Coronary Heart Disease Patients Research Articles

The association between the triglyceride-glucose index and in-stent restenosis in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis

BackgroundInsulin resistance (IR) can lead to cellular metabolic disorders, activation of oxidative stress, and endothelial dysfunction, contributing to in-stent restenosis (ISR). The triglyceride-glucose index (TyG index), a new indicator reflecting IR, is extensively researched in the cardiovascular field. This study, through a meta-analysis, aimed to utilize a larger combined sample size and thereby enhance the overall test efficacy to explore the TyG index-ISR relationship.MethodsA thorough search was conducted in the PubMed, EMBASE, Web of Science, and Cochrane Library databases to find original papers and their references published between 1990 and January 2024. This search included both prospective and retrospective studies detailing the correlation between the TyG index and ISR in individuals with coronary heart disease (CHD).OutcomesThe five included articles comprised 3,912 participants, and the odds ratio (OR) extracted from each study was combined using the Inverse Variance method. Results showed that, in the context of CHD patients, each incremental unit in the TyG index, when treated as a continuous variable, corresponded to a 42% elevation in ISR risk (95% CI 1.26–1.59, I²=13%, p < 0.005). When analyzing the TyG index categorically, the results revealed a higher ISR risk in the highest TyG index group compared to the lowest group (OR: 1.69, 95% CI 1.32–2.17, I²=0). Additionally, in patients with chronic coronary syndrome (CCS), each unit increase in the TyG index, the risk of ISR in patients increased by 37% (95% CI 1.19–1.57, I²=0%, p < 0.005). This correlation was also observable in acute coronary syndrome (ACS) patients (OR:1.48, 95% CI 1.19–1.85, I²=0, p < 0.005).ConclusionsThe TyG index, an economical and precise surrogate for IR, is significantly linked with ISR. Furthermore, this correlation is unaffected by the type of coronary heart disease.

Hospitalization expenses of coronary heart disease inpatients in China: evidence from two hospitals in Ningxia Hui autonomous region

AimThe increasing morbidity from coronary health disease (CHD) has imposed a significant social and economic burden in China. We analyzed the factors affecting hospitalization expenses of CHD patients.DesignFrom 2012 to 2018, data on 16,726 CHD patients were collected from the hospital information system in Ningxia Hui Autonomous Region.MethodsA multiple ordered logistic regression model was used to analyze the factors affecting hospitalization expenses.ResultsThe average hospitalization expense was RMB30998.26 ± 29890.03. Hospital materials expenses accounted for roughly 60% of total hospitalization costs. The older adult, patients who were male, in critical health status, with longer hospital stays, unemployed, using antibiotics and undergoing an operation without incision had significantly raised hospital expenses, while those with fewer complications, no operations and self-paying for health care had reduced hospitalization costs (p &amp;lt; 0.05). The length of hospital stay played a partial mediator role (p &amp;lt; 0.05).Public contributionControlling the increase of medical materials costs and preventing over-consumption of hospital services by insured patients are recommended.

Identification of Necroptosis-Related Diagnostic Biomarkers in Coronary Heart Disease

BackgroundThe implication of necroptosis in cardiovascular disease was already recognized. However, the molecular mechanism of necroptosis has not been extensively studied in coronary heart disease (CHD). MethodsThe differentially expressed genes (DEGs) between CHD and control samples were acquired in the GSE20681 dataset downloaded from the GEO database. Key necroptosis-related DEGs were captured and ascertained by bioinformatics analysis techniques, including weighted gene co-expression network analysis (WGCNA) and two machine learning algorithms, while single-gene gene set enrichment analysis (GSEA) revealed their molecular mechanisms. The diagnostic biomarkers were selected via receiver operating characteristic (ROC) analysis. Moreover, an analysis of immune elements infiltration degree was carried out. Authentication of pivotal gene expression at the mRNA level was investigated in vitro utilizing quantitative real-time PCR (qRT-PCR). ResultsA total of 94 DE-NRGs were recognized here, among which, FAM166B, NEFL, POLDIP3, PRSS37, and ZNF594 were authenticated as necroptosis-related biomarkers, and the linear regression model based on them presented an acceptable ability to different sample types. Following regulatory analysis, the ascertained biomarkers were markedly abundant in functions pertinent to blood circulation, calcium ion homeostasis, and the MAPK/cAMP/Ras signaling pathway. Single-sample GSEA exhibited that APC co-stimulation and CCR were more abundant, and aDCs and B cells were relatively scarce in CHD patients. Consistent findings from bioinformatics and qRT-PCR analyses confirmed the upregulation of NEFL and the downregulation of FAM166B, POLDIP3, and PRSS37 in CHD. ConclusionOur current investigation identified 5 necroptosis-related genes that could be diagnostic markers for CHD and brought a novel comprehension of the latent molecular mechanisms of necroptosis in CHD.

Drug-coated balloon in the treatment of coronary artery de-novo large lesions angiography.

The superiority of drug-coated balloon (DCB) in treating small vessels, branching lesions, and high-risk bleeding lesions in coronary heart disease patients has been confirmed. However, its safety and efficacy in large vessels are still unclear. We aimed to investigate whether the efficacy of DCB in large vessels is not inferior to that of drug-eluting stent (DES). From November 2019 to April 2022, a total of 88 patients in our hospital who underwent coronary angiography for the first time and decided to receive DCB or DES treatment were selected. Indicators including late lumen loss (LLL), major adverse cardiovascular event (MACE) rate, major bleeding and all-cause mortality were evaluated at 9 months and 1-year post percutaneous coronary intervention (PCI) therapy. The primary endpoint of 9-month LLL was -0.07 in the DCB group and 0.19 mm in the DES group (p value＜0.001). 1-year cumulative MACE rates were similar in the DCB and DES groups (3.03% vs. 7.23%, P=0.519), TLR rates were similar (3.03% vs. 7.23%, P=0.519), Major bleeding was similar (3.03% vs. 5.45%, P=0.580), and 1 case of Cardiac death in DES group. For LLL, the DCB-only strategy was non-inferior to DES in treating de novo large lesions in the coronary arteries. Furthermore, the efficacy of DCB was comparable to DES at 1 year of follow-up for secondary clinical endpoints.

Phthalate Exposure and Coronary Heart Disease: Possible Implications of Oxidative Stress and Altered miRNA Expression.

The relationship between phthalate exposure and coronary heart disease (CHD) is still unclear. This study aimed to investigate the association between phthalate exposure and CHD and determine the possible atherogenic mechanisms of phthalates by assessing oxidative stress and altering miRNA expression. This case-control study included 110 participants (55 CHD patients and 55 healthy controls). The levels of oxidative stress markers, malondialdehyde (MDA), and superoxide dismutase (SOD), and the expression of miRNA-155 (miR-155) and miRNA-208a (miR-208a), were measured and correlated with the urinary mono-2-ethylhexyl phthalate (MEHP). Highly significant differences were detected between the CHD cases and the control group regarding MEHP, MDA, SOD, miR-155, and miR-208a (p-value < 0.001). Spearman correlations revealed a significant positive correlation between MDA and MEHP in urine (P = 0.001 and rs = 0.316) and a significant negative correlation between SOD and MEHP in urine (P < 0.001 and rs = -0.345). Furthermore, significant positive correlations were observed between miR-155 and urinary MEHP (P = 0.001 and rs = 0.318) and miR-208a and urinary MEHP (P < 0.001 and rs = -0.352). This study revealed an association between phthalate exposure, as indicated by urinary MEHP and CHD; altered expression of miR-155 and miR-208a and oxidative stress could be the fundamental mechanisms.

High Perceived Stress Predicts Worse Clinical Outcomes in Patients with Stable Coronary Heart Disease

Background. High stress is associated with coronary heart disease (CHD), but the impact of perceived stress on prognosis with stable CHD remains unclear. This study investigated the impact of high perceived stress (HPS) on cardiovascular events in stable CHD patients. Methods. From March 2015 and December 2020, 2215 stable CHD patients were recruited. The Chinese version of the Perceived Stress Scale-14 (CPSS) was used, with follow-up conducted every 6 months until the occurrence of a cardiovascular event or March 31, 2022. Cardiovascular-related events were used as outcomes, including myocardial infarction, unplanned revascularization, stroke, death, or rehospitalization from angina. Patients were divided into HPS (CPSS≥31) and nonhigh perceived stress (NHPS) groups. The Kaplan-Meier survival curves were plotted, and the log-rank test compared the incidence of adverse events after adjusting for sociodemographic, lifestyle, and clinical information. Results. The recruited CHD population was 59.6 years old on average, 79.6% male, 27.2 points average CPSS, and median follow-up of 47 months. There were 523 HPS patients, with 98 (18.7%) cardiovascular events, and 1692 NHPS patients with 239 (14.1%) cardiovascular events. The log-rank analysis showed that risk of cardiovascular events with HPS was higher than NHPS (P=0.012). After adjusting for demographic, lifestyle, and clinical information, the HPS group had significantly increased risk of events within 24 months (HR 1.369, 95% CI 1.037-1.807, P=0.027), but less impact after 24 months. Conclusions. HPS predicts subsequent cardiovascular events in patients with stable CHD within 24 months. Therefore, more attention should be given to CHD patients with HPS, which may improve clinical prognosis.

Circulating microRNA-33b levels are associated with the presence and severity of coronary heart disease

MicroRNA-33b (miR-33b) affected various biological pathways in regulating cholesterol homeostasis which may link to the pathogenesis of atherosclerotic lesions. However, whether this marker is associated with the presence and severity of coronary heart disease (CHD) is undetermined. We aim to explore the diagnostic value of circulating miR-33b level in the presence and severity of CHD. Altogether 320 patients were enrolled, including 240 patients diagnosed with CHD while 80 were classified as controls after CAG examination. Circulating miR-33b level was analyzed in all subjects, the Gensini score was calculated to assess the severity of stenotic lesions. The association between miR-33b and the presence and severity of CHD was analyzed, and the diagnostic potential of miR-33b of CHD was performed by the receiver operating characteristic (ROC) analysis. The CHD group had higher miR-33b levels (p < 0.001), and the miR-33b content significantly elevated following an increasing Gensini score (p for trend < 0.001). After adjustments for potential risk factors, such as several blood lipid markers, miR-33b remained a significant determinant for CHD (p < 0.001). ROC analysis disclosed that the AUC was 0.931. The optimal cutoff value of miR-33b was with a sensitivity of 81.3% and a specificity of 98.7% in differentiating CHD. It can prognosticate that the higher level of miR-33b was linked to increased severity of disease in CHD patients. Thus, the application of this marker might assist in the diagnosis and classification of CHD patients. Nevertheless, additional studies with larger sample sizes will be required to verify these results.

Pharmacological test with nitroglycerin in combination with perfusion SPECT with &lt;sup&gt;99m&lt;/sup&gt;Tc-Technetril in assessing the viability of ischemic myocardium in patients after acute infarction

Aim. To evaluate the possibility of using nitroglycerin sublingually in combination with 99mTc-Technetril cardiac perfusion single-photon emission computed tomography (SPECT) as a test for detecting viable myocardium. Material and methods. 28 male patients with coronary heart disease (CHD) and postinfarction cardiosclerosis were examined. Group 1 included 10 patients with CHD without signs of acute myocardial infarction (AMI). Group 2 comprised 18 patients with CHD, postinfarction cardiosclerosis (PICS). The control group consisted of patients who were subsequently rejected a diagnosis of CHD. Patients took 2 tablets (1 mg) of nitroglycerin sublingually, and then, at the peak of the drug’s action (after 3–5 minutes), they were intravenously administered 370 MBq of 99mTc-Technetril (by Diamed, Russia). Myocardial SPECT with 99mTc-Technetril was performed 1 hour after RFP injection. The next day, myocardial SPECT with 99mTc-Technetril was repeated at rest. Results. When taking tableted nitroglycerin at a dose of 1 mg sublingually, its maximum plasma concentration is on average 0.26 ± 0.04 microcgram/l. It is reached by 110–150 s, then maintained within 10 % of the maximum for 7-9 minutes. Nitroglycerin leads to improvement in global and local contractility and increased LV pumping function in CHD patients. This is most pronounced in individuals with a higher class of angina pectoris after AMI and major changes in intracardiac hemodynamics initially. The nitroglycerin test in combination with 99mTc-Technetril SPECT-CT allowed to identify myocardial areas with improved blood flow and increased EFLV after CABG. Conclusion. The nitroglycerin test in combination with 99mTc-Technetril SPECT-CT is effective for detecting viable myocardium in patients with coronary atherosclerosis and CHD, safe and relatively simple due to the sublingual route of nitroglycerin intake.

Nursing interventions for improving quality of life among patients with coronary heart disease after percutaneous coronary intervention: A scoping review

Background: Percutaneous coronary intervention (PCI) aims to improve the quality of life (QoL) for coronary heart disease (CHD) patients, but many patients still have poor QoL. The impact of poor QoL causes long-lasting feelings of frustration, anxiety, fear, and worry that make a person give up or lose enthusiasm for the future. Objective: This study aimed to describe nursing interventions to improve the QoL of CHD patients after PCI. Methods: This research used the scoping review method by including all full-text primary studies written in English and published between 2013 to 2023 from three databases, EBSCO-host, PubMed, and Scopus, and one e-resource,  Sage Journals. The keywords used were “coronary artery disease OR myocardial infarction OR cardiovascular disease AND quality of life AND percutaneous coronary intervention OR PCI OR Angioplasty AND Nursing care OR nursing intervention.” Results: A total of eight articles discussed nursing interventions to improve the QoL among CHD patients after PCI. There are two categories of interventions that nurses can carry out: hospital-based (inpatient or outpatient) rehabilitation and cardiac tele-rehabilitation.  Conclusions: Hospital-based (inpatient or outpatient) rehabilitation and tele-rehabilitation interventions potentially improve post-PCI patients’ QoL, psychological well-being, cardiovascular capacity, social support, and adherence to CHD rehabilitation program. Standardized intervention guidelines need to be created in the future for each outcome of interest based on evidence-based findings so that specific interventions to improve the quality of life of CHD patients can be applied directly in daily practice.

Cardiac hemodynamics phenotypes and individual responses to training in coronary heart disease patients.

In patients with coronary heart disease (CHD), individualized exercise training (ET) programs are strongly recommended to optimize peak oxygen uptake ( O2peak) improvement and prognosis. However, the cardiac hemodynamic factors responsible for a positive response to training remain unclear. The aim of this study was to compare cardiac hemodynamic changes after an ET program in responder (R) versus non-responder (NR) CHD patients. A total of 72 CHD patients completed a 3-month ET program and were assessed by cycle ergometer cardiopulmonary exercise test (CPET: O2peak assessment) with impedance cardiography (ICG) for hemodynamic measurements before and after training. Cardiac hemodynamics (e.g., CO, CI, SV, ESV, EDV, and SVR) were measured by ICG during CPET. The R and NR groups were classified using the median change in O2peak (>the median for R and ≤the median for NR). In the R group, O2peak (+17%, p < 0.001), CO, CI, SV, and HR increased by 17%, 17%, 13%, and 5%, respectively (p < 0.05) after the training program. In the NR group, O2peak, CO, CI, and SV increased by 0.5%, 5%, 8%, and 6%, respectively (p < 0.01). The SVR decreased in both groups (-19% in R and -11% in NR, p < 0.001). Among CHD patients, the R group showed a better improvement in peak cardiac output via an increase in peak stroke volume and heart rate and a reduced systemic vascular resistance than the NR group. Different cardiac phenotype adaptations and clinical individual responses were identified in CHD patients according to the aerobic fitness responder's status.

Soluble ST2 for predicting heart failure, atrial fibrillation and death in patients with coronary heart disease with or without renal insufficiency

Soluble ST2 for predicting heart failure, atrial fibrillation and death in patients with coronary heart disease with or without renal insufficiency

The impact of serum BNP on retinal perfusion assessed by an AI-based denoising optical coherence tomography angiography in CHD patients

BackgroundTo investigate the correlation between retinal vessel density (VD) parameters with serum B-type natriuretic peptide (BNP) in patients with coronary heart disease (CHD) using novel optical coherence tomography angiography (OCTA) denoising images based on artificial intelligence (AI). MethodsOCTA images of the optic nerve and macular area were obtained using a Canon-HS100 OCT device in 176 patients with CHD. Baseline information and blood test results were recorded. ResultsRetinal VD parameters of the macular and optic nerves on OCTA were significantly decreased in patients with CHD after denoising. Retinal VD of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and radial peripapillary capillary (RPC) was strongly correlated with serum BNP levels in patients with CHD. Significant differences were noted in retinal thickness and retinal VD (SCP, DCP and RPC) between the increased BNP and normal BNP groups in patients with CHD. ConclusionDeep learning denoising can remove background noise and smooth rough vessel surfaces. SCP,DCP and RPC may be potential clinical markers of cardiac function in patients with CHD. Denoising shows great potential for improving the sensitivity of OCTA images as a biomarker for CHD progression.

Correlation Between Cardiopulmonary Bypass Time (CPB Time) during Coronary Artery Bypass Graft on ICU Length of Stay

Highlight: 1. CHD remains one of the most threatening CVD in Indonesia. Studies discussing CHD will contribute in future studies for cardiologists to assert better options for treatment. - Abstract Background: Coronary heart disease (CHD) is one of the deadliest diseases in Indonesia. Coronary artery bypass graft using cardiopulmonary bypass (CPB) is an integral measure in its treatment. The objective of this study is to identify the correlation of CPB Time and Length of Stay (LOS) in the Intensive Care Unit (ICU) in Dr.Soetomo General Academic Hospital, Surabaya. Material and Methods: This study was conducted using observational and analytic methods. The population are coronary heart disease patients who underwent coronary artery bypass graft. A total sampling method was used from the medical records of Dr. Soetomo General Academic Hospital, Surabaya from October 2021 until September 2022. The research variables are: CPB time and ICU LOS. The relationship between CPB and ICU LOS was analyzed using the Spearman correlation test and logistic regression as well Mann-Whitney test using Microsoft Excel and SPSS version 25. Results: From the results of the correlation test, there is no correlation between CPB Time and ICU LOS with a correlation coefficient of r=0212, there is no significant difference between CPB ≤180 minutes and CPB &gt;180 minutes on ICU LOS p=0.123.  From  the  overall  sample,  the  average  age  was  62.24+7.765  years,  with the majority of the sample were male  87.3%. Conclusion: There is no correlation between the CPB Time and ICU LOS in patients after coronary artery bypass graft at RSUD Dr. Soetomo.

Role of inflammatory signaling pathways involving the CD40-CD40L-TRAF cascade in diabetes and hypertension-insights from animal and human studies.

CD40L-CD40-TRAF signaling plays a role in atherosclerosis progression and affects the pathogenesis of coronary heart disease (CHD). We tested the hypothesis that CD40L-CD40-TRAF signaling is a potential therapeutic target in hyperlipidemia, diabetes, and hypertension. In mouse models of hyperlipidemia plus diabetes (db/db mice) or hypertension (1mg/kg/d angiotensin-II for 7days), TRAF6 inhibitor treatment (2.5mg/kg/d for 7 or 14days) normalized markers of oxidative stress and inflammation. As diabetes and hypertension are important comorbidities aggravating CHD, we explored whether the CD40L-CD40-TRAF signaling cascade and their associated inflammatory pathways are expressed in CHD patients suffering from comorbidities. Therefore, we analyzed vascular bypass material (aorta or internal mammary artery) and plasma from patients with CHD with diabetes and/or hypertension. Our Olink targeted plasma proteomic analysis using the IMMUNO-ONCOLOGY panel revealed a pattern of step-wise increase for 13/92 markers of low-grade inflammation with significant changes. CD40L or CD40 significantly correlated with 38 or 56 other inflammatory targets. In addition, specific gene clusters that correlate with the comorbidities were identified in isolated aortic mRNA of CHD patients through RNA-sequencing. These signaling clusters comprised CD40L-CD40-TRAF, immune system, hemostasis, muscle contraction, metabolism of lipids, developmental biology, and apoptosis. Finally, immunological analysis revealed key markers correlated with comorbidities in CHD patients, such as CD40L, NOX2, CD68, and 3-nitrotyrosine. These data indicate that comorbidities increase inflammatory pathways in CHD, and targeting these pathways will be beneficial in reducing cardiovascular events in CHD patients with comorbidities.

Characteristics of neurovegetative disorders in ischemic heart disease patients after coronavirus disease 2019 (COVID-19)

The aim of the study. To examine the frequency and spectrum of cognitive, anxiety-depressive, autonomic disorders and their interrelationship in patients with coronary heart disease (CHD) after COVID-19 infection. Materials and methods. The study involved 71 patients with CHD, stable angina pectoris FC II–III (age 69.0 [64.0; 76.0] years): group 1 (main) – 31 CHD patients after COVID-19; group 2 (comparison) – 40 CHD patients without COVID-19 history. Spectral and temporal HRV parameters were assessed using 24-hour Holter ECG monitoring, anxiety-depressive disorders (ADD) – using the HADS scale, cognitive status of patients – according to the MoCa scale. Results. CHD patients after COVID-19 had a higher frequency of ADD detection and a greater anxiety level (16 [10; 24] versus 10 [9; 13] points, p &lt; 0.05), depression (14 [8; 20] versus 11 [10; 12] points, p &lt; 0.05) as compared to patients without previous history of COVID-19. At the same time, the predominance of the anxiety component over the depressive one in patients of both groups has been revealed. In CHD patients after COVID-19, a decrease in the total MoCa scale score has been found as compared to patients without COVID-19: 24 [22; 26] versus 28 [26; 30] points, p &lt; 0.05. There was an association between the total level of anxiety and depression and the severity of cognitive impairment (r = -0.36, p &lt; 0.05). CHD patients exposed to COVID-19 showed an increased sympathetic and parasympathetic tone of the central nervous system within 24 hours, an increased LF/HF ratio during the active period, activation of slow-acting humoral regulation mechanisms amid increasing stress index and centralization index. In the group of patients with CHD after COVID-19, a wide range of correlations between the rate of ADD, cognitive disorders and HRV parameters has been found. Conclusions. Patients with coronary heart disease recovered from COVID-19 have shown an increase in the incidence and degree of ADD and cognitive disorder manifestations which was accompanied by autonomic dysfunction resulting in stress on the functional and adaptive state of the cardiovascular system. The association between ADD, autonomic and cognitive disorders in patients with coronary heart disease after COVID-19 has confirmed the common pathogenetic links of the disorders found.

Blood urea nitrogen to serum albumin ratio: a novel mortality indicator in intensive care unit patients with coronary heart disease

The blood urea nitrogen to albumin ratio (BAR) has been demonstrated as a prognostic factor in sepsis and respiratory diseases, yet its role in severe coronary heart disease (CHD) remains unexplored. This retrospective study, utilizing data from the Medical Information Mart for Intensive Care-IV database, included 4254 CHD patients, predominantly male (63.54%), with a median age of 74 years (IQR 64–83). Primary outcomes included in-hospital, 28-day and 1-year all-cause mortality after ICU admission. The Kaplan–Meier curves, Cox regression analysis, multivariable restricted cubic spline regression were employed to assess association between BAR index and mortality. In-hospital, within 28-day and 1-year mortality rates were 16.93%, 20.76% and 38.11%, respectively. Multivariable Cox proportional hazards analysis revealed associations between the increased BAR index and higher in-hospital mortality (HR 1.11, 95% CI 1.02–1.21), 28-day mortality (HR 1.17, 95% CI 1.08–1.27) and 1-year mortality (HR 1.23, 95% CI 1.16–1.31). Non-linear relationships were observed for 28-day and 1-year mortality with increasing BAR index (both P for non-linearity < 0.05). Elevated BAR index was a predictor for mortality in ICU patients with CHD, offering potential value for early high-risk patient identification and proactive management by clinicians.

Identification of Plasma Exosomes hsa_circ_0001360 and hsa_circ_0000038 as Key Biomarkers of Coronary Heart Disease.

Coronary heart disease (CHD) is the leading cause of death and disability worldwide. Accumulating evidence reveals that atherosclerosis (AS), characterized by systemic, chronic, and multifocal disease, and is the primary pathological basis of cardiovascular diseases, including CHD. However, the molecular underpinnings of CHD are still far from well understood. Our study attempted to identify aberrant plasma exosome-derived circRNAs and key exosomal circRNA biomarkers for CHD. The expression profiles of mRNAs, circRNAs, and lncRNAs in the blood exosomes of CHD patients and healthy controls were obtained from the exoRBase database. The corresponding miRNAs of the differentially expressed mRNAs, circRNAs, and lncRNAs were predicted via ENCORI and the miRcode database. LncRNAs/circRNAs and mRNAs with the cotargeted miRNAs were selected to construct an interaction network. Multiple machine learning algorithms have been used to explore potential biomarkers, followed by verification in patients with CHD using real-time quantitative reverse transcription-polymerase chain reaction (RT-qPCR). Based on the cutoff criterion of P < 0.05, we identified 85 differentially expressed circRNAs (4 upregulated and 81 downregulated), 43 differentially expressed lncRNAs (24 upregulated and 19 downregulated), and 312 differentially expressed mRNAs (55 upregulated and 257 downregulated). Functional enrichment analysis revealed that the differentially expressed mRNAs were involved mainly in neutrophil extracellular trap (NET) formation and the nucleotide-binding oligomerization domain- (NOD-) like receptor signaling pathway. Further analysis revealed that the DEGs in the circRNA/lncRNA-miRNA-mRNA interaction network were closely related to lipid and atherosclerotic signaling pathways. Hsa_circ_0001360 and hsa_circ_0000038 were identified as potential biomarkers for CHD based on three machine learning algorithms. The relative expression levels of hsa_circ_0001360 and hsa_circ_0000038 were significantly altered in plasma exosomes from patients with CHD. ROC curve analysis revealed that the areas under the curve (AUCs) were 0.860, 0.870, and 0.940 for hsa_circ_0001360, hsa_circ_0000038, and the two-gene combination, respectively. The circRNA/lncRNA-miRNA-mRNA interaction network might help to elucidate the pathogenesis of CHD. Hsa_circ_0001360 combined with hsa_circ_0000038 might be an important diagnostic biomarker.

A Meta-Analysis of Essential Trace Elements in Patients with Coronary Heart Disease

There is growing evidence that presence of essential trace elements that pose risk for coronary heart disease (CHD) patients. A meta-analysis was conducted on the levels of trace elements Copper (Cu), Zinc (Zn), Iron (Fe), Manganese (Mn), Cobalt (Co) and Chromium (Cr) in CHD patients. Eligible articles from the databases of Web of Science, Scopus, PubMed, EBSCOHost and Ovid were searched based on PRISMA guidelines. English articles published between 2011 to 2021 were included and analysed by descriptive statistics and RevMan 5.4. Quality assessment was assessed with Newcastle-Ottawa scale. There were six studies selected with 322 participants’ data. Trace elements Cu (SMD=-0.13, 95%CI=[-0.99, 0.73], I2=92%, p=0.77), Zn (SMD=-0.38, 95%CI=[-0.81, 0.06], I2=71%, p=0.09), Fe (SMD=0.47, 95%CI=[-1.19, 2.13], I2=97%, p=0.58) and Mn (SMD=0.11, 95%CI=[-0.11, 0.33], I2=0%, p=0.33) levels were not significant. Sensitivity analysis revealed significant Cu level among patients with CHD (SMD=-0.54, 95%CI=[-0.85, -0.22], I2=0%, p=0.0008) and Fe level among the controls (SMD=1.41, 95%CI=[0.08, 2.73], I2=95%, p=0.04). Whereas Co and Cr levels varied according to dietary and smoking behaviours. Overall quality assessment was medium-to-high quality. Elements Cu was found significant in CHD patients and Fe was found significant among the controls, while other findings were inconclusive.

Effects of Ninjurin 2 polymorphisms on susceptibility to coronary heart disease

ABSTRACT Objective The aim of this study was to explore the effects of Ninjurin 2 (NINJ2) polymorphisms on susceptibility to coronary heart disease (CHD). Methods We conducted a case-control study with 499 CHD cases and 505 age and gender-matched controls. Five single nucleotide polymorphisms (SNPs) in NINJ2 (rs118050317, rs75750647, rs7307242, rs10849390, and rs11610368) were genotyped by the Agena MassARRAY platform. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis to assess the association of NINJ2 polymorphisms and CHD risk-adjusted for age and gender. What’s more, risk genes and molecular functions were screened via protein-protein interaction (PPI) network and functional enrichment analysis. Results Rs118050317 in NINJ2 significantly increased CHD risk in people aged more than 60 years and women. Rs118050317 and rs7307242 had strong relationships with hypertension risk in CHD patients. Additionally, rs75750647 exceedingly raised diabetes risk in cases under multiple models, whereas rs10849390 could protect CHD patients from diabetes in allele, homozygote, and additive models. We also observed two blocks in NINJ2. Further interaction network and enrichment analysis showed that NINJ2 played a greater role in the pathogenesis and progression of CHD. Conclusion Our results suggest that NINJ2 polymorphisms are associated with CHD risk.

Islamic Spiritual Care with Murottal for Reducing Anxiety and Depression in Coronary Heart Disease Patients: A Comprehensive Systematic Review

Background:Spiritual care is a vital aspect of the nursing process, particularly for palliative patients such as those with Coronary heart disease. While pharmacological and medical interventions remain paramount for managing heart conditions, the efficacy of Islamic spiritual therapy with Murottal has also been significant. Research has demonstrated its notable influence on patients' quality of life, particularly in mitigating anxiety and depression. Objective:This study aims to conduct a systematic review to explore the role of Islamic spirituality in nursing, specifically through Murottal recitations, and its impact on anxiety and depression among Coronary heart disease patients. Method:Employing a systematic review design, we utilized various electronic databases including PubMed, ProQuest, Science Direct, DOAJ, Wiley, Garuda, and secondary PubMed-indexed sources from 2018 to 2023. Inclusion criteria comprised studies with a clear definition of spiritual care involving Murottal in nursing, confirmed Coronary heart disease diagnoses, and reporting outcomes such as the incidence of death, cardiovascular outcomes, and quality of life. Result:The search focused on examining the correlation between Islamic spiritual care with Murottal and the quality of life in patients with coronary heart disease. Following a rigorous methodology, which included study selection, critical appraisal, data extraction, and synthesis, the search yielded 1,286 articles, with seven meeting the inclusion criteria. Analysis and categorization of these articles based on evidence level and recommendations revealed a consistent association between Islamic spiritual care with Murottal and reduced anxiety and depression in Coronary heart disease patients. However, heterogeneity was observed in research instruments, implementation duration, and outcomes. Conclusion:The conclusive evidence from this review supports the notion that Islamic spiritual care, particularly through Murottal recitations, significantly impacts the quality of life among Coronary heart disease patients. Keywords: Anxiety, Coronary Heart Disease, Depression, Murottal, Spiritual Care