Background: Septic cardiomyopathy (SCM) is a fatal sepsis-induced dysfunction. While Pueraria (Pue) exhibits protective effects in sepsis, its regulatory role regarding programmed cell death (PCD) in SCM remains unclear. This study aimed to identify Pue's PCD-related targets in SCM and construct a validated diagnostic model. Methods: We analyzed 14 PCD modalities across seven GEO transcriptomic datasets. A robust machine learning framework integrating 171 algorithm combinations built a diagnostic signature. The immune landscape was profiled using single-cell RNA sequencing and enrichment analyses. Experimental validation utilized SCM patient blood samples and heart tissues from an LPS-induced murine model. Results: Nine PCD patterns were significantly altered in SCM. Intersection analysis and machine learning identified five core Pue targets: STAT3, RIPK2, GM2A, ALOX5, and DPP4. A diagnostic model constructed with these genes achieved high AUCs across all datasets. Single-cell analysis revealed cell-type-specific expression within the myocardial immune landscape. Differential expression of these five genes was validated in both human and animal samples, correlating significantly with cardiac function indices. Conclusions: Our results demonstrate that Pueraria mitigates SCM and restores cardiac function by modulating the expression of core PCD-related targets. These targets are closely associated with the localized inflammatory response, providing potential therapeutic avenues for SCM.

Background We previously pioneered a negatively ionized polyethylene terephthalate membrane method (the SMART technique) with the LAMax (test) occluder to reduce platelet adhesion and promote endothelialization. Objectives This study aimed to compare the safety and efficacy of the test occluder with the Watchman 2.5 device (control) in patients with nonvalvular atrial fibrillation to reduce stroke risk. Methods Overall, 236 patients were randomly assigned (1:1) (open-label) to the test or control device for left atrial appendage occlusion (LAAO). The effectiveness endpoints included 12-month successful left atrial appendage (LAA) sealing with residual flow <= 5 mm and clinical success (composite of ischemic stroke, transient ischemic attack, and systemic embolism). Safety endpoints were also studied. A noninferiority margin of -7% was set between the devices. Results The test device was noninferior to the control device for the effectiveness endpoints of successful LAA sealing (test 93.2% vs control 89.8%; P < 0.05) and clinical success (test 93.2% vs control 89.8%; P < 0.05). The 12-month safety endpoints were similar between the 2 devices. The device-related thrombus rates for the control device at the 3- and 12-month visits were 5.7% and 4.6%, respectively; no cases of device-related thrombus occurred with the test device. Conclusions This study suggests that transcatheter LAAO using the SMART technique may effectively and safely prevent stroke in patients with nonvalvular atrial fibrillation. Although further studies with larger sample sizes are needed, this novel technique may prevent device-related thrombus formation and has high potential for application in interventional therapies. (LAMax Vs. Watchman LAAC Device for Subjects With Non-valvular AF to Reduce the Risk of Stroke; NCT04429646) (c) 2025 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Macrophages, one of the key immune cells, are closely associated with various diseases and play critical roles in tissue regeneration via proper polarization. Mesoporous bioactive glass (MBG) has been widely used in bone tissue regeneration; thus, it is charming and beneficial to understand the interactions between MBG and the immune system. Herein, MBG particles with sizes of about 75 nm (MBG-1), 200 nm (MBG-2), and 500 nm (MBG-5) were prepared, and their size effects on macrophage polarization were investigated. The results demonstrated that small MBG particles (75 nm) promoted macrophage polarization toward the M2 phenotype while inhibiting M1 polarization at an early stage (3 days). Meanwhile, medium-sized MBG particles (200 nm) induce a mild inflammatory response in the early stage and promote a high proportion of anti-inflammatory M2 macrophages in the late stage. In contrast, large-sized MBG particles (500 nm) trigger a strong multidirectional activation of macrophages during the early stage, accompanied by a marked upregulation in the expression of both M1 and M2 phenotypic markers. This work preliminarily investigates the relationship between the particle size of MBG and polarization of macrophages, providing insights for the design and further applications of MBG-based biomaterials.

Objective To analyze the relationship between red cell distribution width(RDW)and 1-year all-cause mortality in critically ill patients with aortic stenosis(AS)and aortic regurgitation(AR),aiming to evaluate the potential of RDW as an independent prognostic indicator. Methods Patients were divided into four groups based on the quartiles of their RDW levels:Q1,Q2,Q3,and Q4.The impact of different RDW levels on 1-year all-cause mortality in patients with AS and AR was analyzed using Cox regression analysis,Kaplan-Meier survival curves,Log-Rank tests,and restricted cubic spline（RCS）analysis.The predictive performance of RDW and various clinical scores was compared using Receiver Operating Characteristic(ROC)and Decision Curve Analysis(DCA).Subgroup analyses were conducted to ensure the robustness of the results. Results A total of 2,820 patients were included in the study.Patients in the high RDW group were older,had more comorbidities,and exhibited significantly higher 1-year all-cause mortality.After adjusting for confounding factors in the multivariate Cox regression analysis,elevated RDW was significantly associated with 1-year all-cause mortality(95%CI:1.13–1.29,P<0.01).Kaplan-Meier and RCS analyses revealed that the high RDW group had the lowest survival rates,with a nonlinear relationship observed between RDW and mortality risk.RDW outperformed most traditional scoring systems in predicting 1-year mortality.Subgroup analyses showed that RDW was significantly associated with 1-year all-cause mortality across all subgroups. Conclusion RDW is an independent predictor of 1-year all-cause mortality in critically ill patients with AS and AR.

Background Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation surgery. Cryoballoon ablation (CBA), a conventional thermal ablation technique, enjoys widespread clinical application. In contrast, Pulsed field ablation (PFA) is a novel non thermal ablation technique for the treatment of atrial fibrillation (AF) patients, with safety comparable to traditional thermal ablation surgery. The present study aims to evaluate and compare the procedural efficiency and safety profiles of PFA and CBA in the management of AF.Method We performed a systematic search across PubMed, the Cochrane Library, and Embase databases, encompassing the literature up to February 2024, to inform our systematic review and meta-analysis. When assessing outcome indicators, the risk ratio (RR) and its corresponding 95% confidence interval (CI) were calculated for dichotomous variables. For continuous variables, the mean difference (MD) and the associated 95% CI were determined. In this context, an RR less than 1 and an MD less than 0 were considered advantageous for the PFA group.Result In this analysis, nine observational studies encompassing 2,875 patients with AF were included. Among these, 38% ( n =1105) were treated with PFA, while 62% ( n =1,770) received CBA. The results indicated that PFA was associated with a significantly shorter surgical duration compared to CBA, with a mean difference (MD) of -10.49 minutes (95% CI [-15.50, -5.49]; p <0.0001). Additionally, the PFA group exhibited a reduced risk of perioperative complications relative to the CBA group, with a risk ratio (RR) of 0.52 (95% CI 0.30-0.89; p =0.02). Nevertheless, no statistically significant differences were observed when comparing the two treatment cohorts concerning fluorescence irradiation time (MD 0.71; 95% CI [-0.45, 1.86]; p =0.23) and the recurrence of atrial arrhythmias during follow-up (RR 0.95; 95% CI 0.78-1.14; p =0.57).Conclusion The outcomes of this investigation reveal that PFA holds a relative advantage over CBA in certain respects, notably by reducing both surgical duration and the incidence of perioperative complications. However, no significant distinction was identified between the two modalities concerning the duration of fluorescence irradiation or the rate of atrial arrhythmia recurrence. To enhance the robustness of these estimates, further research is needed, especially by incorporating additional randomized controlled trials.### Competing Interest StatementThe authors have declared no competing interest.

Background Vaccination could provide effective protection against coronavirus disease 2019 (COVID-19). This study aims to describe the COVID-19 vaccination coverage and influential factors in Chinese older hypertensive patients.Methods Using a cross-sectional design, participants were randomly selected from the electronic health records system during the pandemic era in Hangzhou, China. Logistic regression models were employed to compute the OR and 95% CI in order to assess the relationships between variables and the extent of COVID-19 vaccination coverage.Results As of 3 August 2022, among a sample of 77 970 individuals, 75.11% had completed the full COVID-19 vaccination, while 57.66% had received a booster dose. Disparities in coverage were observed across genders, regions and age groups. Unhealthy lifestyles, cardiovascular disease, cancer, uncontrolled blood pressure, abnormal fasting plasma glucose, dyslipidemia and renal dysfunction were risk factors for COVID-19 vaccination coverage. The coverage rates continuously declined along with the number of risk factors. The ORs for full and booster vaccination in subjects with >= 4 risk factors were 2.55 (2.12 similar to 3.07) and 2.60 (2.16 similar to 3.13), compared to individuals without risk factors.Conclusion The COVID-19 vaccination program for older hypertensive patients must be strengthened further. Emphasis should be placed on patients who reside in urban areas, have comorbidities or multiple risk factors.

Key Clinical MessageSuccessful treatment by miniscrew‐assisted rapid expansion and clinical aligner therapy for an adult diagnosed with maxillary transverse deficiency (MTD) by clinical examinations and Yonsei transverse analysis.AbstractAdult orthodontic diagnosis and treatment with maxillary transverse deficiency (MTD) is challenging. Miniscrew‐assisted rapid palatal expansion (MARPE) is a fast and low‐risk method to expand the width of maxillary basal bone. This case report describes a 23‐year‐old female with mandible deviation and bilateral posterior teeth crossbite. She was diagnosed as MTD by the clinical examinations and Yonsei transverse analysis, and treated by the MARPE and clinical aligner therapy. After 26 months' treatment, cone‐beam computed tomography (CBCT) images showed that the width of maxillary basal bone increased by 3.8 mm, that of zygomatic arch and nasal bone increased by 1.0 and 1.9 mm, respectively, and the bilateral posterior teeth crossbite was corrected. Furthermore, the dental midline of lower arch was consistent with that of upper arch and face, the molars arrived Angle Class II and canines was Class I relationships, the profile was maintained, the facial asymmetry was improved. The results of seventeen‐month follow‐up showed that the effect of orthodontic treatment is very stable. This case report demonstrates that MARPE is the effective approach for patients with MTD and facial asymmetry, which provide the alternative for the treatment of similar cases.

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Abstract Circular RNA (circRNA) is involved in the pathogenesis of atherosclerosis (AS). The present work analyzed the RNA expression of circ_0113656, microRNA-188-3p (miR-188-3p), and insulin-like growth factor 2 (IGF2) by quantitative real-time polymerase chain reaction. The protein expression of proliferating cell nuclear antigen (PCNA), matrix metalloprotein 2 (MMP2), and IGF2 was detected by Western blotting. Cell viability, proliferation, invasion, and migration were analyzed using the cell counting kit-8, 5-ethynyl-2′-deoxyuridine, transwell invasion, and wound-healing assays, respectively. The interactions among circ_0113656, miR-188-3p, and IGF2 were identified by dual-luciferase reporter assay and RNA immunoprecipitation assay. The results showed that circ_0113656 and IGF2 expression were significantly upregulated, while miR-188-3p was downregulated in the blood of AS patients and oxidized low-density lipoprotein (ox-LDL)-treated HVSMCs in comparison with controls. The ox-LDL treatment induced HVSMC proliferation, migration, and invasion accompanied by increases in PCNA and MMP2 expression; however, these effects were attenuated after circ_0113656 knockdown. Circ_0113656 acted as a miR-188-3p sponge and it regulated ox-LDL-induced HVSMC disorders by binding to miR-188-3p. Besides, the regulation of miR-188-3p in ox-LDL-induced HVSMC injury involved IGF2. Further, the depletion of circ_0113656 inhibited IGF2 expression by interacting with miR-188-3p. Thus, the circ_0113656/miR-188-3p/IGF2 axis may mediate ox-LDL-induced HVSMC disorders in AS, providing a new therapeutic strategy for AS.

BackgroundThe triglyceride and glucose (TyG) index is associated with the risk of nonalcoholic fatty liver disease (NAFLD), but the dose−response relationship between them is still unknown. We conducted a comprehensive meta-analysis to study the dose−response association between the TyG index and the risk of NAFLD.MethodsWe systematically searched the Cochrane Library, PubMed, and Embase databases until July 2022 for relevant studies. The robust error meta-regression method was used to investigate the dose−response association between the TyG index and NAFLD. Summary relative risks (ORs) and 95% CIs were estimated by using a random-effects model.ResultsA total of 4 cohort and 8 cross-sectional studies were included, with 28,788 NAFLD cases among the 105,365 participants. A positive association for the risk of NAFLD was observed for each additional unit of the TyG index with a linear association (p=0.82), and the summary OR was 2.84 (95% CI, 2.01-4.01). In the subgroup analyses, a stronger association of the TyG index with NAFLD was shown in females than in males (men: OR=2.97, 95% CI 2.55-3.46, women: OR=4.80, 95% CI 3.90-5.90, Psubgroup<0.001).ConclusionThe TyG index may be a novel independent risk factor for NAFLD beyond traditional risk factors.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero, identifier (CRD42022347813).

AIMS:This study aims to assess the effectiveness of COVID-19 vaccination against all-cause death in patients with type 2 diabetes mellitus (T2DM). METHODS:Subjects were patients with T2DM who were administered by general practitioner (GP). Use electronic exchange platform to obtain the information on COVID-19 vaccination, all-cause deaths and risk factors. Logistic regression models were used to calculate the odd ratio (OR) and 95% CI for the association between COVID-19 vaccination and mortality. The vaccine effectiveness (VE) was calculated as (1- adjusted OR) × 100%. RESULTS:A total of 26,916 subjects had 53.81%, 17.65%, and 23.43% coverage for the booster, full, and partial COVID-19 vaccination, reported 328 deaths and a mortality of 1.2%. The adjusted OR (95%CI) was 0.85(0.60-1.21) for those received partial vaccination, 0.31(0.22-0.43) for those received full vaccination, and 0.12(0.08-0.18) for those received booster vaccination, compared to the unvaccinated individuals. The VE (95%CI) was 88.00%(82.30-91.80) of booster vaccination, 69.30%(56.60-78.30) of full vaccination, and 17.60%(-17.10-42.00) of partial vaccination. CONCLUSION:COVID-19 vaccination could effectively prevent the all-cause death in patients with T2DM during the omicron variant outbreak period, after the cancellation of the "Dynamic Zero Policy" in mainland China.

Background The triglyceride and glucose (TyG) index has been linked to various cardiovascular diseases. However, it's still unclear whether the TyG index is associated with arterial stiffness and coronary artery calcification (CAC). Methods We conducted a systematic review and meta-analysis of relevant studies until September 2022 in the PubMed, Cochrane Library, and Embase databases. We used a random-effects model to calculate the pooled effect estimate and the robust error meta-regression method to summarize the exposure-effect relationship. Results Twenty-six observational studies involving 87,307 participants were included. In the category analysis, the TyG index was associated with the risk of arterial stiffness (odds ratio [OR]: 1.83; 95% CI 1.55–2.17, I 2 = 68%) and CAC (OR: 1.66; 95% CI 1.51–1.82, I 2 = 0). The per 1-unit increment in the TyG index was also associated with an increased risk of arterial stiffness (OR: 1.51, 95% CI 1.35–1.69, I 2 = 82%) and CAC (OR: 1.73, 95% CI 1.36–2.20, I 2 = 51%). Moreover, a higher TyG index was shown to be a risk factor for the progression of CAC (OR = 1.66, 95% CI 1.21–2.27, I 2 = 0, in category analysis, OR = 1.47, 95% CI 1.29–1.68, I 2 = 41% in continuity analysis). There was a positive nonlinear association between the TyG index and the risk of arterial stiffness (P nonlinearity < 0.001). Conclusion An elevated TyG index is associated with an increased risk of arterial stiffness and CAC. Prospective studies are needed to assess causality. Graphical Abstract

BackgroundCardiac resynchronization therapy (CRT) is a major device therapy used to treat patients suffering from heart failure (HF) and electrical asynchrony. It can improve HF symptoms, reduce HF hospitalization time, and improve long-term survival in HF with and without implantable cardioverter (ICD) therapy. However, the benefit of defibrillator therapy in CRT-eligible patients with nonischemic cardiomyopathy (NICM) remains unknown. As a result, we conducted a systematic review and meta-analysis to compare clinical outcomes in patients with NICM and HF who were treated with implantable CRT defibrillators (CRT-D) vs. a CRT pacemaker (CRT-P) alone.MethodsWe searched the electronic databases PubMed, Embase, and Cochrane for all studies comparing CRT-D vs. CRT-P treatment in patients with NICM. The time frame was from 1990 to September 2022. All-cause mortality and cardiovascular mortality were the primary clinical outcomes of interest to us. To pool adjusted hazard ratios (HRs) and 95% confidence intervals (CIs), a random-effects model with inverse variance was used.ResultsA pooled meta-analysis included two randomized controlled trials (RCTs), each with 1,200 CRT-eligible patients with NICM (592 with CRT-D and 608 with CRT-P) and nine cohort studies representing 27,568 CRT-eligible patients with NICM (16,196 with CRT-D and 11,372 with CRT-P). The adjusted HR for all-cause mortality for CRT-D vs. CRT-P was 0.90 (95% CI, 0.81-0.99). In a subgroup analysis of two RCTs and nine cohort studies, the adjusted HR for all-cause mortality was 0.72 (95% CI, 0.43–1.19) and HR 0.92 (95% CI, 0.83–1.03) for CRT-D vs. CRT-P, respectively.ConclusionWith the addition of defibrillation leads, we found a significantly lower risk of all-cause mortality in patients with NICM, but this association was not found in subgroup analyses of RCTs and observational studies.

Living alone is an objective sign of social isolation. It is uncertain whether living alone worsens clinical outcomes in heart failure (HF) patients. We aimed to assess how living alone affected clinical outcomes in individuals with HF. We searched the electronic databases of PubMed, Embase, and Cochrane from 1990 to April 2022 for studies comparing living alone with HF. A random-effects model with inverse variance was used to pool adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Seven studies were deemed to meet the standards. In patients with HF, compared with living with others, living alone was associated with an elevated risk of any hospitalization at the 30-day (HR: 1.78, 95% CI: 1.09-2.89), 90-day (HR: 1.24, 95% CI: 1.02-1.51), or ≥1-year (HR: 1.14, 95% CI: 1.04-1.26) follow-up periods. HF patients living alone also had a greater risk of any hospitalization or death at the 30-day (HR: 1.56, 95% CI: 1.15-2.11), 90-day (HR: 1.26, 95% CI: 1.05-1.50), and ≥1-year (HR: 1.18, 95% CI: 1.09-1.28) follow-up periods. However, patients living alone had no increased risk of all-cause death at the 30-day (HR: 1.0, 95% CI: 0.19-5.36), 90-day (HR: 0.46, 95% CI: 0.03-7.42), or ≥ 1-year (HR: 1.10, 95% CI: 0.73-1.67) follow-up periods. In comparison to living with others, living alone was associated with an increased risk of any hospitalization but not all-cause death in HF patients.

ObjectivesThe aim of this study was to evaluate the shape of the dose-response relationship between body mass index (BMI) and atrial fibrillation (AF) recurrence in patients who have undergone radiofrequency ablation.MethodsStudies investigating BMI and AF recurrence in patients with AF after ablation were identified through electronic searches in the PubMed, EMBASE, and Cochrane Library databases. The potential non-linear relationship was fitted using robust error meta-regression. Our study was registered with PROSPERO (CRD42019121373).ResultsTwenty-six cohort studies with 7,878 cases/26,450 individuals were included, and a linear dose-response relationship between BMI and AF recurrence (Pnon–linearity = 0.12) was found. The risk of AF recurrence in patients with a BMI over 28 was significantly increased. Specifically, for each 5 kg/m2 increase in BMI, the risk of AF recurrence increased by 15% (95% CI: 1.08–1.22) with moderate heterogeneity (I2 = 53%). Subgroup analyses showed that the pooled risk ratio was not significantly changed in subgroup analysis adjustment for the following important potential intermediate factors: left atrial diameter and obstructive sleep apnea.ConclusionThis study showed that there is a borderline positive linear association between BMI and AF recurrence post ablation. Overweight and obesity are significantly associated with AF recurrence.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42019128770.

Background: Respiratory diseases related to chronic pulmonary ventilation dysfunction are mainly composed of chronic obstructive pulmonary disease (COPD) and asthma. Our meta-analysis aimed to illustrate the association of COPD or asthma with risk of atrial fibrillation (AF).& nbsp;Methods: We systematically searched the databases of the PubMed, Embase, and Cochrane library until December 2021 for studies focusing on the relationship between COPD or asthma and AF risk. Due to the potential heterogeneity across studies, the random-effects model was used to pool the studies.& nbsp;Results: Our meta-analysis included 14 studies. Based on the random-effects model, the pooled analysis showed that COPD (risk ratio[RR] = 1.74, 95% confidence interval [CI]: 1.70-1.79) and asthma (RR = 1.08, 95% CI: 1.04-1.12) were significantly associated with an increased risk of AF. The results did not change after each study was excluded.& nbsp;Conclusion: Our current data suggested that COPD or asthma with associated with an increased risk of AF.

Background: The relationship between sex and prognosis of heart failure (HF) remains unclear. This work aims to elucidate whether sex differences influence the prognosis of HF with preserved and HF with intermediate ejection fraction (HFpEF and HFmrEF) patients.Methods: A systematic review and meta-analysis were carried out. As of 23 July 2022, we retrieved three databases to obtain literature reports on gender differences in the prognosis of patients aged over 18 years of HFpEF or HFmrEF (all-cause mortality, CV mortality and HF admission). All the data obtained by the extraction is available. Random effects model was used to summarize the prognostic risk ratio of male to female, and the results were evaluated for bias and quality rating. Registration was performed on PROSPERO (CRD42022349968). Findings: Fourteen cohorts (7 prospective) involving 52,200 HFpEF patients included 41,508 HFpEF patients (44.65% males) and 10,692 HFmrEF patients (61.79% males). For HFpEF patients, men were more likely to die from all causes (13 studies; hazard ratio (HR): 1.24, 95.% confidence interval (CI): 1.15 to 1.33) and cardiovascular diseases (CVDs) (5 studies; HR: 1.22, 95% CI: 1.14 to 1.31), but their HF admissions did not differ (6 studies; HR: 1.01, 95% CI: 0.89 to 1.14). For HFmrEF patients, men were more likely to die from all causes (3 studies; HR: 1.21, 95% CI: 1.12 to 1.31), but their cardiovascular (CV) mortality (3 studies; HR: 1.17, 95% CI: 0.90 to 1.53) and HF admissions did not differ (3 studies; HR: 1.06, 95% CI: 0.98 to 1.15).Interpretation: Men may prominently have a worse prognosis in HFpEF and HFmrEF patients. This will help us develop safer and more effective clinical treatment and management strategies based on gender differences and types of heart failure.Study Registration: PROSPERO (CRD42022349968)Funding: This work was supported by the Natural Science Foundation of Guangzhou (202201011395 to X.L), Natural Science Foundation in Jiangxi Province grant [grant numbers No. 20212BAB216051 to J.Z., No. 20212BAB216047 and No. 202004BCJL23049 to P.Y.] and National Natural Science Foundation of China [grant number No. 82160371 to J.Z., No. 82100869 to P.Y.]Declaration of Interest: All authors declare that they have no competing interests.

Conventional photothermal therapy (PTT) irradiates the tumor tissues by elevating the temperature above 48 °C to exert thermal ablation, killing tumor cells. However, thermal ablation during PTT harmfully damages the surrounding normal tissues, post-treatment inflammatory responses, rapid metastasis due to the short-term mass release of tumor-cellular contents, or other side effects. To circumvent this limitation, mild-temperature photothermal therapy (MTPTT) was introduced to replace PTT as it exerts its activity at a therapeutic temperature of 42–45 °C. However, the significantly low therapeutic effect comes due to the thermoresistance of cancer cells as MTPTT figures out some of the side-effects issues. Herein, our current review suggested the mechanism and various strategies for improving the efficacy of MTPTT. Especially, heat shock proteins (HSPs) are molecular chaperones overexpressed in tumor cells and implicated in several cellular heat shock responses. Therefore, we introduced some methods to inhibit activity, reduce expression levels, and hinder the function of HSPs during MTPTT treatment. Moreover, other strategies also were emphasized, including nucleus damage, energy inhibition, and autophagy mediation. In addition, some therapies, like radiotherapy, chemotherapy, photodynamic therapy, and immunotherapy, exhibited a significant synergistic effect to assist MTPTT. Our current review provides a basis for further studies and a new approach for the clinical application of MTPTT.

Background Several published studies have examined the association of coffee consumption with atrial fibrillation (AF) risk, but their findings are still controversial. Therefore, we performed a systematic review and dose–response meta-analysis of prospective studies to determine the relationship between coffee consumption and the risk of incident AF. Methods We systematically retrieved the PubMed and Embase databases until October 2021 for pertinent studies that reported the association of coffee consumption (caffeinated or decaffeinated coffee) with AF risk. A cubic spline random-effects model was used to fit the potential dose–response curve. The effect estimates were expressed as adjusted risk ratios (RRs) and 95% CIs. Results A total of 10 prospective studies (11 cohorts) involving 30,169 AF events and 723,825 participants were included. In the dose–response analysis, there was a linear inverse association between coffee intake and risk of AF although not statistically significant (Pnon–linearity = 0.25). Compared with participants with no coffee consumption, the RRs (95% CI) of AF risk estimated directly from the dose–response curve were 1.01 (0.98–1.03), 1.00 (0.97–1.04), 0.99 (0.92–1.02), 0.95 (0.89–1.01), 0.94 (0.87–1.01), 0.89 (0.79–1.02), and 0.87 (0.76–1.02) for 1–7 cups of coffee per day, respectively. One cup per day increased in coffee consumption was associated with a 2% reduced risk of AF (RR = 0.98, 95% CI: 0.97–1.00, P = 0.02). Conclusions Our evidence from this meta-analysis suggested that coffee consumption had a trend toward reducing the risk of AF in a dose–response manner. Further studies could be conducted to reinforce our findings.

Respiratory diseases related to chronic pulmonary ventilation dysfunction are mainly composed of chronic obstructive pulmonary disease (COPD) and asthma. Our meta-analysis aimed to illustrate the association of COPD or asthma with risk of atrial fibrillation (AF).We systematically searched the databases of the PubMed, Embase, and Cochrane library until December 2021 for studies focusing on the relationship between COPD or asthma and AF risk. Due to the potential heterogeneity across studies, the random-effects model was used to pool the studies.Our meta-analysis included 14 studies. Based on the random-effects model, the pooled analysis showed that COPD (risk ratio[RR] = 1.74, 95% confidence interval [CI]: 1.70-1.79) and asthma (RR = 1.08, 95% CI: 1.04-1.12) were significantly associated with an increased risk of AF. The results did not change after each study was excluded.Our current data suggested that COPD or asthma with associated with an increased risk of AF.