BackgroundCardiovascular diseases (CVDs) are the leading global disease burden, with alcohol consumption closely linked to their occurrence. This study analyzes data from the Global Burden of Disease Study 2021 (GBD 2021) to assess the distribution and trends of high alcohol use-related CVD from 1990 to 2021 across global, regional, and national levels.Materials and methodsWe used the data from the GBD 2021 to conduct stratification by region, country, gender, age, SDI, and disease type in terms of the number of deaths, age-standardized mortality rate (ASMR), disability-adjusted life years (DALYs), age-standardized rate of DALYs (ASDR), years lived with disability (YLDs), age-standardized rate of YLDs, years of life lost (YLLs), and age-standardized rate of YLLs to comprehensively assess the burden of high alcohol use-related CVD from 1990 to 2021. All statistical analyses in this study were performed using R statistical software (version 4.1.2).ResultsBetween 1990 and 2021, global deaths, DALYs, YLDs, and YLLs attributable to high alcohol use-related CVD showed notable variation. By 2021, global deaths had doubled compared to 1990, while ASMR, ASDR, age-standardized YLD rate, and YLL rate all declined. Eastern Europe had the highest rates in 2021. Males consistently had higher ASMR, ASDR, YLD, and YLL rates compared to females, with the highest number of deaths occurring in the 70–74 age group, and the 65–69 age group showing the highest DALYs, YLDs, and YLLs. These rates increased with age. Stroke was the most common high alcohol use-related CVD, while ischemic heart disease (IHD) was the least common.ConclusionBetween 1990 and 2021, the overall burden of high alcohol use-related CVD declined globally, though some regions experienced an increase. This highlights the need for continued public health efforts, particularly targeting high-risk regions and populations, to mitigate the impact of alcohol on cardiovascular health.

Background and objective Cardiac rehabilitation (CR) has been demonstrated to improve outcomes in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). However, the optimal CR initiation time and duration remain to be determined. This study aimed to explore the impact of the time factors on the CR outcomes in AMI patients who received PCI by the method of meta-regression analysis. Methods We searched five databases (PubMed, Embase, Cochrane Library, Web of Science and Google scholar) up to October 31, 2023. Meta-regression analysis was utilized to explore the impact of the time factors on the effect sizes. Subgroups with more than 3 studies were used for meta-regression analysis. Results Our analysis included 16 studies and a total of 1810 patients. The meta-regression analysis revealed that the initiation time and duration of CR had no significant impact on the occurrence of arrhythmia, coronary artery restenosis and angina pectoris. The initiation time and duration of CR also had no significant impact on the changes in left ventricular ejection fraction (LVEF, starting time: estimate = 0.160, p = 0.130; intervention time: estimate = 0.017, p = 0.149), left ventricular end-diastolic volume (LVEDV, starting time: estimate = − 0.191, p = 0.732; intervention time: estimate = − 0.033, p = 0.160), left ventricular end-systolic volume (LVESV, starting time: estimate = − 0.301, p = 0.464; intervention time: estimate = 0.015, p = 0.368) and 6-minute walk test (6MWT, starting time: estimate = − 0.108, p = 0.467; intervention time: estimate = 0.019, p = 0.116). Conclusion Implementation of CR following PCI in patients with AMI is beneficial. However, in AMI patients, there is no significant difference in the improvement of CR outcomes based on different CR starting times within 1 month after PCI or different durations of the CR programs. It indicates that it is feasible for patients with AMI to commence CR within 1 month after PCI and continue long-term CR, but the time factors which impact CR are intricate and further clinical research is still needed to determine the optimal initiation time and duration of CR.

Background and aimsCoffee contains many bioactive compounds, and its inconsistent association with subclinical atherosclerosis has been reported in observational studies. In this Mendelian randomization study, we investigated whether genetically predicted coffee consumption is associated with subclinical atherosclerosis, as well as the role of potential mediators.MethodsWe first conducted a two-sample Mendelian randomization analysis to examine the causal effect of coffee and its subtypes on subclinical atherosclerosis inferred from coronary artery calcification (CAC). Next, the significant results were validated using another independent dataset. Two-step Mendelian randomization analyses were utilized to evaluate the causal pathway from coffee to subclinical atherosclerosis through potential mediators, including blood pressure, blood lipids, body mass index, and glycated hemoglobin. Mendelian randomization analyses were performed using the multiplicative random effects inverse-variance weighted method as the main approach, followed by a series of complementary methods and sensitivity analyses.ResultsCoffee, filtered coffee, and instant coffee were associated with the risk of CAC (β = 0.79, 95% CI: 0.12 to 1.47, p = 0.022; β = 0.66, 95% CI: 0.17 to 1.15, p = 0.008; β = 0.66, 95% CI: 0.20 to 1.13, p = 0.005; respectively). While no significant causal relationship was found between decaffeinated coffee and CAC (β = −1.32, 95% CI: −2.67 to 0.04, p = 0.056). The association between coffee and CAC was validated in the replication analysis (β = 0.27, 95% CI: 0.07 to 0.48, p = 0.009). Body mass index mediated 39.98% of the effect of coffee on CAC (95% CI: 9.78 to 70.19%, p = 0.009), and 5.79% of the effect of instant coffee on CAC (95% CI: 0.54 to 11.04%, p = 0.030).ConclusionOur study suggests that coffee other than decaffeinated coffee increases the risk of subclinical atherosclerosis inferred from CAC. Body mass index mediated 39.98 and 5.79% of the causal effects of coffee and instant coffee on CAC, respectively. Coffee should be consumed with caution, especially in individuals with established cardiovascular risk factors, and decaffeinated coffee appears to be a safer choice.

Background: Heart failure is a leading public health issue in China, with a steadily increasing burden. This study aims to assess the changing patterns of heart failure in China from 1990 to 2021, providing evidence for informed healthcare strategies. Methods: Data on prevalence, years lived with disability (YLDs), and their corresponding 95% uncertainty intervals (UI) were obtained from the Global Burden of Disease (GBD) Study 2021. The joinpoint regression model was used to identify both overall and localized trends of heart failure burden, and the age-period-cohort model served to analyze the contributions of age, period, and birth cohort separately. We further utilized the autoregressive integrated moving average (ARIMA) model to predict future trends of heart failure in the next 10 years. Results: In 2021, 13099727 (95% UI, 11320895 to 15376467) individuals lived with heart failure and this illness accounted for 1290810 (95% UI, 865894 to 1775731) YLDs in China. The burden of heart failure is more pronounced in males and the elderly, and ischemic heart disease has become the leading cause since 2002. The age-standardized rates of prevalence and YLDs increased at average annual percentage changes of 0.23% (95% CI, 0.20 to 0.26) and 0.25% (95% CI, 0.23 to 0.27) respectively. The curve of local drift showed a downward trend with age. Both the period and cohort rate ratios have increased significantly over the last 30 years. By 2031, the age-standardized rates of prevalence will decrease to 678.69 (95% CI, 640.75 to 716.63), while the age-standardized rates of YLDs will increase to 69.19 (95% CI, 66.95 to 71.43). Conclusions: The burden of heart failure in China remains concerning. The implementation of comprehensive strategies should be taken into consideration, including strengthening primary healthcare system, enhancing public awareness, and promoting cardiac rehabilitation. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was supported by the National Key Research and Development Program of China (grant number: 2022YFC3500101). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: For the secondary analysis of the Global Burden of Disease studies, the Institutional Review Board of the University of Washington reviewed and approved a waiver of informed consent (https://www.healthdata.org/research-analysis/gbd). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Datasets analyzed for this study are publicly available at https://vizhub.healthdata.org/gbd-results/.

Background: Despite significant reductions in in-stent restenosis (ISR) incidence with the adoption of drug-eluting stents (DES) over bare metal stents (BMS), ISR remains an unresolved issue in the DES era. The risk factors associated with DES-ISR have not been thoroughly analyzed. This meta-analysis aims to identify the key factors and quantify their impact on DES-ISR. Methods: We conducted comprehensive literature searches in PubMed, EMBASE, Cochrane, and Web of Science up to 28 February 2023, to identify studies reporting risk factors for DES-ISR. Meta-analysis was performed on risk factors reported in two or more studies to determine their overall effect sizes. Results: From 4357 articles screened, 17 studies were included in our analysis, evaluating twenty-four risk factors for DES-ISR through meta-analysis. The pooled incidence of DES-ISR was approximately 13%, and significant associations were found with seven risk factors. Ranked risk factors included diabetes mellitus (odds ratio [OR]: 1.46; 95% confidence interval [CI]: 1.14–1.87), stent length (OR: 1.026; 95% CI: 1.003–1.050), number of stents (OR: 1.62; 95% CI: 1.11–2.37), involvement of the left anterior descending artery (OR: 1.56; 95% CI: 1.25–1.94), lesion length (OR: 1.016; 95% CI: 1.008–1.024), medical history of myocardial infarction (OR: 1.79; 95% CI: 1.12–2.86) and previous percutaneous coronary intervention (OR: 1.97; 95% CI: 1.53–2.55). Conversely, a higher left ventricular ejection fraction was identified as a protective factor (OR: 0.985; 95% CI: 0.972–0.997). Conclusions: Despite advancements in stent technology, the incidence of ISR remains a significant clinical challenge. Our findings indicate that patient characteristics, lesion specifics, stent types, and procedural factors all contribute to DES-ISR development. Proactive strategies for early identification and management of these risk factors are essential to minimize the risk of ISR following DES interventions. The PROSPERO Registration: CRD42023427398, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=427398.

Background: Guanxinning tablet (GXNT), a Chinese patent medicine, is composed of salvia miltiorrhiza bunge and ligusticum striatum DC, which may play the role of endothelial protection through many pathways. We aimed to explore the molecular mechanisms of GXNT against atherosclerosis (AS) through network pharmacology and molecular docking verification. Methods: The active ingredients and their potential targets of GXNT were obtained in traditional Chinese medicine systems pharmacology database and analysis platform and bioinformatics analysis tool for molecular mechanism of traditional Chinese medicine databases. DrugBank, TTD, DisGeNET, OMIM, and GeneCards databases were used to screen the targets of AS. The intersection targets gene ontology and Kyoto encyclopedia of genes and genomes enrichment analysis were performed in DAVID database. GXNT-AS protein-protein interaction network, ingredient-target network and herb-target-pathway network were constructed by Cytoscape. Finally, we used AutoDock for molecular docking. Results: We screened 65 active ingredients of GXNT and 70 GXNT-AS intersection targets. The key targets of protein-protein interaction network were AKT1, JUN, STAT3, TNF, TP53, IL6, EGFR, MAPK14, RELA, and CASP3. The Kyoto encyclopedia of genes and genomes pathway enrichment analysis showed that pathways in cancer, lipid and atherosclerosis, and PI3K-Akt signaling pathway were the main pathways. The ingredient-target network showed that the key ingredients were luteolin, tanshinone IIA, myricanone, dihydrotanshinlactone, dan-shexinkum d, 2-isopropyl-8-methylphenanthrene-3,4-dione, miltionone I, deoxyneocryptotanshinone, Isotanshinone II and 4-methylenemiltirone. The results of molecular docking showed that tanshinone IIA, dihydrotanshinlactone, dan-shexinkum d, 2-isopropyl-8-methylphenanthrene-3,4-dione, miltionone I, deoxyneocryptotanshinone, Isotanshinone II and 4-methylenemiltirone all had good binding interactions with AKT1, EGFR and MAPK14. Conclusion: The results of network pharmacology and molecular docking showed that the multiple ingredients within GXNT may confer protective effects on the vascular endothelium against AS through multitarget and multichannel mechanisms. AKT1, EGFR and MAPK14 were the core potential targets of GXNT against AS.

心血管疾病负担是影响人类生命健康的首要原因,作为重要典籍的《伤寒杂病论》中有许多对于心系疾病论治的相关条文及方药,对胸痹心痛、心悸、心力衰竭都有不同的论述及其常用方药.这些方药又进一步经过近 2000年的临床验证及现代中药药理学佐证,具有良好的临床指导价值.而在使用这些方药时,也应该建立在中医理论框架的基础之上.

目的 通过临床分析结合文献计量学研究探讨慢性冠状动脉(冠脉)综合征(CCS)患者发生冠脉慢血流(CSF)的影响因素.方法 选择2021年9月至2022年7月于东直门医院心血管内科就诊的CCS患者,根据纳排标准,最终纳入CSF组37例,冠脉正常组40例.分析两组一般资料、临床资料与CSF的相关性.以Web of Science为文献来源,检索2002-2022年CSF相关的研究,运用Citespace和Vosviewer软件以关键词作为节点进行共现、聚类和Burst分析,绘制对应的可视化图谱并进行解析.结果 临床研究中,单因素分析后继行多变量logistic 回归分析显示,血红蛋白(HGB)水平高(OR=1.103,P=0.001)、心房颤动(AF)(OR=19.791,P=0.010)、冠心病家族史(OR=3.811,P=0.046)为CCS患者发生CSF的独立危险因素.文献计量研究中,共检索到CSF相关文献1 367篇,关键词共现及聚类分析显示,CSF相关的研究热点疾病主要集中在心绞痛、心肌梗死、经皮冠状动脉介入治疗和动脉疾病;影像学研究热点集中在血管内超声、心肌梗死溶栓试验(TIMI)血流计数、造影;机制研究热点主要集中在动脉粥样硬化、内皮功能障碍和炎症,且近5年CSF的研究热点偏重于临床管理及预后.结论 CCS患者发生CSF的独立危险因素有HGB水平高、AF、冠心病家族史.文献计量研究中CSF的机制研究热点主要集中于动脉粥样硬化、内皮功能障碍和炎症.

Objective To explore the mechanism of Danggui Sini Decoction in the treatment of menstrual migraine（MM）by network pharmacology and molecular docking.Methods The active ingredients and targets of Angelicae Sinensis Radix, Cinnamomi Ramulus, Paeoniae Radix Alba, Asari Radix et Rhizoma, Tetrapanacis Medulla, Glycyrrhizae Radix et Rhizoma, and Jujubae Fructus were collected from the Traditional Chinese Medicine Systems Pharmacology Platform（TCMSP）.The targets of MM were retrieved from the Therapeutic Target Database, Drugbank, and DisGeNET,and the Venn diagram was established to screen the common targets shared by Danggui Sini Decoction and MM.The protein-protein interaction network of the common targets was built in String and Cytoscape 3.9.0,and the key targets were selected based on the parameters of network topology.Metascape was used to analyze the biological processes and signaling pathways involving the common targets, and the results were visualized as bar and bubble charts in Bioinformatics.The network of herb-core target-signaling pathway was built to visualize the main mechanism of Danggui Sini Decoction in the treatment of MM.Molecular docking was performed in AutoDock to verify the interaction between core components and key targets.Results A total of 77 active ingredients of Danggui Sini Decoction were screened out, corresponding to 256 therapeutic targets, 122 of which involved MM.The 10 core ingredients included quercetin, glypallichalcone, beta-sitosterol, kaempferol, cryptopin, stigmasterol, vestitol, licochalconea, isorhamnetin, and fumarine.Eight core targets were obtained, including PTGS2,PTGS1,ESR1,PPARG,NOS2,AR,F10,and ADRB2,among which ESR1,PTGS2,PTGS1,and AR were also those of the currently marketed drugs.The four newly discovered targets were PPARG,NOS2,ADRB2,and F10.The GO functional annotation predicted that the targets were mainly involved in inflammation, response to lipopolysaccharide, response to extracellular stimuli, organic matter cycle and complex cellular response.The KEGG enrichment predicted 89 pathways, which were mainly pathways in cancer, lipid and atherosclerosis, relaxin signaling pathway, HIF-1 signaling pathway, serotonergic synapse, prolactin signaling pathway, calcium signaling pathway, thyroid hormone signaling pathway, complement and coagulation cascades, and ovarian steroidogenesis.Conclusion Danggui Sini Decoction can treat MM in a multi-component, multi-target, and multi-pathway manner, demonstrating the principle of nourishing blood and dredging collaterals in the treatment of MM.Four targets, PPARG,NOS2,ADRB2,and F10,are revealed for the first time in this study and not involved in the available drugs for treating MM,which have the potential for research and application and remain to be validated by experimental studies.

Background There is growing emphasis on the cardiotoxicity research over the past 12 years. To look for the hotspots evolution and to explore the emerging trends in the field of cardiotoxicity, publications related to cardiotoxicity were acquired from the Web of Science Core Collection on August 2, 2022. Methods We used the CiteSpace 5.8 R3 and VOSviewer 1.6.18 to perform bibliometric and knowledge-map analysis. Results A total of 8,074 studies by 39,071 authors from 6,530 institutions in 124 countries or regions were published in different academic journals. The most productive country was absolutely the United States, and the University of Texas MD Anderson Cancer Center was the institution with the largest output. Zhang, Yun published the most articles, and the author who had the most frequent co-citations was Moslehi, Javid. New England Journal of Medicine was the most frequently cited journals in this field. Mechanisms of cardiotoxicity have received the most attention and was the main research directions in the field. The disease of cardiotoxicity together with the related risk factors are potential research hotspots. Immune checkpoint inhibitor and myocarditis are two recently discussed and rapidly expanding research topic in the areas of cardiotoxicity. Conclusions This bibliometric analysis provided a thorough analysis of the cardiotoxicity, which would provide crucial sources of information and concepts for academics studying this area. As a rapidly expanding field in cardiology, the related field of cardiotoxicity will continue to be a focus of research.

蒽环类药物是临床上治疗多种实体瘤和血液肿瘤的基石.蒽环类药物诱导的心脏毒性正在成为癌症幸存者的一个关键问题.由于容易引起心脏毒性,导致心肌病和心功能不全,蒽环类药物的使用受到极大限制.目前认为蒽环类药物诱导的心脏毒性的机制,包括氧化应激和活性氧的有害作用、线粒体损伤以及多种不同类型的调节细胞死亡途径等.针对蒽环类药物心脏毒性的分子机制靶向研究心脏保护药物迫在眉睫,并已经崭露头角.本文对蒽环类药物诱导的心脏毒性机制及新型心脏保护剂的研究进展进行综述.

目的 探讨血脂康胶囊联合耳穴压丸对颈动脉粥样硬化患者血脂、炎症因子及颈动脉斑块的影响.方法 选取2021年1-10月在北京中医药大学东直门医院治疗的60例颈动脉粥样硬化患者,依据治疗方式不同分为2组.对照组32例采用阿托伐他汀钙片治疗,观察组28例采用血脂康胶囊联合耳穴压丸治疗,观察2 组患者治疗3 个月后血脂指标[低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、脂蛋白a(Lp(a)]、炎症因子指标[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]和颈动脉斑块变化情况.结果 2组患者治疗后血清LDL-C、TC、TG、Lp(a)、hs-CRP、TNF-α、IL-6水平均较治疗前明显降低(P 均<0.05),HDL-C 水平均较治疗前明显升高(P 均<0.05),但2组治疗后各指标比较差异均无统计学意义(P均>0.05);2组治疗后颈动脉内膜中层厚度(IMT)、斑块面积和斑块积分与治疗前相比及治疗后组间比较差异均无统计学意义(P均>0.05).结论 血脂康胶囊联合耳穴压丸能有效调节颈动脉粥样硬化患者脂代谢,降低炎症因子水平,缩小颈动脉斑块,治疗效果与阿托伐他汀相当.