sensitivity of CHD patients and different grades of hypertension, especially in different ages, sexes, blood glucose levels, smoking, and drinking statuses. Among the 34,310 participants, 19,610 (57.16 %) were diagnosed with hypertension. The risk of hypertension and TSHI (OR: 0.88; 95 % CI: 0.87-0.90; P < 0.001), TT4RI (OR: 0.998; 95 % CI: 0.998-0.999; P < 0.001), TFQI (OR: 0.63; 95 % CI: 0.60-0.67; P < 0.001), PTFQI (OR: 0.63; 95 % CI: 0.59-0.67; P < 0.001) was negatively associated. The risk of hypertension was positively associated with FT3/FT4 (OR: 1.20; 95 % CI: 1.17-1.22; P < 0.001). After stratified analysis, these associations remained significant at different ages, sexes, blood glucose levels, grades of hypertension, smoking, and drinking statuses (P < 0.001). CONCLUSIONS:This study shows that the decrease in central THs sensitivity index and the increase in peripheral THs sensitivity index are associated with a higher risk of hypertension in CHD patients.

目的 评价血府逐瘀胶囊治疗冠心病心绞痛的临床疗效.方法 通过多中心前瞻性队列研究,共纳入冠心病心绞痛患者543例,根据冠心病心绞痛患者是否使用血府逐瘀胶囊分为治疗组262例和对照组281例.对照组给予西医常规药物治疗,治疗组在西医常规药物治疗的基础上给予口服血府逐瘀胶囊(每粒0.4g),每次6粒,每日2次.两组疗程均为8周.治疗前后比较两组患者西雅图心绞痛量表(SAQ)评分[包括躯体运动受限情况(PL)、心绞痛平稳状况(AS)、心绞痛发生状况(AF)、医疗满意度(TS)和病情认知能力(DP)],并对两组患者治疗后SAQ评分影响因素进行多元线性回归分析.根据不同类型(稳定型心绞痛和不稳定型心绞痛)、性别(男/女)、年龄段(＜65岁和≥65岁)和合并高血压病情况(是/否)进一步比较两组患者治疗后SAQ评分情况.结果 研究过程中脱落41例,最终纳入分析治疗组253例,对照组249例.与本组治疗前比较,治疗后两组SAQ中PL、AS、AF、TS和DP评分均明显升高,且治疗组SAQ各项评分均优于对照组(P＜0.05).与对照组比较,治疗后治疗组不稳定型心绞痛患者治疗后SAQ各项目评分均明显升高(P＜0.05);治疗组男性患者治疗后AS、TS、DP评分和女性患者治疗后PL、AF明显升高(P＜0.05);治疗组≥65岁患者治疗后PL、AS、DP升高,＜65岁患者治疗后AS、AF、TS、DP评分均明显升高(P＜0.05);治疗组合并高血压病患者治疗后SAQ各项评分均明显高于对照组合并高血压病患者(P＜0.05).经多重线性回归分析校正年龄、性别、合并疾病及治疗用药等潜在混杂因素后,血府逐瘀胶囊联合西医常规治疗可明显改善SAQ评分(P＜O.05).结论 在西医常规治疗基础上,应用血府逐瘀胶囊可改善冠心病心绞痛患者躯体运动、心绞痛发生状况,从而提高生活质量,可能在改善不稳定型心绞痛患者效果更佳,对合并高血压病患者亦有疗效.

Introduction Liver X Receptor (LXR) agonists could attenuate the development of atherosclerosis but bring excess lipid accumulation in the liver. Danlou Recipe was believed to be a benefit for improving the lipid profile. Thus, it is unclear whether Danlou Recipe could attenuate hyperlipidemia without excess lipid accumulated in the liver of mice. This study aimed to clarify if Danlou Recipe could alleviate the progression of hyperlipidemia in mice without extra lipids accumulated in the liver. Methods Male murine macrophage RAW264.7 cells and murine peritoneal macrophages were used for the in vitro experiments. Cellular cholesterol efflux was determined using the fluorescent cholesterol labeling method. Those genes involved in lipid metabolism were evaluated by qRT‐PCR and western blotting respectively. In vivo, a mouse model of hyperlipidemia induced by P407 was used to figure out the effect of Danlou Recipe on reverse cholesterol transport (RCT) and hyperlipidemia. Ethanol extract of Danlou tablet (EEDL) was prepared by extracting the whole powder of Danlou Prescription from ethanol, and the chemical composition was analyzed by ultra-performance liquid chromatography (UPLC). Results EEDL inhibits the formation of RAW264.7 macrophage-derived foam cells, and promotes ABCA1/apoA1 conducted cholesterol efflux in RAW264.7 macrophages and mouse peritoneal macrophages. In the P407-induced hyperlipidemia mouse model, oral administration of EEDL can promote RCT in vivo and improve fatty liver induced by a high-fat diet. Consistent with the findings in vitro, EEDL promotes RCT by upregulating the LXR activities. Conclusion Our results demonstrate that EEDL has the potential for targeting RCT/LXR in the treatment of lipid metabolism disorders to be developed as a safe and effective therapy.