Cardiovascular Reviews

The Impact Analysis of Different Lipid-Lowering Regimens and Major Adverse Cardiovascular Events in ACS Patients after PCI

2026-07-10T13:24:41+08:00

Background and Objective: Intensive lipid-lowering therapy serves as a core intervention to improve the long-term prognosis of patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Currently, evidence-based clarification is still required for the efficacy discrepancies and applicable populations of three first-line lipid-lowering regimens: high-intensity statin monotherapy, statin plus ezetimibe, and statin plus proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i). This study aimed to systematically evaluate the impacts of these three regimens on major adverse cardiovascular events (MACE) in patients with ACS after PCI. Methods: We collected relevant randomized controlled trials (RCTs) and high-quality cohort studies on the three first-line regimens published from 2016 to 2022 worldwide. A random-effects model was adopted to analyze the risk of MACE in post-PCI ACS patients, and the therapeutic effects and sources of heterogeneity across different regimens were assessed. Results: Thirty-four studies with a total of 50,537 patients were finally included. The baseline characteristics were generally comparable between groups, and minor inter-group differences did not affect the analysis. (1) High-intensity statin significantly reduced the risk of MACE (RR = 0.52, 95% CI [0.37, 0.72], p < 0.0001), with pronounced benefits in Asian populations but no significant benefit in European and American populations. (2) Statin combined with ezetimibe lowered the MACE risk (RR = 0.59, 95% CI [0.40, 0.86], p = 0.006), and the benefit was more significant in Asian populations and in patients with a follow-up duration of ≥12 months. (3) Statin combined with PCSK9i reduced the MACE risk (RR = 0.80, 95% CI [0.72, 0.89], p < 0.0001) with low heterogeneity, and the benefit was more prominent in Asian populations and on the basis of moderate-intensity statin. Only the high-intensity statin group presented a positive Egger test, which was a false positive driven by heterogeneity, and the pooled results were stable. Conclusion: All three intensive lipid-lowering regimens can reduce the risk of MACE in post-PCI ACS patients, with more significant benefits observed in Asian populations. Statin combined with PCSK9i shows a stable risk-reduction effect.

Effects of Zhuang Medicine Longzuan Tongbi Decoction on the Expression of PDGF, IGF1 and VEGF in Rats with Left Ventricular Remodeling after Myocardial Infarction

2026-07-10T13:24:38+08:00

Objective: To investigate the effects of Zhuang Medicine Longzuan Tongbi Decoction on left ventricular remodeling in rats after myocardial infarction (MI), and to explain its underlying mechanism based on expressions of PDGF, IGF‑1, VEGF and related inflammatory factors. Methods: A total of 120 SD rats were randomly divided into a sham operation group, a model group, a positive control (Shexiang Baoxin Pill) group, as well as low-, medium-, and high-dose groups of Longzuan Tongbi Decoction. The MI model was established by ligation of the left anterior descending coronary artery. Postoperatively, gavage administration was performed once daily for 6 consecutive weeks. At the end of the experiment, the infarct size and microvessel density in myocardial tissues were measured; the expression levels of PDGF, IGF‑1, VEGF, IL‑1β and IL‑6 in myocardium were detected, and the serum contents of IL‑1β and IL‑6 were determined. Results: Compared with the model group, all dosage groups of Longzuan Tongbi Decoction significantly reduced myocardial infarct size, elevated the number and density of microvessels in myocardial tissue, upregulated the protein expressions of PDGF, IGF‑1 and VEGF in myocardium, and downregulated the levels of IL‑1β and IL‑6 in myocardial tissue and serum (P < 0.05). In terms of promoting angiogenesis and regulating related cytokines, the medium‑ and high‑dose groups of Longzuan Tongbi Decoction exhibited superior efficacy to the Shexiang Baoxin Pill group (P < 0.05), with an overall dose‑dependent effect. Conclusion: Zhuang Medicine Longzuan Tongbi Decoction may exert synergistic multi‑target effects to upregulate the expression of pro‑angiogenic factors and suppress inflammatory responses, thereby facilitating myocardial angiogenesis and ameliorating left ventricular remodeling. Its underlying mechanism is closely associated with the regulation of angiogenesis‑ and inflammation‑related signaling pathways.

Research on the Effectiveness of Teacher-Led Cardiopulmonary Resuscitation (CPR) Training for Middle School Students Using Standardized Videos under the Train-the-Trainer Model

2026-07-10T14:00:14+08:00

Objective: To explore the effectiveness of teacher-led CPR training for middle school students using standardized videos under the Train-the-Trainer model and verify its non-inferiority. Methods: A total of 400 students from 10 second-grade classes at a middle school in Deyang City were selected from December 2024 to December 2025 and randomly assigned to an experimental group and a control group, with 200 students in each group. The experimental group was taught by teachers who had undergone standardized training using standardized videos, while the control group was taught by medical personnel using the same videos and courseware. The scores of emergency medical theory knowledge, the pass rate of CPR practical skills, and the ratings on the training attitude scale were compared between the two groups after training and three months after training. Results: After training, the theoretical knowledge scores and the pass rate of practical skills in the experimental group were compared with those in the control group (P > 0.05). The 95% confidence intervals of the scores between the two groups were entirely within the non-inferiority margin. During the three-month follow-up after training, the skill retention in the experimental group was comparable to that in the control group. Both groups of students had high ratings on the training attitude scale. Conclusion: Under the Train-the-Trainer model, the effectiveness of teacher-led CPR training for middle school students using standardized videos is not inferior to that of medical personnel-led training. This model can effectively alleviate the shortage of emergency training teachers in schools and is worthy of promotion and application.

Research on the Correlation between Eye Movement Characteristics and Cognitive Impairment in Patients with Cerebral Small Vessel Disease

2026-07-10T13:24:37+08:00

Objective: To explore the eye movement characteristics of patients with cerebral small vessel disease (CSVD) and their correlation with cognitive impairment, and to validate the application value of eye-tracking technology in the early screening of CSVD-related cognitive impairment. Methods: A total of 81 subjects were included, with 51 in the CSVD group and 30 in the healthy control group. Cognitive assessment was conducted using the MoCA scale, and visual pairing and antisaccade tasks were detected using an AI-assisted eye-tracking system. Differences in eye movement parameters between the two groups were compared, and the correlation between eye movement indicators and cognitive scores was analyzed. Results: The saccade error rate in the CSVD group was significantly higher than that in the control group (P = 0.009). The total MoCA score, visuospatial and executive function, attention, and language function scores were significantly lower in the CSVD group than in the control group (all P < 0.05). The saccade error rate was significantly negatively correlated with the total MoCA score (rs = -0.382, P = 0.0005) and visuospatial and executive function score (rs = -0.313, P = 0.005). Conclusion: Patients with CSVD exhibit characteristic eye movement abnormalities, and the saccade error rate can serve as an objective biomarker reflecting their executive function and overall cognitive impairment. Eye-tracking technology provides a non-invasive, objective, and efficient new means for the early screening of CSVD-related cognitive impairment.

Trends in the Burden of Ischemic Heart Disease in Women: An Analysis of High Body Mass Index and Low Physical Activity Factors Based on GBD 2021 Data

2026-07-10T13:24:35+08:00

Objective: This study systematically assessed temporal trends in the global burden of ischemic heart disease (IHD) attributable to high body mass index (BMI) and low physical activity (PA) among women from 1990 to 2021. Methods: Data were obtained from the 2021 Global Burden of Disease Database, which covers disability-adjusted life years (DALYs), mortality rates, years lived with disability (YLDs), years of life lost (YLLs), and age-standardized rates (ASRs) attributable to high BMI and low PA among women. ASRs and estimated annual percentage changes (EAPCs) were calculated over 32 years. Temporal trends were analyzed by country, region, and sociodemographic index (SDI). A decomposition analysis was performed, and future predictions were made using the ARIMA time-series method to assess these trends comprehensively. Results: DALYs associated with IHD attributable to high BMI in women increased from 5.17 million in 1990 to 9.87 million in 2021. Deaths increased from 243,512 to 461,122, YLDs from 85,634 to 238,639, and YLLs from 5.08 to 9.63 million. However, DALYs related to female IHD caused by low PA increased from 146 to 242 million. Deaths increased from 87,707 to 152,305, YLDs from 23,564 to 54,301, and YLLs from 144 to 236 million. Although the ASRs of DALYs, mortality, and YLLs associated with high BMI and low PA have decreased, the ASR of YLDs has remained relatively stable over 32 years. This overall increase in disease burden underscores the urgency of intervention strategies to address the risk factors of high BMI and low PA. Significant regional and national differences were observed, with the burden shifting from high-SDI areas to low- and low-middle-SDI areas, a trend further amplified by population growth and aging. Although overall health inequalities have decreased, predictions indicate that the ASR of female IHD will continue to decline over the next 29 years, whereas the ASR of YLDs is expected to increase. This indicates that although women’s health awareness is increasing, more efforts are needed to maintain cardiovascular health, reduce the burden of IHD, and improve the quality of life for women. Conclusions: Since 1990, high BMI and insufficient PA have substantially contributed to the global burden of IHD in women, with profound variation by age, region, and sociodemographic context. These effects differ from those in men due to women's unique physiological and social roles, underscoring the need for targeted health strategies aimed at women. Nations should focus on managing BMI and promoting physical activity to reduce the IHD burden and inform public health policies to improve women’s cardiovascular health and quality of life.

Myocardial Infarction Model in Mice: Left Anterior Descending Coronary Artery Ligation

2026-07-10T13:24:40+08:00

Background: A stable and feasible animal model for myocardial infarction (MI) is of great significance for the research on MI treatment. This study clarified the establishment process of the mouse MI model, aiming to enhance the efficiency of the modeling procedure. Method: Male C57 mice were randomly divided into a sham group and a model group, with 10 mice in each group. In the sham group, after anesthesia, the chest skin was incised to expose the heart, which was briefly exteriorized and then rapidly returned to the thoracic cavity before suturing. In the model group, MI was induced by ligation of the left anterior descending coronary artery. Subsequently, the 24-hour survival rate was recorded, heart rate, blood pressure, and electrocardiogram were measured, and myocardial infarct size was assessed by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Result: After modeling, the 24-hour survival rate of mice in the model group was 70%. There was no significant difference in heart rate between the model group and the sham group, while both diastolic and systolic blood pressures were higher in the model group compared to the sham group. Compared with the sham group, the model group exhibited ST segment elevation and T wave inversion on the electrocardiogram. TTC staining revealed no infarcted areas in the hearts of the sham group, whereas distinct pale infarcted areas were observed in the model group. Conclusion: The method of inducing myocardial ischemia and necrosis by ligating the left anterior descending coronary artery of mice employed in this study proved to be a reliable approach for successfully establishing the model.

Insulin and Cardiovascular Health: New Insights in the Field of Coronary Heart Disease Complicated with Type 2 Diabetes

2026-07-10T13:24:34+08:00

Insulin is currently a crucial treatment for treating type 2 diabetes and plays a significant role in improving the prognosis of patients. When patients with cardiovascular disease who also have type 2 diabetes, the all-cause mortality rate increases by approximately 1.5 times. Consequently, many patients choose insulin as a treatment method for type 2 diabetes. However, the effects and mechanisms of insulin treatment on cardiovascular disease are rarely discussed. This review systematically explores the role and mechanisms of insulin and its related receptors in the progression of cardiovascular disease in patients with both conditions. It focuses on the impact of insulin on coronary plaques, cardiovascular neogenesis, and myocardium, aiming to guide clinical treatment and improve patient outcomes.