Startseite Combination of C-reactive protein and fibrinogen-to-albumin ratio as a novel predictor of all-cause mortality in heart failure patients
Artikel Open Access

Combination of C-reactive protein and fibrinogen-to-albumin ratio as a novel predictor of all-cause mortality in heart failure patients

  • Sirui Yang , Hongyan Cai , Zhao Hu , Wei Huang , Qin Fu , Ping Xia , Wenyi Gu , Tao Shi , Fazhi Yang und Lixing Chen EMAIL logo
Veröffentlicht/Copyright: 18. November 2024
Artikel downloaden (PDF)
Open Medicine
Aus der Zeitschrift Open Medicine Band 19 Heft 1

Abstract

Heart failure (HF) is a common cardiovascular disease that is related to systemic inflammation. This study aimed to assess the role of C-reactive protein (CRP) combined with fibrinogen-to-albumin ratio (C-FAR) on the prognosis of all-cause mortality in different types of HF. A total of 1,221 hospitalized HF patients from the First Affiliated Hospital of Kunming Medical University between January 2017 and October 2021 were retrospectively analyzed. Patients were categorized into a low C-FAR group (C-FAR < 0.69) and a high C-FAR group (C-FAR ≥ 0.69) according to the median C-FAR value. We used Kaplan–Meier plots, restricted cubic spline regression, Cox survival analyses, and time-dependent receiver operating characteristic (ROC) analyses to evaluate the prognostic role of C-FAR on all-cause mortality in different types of HF. After excluding patients lost to follow-up and those with missing data, we ultimately included 1,196 patients with HF. The Kaplan–Meier plots showed that HF patients with high C-FAR levels had a significantly greater risk of all-cause mortality. In all four Cox proportional risk models, C-FAR was an independent predictor of all-cause mortality. Based on the ROC curve, the area under the curve (AUC) for C-FAR was greater than the AUC for Lg BNP. In the subgroup analyses, patients had the highest risk of all-cause mortality when FAR ≥ 0.091 and CRP ≥ 7.470. Regardless of the type of HF, C-FAR can be a good predictor of prognosis for all-cause mortality in HF patients, and patients with high C-FAR had a significantly increased risk of death compared to those with low C-FAR.

Keywords: C-reactive protein; fibrinogen/albumin ratio; heart failure; inflammation; prognosis

1 Introduction

Heart failure (HF) remains a rising global epidemic and the fastest-growing cardiovascular disease (CVD) in the world [1]. Despite improved survival, patients with HF are still at risk of substantial mortality or recurrent decompensation requiring hospitalization [2]. The 2021 ESC HF Guidelines state that patients with HF can be divided into three categories according to left ventricular ejection fraction (LVEF): HF with reduced ejection fraction (HFrEF) is defined as an LVEF <40%; HF with mildly reduced ejection fraction (HFmrEF) is defined as an LVEF of 40–49%; and HF with preserved ejection fraction (HFpEF) is defined as an LVEF ≥50%. There are also differences in risk factors, pathophysiology, and treatments among different types of HF [3]. HF is characterized by chronic inflammation, both locally in the heart and in the circulation, so chronic systemic inflammation is associated with an increased risk of HF. More precisely, the high plasma concentrations of several proinflammatory cytokines are closely related to disease progression and poor prognosis [4,5].

C-reactive protein (CRP), an acute-phase reactant predominantly released from hepatocytes, is a nonspecific inflammatory marker clearly associated with adverse CVD outcomes [6]. Previous observational studies reported that CRP, as a representative biomarker of systemic inflammation, can predict the development and prognosis of HF [7,8,9].

Another inflammatory marker, fibrinogen (FIB), is an important determinant of blood viscosity and platelet aggregation and is also considered to be related to HF risk [10]. Some studies have confirmed the relationship between low serum albumin (ALB) and an increase in CVD incidence and mortality [11,12,13]. The fibrinogen-to-ALB ratio (FAR), which comprises these two indicators, is independently associated with the presence and severity of coronary artery disease and may serve as a potential prognostic indicator for patients with CVD [14,15]. A study by Rong Huang et al. demonstrated that FAR was independently associated with adverse prognosis in patients with acute decompensated HF in diabetes mellitus [16]. Xu et al. found that the FAR is an independent prognostic risk factor for 90-day and 1-year all-cause mortality among HF patients [17].

Several studies have shown that FAR and CRP are associated with the prognosis of HF patients [16,18,19], so we speculate that FAR combined with CRP may also affect the prognosis of patients with HF. The aim of our study was to evaluate the clinical prognostic impact of FAR combined with CRP in worsening HF patients with different ejection fractions.

2 Materials and methods

2.1 Study population

A retrospective analysis of 1,221 consecutive patients with acute exacerbation of chronic HF admitted to the First Affiliated Hospital of Kunming Medical University from January 2017 to October 2021 was carried out. The enrolled patients with HF had a New York Heart Association (NYHA) functional class of III or IV and brain natriuretic peptide (BNP) levels of at least 500 pg/mL on admission. After excluding patients with missing data (blood test results, echocardiographic data), other serious illnesses (malignancy, infections, or severe renal or hepatic impairment), and those who were lost to follow-up, 1,196 patients remained and were included in this study.

2.2 Data collection and definitions

Patient demographics (including age and sex), clinical history, anthropometric data, laboratory test results, echocardiographic data, and information on medication use during hospitalization were collected at admission. Some peripheral venous blood samples were collected on admission for routine blood tests, while some were collected after overnight fasting (>8 h), and the different variables were measured in the laboratory. FIB, ALB, CRP, D-dimer, troponin, creatine kinase-MB, BNP, hemoglobin, uric acid (UA), creatinine, white blood cell (WBC) count, fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TGs), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, serum sodium, serum potassium, alanine aminotransferase (ALT), and aspartate transaminase (AST) levels were measured.

Patients were followed up primarily through telephone contact. If no response was received, follow-up was terminated at the time of the patient’s last available medical record. The endpoint of this study was all-cause mortality in patients with HF.

FAR was defined as the ratio of the plasma FIB level (g/L) to the plasma ALB level (g/L). C-FAR was calculated as the serum CRP level (mg/L) × FAR. Because the raw values of BNP had a highly skewed distribution, they were logarithmically transformed.

2.3 Statistical analysis

We divided the patients into a low C-FAR group (C-FAR <0.69) and a high C-FAR group (C-FAR ≥ 0.69) according to the median C-FAR value. Continuous variables were classified as normally or nonnormally distributed by the normality test. The independent samples t test was used to compare differences in normally distributed continuous variables, and the Mann‒Whitney U rank sum test was used to compare differences in nonnormally distributed data. Continuous variables are presented as the mean ± standard deviation if normally distributed or as the median with interquartile range if nonnormally distributed. Categorical variables are summarized as numbers and percentages. Between-group differences in categorical variables were compared using the χ 2 test.

The cumulative incidence of all-cause death was calculated using Kaplan–Meier plots and the log-rank test. The restricted cubic spline models allowed us to determine the association of C-FAR with the risk of all-cause mortality. Unadjusted univariate Cox proportional hazard regression analyses were applied to show the estimated impact of each variable on all-cause mortality. Multivariate analysis using COX regression model tested variables that were significant (P < 0.05) in the univariate analysis to determine independent predictors of all-cause mortality. Multivariate Cox proportional hazards models were applied to determine the associations of C-FAR with the incidence rates of all-cause mortality. The first unadjusted group was regarded as the reference group. The results are expressed as hazard ratios (HRs) with 95% confidence intervals (CIs). Time-dependent receiver operating characteristic (ROC) curves and the corresponding area under the curve (AUC) were calculated to compare the predictive ability of C-FAR in HF patients.

The correlation coefficient was calculated for statistical correlations between continuous variables based on Spearman’s nonparametric test. In addition, we performed stratification analysis to confirm whether the effect of FAR and CRP differed in each of the subgroups. Patients with HF were divided into group 1 (FAR < 0.091 + CRP < 7.470), group 2 (FAR < 0.091 + CRP ≥ 7.470), group 3 (FAR ≥ 0.091 + CRP < 7.470), and group 4 (FAR ≥ 0.091 + CRP ≥ 7.470) according to the median FAR and CRP values.

Data were analyzed statistically using SPSS ver. 25.0 and R 4.3.1. A double-sided P value <0.05 was considered statistically significant.

  1. Informed consent: Informed written consent was obtained from all patients before the intervention.

  2. Ethical approval: This study was endorsed by the medical ethics committee of the First Affiliated Hospital of Kunming Medical University and complied with the Declaration of Helsinki.

3 Results

3.1 Baseline patient characteristics

After excluding patients lost to follow-up and those with missing data, 1,196 HF patients were enrolled in the study. The median age of the patients was 67 years, and 38.0% were women. Compared to the low C-FAR group, patients in the high C-FAR group had higher values of WBC, FIB, CRP, FPG, UA, creatinine, and sodium and worse NYHA class, while they had lower values of RBC, hemoglobin, and GFR and a higher proportion of combined diabetes (all P values <0.05) (Table 1).

Table 1

Baseline characteristics according to C-FAR

Characteristics Total (n = 1,196) Low C-FAR group (n = 598) High C-FAR group (n = 598) P value
Age, years 66.83 ± 12.51 65.55 ± 12.90 68.11 ± 12.00 0.113
Female, n (%) 454 (38.0) 239 (40.0) 215 (47.4) 0.153
BMI, kg/m2 23.02 ± 3.81 22.98 ± 3.96 23.06 ± 3.66 0.304
NYHA, n (%) 0.001
 Class Ⅳ 444 (37.1) 194 (32.4) 250 (41.8)
Heart rate (bpm) 85.24 ± 21.02 83.05 ± 20.08 87.43 ± 21.71 0.023
SBP, mmHg 122.10 ± 22.94 122.20 ± 22.65 122.00 ± 23.26 0.927
DBP, mmHg 76.23 ± 15.04 76.79 ± 15.20 75.67 ± 14.88 0.212
Medical history, n (%)
 Smoking status 409 (34.2) 195 (32.6) 214 (35.8) 0.247
 Drinking status 201 (16.8) 100 (16.7) 101 (16.9) 0.983
 Coronary heart disease 619 (51.8) 298 (49.8) 321 (53.7) 0.183
 Hypertension 660 (55.2) 319 (53.3) 341 (57.0) 0.201
 Diabetes 341 (28.5) 147 (24.6) 194 (32.4) 0.003
 Atrial fibrillation 406 (33.9) 202 (33.8) 204 (34.1) 0.903
LVEF 0.812
 HFrEF 499 (41.7) 249 (41.6) 250 (41.8)
 HFmrEF 233 (19.5) 113 (18.9) 120 (20.1)
 HFpEF 464 (38.8) 236 (39.5) 228 (38.1)
Laboratory data
 WBC (109/L) 6.93 (5.54, 9.07) 6.47 (5.34, 8.21) 7.39 (5.78, 10.09) <0.001
 RBC (1012/L) 4.55 ± 0.77 4.61 ± 0.72 4.48 ± 0.80 0.041
 PLT (109/L) 192.00 (148.00, 243.00) 192.50 (152.00, 240.00) 191.00 (145.75, 247.25) 0.730
 Fibrinogen (g/L) 3.57 ± 1.30 3.12 ± 0.96 4.01 ± 1.43 <0.001
 ALB (g/L) 36.69 ± 4.55 37.93 ± 4.23 35.46 ± 4.53 0.465
 Hemoglobin (g/L) 138.11 ± 24.17 140.15 ± 22.70 136.06 ± 25.41 0.006
 Lg BNP 3.17 ± 0.28 3.13 ± 0.27 3.20 ± 0.29 0.155
 CRP (mg/L) 7.47 (3.00, 21.78) 3.00 (1.60, 5.00) 21.69 (12.60,47.89) <0.001
 FPG (mmol/L) 5.03 (4.16, 6.50) 4.89 (4.12, 5.99) 5.12 (4.22, 7.15) <0.001
 UA (μmol/L) 477.10 (370.50, 588.10) 467.90 (365.00, 567.10) 493.35 (382.08, 606.55) 0.016
 Creatinine (μmol/L) 103.50 (83.20, 134.10) 98.85 (81.13, 125.35) 108.70 (86.68, 140.90) <0.001
 GFR (ml/min) 44.10 (32.33, 56.69) 46.13 (34.87, 59.36) 42.16 (29.74, 54.13) <0.001
 Sodium (mmol/L) 141.01 ± 4.43 141.55 ± 4.01 140.46 ± 4.75 0.001
 Potassium (mmol/L) 3.94 ± 0.60 3.96 ± 0.58 3.92 ± 0.62 0.203
 Chlorine (mmol/L) 102.92 ± 4.68 103.62 ± 4.49 102.21 ± 4.76 0.148
 Total cholesterol (mmol/L) 3.64 ± 1,01 3.73 ± 0.99 3.56 ± 1.03 0.552
 TG (mmol/L) 1.10 (0.86, 1.50 1.10 (0.85, 1.53) 1.10 (0.87, 1.46) 0.768
 AST (U/L) 28.60 (20.03, 43.28) 28.20 (20.28,40.00) 28.85 (20.00, 48.93) 0.081
 ALT (U/L) 25.05 (16.70, 42.30) 25.00 (16.88, 41.00) 25.80 (16.25, 45.40) 0.513
Medications at admission, n (%)
 CRT/ICD 116 (9.7) 54(9.0) 62(10.4) 0.895
 SGLT2i 263 (22.0) 145 (24.2) 118 (19.7) 0.059
 Beta-blocker 690 (57.7) 365 (61.1) 325 (54.4) 0.615
 Aldosterone antagonist 947 (79.2) 435 (72.7) 474 (79.3) 0.943
 ACEI/ARB/ARNI 587 (49.1) 330 (55.2) 257 (43.0) 0.321
 Diuretics 930 (77.8) 397 (66.4) 533 (89.1) 0.838

BMI: body mass index; NYHA: New York Heart Association; SBP: systolic blood pressure; DBP: diastolic blood pressure; LVEF: left ventricular ejection fraction; WBC: white blood cell; RBC: red blood cell; PLT: blood platelet; ALB: albumin; BNP: B-type natriuretic peptide; CRP: C-reactive protein; FPG: fasting plasma glucose; UA: uric acid; GFR: glomerular filtration rate; AST: alanine aminotransferase; ALT: aspartate transaminase; SGLT2i: sodium-glucose cotransporter 2 inhibitor; ACEI: angiotensin-converting enzyme inhibitor; ARB: angiotensin receptor inhibitor; ARNI: angiotensin receptor neprilysin inhibitor.

Note: low C-FAR: C-FAR < 0.69, high C-FAR: C-FAR ≥ 0.69.

Differences in normally distributed continuous variables were compared using variance analyses, and those in nonnormally distributed data were compared using Mann‒Whitney U tests. chi-square tests were used to compare differences in categorical variables between groups.

3.2 Prediction of the incidence of all-cause mortality by C-FAR

Kaplan‒Meier analysis showed that the cumulative incidence of all-cause mortality was higher in the high C-FAR group (C-FAR ≥ 0.69) than in the low C-FAR group (C-FAR <0.69) for all patients (log-rank test, chi-square 122.113, P < 0.001) (Figure 1a), HFrEF + HFmrEF patients (log-rank test, chi-square 77.427, P < 0.001) (Figure 1b), and HFpEF patients (log-rank test, chi-square 44.780, P < 0.001) (Figure 1c).

Figure 1 Kaplan‒Meier analysis for all-cause mortality according to different C-FAR levels. (a) All HF patients, (b) HFrEF plus HFmrEF patients, and (c) HFpEF patients. Note: Q1: low C-FAR, C-FAR < 0.69, Q2: high C-FAR, C-FAR ≥ 0.69. The line represents the reference value of the survival rate, and the corresponding color area represents the CI. The all-cause mortality of the high C-FAR group was higher than the low C-FAR group for all patients, regardless of the type of HF.
Figure 1

Kaplan‒Meier analysis for all-cause mortality according to different C-FAR levels. (a) All HF patients, (b) HFrEF plus HFmrEF patients, and (c) HFpEF patients. Note: Q1: low C-FAR, C-FAR < 0.69, Q2: high C-FAR, C-FAR ≥ 0.69. The line represents the reference value of the survival rate, and the corresponding color area represents the CI. The all-cause mortality of the high C-FAR group was higher than the low C-FAR group for all patients, regardless of the type of HF.

As shown in Figure 2, we used restricted cubic splines to flexibly model and visualize the relation of C-FAR levels with all-cause mortality in all HF patients and different types of HF patients. C-FAR was roughly positively correlated with the risk rate of all-cause death for all patients. In HFpEF patients, C-FAR was also roughly positively correlated with the risk rate of all-cause death. However, in HFrEF + HFmrEF patients, C-FAR was positively correlated with the risk of all-cause death at first and then negatively correlated.

Figure 2 Restricted cubic spline analysis for the association of C-FAR and all-cause mortality. (a) All HF patients, (b) HFrEF plus HFmrEF patients, and (c) HFpEF patients. Note: HRs are indicated by solid lines and 95% CIs by shaded areas.
Figure 2

Restricted cubic spline analysis for the association of C-FAR and all-cause mortality. (a) All HF patients, (b) HFrEF plus HFmrEF patients, and (c) HFpEF patients. Note: HRs are indicated by solid lines and 95% CIs by shaded areas.

3.3 C-FAR as an independent predictor

Table 2 shows the four multivariate Cox proportional hazard models used to determine the correlation between the C-FAR groups and all-cause mortality. In model 4, the covariates adjusted for included age, body mass index, NYHA cardiac function classification, Lg BNP, creatinine, serum UA, and GFR. With the low C-FAR group as a reference, high C-FAR was associated with a higher incidence of all-cause mortality in all HF patients and in different types of HF patients. Compared with low-level C-FAR patients, the HR of high-level C-FAR patients increased by 1.168 times in all HF patients, by 1.152 times in HFrEF plus HFmrEF patients, and by 0.915 times in HFpEF patients (P < 0.001).

Table 2

Cox proportional hazards models for the association of C-FAR and the risk of all-cause mortality

Model All HF patients HFrEF plus HFmrEF HFpEF
HR (95% CI) P HR (95% CI) P HR (95% CI) P
Unadjusted 2.601 (2.181, 3.101) <0.001 2.582 (2.074,3.216) <0.001 2.641 (1.965, 3.551) <0.001
Adjusted model 1 2.464 (2.066, 2.940) <0.001 2.466 (1.979, 3.073) <0.001 2.437 (1.812, 3.278) <0.001
Adjusted model 2 2.512 (2.105, 2.998) <0.001 2.516 (2.019,3.136) <0.001 2.479 (1.843, 3.335) <0.001
Adjusted model 3 2.267 (1.897, 2.709) <0.001 2.207 (1.757, 2.772) <0.001 1.996 (1.471, 2.707) <0.001
Adjusted model 4 2.168 (1.808, 2.600) <0.001 2.152 (1.710, 2.707) <0.001 1.915 (1.407, 2.606) <0.001

Ref.: low C-FAR (C-FAR <0.69).

Adjusted model 1: adjusted for age.

Adjusted model 2: adjusted for age and BMI.

Adjusted model 3: model 2 + NYHA cardiac function classification and Lg BNP.

Adjusted model 4: model 3 + creatinine, serum UA, and GFR.

3.4 Predictive ability of C-FAR

We constructed time-dependent ROC curves to investigate the ability of C-FAR to predict all-cause mortality in HF patients. In ROC curve analysis, C-FAR had an AUC of 0.717 (95% CI 0.688–0.746), with a sensitivity of 63.9% and a specificity of 70.0%, for predicting the prognosis of all HF patients. C-FAR was significantly better than Lg BNP (AUC 0.639, 95% CI 0.608–0.671, P < 0.001) (Figure 3a).

Figure 3 Time-dependent ROC curves of C-FAR with the reference line for all-cause mortality. (a) All HF patients. (b) HFrEF plus HFmrEF patients. (c) HFpEF patients.
Figure 3

Time-dependent ROC curves of C-FAR with the reference line for all-cause mortality. (a) All HF patients. (b) HFrEF plus HFmrEF patients. (c) HFpEF patients.

C-FAR was also better than Lg BNP in predicting the prognosis of patients with different types of HF. Among patients with HFrEF plus HFmrEF, the AUC of C-FAR was 0.721 (95% CI 0.684–0.758) and that of Lg BNP was 0.638 (95% CI 0.598–0.678) (Figure 3b). Among patients with HFrEF, the AUC of C-FAR was 0.717 (95% CI 0.670–0.763) and that of Lg BNP was 0.627 (95% CI 0.575–0.679) (Figure 3c) (all P values were <0.001).

3.5 Correlation and subgroup analysis

The Spearman’s rank correlation analysis results are reported in Table A1. FAR was positively correlated with CRP in the total participant population [Spearman’s correlation coefficient (r): 0.318, P < 0.001]. In addition, C-FAR was positively correlated with age, LVEF, Lg BNP, FPG, WBC, PLT, AST, and creatinine but negatively correlated with RBC, HB, serum sodium, serum chlorine, GFR, and TC (P < 0.05).

There was an interaction between FAR and CRP, so subgroup analysis was performed to determine the association. All patients with HF were divided into four groups (group 1: FAR < 0.091 + CRP < 7.470, group 2: FAR < 0.091 + CRP ≥ 7.470, group 3: FAR ≥ 0.091 + CRP < 7.470, group 4: FAR ≥ 0.091 + CRP ≥ 7.470). Using group 1 as a reference, group 4 patients had the highest risk of all-cause mortality (Table 3).

Table 3

Subgroup analysis

Unadjusted Adjusted
HR (95% CI) P HR (95% CI) P
All HF patients
FAR < 0.091 Ref. Ref.
FAR ≥ 0.091 1.252 (1.061, 1.478) 0.008 1.195 (1.003, 1.425) 0.046
CRP < 7.470 Ref. Ref.
CRP ≥ 7.470 2.900 (2.427, 3.465) <0.001 2.182 (1.811, 2.629) <0.001
Combined categories
Group 1: FAR < 0.091 + CRP < 7.470 Ref. Ref.
Group 2: FAR < 0.091 + CRP ≥ 7.470 2.468 (1.928, 3.158) <0.001 1.591 (1.226, 2.066) <0.001
Group 3: FAR ≥ 0.091 + CRP < 7.470 0.818 (0.602, 1.111) 0.199 0.723 (0.530, 0,988) 0.042
Group 4: FAR ≥ 0.091 + CRP ≥ 7.470 2.827 (2.262, 3.532) <0.001 2.117 (1.674, 2.675) <0.001
HFrEF plus HFmrEF patients
FAR < 0.091 Ref. Ref.
FAR ≥ 0.091 1.187 (0.996, 1.459) 0.102 1.142 (0.919, 1.419) 0.230
CRP < 7.470 Ref. Ref.
CRP ≥ 7.470 2.986 (2.386, 3.736) <0.001 2.369 (1.870, 3.000) <0.001
Combined categories
Group 1: FAR < 0.091 + CRP < 7.470 Ref. Ref.
Group 2: FAR < 0.091 + CRP ≥ 7.470 2.617 (1.954, 3.504) <0.001 1.768 (1.291, 2.422) <0.001
Group 3: FAR ≥ 0.091 + CRP < 7.470 0.728 (0.483, 1.098) 0.130 0.620 (0.408, 0,944) 0.026
Group 4: FAR ≥ 0.091 + CRP ≥ 7.470 2.757 (2.095, 3.626) <0.001 2.170 (1.628, 2.893) <0.001
HFpEF patients
FAR < 0.091 Ref. Ref.
FAR ≥ 0.091 1.461 (1.093, 1.952) 0.010 1.306 (0.956, 1.784) 0.093
CRP < 7.470 Ref. Ref.
CRP ≥ 7.470 2.753 (2.052, 3.693) <0.001 1.826 (1.332, 2.503) <0.001
Combined categories
Group 1: FAR < 0.091 + CRP < 7.470 Ref. Ref.
Group 2: FAR < 0.091 + CRP ≥ 7.470 2.082 (1.303, 3.328) 0.002 1.215 (0.738, 2.000) 0.445
Group 3: FAR ≥ 0.091 + CRP < 7.470 0.992 (0.617, 1.597) 0.975 0.878 (0.542, 1.424) 0.598
Group 4: FAR ≥ 0.091 + CRP ≥ 7.470 3.107 (2.107, 4.580) <0.001 2.038 (1.335, 3.109) 0.001

Note: Adjusted for age, BMI, NYHA cardiac function classification, Lg BNP, PLT, HB, chlorine, AST, and UA.

4 Discussion

This study suggested that C-FAR plays an important role in predicting the prognosis of patients with different types of HF. Kaplan‒Meier analysis showed that the all-cause mortality of the high C-FAR group was higher regardless of the type of HF. In all four Cox proportional risk models, for all HF patients and for different HF subgroups (HFrEF plus HFmrEF and HFpEF), C-FAR was an independent predictor of all-cause mortality. Subgroup analysis showed that patients had the highest risk of all-cause mortality when FAR ≥ 0.091 and CRP ≥ 7.470. Among all HF patients, the risk of death was 2.117 times higher than that in the FAR < 0.091 and CRP < 7.470 group; among HFrEF plus HFmrEF patients, it was 2.170 times higher; and among HFpEF patients, it was 2.038 times higher. The time-dependent ROC curves showed that the AUC for C-FAR was 0.717 (P < 0.001) in all HF patients, with a sensitivity of 63.9% and a specificity of 70.0%, which provided an incremental prognostic value beyond that of plasma BNP (AUC = 0.639). In HFrEF plus HFmrEF and HFpEF patients, C-FAR was also better than Lg BNP in predicting the prognosis of patients.

FIB is a marker of thrombosis and inflammation and is associated with the prognosis of many diseases, including coronary artery disease [20], diabetes [21], and chronic kidney disease [22]. There is growing evidence that FIB is a poor prognostic predictor of CVD [23,24,25]. FIB may increase cardiovascular risk through platelet aggregation, plasma viscosity, and fibrin formation. A study by Kotbi et al. has also shown that FIB is related to the severity of coronary artery disease and cardiovascular risk in Moroccan patients [26]. ALB is a protein synthesized in the liver that influences nutrient absorption, colloidal pressure, and systemic inflammation [27]. In HF, hypoalbuminemia may be a marker of comorbid burden, inflammatory state, malnutrition, and cachexia. Low serum ALB levels are associated with an increased risk of HF onset and progression. Hypoproteinemia may promote pulmonary bruising, myocardial edema, and subsequent worsening of myocardial dysfunction, diuretic resistance, and fluid retention and reduce antioxidant function and anti-inflammatory properties [28,29,30,31]. In patients with HFpEF, the excessive activation of renin–angiotensin–aldosterone system leads to the expansion of blood volume, and the circulating blood volume continues to increase through progressive sodium and water retention, resulting in the decrease of plasma ALB concentration. In patients with HFrEF, to maintain circulatory homeostasis, the sympathetic nervous system and the renin–angiotensin–aldosterone system are continuously activated through continuous efforts [32,33]. In this process, the over-expression of bioactive molecules has toxic effects on the heart and circulation, accompanied by the further activation of inflammatory signaling pathway [34] which leads to the increase of CRP and FIB levels. The role of FAR, as a ratio of FIB to ALB, has been elucidated in several diseases. FAR has been associated with poor prognosis in a variety of cancers [35,36,37,38] and has also been directly associated with the severity of coronary artery calcification and poor prognosis in acute coronary syndromes [15,39,40], but it is less studied in HF. In addition, it is more sensitive and specific in predicting major adverse cardiovascular events than FIB and ALB alone [14].

Serum CRP level has been widely considered to be a nonspecific but sensitive marker of the acute inflammatory response. During acute inflammation, CRP levels can be increased by 100 times or even 500 times. This reaction is mainly regulated by proinflammatory cytokines, especially IL-6 [41]. Many prospective studies have shown that plasma CRP is a strong independent predictor of the risk of acute myocardial infarction, stroke, peripheral arterial disease, and vascular death [42,43,44]. Anand et al. found that higher CRP levels are associated with features of more severe HF and are independently associated with mortality and morbidity [18]. Jin et al. reported that CRP was an excellent prognostic marker for HFrEF, HFmrEF, and HFpEF [45]. The primary cause of elevated CRP is related to cardiac decompensation and ongoing damage to other organs; low cardiac output and venous stasis may induce IL-6 production. This key cytokine activates CRP through TNF-α production, which in turn activates complement and amplifies the inflammatory response; this may lead to myocardial tissue damage or dysfunction [46]. The contribution of CRP to the progression of HF may also be related to effects on organs other than the heart. The common comorbidities of HF, anemia, and renal dysfunction may be caused in part by inflammatory activation [47]. However, the specific inflammatory processes that lead to elevated CRP levels in patients with HF and their specific mechanisms for disease progression have not been clarified.

5 Conclusion

This study indicates that FAR and CRP are independent predictors of prognosis in CHF patients. C-FAR was significantly associated with the incidence of all-cause mortality in HF patients, regardless of HF subtype, and roughly positively correlated with the risk of all-cause death. Our study demonstrated that C-FAR can predict the prognosis of patients with HF.

6 Limitations

This is a retrospective observational study, and data bias could not be avoided despite correcting for multiple confounding factors. Further prospective studies are needed to validate the role of C-FAR in the prognosis of patients with CHF. The risk of selection bias in retrospective research is inevitable, which might affect the results’ generalizability. Patients with HF who were in NYHA class III or IV were the primary subjects in this study. The predictive value of the C-FAR for all-cause mortality in HF patients with NYHA class I or II was not explored.

# Sirui Yang and Hongyan Cai are co-first authors.

  1. Funding information: This study was supported by the Applied Basic Research Program of the Science and Technology Hall of Yunnan Province and Kunming Medical University (Project No. 202301AY070001-130), Yunnan health training project of high-level talents (H2019052), and Yunnan Provincial Health Commission Clinical Medical Center (ZX2019-03-01).

  2. Author contributions: Sirui Yang, Hongyan Cai, and Lixing Chen conceived and designed the survey, conducted the statistical analyses, drafted the first manuscript, and approved the final manuscript as submitted. Zhao Hu, Wei Huang, Qin Fu, and Ping Xia participated in drafting the manuscript and conducted the statistical analyses. Wenyi Gu, Tao Shi, and Fazhi Yang performed data collection and statistical analysis. All the authors have read and approved the final version of the manuscript.

  3. Conflict of interest: The authors claim that they have no competing interests.

  4. Data availability statement: The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Appendix

 

Table A1

Correlation coefficients between C-FAR and other factors

Variable FAR CRP C-FAR
r p r p r p
FAR 1 0.318 <0.001
CRP 0.318 <0.001 1
Age 0.057 0.047 0.065 0.025 0.064 0.026
BMI 0.019 0.505 −0.001 0.985 0.025 0.391
LVEF 0.145 <0.001 0.029 0.323 0.071 0.014
NYHA 0.012 0.676 0.112 <0.001 0.132 <0.001
Lg BNP −0.004 0.885 0.093 0.001 0.087 0.003
FPG 0.135 <0.001 0.117 <0.001 0.137 <0.001
WBC 0.193 <0.001 0.277 <0.001 0.277 <0.001
RBC −0.181 <0.001 0.094 0.001 −0.106 <0.001
PLT 0.288 <0.001 0.008 0.784 0.071 0.013
HB −0.212 <0.001 −0.092 0.001 −0.114 <0.001
Sodium −0.111 <0.001 −0.127 <0.001 −0.111 <0.001
Potassium −0.014 0.641 0.001 0.976 −0.010 0.741
Chlorine −0.061 0.035 −0.150 <0.001 −0.131 <0.001
ALT −0.076 <0.001 0.110 <0.001 0.038 0.190
AST −0.022 0.443 0.132 <0.001 0.088 0.002
Creatinine 0.161 <0.001 0.111 <0.001 0.097 0.001
UA −0.112 <0.001 0.060 0.040 0.058 0.048
GFR −0.094 0.001 −0.109 <0.001 −0.091 0.002
TC 0.021 0.472 −0.127 <0.001 −0.114 <0.001

FAR: fibrinogen-to-albumin ratio; CRP: C-reactive protein; BMI: body mass index; LVEF: left ventricular ejection fraction; NYHA: New York Heart Association; BNP: B-type natriuretic peptide; FPG: fasting plasma glucose; WBC: white blood cell; RBC: red blood cell; PLT: blood platelet; HB: haemoglobin; ALT: aspartate transaminase; AST: alanine aminotransferase; UA: uric acid; GFR: glomerular filtration rate.

References

[1] Boback Z, Gregg C. Epidemiology and aetiology of heart failure. Nat Rev Cardiol. 2016;13:368–78. 10.1038/nrcardio.2016.25.Suche in Google Scholar PubMed PubMed Central

[2] Chioncel O, Lainscak M, Seferovic PM, Anker SD, Crespo-Leiro MG, Harjola V-P, et al. Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC heart failure long-term registry. Eur J Heart Failure. 2017;19:1574–85. 10.1002/ejhf.813.Suche in Google Scholar PubMed

[3] McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, et al. Authors/Task Force Members. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Failure. 2021;24:4–131. 10.1002/ejhf.2333.Suche in Google Scholar PubMed

[4] Koller L, Kleber M, Goliasch G, Sulzgruber P, Scharnagl H, Silbernagel G, et al. C-reactive protein predicts mortality in patients referred for coronary angiography and symptoms of heart failure with preserved ejection fraction. Eur J Heart Failure. 2014;16:758–66. 10.1002/ejhf.104.Suche in Google Scholar PubMed

[5] Yndestad A, Damås JK, Øie E, Ueland T, Gullestad L, Aukrust P. Role of inflammation in the progression of heart failure. Curr Cardiol Rep. 2007;9:236–41. 10.1007/BF02938356.Suche in Google Scholar PubMed

[6] Yousuf O, Mohanty BD, Martin SS, Joshi PH, Blaha MJ, Nasir K, et al. High-sensitivity C-reactive protein and cardiovascular disease: a resolute belief or an elusive link? J Am Coll Cardiol. 2013;62:397–408. 10.1016/j.jacc.2013.05.016.Suche in Google Scholar PubMed

[7] Araújo JP, Lourenço P, Azevedo A, Friões F, Rocha-Gonçalves F, Ferreira A, et al. Prognostic value of high-sensitivity C-reactive protein in heart failure: a systematic review. J Card Failure. 2009;15:256–66. 10.1016/j.cardfail.2008.10.030.Suche in Google Scholar PubMed

[8] Benz AP, Aeschbacher S, Krisai P, Moschovitis G, Blum S, Meyre P, et al. Biomarkers of inflammation and risk of hospitalization for heart failure in patients with atrial fibrillation. JAHA. 2021;10:e019168. 10.1161/JAHA.120.019168.Suche in Google Scholar PubMed PubMed Central

[9] Kang S, Fan L-Y, Chen M, Li J, Liu Z-M. Relationship of high-sensitivity C-reactive protein concentrations and systolic heart failure. Curr Vasc Pharmacol. 2017;15:390–6. 10.2174/1570161115666170404121619.Suche in Google Scholar PubMed

[10] Eisen A, Benderly M, Behar S, Goldbourt U, Haim M. Inflammation and future risk of symptomatic heart failure in patients with stable coronary artery disease. Am Heart J. 2014;167:707–14. 10.1016/j.ahj.2014.01.008.Suche in Google Scholar PubMed

[11] Phillips A, Shaper AG, Whincup PH. Association between serum albumin and mortality from cardiovascular disease, cancer, and other causes. Lancet. 1989;2:1434–6. 10.1016/s0140-6736(89)92042-4.Suche in Google Scholar PubMed

[12] Gillum RF, Makuc DM. Serum albumin, coronary heart disease, and death. Am Heart J. 1992;123:507–13. 10.1016/0002-8703(92)90667-k.Suche in Google Scholar PubMed

[13] Arques S. Human serum albumin in cardiovascular diseases. Eur J Intern Med. 2018;52:8–12. 10.1016/j.ejim.2018.04.014.Suche in Google Scholar PubMed

[14] Karahan O, Acet H, Ertaş F, Tezcan O, Çalişkan A, Demir M, et al. The relationship between fibrinogen to albumin ratio and severity of coronary artery disease in patients with STEMI. Am J Emerg Med. 2016;34:1037–42. 10.1016/j.ajem.2016.03.003.Suche in Google Scholar PubMed

[15] Duan Z, Luo C, Fu B, Han D. Association between fibrinogen-to-albumin ratio and the presence and severity of coronary artery disease in patients with acute coronary syndrome. BMC Cardiovasc Disord. 2021;21:588. 10.1186/s12872-021-02400-z.Suche in Google Scholar PubMed PubMed Central

[16] Huang R, Dai Q, Chang L, Wang Z, Chen J, Gu R, et al. The association between fibrinogen-to-albumin ratio (FAR) and adverse prognosis in patients with acute decompensated heart failure at different glucose metabolic states. Cardiovasc Diabetol. 2022;21:241. 10.1186/s12933-022-01662-x.Suche in Google Scholar PubMed PubMed Central

[17] Xu Q, Zhu C, Zhang Q, Hu Z, Ji K, Qian L. Association between fibrinogen-to-albumin ratio and prognosis of patients with heart failure. Eur J Clin Invest. 2023;53(10):e14049. 10.1111/eci.14049.Suche in Google Scholar PubMed

[18] Anand IS, Latini R, Florea VG, Kuskowski MA, Rector T, Masson S, et al. C-reactive protein in heart failure: prognostic value and the effect of valsartan. Circulation. 2005;112:1428–34. 10.1161/Circulationaha.104.508465.Suche in Google Scholar

[19] Suleiman M, Khatib R, Agmon Y, Mahamid R, Boulos M, Kapeliovich M, et al. Early inflammation and risk of long-term development of heart failure and mortality in survivors of acute myocardial infarction predictive role of C-reactive protein. J Am Coll Cardiol. 2006;47:962–8. 10.1016/j.jacc.2005.10.055.Suche in Google Scholar PubMed

[20] Mjelva ØR, Svingen GFT, Pedersen EKR, Seifert R, Kvaløy JT, Midttun Ø, et al. Fibrinogen and neopterin is associated with future myocardial infarction and total mortality in patients with stable coronary artery disease. Thromb Haemost. 2018;118:778–90. 10.1055/s-0038-1629912.Suche in Google Scholar PubMed

[21] Yang S-H, Du Y, Zhang Y, Li X-L, Li S, Xu R-X, et al. Serum fibrinogen and cardiovascular events in Chinese patients with type 2 diabetes and stable coronary artery disease: a prospective observational study. BMJ Open. 2017;7:e015041. 10.1136/bmjopen-2016-015041.Suche in Google Scholar PubMed PubMed Central

[22] Goicoechea M, de Vinuesa SG, Gómez-Campderá F, Aragoncillo I, Verdalles U, Mosse A, et al. Serum fibrinogen levels are an independent predictor of mortality in patients with chronic kidney disease (CKD) stages 3 and 4. Kidney Int Suppl. 2008;(111):S67–70. 10.1038/ki.2008.519.Suche in Google Scholar PubMed

[23] Liu S-L, Wu N-Q, Shi H-W, Dong Q, Dong Q-T, Gao Y, et al. Fibrinogen is associated with glucose metabolism and cardiovascular outcomes in patients with coronary artery disease. Cardiovasc Diabetol. 2020;19:36. 10.1186/s12933-020-01012-9.Suche in Google Scholar PubMed PubMed Central

[24] Danesh J, Lewington S, Thompson SG, Lowe GDO, Collins R, Kostis JB, et al. Fibrinogen Studies Collaboration. Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. JAMA. 2005;294:1799–809. 10.1001/jama.294.14.1799.Suche in Google Scholar PubMed

[25] Song J, Yu T, Sun Z, Li Z, He D, Sun Z. Comparison of prognostic significance between serum fibrinogen and Global Registry of Acute Coronary Events score for prognosis of patients with non-ST-elevation acute coronary syndromes undergoing percutaneous coronary intervention. Coron Artery Dis. 2020;31:124–9. 10.1097/MCA.0000000000000789.Suche in Google Scholar PubMed

[26] Wb K. Influence of fibrinogen on cardiovascular disease. Drugs. 1997;54(Suppl 3):32–40. 10.2165/00003495-199700543-00006.Suche in Google Scholar PubMed

[27] Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004;17:432–7. 10.1111/j.0894-0959.2004.17603.x.Suche in Google Scholar PubMed

[28] Arques S, Ambrosi P. Human serum albumin in the clinical syndrome of heart failure. J Card Failure. 2011;17:451–8. 10.1016/j.cardfail.2011.02.010.Suche in Google Scholar PubMed

[29] Dongaonkar RM, Stewart RH, Geissler HJ, Laine GA. Myocardial microvascular permeability, interstitial oedema, and compromised cardiac function. Cardiovasc Res. 2010;87:331–9. 10.1093/cvr/cvq145.Suche in Google Scholar PubMed PubMed Central

[30] Elwell RJ, Spencer AP, Eisele G. Combined furosemide and human albumin treatment for diuretic-resistant edema. Ann Pharmacother. 2003;37:695–700. 10.1345/aph.1C320.Suche in Google Scholar PubMed

[31] Belinskaia DA, Voronina PA, Shmurak VI, Jenkins RO, Goncharov NV. Serum albumin in health and disease: esterase, antioxidant, transporting and signaling properties. Int J Mol Sci. 2021;22:10318. 10.3390/ijms221910318.Suche in Google Scholar PubMed PubMed Central

[32] Konstam MA, Kramer DG, Patel AR, Maron MS, Udelson JE. Left ventricular remodeling in heart failure: current concepts in clinical significance and assessment. JACC Cardiovasc Imaging. 2011;4:98–108. 10.1016/j.jcmg.2010.10.008.Suche in Google Scholar PubMed

[33] Francis GS. Pathophysiology of chronic heart failure. Am J Med. 2001;110(Suppl 7A):37S–46S. 10.1016/s0002-9343(98)00385-4.Suche in Google Scholar PubMed

[34] Mann DL, Felker GM. Mechanisms and models in heart failure: a translational approach. Circ Res. 2021;128:1435–50. 10.1161/CIRCRESAHA.121.318158.Suche in Google Scholar PubMed PubMed Central

[35] Xu W-Y, Zhang H-H, Xiong J-P, Yang X-B, Bai Y, Lin J-Z, et al. Prognostic significance of the fibrinogen-to-albumin ratio in gallbladder cancer patients. World J Gastroenterol. 2018;24:3281–92. 10.3748/wjg.v24.i29.3281.Suche in Google Scholar PubMed PubMed Central

[36] Zheng Y, Wu C, Yan H, Chen S. Prognostic value of combined preoperative fibrinogen-albumin ratio and platelet-lymphocyte ratio score in patients with breast cancer: A prognostic nomogram study. Clin Chim Acta. 2020;506:110–21. 10.1016/j.cca.2020.03.011.Suche in Google Scholar PubMed

[37] Chen S, Yan H, Du J, Li J, Shen B, Ying H, et al. Prognostic significance of pre-resection albumin/fibrinogen ratio in patients with non-small cell lung cancer: A propensity score matching analysis. Clin Chim Acta. 2018;482:203–8. 10.1016/j.cca.2018.04.012.Suche in Google Scholar PubMed

[38] Li B, Deng H, Lei B, Chen L, Zhang X, Sha D. The prognostic value of fibrinogen to albumin ratio in malignant tumor patients: A meta-analysis. Front Oncol. 2022;12:985377. 10.3389/fonc.2022.985377.Suche in Google Scholar PubMed PubMed Central

[39] Wang P, Yuan D, Zhang C, Zhu P, Jia S, Song Y, et al. High fibrinogen-to-albumin ratio with type 2 diabetes mellitus is associated with poor prognosis in patients undergoing percutaneous coronary intervention: 5-year findings from a large cohort. Cardiovasc Diabetol. 2022;21:46. 10.1186/s12933-022-01477-w.Suche in Google Scholar PubMed PubMed Central

[40] Zhang D-P, Mao X-F, Wu T-T, Chen Y, Hou X-G, Yang Y, et al. The fibrinogen-to-albumin ratio is associated with outcomes in patients with coronary artery disease who underwent percutaneous coronary intervention. Clin Appl Thromb Hemost. 2020;26:1076029620933008. 10.1177/1076029620933008.Suche in Google Scholar PubMed PubMed Central

[41] Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation. 2000;102:2165–8. 10.1161/01.cir.102.18.2165.Suche in Google Scholar PubMed

[42] Ridker PM. C-reactive protein and risks of future myocardial infarction and thrombotic stroke. Eur Heart J. 1998;19:1–3. 10.1053/euhj.1997.0604.Suche in Google Scholar PubMed

[43] Chew DP, Bhatt DL, Robbins MA, Penn MS, Schneider JP, Lauer MS, et al. Incremental prognostic value of elevated baseline C-reactive protein among established markers of risk in percutaneous coronary intervention. Circulation. 2001;104:992–7. 10.1161/hc3401.095074.Suche in Google Scholar PubMed

[44] Strandberg TE, Tilvis RS. C-reactive protein, cardiovascular risk factors, and mortality in a prospective study in the elderly. Arterioscler Thromb Vasc Biol. 2000;20:1057–60. 10.1161/01.atv.20.4.1057.Suche in Google Scholar PubMed

[45] Park JJ, Yoon M, Cho HW, Cho HJ, Kim KH, Yang DH, et al. C-reactive protein and statins in heart failure with reduced and preserved ejection fraction. Front Cardiovasc Med. 2022;9:1064967. 10.3389/fcvm.2022.1064967.Suche in Google Scholar PubMed PubMed Central

[46] Clark DJ, Cleman MW, Pfau SE, Rollins SA, Ramahi TM, Mayer C, et al. Serum complement activation in congestive heart failure. Am Heart J. 2001;141:684–90. 10.1067/mhj.2001.113758.Suche in Google Scholar PubMed

[47] Anker SD, von Haehling S. Inflammatory mediators in chronic heart failure: an overview. Heart. 2004;90:464–70. 10.1136/hrt.2002.007005.Suche in Google Scholar PubMed PubMed Central

Received: 2023-12-03
Revised: 2024-07-02
Accepted: 2024-08-27
Published Online: 2024-11-18

© 2024 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

Artikel in diesem Heft

  1. Research Articles
  2. EDNRB inhibits the growth and migration of prostate cancer cells by activating the cGMP-PKG pathway
  3. STK11 (LKB1) mutation suppresses ferroptosis in lung adenocarcinoma by facilitating monounsaturated fatty acid synthesis
  4. Association of SOX6 gene polymorphisms with Kashin-Beck disease risk in the Chinese Han population
  5. The pyroptosis-related signature predicts prognosis and influences the tumor immune microenvironment in dedifferentiated liposarcoma
  6. METTL3 attenuates ferroptosis sensitivity in lung cancer via modulating TFRC
  7. Identification and validation of molecular subtypes and prognostic signature for stage I and stage II gastric cancer based on neutrophil extracellular traps
  8. Novel lumbar plexus block versus femoral nerve block for analgesia and motor recovery after total knee arthroplasty
  9. Correlation between ABCB1 and OLIG2 polymorphisms and the severity and prognosis of patients with cerebral infarction
  10. Study on the radiotherapy effect and serum neutral granulocyte lymphocyte ratio and inflammatory factor expression of nasopharyngeal carcinoma
  11. Transcriptome analysis of effects of Tecrl deficiency on cardiometabolic and calcium regulation in cardiac tissue
  12. Aflatoxin B1 induces infertility, fetal deformities, and potential therapies
  13. Serum levels of HMW adiponectin and its receptors are associated with cytokine levels and clinical characteristics in chronic obstructive pulmonary disease
  14. METTL3-mediated methylation of CYP2C19 mRNA may aggravate clopidogrel resistance in ischemic stroke patients
  15. Understand how machine learning impact lung cancer research from 2010 to 2021: A bibliometric analysis
  16. Pressure ulcers in German hospitals: Analysis of reimbursement and length of stay
  17. Metformin plus L-carnitine enhances brown/beige adipose tissue activity via Nrf2/HO-1 signaling to reduce lipid accumulation and inflammation in murine obesity
  18. Downregulation of carbonic anhydrase IX expression in mouse xenograft nasopharyngeal carcinoma model via doxorubicin nanobubble combined with ultrasound
  19. Feasibility of 3-dimensional printed models in simulated training and teaching of transcatheter aortic valve replacement
  20. miR-335-3p improves type II diabetes mellitus by IGF-1 regulating macrophage polarization
  21. The analyses of human MCPH1 DNA repair machinery and genetic variations
  22. Activation of Piezo1 increases the sensitivity of breast cancer to hyperthermia therapy
  23. Comprehensive analysis based on the disulfidptosis-related genes identifies hub genes and immune infiltration for pancreatic adenocarcinoma
  24. Changes of serum CA125 and PGE2 before and after high-intensity focused ultrasound combined with GnRH-a in treatment of patients with adenomyosis
  25. The clinical value of the hepatic venous pressure gradient in patients undergoing hepatic resection for hepatocellular carcinoma with or without liver cirrhosis
  26. Development and validation of a novel model to predict pulmonary embolism in cardiology suspected patients: A 10-year retrospective analysis
  27. Downregulation of lncRNA XLOC_032768 in diabetic patients predicts the occurrence of diabetic nephropathy
  28. Circ_0051428 targeting miR-885-3p/MMP2 axis enhances the malignancy of cervical cancer
  29. Effectiveness of ginkgo diterpene lactone meglumine on cognitive function in patients with acute ischemic stroke
  30. The construction of a novel prognostic prediction model for glioma based on GWAS-identified prognostic-related risk loci
  31. Evaluating the impact of childhood BMI on the risk of coronavirus disease 2019: A Mendelian randomization study
  32. Lactate dehydrogenase to albumin ratio is associated with in-hospital mortality in patients with acute heart failure: Data from the MIMIC-III database
  33. CD36-mediated podocyte lipotoxicity promotes foot process effacement
  34. Efficacy of etonogestrel subcutaneous implants versus the levonorgestrel-releasing intrauterine system in the conservative treatment of adenomyosis
  35. FLRT2 mediates chondrogenesis of nasal septal cartilage and mandibular condyle cartilage
  36. Challenges in treating primary immune thrombocytopenia patients undergoing COVID-19 vaccination: A retrospective study
  37. Let-7 family regulates HaCaT cell proliferation and apoptosis via the ΔNp63/PI3K/AKT pathway
  38. Phospholipid transfer protein ameliorates sepsis-induced cardiac dysfunction through NLRP3 inflammasome inhibition
  39. Postoperative cognitive dysfunction in elderly patients with colorectal cancer: A randomized controlled study comparing goal-directed and conventional fluid therapy
  40. Long-pulsed ultrasound-mediated microbubble thrombolysis in a rat model of microvascular obstruction
  41. High SEC61A1 expression predicts poor outcome of acute myeloid leukemia
  42. Comparison of polymerase chain reaction and next-generation sequencing with conventional urine culture for the diagnosis of urinary tract infections: A meta-analysis
  43. Secreted frizzled-related protein 5 protects against renal fibrosis by inhibiting Wnt/β-catenin pathway
  44. Pan-cancer and single-cell analysis of actin cytoskeleton genes related to disulfidptosis
  45. Overexpression of miR-532-5p restrains oxidative stress response of chondrocytes in nontraumatic osteonecrosis of the femoral head by inhibiting ABL1
  46. Autologous liver transplantation for unresectable hepatobiliary malignancies in enhanced recovery after surgery model
  47. Clinical analysis of incomplete rupture of the uterus secondary to previous cesarean section
  48. Abnormal sleep duration is associated with sarcopenia in older Chinese people: A large retrospective cross-sectional study
  49. No genetic causality between obesity and benign paroxysmal vertigo: A two-sample Mendelian randomization study
  50. Identification and validation of autophagy-related genes in SSc
  51. Long non-coding RNA SRA1 suppresses radiotherapy resistance in esophageal squamous cell carcinoma by modulating glycolytic reprogramming
  52. Evaluation of quality of life in patients with schizophrenia: An inpatient social welfare institution-based cross-sectional study
  53. The possible role of oxidative stress marker glutathione in the assessment of cognitive impairment in multiple sclerosis
  54. Compilation of a self-management assessment scale for postoperative patients with aortic dissection
  55. Left atrial appendage closure in conjunction with radiofrequency ablation: Effects on left atrial functioning in patients with paroxysmal atrial fibrillation
  56. Effect of anterior femoral cortical notch grade on postoperative function and complications during TKA surgery: A multicenter, retrospective study
  57. Clinical characteristics and assessment of risk factors in patients with influenza A-induced severe pneumonia after the prevalence of SARS-CoV-2
  58. Analgesia nociception index is an indicator of laparoscopic trocar insertion-induced transient nociceptive stimuli
  59. High STAT4 expression correlates with poor prognosis in acute myeloid leukemia and facilitates disease progression by upregulating VEGFA expression
  60. Factors influencing cardiovascular system-related post-COVID-19 sequelae: A single-center cohort study
  61. HOXD10 regulates intestinal permeability and inhibits inflammation of dextran sulfate sodium-induced ulcerative colitis through the inactivation of the Rho/ROCK/MMPs axis
  62. Mesenchymal stem cell-derived exosomal miR-26a induces ferroptosis, suppresses hepatic stellate cell activation, and ameliorates liver fibrosis by modulating SLC7A11
  63. Endovascular thrombectomy versus intravenous thrombolysis for primary distal, medium vessel occlusion in acute ischemic stroke
  64. ANO6 (TMEM16F) inhibits gastrointestinal stromal tumor growth and induces ferroptosis
  65. Prognostic value of EIF5A2 in solid tumors: A meta-analysis and bioinformatics analysis
  66. The role of enhanced expression of Cx43 in patients with ulcerative colitis
  67. Choosing a COVID-19 vaccination site might be driven by anxiety and body vigilance
  68. Role of ICAM-1 in triple-negative breast cancer
  69. Cost-effectiveness of ambroxol in the treatment of Gaucher disease type 2
  70. HLA-DRB5 promotes immune thrombocytopenia via activating CD8+ T cells
  71. Efficacy and factors of myofascial release therapy combined with electrical and magnetic stimulation in the treatment of chronic pelvic pain syndrome
  72. Efficacy of tacrolimus monotherapy in primary membranous nephropathy
  73. Mechanisms of Tripterygium wilfordii Hook F on treating rheumatoid arthritis explored by network pharmacology analysis and molecular docking
  74. FBXO45 levels regulated ferroptosis renal tubular epithelial cells in a model of diabetic nephropathy by PLK1
  75. Optimizing anesthesia strategies to NSCLC patients in VATS procedures: Insights from drug requirements and patient recovery patterns
  76. Alpha-lipoic acid upregulates the PPARγ/NRF2/GPX4 signal pathway to inhibit ferroptosis in the pathogenesis of unexplained recurrent pregnancy loss
  77. Correlation between fat-soluble vitamin levels and inflammatory factors in paediatric community-acquired pneumonia: A prospective study
  78. CD1d affects the proliferation, migration, and apoptosis of human papillary thyroid carcinoma TPC-1 cells via regulating MAPK/NF-κB signaling pathway
  79. miR-let-7a inhibits sympathetic nerve remodeling after myocardial infarction by downregulating the expression of nerve growth factor
  80. Immune response analysis of solid organ transplantation recipients inoculated with inactivated COVID-19 vaccine: A retrospective analysis
  81. The H2Valdien derivatives regulate the epithelial–mesenchymal transition of hepatoma carcinoma cells through the Hedgehog signaling pathway
  82. Clinical efficacy of dexamethasone combined with isoniazid in the treatment of tuberculous meningitis and its effect on peripheral blood T cell subsets
  83. Comparison of short-segment and long-segment fixation in treatment of degenerative scoliosis and analysis of factors associated with adjacent spondylolisthesis
  84. Lycopene inhibits pyroptosis of endothelial progenitor cells induced by ox-LDL through the AMPK/mTOR/NLRP3 pathway
  85. Methylation regulation for FUNDC1 stability in childhood leukemia was up-regulated and facilitates metastasis and reduces ferroptosis of leukemia through mitochondrial damage by FBXL2
  86. Correlation of single-fiber electromyography studies and functional status in patients with amyotrophic lateral sclerosis
  87. Risk factors of postoperative airway obstruction complications in children with oral floor mass
  88. Expression levels and clinical significance of serum miR-19a/CCL20 in patients with acute cerebral infarction
  89. Physical activity and mental health trends in Korean adolescents: Analyzing the impact of the COVID-19 pandemic from 2018 to 2022
  90. Evaluating anemia in HIV-infected patients using chest CT
  91. Ponticulus posticus and skeletal malocclusion: A pilot study in a Southern Italian pre-orthodontic court
  92. Causal association of circulating immune cells and lymphoma: A Mendelian randomization study
  93. Assessment of the renal function and fibrosis indexes of conventional western medicine with Chinese medicine for dredging collaterals on treating renal fibrosis: A systematic review and meta-analysis
  94. Comprehensive landscape of integrator complex subunits and their association with prognosis and tumor microenvironment in gastric cancer
  95. New target-HMGCR inhibitors for the treatment of primary sclerosing cholangitis: A drug Mendelian randomization study
  96. Population pharmacokinetics of meropenem in critically ill patients
  97. Comparison of the ability of newly inflammatory markers to predict complicated appendicitis
  98. Comparative morphology of the cruciate ligaments: A radiological study
  99. Immune landscape of hepatocellular carcinoma: The central role of TP53-inducible glycolysis and apoptosis regulator
  100. Serum SIRT3 levels in epilepsy patients and its association with clinical outcomes and severity: A prospective observational study
  101. SHP-1 mediates cigarette smoke extract-induced epithelial–mesenchymal transformation and inflammation in 16HBE cells
  102. Acute hyper-hypoxia accelerates the development of depression in mice via the IL-6/PGC1α/MFN2 signaling pathway
  103. The GJB3 correlates with the prognosis, immune cell infiltration, and therapeutic responses in lung adenocarcinoma
  104. Physical fitness and blood parameters outcomes of breast cancer survivor in a low-intensity circuit resistance exercise program
  105. Exploring anesthetic-induced gene expression changes and immune cell dynamics in atrial tissue post-coronary artery bypass graft surgery
  106. Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism
  107. Analysis of the risk factors of the radiation-induced encephalopathy in nasopharyngeal carcinoma: A retrospective cohort study
  108. Reproductive outcomes in women with BRCA 1/2 germline mutations: A retrospective observational study and literature review
  109. Evaluation of upper airway ultrasonographic measurements in predicting difficult intubation: A cross-section of the Turkish population
  110. Prognostic and diagnostic value of circulating IGFBP2 in pancreatic cancer
  111. Postural stability after operative reconstruction of the AFTL in chronic ankle instability comparing three different surgical techniques
  112. Research trends related to emergence agitation in the post-anaesthesia care unit from 2001 to 2023: A bibliometric analysis
  113. Frequency and clinicopathological correlation of gastrointestinal polyps: A six-year single center experience
  114. ACSL4 mediates inflammatory bowel disease and contributes to LPS-induced intestinal epithelial cell dysfunction by activating ferroptosis and inflammation
  115. Affibody-based molecular probe 99mTc-(HE)3ZHER2:V2 for non-invasive HER2 detection in ovarian and breast cancer xenografts
  116. Effectiveness of nutritional support for clinical outcomes in gastric cancer patients: A meta-analysis of randomized controlled trials
  117. The relationship between IFN-γ, IL-10, IL-6 cytokines, and severity of the condition with serum zinc and Fe in children infected with Mycoplasma pneumoniae
  118. Paraquat disrupts the blood–brain barrier by increasing IL-6 expression and oxidative stress through the activation of PI3K/AKT signaling pathway
  119. Sleep quality associate with the increased prevalence of cognitive impairment in coronary artery disease patients: A retrospective case–control study
  120. Dioscin protects against chronic prostatitis through the TLR4/NF-κB pathway
  121. Association of polymorphisms in FBN1, MYH11, and TGF-β signaling-related genes with susceptibility of sporadic thoracic aortic aneurysm and dissection in the Zhejiang Han population
  122. Application value of multi-parameter magnetic resonance image-transrectal ultrasound cognitive fusion in prostate biopsy
  123. Laboratory variables‐based artificial neural network models for predicting fatty liver disease: A retrospective study
  124. Decreased BIRC5-206 promotes epithelial–mesenchymal transition in nasopharyngeal carcinoma through sponging miR-145-5p
  125. Sepsis induces the cardiomyocyte apoptosis and cardiac dysfunction through activation of YAP1/Serpine1/caspase-3 pathway
  126. Assessment of iron metabolism and iron deficiency in incident patients on incident continuous ambulatory peritoneal dialysis
  127. Tibial periosteum flap combined with autologous bone grafting in the treatment of Gustilo-IIIB/IIIC open tibial fractures
  128. The application of intravenous general anesthesia under nasopharyngeal airway assisted ventilation undergoing ureteroscopic holmium laser lithotripsy: A prospective, single-center, controlled trial
  129. Long intergenic noncoding RNA for IGF2BP2 stability suppresses gastric cancer cell apoptosis by inhibiting the maturation of microRNA-34a
  130. Role of FOXM1 and AURKB in regulating keratinocyte function in psoriasis
  131. Parental control attitudes over their pre-school children’s diet
  132. The role of auto-HSCT in extranodal natural killer/T cell lymphoma
  133. Significance of negative cervical cytology and positive HPV in the diagnosis of cervical lesions by colposcopy
  134. Echinacoside inhibits PASMCs calcium overload to prevent hypoxic pulmonary artery remodeling by regulating TRPC1/4/6 and calmodulin
  135. ADAR1 plays a protective role in proximal tubular cells under high glucose conditions by attenuating the PI3K/AKT/mTOR signaling pathway
  136. The risk of cancer among insulin glargine users in Lithuania: A retrospective population-based study
  137. The unusual location of primary hydatid cyst: A case series study
  138. Intraoperative changes in electrophysiological monitoring can be used to predict clinical outcomes in patients with spinal cavernous malformation
  139. Obesity and risk of placenta accreta spectrum: A meta-analysis
  140. Shikonin alleviates asthma phenotypes in mice via an airway epithelial STAT3-dependent mechanism
  141. NSUN6 and HTR7 disturbed the stability of carotid atherosclerotic plaques by regulating the immune responses of macrophages
  142. The effect of COVID-19 lockdown on admission rates in Maternity Hospital
  143. Temporal muscle thickness is not a prognostic predictor in patients with high-grade glioma, an experience at two centers in China
  144. Luteolin alleviates cerebral ischemia/reperfusion injury by regulating cell pyroptosis
  145. Therapeutic role of respiratory exercise in patients with tuberculous pleurisy
  146. Effects of CFTR-ENaC on spinal cord edema after spinal cord injury
  147. Irisin-regulated lncRNAs and their potential regulatory functions in chondrogenic differentiation of human mesenchymal stem cells
  148. DMD mutations in pediatric patients with phenotypes of Duchenne/Becker muscular dystrophy
  149. Combination of C-reactive protein and fibrinogen-to-albumin ratio as a novel predictor of all-cause mortality in heart failure patients
  150. Significant role and the underly mechanism of cullin-1 in chronic obstructive pulmonary disease
  151. Ferroptosis-related prognostic model of mantle cell lymphoma
  152. Observation of choking reaction and other related indexes in elderly painless fiberoptic bronchoscopy with transnasal high-flow humidification oxygen therapy
  153. A bibliometric analysis of Prader-Willi syndrome from 2002 to 2022
  154. The causal effects of childhood sunburn occasions on melanoma: A univariable and multivariable Mendelian randomization study
  155. Oxidative stress regulates glycogen synthase kinase-3 in lymphocytes of diabetes mellitus patients complicated with cerebral infarction
  156. Role of COX6C and NDUFB3 in septic shock and stroke
  157. Trends in disease burden of type 2 diabetes, stroke, and hypertensive heart disease attributable to high BMI in China: 1990–2019
  158. Purinergic P2X7 receptor mediates hyperoxia-induced injury in pulmonary microvascular endothelial cells via NLRP3-mediated pyroptotic pathway
  159. Investigating the role of oviductal mucosa–endometrial co-culture in modulating factors relevant to embryo implantation
  160. Analgesic effect of external oblique intercostal block in laparoscopic cholecystectomy: A retrospective study
  161. Elevated serum miR-142-5p correlates with ischemic lesions and both NSE and S100β in ischemic stroke patients
  162. Correlation between the mechanism of arteriopathy in IgA nephropathy and blood stasis syndrome: A cohort study
  163. Risk factors for progressive kyphosis after percutaneous kyphoplasty in osteoporotic vertebral compression fracture
  164. Predictive role of neuron-specific enolase and S100-β in early neurological deterioration and unfavorable prognosis in patients with ischemic stroke
  165. The potential risk factors of postoperative cognitive dysfunction for endovascular therapy in acute ischemic stroke with general anesthesia
  166. Fluoxetine inhibited RANKL-induced osteoclastic differentiation in vitro
  167. Detection of serum FOXM1 and IGF2 in patients with ARDS and their correlation with disease and prognosis
  168. Rhein promotes skin wound healing by activating the PI3K/AKT signaling pathway
  169. Differences in mortality risk by levels of physical activity among persons with disabilities in South Korea
  170. Review Articles
  171. Cutaneous signs of selected cardiovascular disorders: A narrative review
  172. XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis
  173. A narrative review on adverse drug reactions of COVID-19 treatments on the kidney
  174. Emerging role and function of SPDL1 in human health and diseases
  175. Adverse reactions of piperacillin: A literature review of case reports
  176. Molecular mechanism and intervention measures of microvascular complications in diabetes
  177. Regulation of mesenchymal stem cell differentiation by autophagy
  178. Molecular landscape of borderline ovarian tumours: A systematic review
  179. Advances in synthetic lethality modalities for glioblastoma multiforme
  180. Investigating hormesis, aging, and neurodegeneration: From bench to clinics
  181. Frankincense: A neuronutrient to approach Parkinson’s disease treatment
  182. Sox9: A potential regulator of cancer stem cells in osteosarcoma
  183. Early detection of cardiovascular risk markers through non-invasive ultrasound methodologies in periodontitis patients
  184. Advanced neuroimaging and criminal interrogation in lie detection
  185. Maternal factors for neural tube defects in offspring: An umbrella review
  186. The chemoprotective hormetic effects of rosmarinic acid
  187. CBD’s potential impact on Parkinson’s disease: An updated overview
  188. Progress in cytokine research for ARDS: A comprehensive review
  189. Utilizing reactive oxygen species-scavenging nanoparticles for targeting oxidative stress in the treatment of ischemic stroke: A review
  190. NRXN1-related disorders, attempt to better define clinical assessment
  191. Lidocaine infusion for the treatment of complex regional pain syndrome: Case series and literature review
  192. Trends and future directions of autophagy in osteosarcoma: A bibliometric analysis
  193. Iron in ventricular remodeling and aneurysms post-myocardial infarction
  194. Case Reports
  195. Sirolimus potentiated angioedema: A case report and review of the literature
  196. Identification of mixed anaerobic infections after inguinal hernia repair based on metagenomic next-generation sequencing: A case report
  197. Successful treatment with bortezomib in combination with dexamethasone in a middle-aged male with idiopathic multicentric Castleman’s disease: A case report
  198. Complete heart block associated with hepatitis A infection in a female child with fatal outcome
  199. Elevation of D-dimer in eosinophilic gastrointestinal diseases in the absence of venous thrombosis: A case series and literature review
  200. Four years of natural progressive course: A rare case report of juvenile Xp11.2 translocations renal cell carcinoma with TFE3 gene fusion
  201. Advancing prenatal diagnosis: Echocardiographic detection of Scimitar syndrome in China – A case series
  202. Outcomes and complications of hemodialysis in patients with renal cancer following bilateral nephrectomy
  203. Anti-HMGCR myopathy mimicking facioscapulohumeral muscular dystrophy
  204. Recurrent opportunistic infections in a HIV-negative patient with combined C6 and NFKB1 mutations: A case report, pedigree analysis, and literature review
  205. Letter to the Editor
  206. Letter to the Editor: Total parenteral nutrition-induced Wernicke’s encephalopathy after oncologic gastrointestinal surgery
  207. Erratum
  208. Erratum to “Bladder-embedded ectopic intrauterine device with calculus”
  209. Retraction
  210. Retraction of “XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis”
  211. Corrigendum
  212. Corrigendum to “Investigating hormesis, aging, and neurodegeneration: From bench to clinics”
  213. Corrigendum to “Frankincense: A neuronutrient to approach Parkinson’s disease treatment”
  214. Special Issue The evolving saga of RNAs from bench to bedside - Part II
  215. Machine-learning-based prediction of a diagnostic model using autophagy-related genes based on RNA sequencing for patients with papillary thyroid carcinoma
  216. Unlocking the future of hepatocellular carcinoma treatment: A comprehensive analysis of disulfidptosis-related lncRNAs for prognosis and drug screening
  217. Elevated mRNA level indicates FSIP1 promotes EMT and gastric cancer progression by regulating fibroblasts in tumor microenvironment
  218. Special Issue Advancements in oncology: bridging clinical and experimental research - Part I
  219. Ultrasound-guided transperineal vs transrectal prostate biopsy: A meta-analysis of diagnostic accuracy and complication rates
  220. Assessment of diagnostic value of unilateral systematic biopsy combined with targeted biopsy in detecting clinically significant prostate cancer
  221. SENP7 inhibits glioblastoma metastasis and invasion by dissociating SUMO2/3 binding to specific target proteins
  222. MARK1 suppress malignant progression of hepatocellular carcinoma and improves sorafenib resistance through negatively regulating POTEE
  223. Analysis of postoperative complications in bladder cancer patients
  224. Carboplatin combined with arsenic trioxide versus carboplatin combined with docetaxel treatment for LACC: A randomized, open-label, phase II clinical study
  225. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part I
  226. Comprehensive pan-cancer investigation of carnosine dipeptidase 1 and its prospective prognostic significance in hepatocellular carcinoma
  227. Identification of signatures associated with microsatellite instability and immune characteristics to predict the prognostic risk of colon cancer
  228. Single-cell analysis identified key macrophage subpopulations associated with atherosclerosis
https://doi.org/10.1515/med-2024-1045
Schlagwörter für diesen Artikel
C-reactive protein; fibrinogen/albumin ratio; heart failure; inflammation; prognosis
Creative Commons
BY 4.0

Artikel in diesem Heft

  1. Research Articles
  2. EDNRB inhibits the growth and migration of prostate cancer cells by activating the cGMP-PKG pathway
  3. STK11 (LKB1) mutation suppresses ferroptosis in lung adenocarcinoma by facilitating monounsaturated fatty acid synthesis
  4. Association of SOX6 gene polymorphisms with Kashin-Beck disease risk in the Chinese Han population
  5. The pyroptosis-related signature predicts prognosis and influences the tumor immune microenvironment in dedifferentiated liposarcoma
  6. METTL3 attenuates ferroptosis sensitivity in lung cancer via modulating TFRC
  7. Identification and validation of molecular subtypes and prognostic signature for stage I and stage II gastric cancer based on neutrophil extracellular traps
  8. Novel lumbar plexus block versus femoral nerve block for analgesia and motor recovery after total knee arthroplasty
  9. Correlation between ABCB1 and OLIG2 polymorphisms and the severity and prognosis of patients with cerebral infarction
  10. Study on the radiotherapy effect and serum neutral granulocyte lymphocyte ratio and inflammatory factor expression of nasopharyngeal carcinoma
  11. Transcriptome analysis of effects of Tecrl deficiency on cardiometabolic and calcium regulation in cardiac tissue
  12. Aflatoxin B1 induces infertility, fetal deformities, and potential therapies
  13. Serum levels of HMW adiponectin and its receptors are associated with cytokine levels and clinical characteristics in chronic obstructive pulmonary disease
  14. METTL3-mediated methylation of CYP2C19 mRNA may aggravate clopidogrel resistance in ischemic stroke patients
  15. Understand how machine learning impact lung cancer research from 2010 to 2021: A bibliometric analysis
  16. Pressure ulcers in German hospitals: Analysis of reimbursement and length of stay
  17. Metformin plus L-carnitine enhances brown/beige adipose tissue activity via Nrf2/HO-1 signaling to reduce lipid accumulation and inflammation in murine obesity
  18. Downregulation of carbonic anhydrase IX expression in mouse xenograft nasopharyngeal carcinoma model via doxorubicin nanobubble combined with ultrasound
  19. Feasibility of 3-dimensional printed models in simulated training and teaching of transcatheter aortic valve replacement
  20. miR-335-3p improves type II diabetes mellitus by IGF-1 regulating macrophage polarization
  21. The analyses of human MCPH1 DNA repair machinery and genetic variations
  22. Activation of Piezo1 increases the sensitivity of breast cancer to hyperthermia therapy
  23. Comprehensive analysis based on the disulfidptosis-related genes identifies hub genes and immune infiltration for pancreatic adenocarcinoma
  24. Changes of serum CA125 and PGE2 before and after high-intensity focused ultrasound combined with GnRH-a in treatment of patients with adenomyosis
  25. The clinical value of the hepatic venous pressure gradient in patients undergoing hepatic resection for hepatocellular carcinoma with or without liver cirrhosis
  26. Development and validation of a novel model to predict pulmonary embolism in cardiology suspected patients: A 10-year retrospective analysis
  27. Downregulation of lncRNA XLOC_032768 in diabetic patients predicts the occurrence of diabetic nephropathy
  28. Circ_0051428 targeting miR-885-3p/MMP2 axis enhances the malignancy of cervical cancer
  29. Effectiveness of ginkgo diterpene lactone meglumine on cognitive function in patients with acute ischemic stroke
  30. The construction of a novel prognostic prediction model for glioma based on GWAS-identified prognostic-related risk loci
  31. Evaluating the impact of childhood BMI on the risk of coronavirus disease 2019: A Mendelian randomization study
  32. Lactate dehydrogenase to albumin ratio is associated with in-hospital mortality in patients with acute heart failure: Data from the MIMIC-III database
  33. CD36-mediated podocyte lipotoxicity promotes foot process effacement
  34. Efficacy of etonogestrel subcutaneous implants versus the levonorgestrel-releasing intrauterine system in the conservative treatment of adenomyosis
  35. FLRT2 mediates chondrogenesis of nasal septal cartilage and mandibular condyle cartilage
  36. Challenges in treating primary immune thrombocytopenia patients undergoing COVID-19 vaccination: A retrospective study
  37. Let-7 family regulates HaCaT cell proliferation and apoptosis via the ΔNp63/PI3K/AKT pathway
  38. Phospholipid transfer protein ameliorates sepsis-induced cardiac dysfunction through NLRP3 inflammasome inhibition
  39. Postoperative cognitive dysfunction in elderly patients with colorectal cancer: A randomized controlled study comparing goal-directed and conventional fluid therapy
  40. Long-pulsed ultrasound-mediated microbubble thrombolysis in a rat model of microvascular obstruction
  41. High SEC61A1 expression predicts poor outcome of acute myeloid leukemia
  42. Comparison of polymerase chain reaction and next-generation sequencing with conventional urine culture for the diagnosis of urinary tract infections: A meta-analysis
  43. Secreted frizzled-related protein 5 protects against renal fibrosis by inhibiting Wnt/β-catenin pathway
  44. Pan-cancer and single-cell analysis of actin cytoskeleton genes related to disulfidptosis
  45. Overexpression of miR-532-5p restrains oxidative stress response of chondrocytes in nontraumatic osteonecrosis of the femoral head by inhibiting ABL1
  46. Autologous liver transplantation for unresectable hepatobiliary malignancies in enhanced recovery after surgery model
  47. Clinical analysis of incomplete rupture of the uterus secondary to previous cesarean section
  48. Abnormal sleep duration is associated with sarcopenia in older Chinese people: A large retrospective cross-sectional study
  49. No genetic causality between obesity and benign paroxysmal vertigo: A two-sample Mendelian randomization study
  50. Identification and validation of autophagy-related genes in SSc
  51. Long non-coding RNA SRA1 suppresses radiotherapy resistance in esophageal squamous cell carcinoma by modulating glycolytic reprogramming
  52. Evaluation of quality of life in patients with schizophrenia: An inpatient social welfare institution-based cross-sectional study
  53. The possible role of oxidative stress marker glutathione in the assessment of cognitive impairment in multiple sclerosis
  54. Compilation of a self-management assessment scale for postoperative patients with aortic dissection
  55. Left atrial appendage closure in conjunction with radiofrequency ablation: Effects on left atrial functioning in patients with paroxysmal atrial fibrillation
  56. Effect of anterior femoral cortical notch grade on postoperative function and complications during TKA surgery: A multicenter, retrospective study
  57. Clinical characteristics and assessment of risk factors in patients with influenza A-induced severe pneumonia after the prevalence of SARS-CoV-2
  58. Analgesia nociception index is an indicator of laparoscopic trocar insertion-induced transient nociceptive stimuli
  59. High STAT4 expression correlates with poor prognosis in acute myeloid leukemia and facilitates disease progression by upregulating VEGFA expression
  60. Factors influencing cardiovascular system-related post-COVID-19 sequelae: A single-center cohort study
  61. HOXD10 regulates intestinal permeability and inhibits inflammation of dextran sulfate sodium-induced ulcerative colitis through the inactivation of the Rho/ROCK/MMPs axis
  62. Mesenchymal stem cell-derived exosomal miR-26a induces ferroptosis, suppresses hepatic stellate cell activation, and ameliorates liver fibrosis by modulating SLC7A11
  63. Endovascular thrombectomy versus intravenous thrombolysis for primary distal, medium vessel occlusion in acute ischemic stroke
  64. ANO6 (TMEM16F) inhibits gastrointestinal stromal tumor growth and induces ferroptosis
  65. Prognostic value of EIF5A2 in solid tumors: A meta-analysis and bioinformatics analysis
  66. The role of enhanced expression of Cx43 in patients with ulcerative colitis
  67. Choosing a COVID-19 vaccination site might be driven by anxiety and body vigilance
  68. Role of ICAM-1 in triple-negative breast cancer
  69. Cost-effectiveness of ambroxol in the treatment of Gaucher disease type 2
  70. HLA-DRB5 promotes immune thrombocytopenia via activating CD8+ T cells
  71. Efficacy and factors of myofascial release therapy combined with electrical and magnetic stimulation in the treatment of chronic pelvic pain syndrome
  72. Efficacy of tacrolimus monotherapy in primary membranous nephropathy
  73. Mechanisms of Tripterygium wilfordii Hook F on treating rheumatoid arthritis explored by network pharmacology analysis and molecular docking
  74. FBXO45 levels regulated ferroptosis renal tubular epithelial cells in a model of diabetic nephropathy by PLK1
  75. Optimizing anesthesia strategies to NSCLC patients in VATS procedures: Insights from drug requirements and patient recovery patterns
  76. Alpha-lipoic acid upregulates the PPARγ/NRF2/GPX4 signal pathway to inhibit ferroptosis in the pathogenesis of unexplained recurrent pregnancy loss
  77. Correlation between fat-soluble vitamin levels and inflammatory factors in paediatric community-acquired pneumonia: A prospective study
  78. CD1d affects the proliferation, migration, and apoptosis of human papillary thyroid carcinoma TPC-1 cells via regulating MAPK/NF-κB signaling pathway
  79. miR-let-7a inhibits sympathetic nerve remodeling after myocardial infarction by downregulating the expression of nerve growth factor
  80. Immune response analysis of solid organ transplantation recipients inoculated with inactivated COVID-19 vaccine: A retrospective analysis
  81. The H2Valdien derivatives regulate the epithelial–mesenchymal transition of hepatoma carcinoma cells through the Hedgehog signaling pathway
  82. Clinical efficacy of dexamethasone combined with isoniazid in the treatment of tuberculous meningitis and its effect on peripheral blood T cell subsets
  83. Comparison of short-segment and long-segment fixation in treatment of degenerative scoliosis and analysis of factors associated with adjacent spondylolisthesis
  84. Lycopene inhibits pyroptosis of endothelial progenitor cells induced by ox-LDL through the AMPK/mTOR/NLRP3 pathway
  85. Methylation regulation for FUNDC1 stability in childhood leukemia was up-regulated and facilitates metastasis and reduces ferroptosis of leukemia through mitochondrial damage by FBXL2
  86. Correlation of single-fiber electromyography studies and functional status in patients with amyotrophic lateral sclerosis
  87. Risk factors of postoperative airway obstruction complications in children with oral floor mass
  88. Expression levels and clinical significance of serum miR-19a/CCL20 in patients with acute cerebral infarction
  89. Physical activity and mental health trends in Korean adolescents: Analyzing the impact of the COVID-19 pandemic from 2018 to 2022
  90. Evaluating anemia in HIV-infected patients using chest CT
  91. Ponticulus posticus and skeletal malocclusion: A pilot study in a Southern Italian pre-orthodontic court
  92. Causal association of circulating immune cells and lymphoma: A Mendelian randomization study
  93. Assessment of the renal function and fibrosis indexes of conventional western medicine with Chinese medicine for dredging collaterals on treating renal fibrosis: A systematic review and meta-analysis
  94. Comprehensive landscape of integrator complex subunits and their association with prognosis and tumor microenvironment in gastric cancer
  95. New target-HMGCR inhibitors for the treatment of primary sclerosing cholangitis: A drug Mendelian randomization study
  96. Population pharmacokinetics of meropenem in critically ill patients
  97. Comparison of the ability of newly inflammatory markers to predict complicated appendicitis
  98. Comparative morphology of the cruciate ligaments: A radiological study
  99. Immune landscape of hepatocellular carcinoma: The central role of TP53-inducible glycolysis and apoptosis regulator
  100. Serum SIRT3 levels in epilepsy patients and its association with clinical outcomes and severity: A prospective observational study
  101. SHP-1 mediates cigarette smoke extract-induced epithelial–mesenchymal transformation and inflammation in 16HBE cells
  102. Acute hyper-hypoxia accelerates the development of depression in mice via the IL-6/PGC1α/MFN2 signaling pathway
  103. The GJB3 correlates with the prognosis, immune cell infiltration, and therapeutic responses in lung adenocarcinoma
  104. Physical fitness and blood parameters outcomes of breast cancer survivor in a low-intensity circuit resistance exercise program
  105. Exploring anesthetic-induced gene expression changes and immune cell dynamics in atrial tissue post-coronary artery bypass graft surgery
  106. Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism
  107. Analysis of the risk factors of the radiation-induced encephalopathy in nasopharyngeal carcinoma: A retrospective cohort study
  108. Reproductive outcomes in women with BRCA 1/2 germline mutations: A retrospective observational study and literature review
  109. Evaluation of upper airway ultrasonographic measurements in predicting difficult intubation: A cross-section of the Turkish population
  110. Prognostic and diagnostic value of circulating IGFBP2 in pancreatic cancer
  111. Postural stability after operative reconstruction of the AFTL in chronic ankle instability comparing three different surgical techniques
  112. Research trends related to emergence agitation in the post-anaesthesia care unit from 2001 to 2023: A bibliometric analysis
  113. Frequency and clinicopathological correlation of gastrointestinal polyps: A six-year single center experience
  114. ACSL4 mediates inflammatory bowel disease and contributes to LPS-induced intestinal epithelial cell dysfunction by activating ferroptosis and inflammation
  115. Affibody-based molecular probe 99mTc-(HE)3ZHER2:V2 for non-invasive HER2 detection in ovarian and breast cancer xenografts
  116. Effectiveness of nutritional support for clinical outcomes in gastric cancer patients: A meta-analysis of randomized controlled trials
  117. The relationship between IFN-γ, IL-10, IL-6 cytokines, and severity of the condition with serum zinc and Fe in children infected with Mycoplasma pneumoniae
  118. Paraquat disrupts the blood–brain barrier by increasing IL-6 expression and oxidative stress through the activation of PI3K/AKT signaling pathway
  119. Sleep quality associate with the increased prevalence of cognitive impairment in coronary artery disease patients: A retrospective case–control study
  120. Dioscin protects against chronic prostatitis through the TLR4/NF-κB pathway
  121. Association of polymorphisms in FBN1, MYH11, and TGF-β signaling-related genes with susceptibility of sporadic thoracic aortic aneurysm and dissection in the Zhejiang Han population
  122. Application value of multi-parameter magnetic resonance image-transrectal ultrasound cognitive fusion in prostate biopsy
  123. Laboratory variables‐based artificial neural network models for predicting fatty liver disease: A retrospective study
  124. Decreased BIRC5-206 promotes epithelial–mesenchymal transition in nasopharyngeal carcinoma through sponging miR-145-5p
  125. Sepsis induces the cardiomyocyte apoptosis and cardiac dysfunction through activation of YAP1/Serpine1/caspase-3 pathway
  126. Assessment of iron metabolism and iron deficiency in incident patients on incident continuous ambulatory peritoneal dialysis
  127. Tibial periosteum flap combined with autologous bone grafting in the treatment of Gustilo-IIIB/IIIC open tibial fractures
  128. The application of intravenous general anesthesia under nasopharyngeal airway assisted ventilation undergoing ureteroscopic holmium laser lithotripsy: A prospective, single-center, controlled trial
  129. Long intergenic noncoding RNA for IGF2BP2 stability suppresses gastric cancer cell apoptosis by inhibiting the maturation of microRNA-34a
  130. Role of FOXM1 and AURKB in regulating keratinocyte function in psoriasis
  131. Parental control attitudes over their pre-school children’s diet
  132. The role of auto-HSCT in extranodal natural killer/T cell lymphoma
  133. Significance of negative cervical cytology and positive HPV in the diagnosis of cervical lesions by colposcopy
  134. Echinacoside inhibits PASMCs calcium overload to prevent hypoxic pulmonary artery remodeling by regulating TRPC1/4/6 and calmodulin
  135. ADAR1 plays a protective role in proximal tubular cells under high glucose conditions by attenuating the PI3K/AKT/mTOR signaling pathway
  136. The risk of cancer among insulin glargine users in Lithuania: A retrospective population-based study
  137. The unusual location of primary hydatid cyst: A case series study
  138. Intraoperative changes in electrophysiological monitoring can be used to predict clinical outcomes in patients with spinal cavernous malformation
  139. Obesity and risk of placenta accreta spectrum: A meta-analysis
  140. Shikonin alleviates asthma phenotypes in mice via an airway epithelial STAT3-dependent mechanism
  141. NSUN6 and HTR7 disturbed the stability of carotid atherosclerotic plaques by regulating the immune responses of macrophages
  142. The effect of COVID-19 lockdown on admission rates in Maternity Hospital
  143. Temporal muscle thickness is not a prognostic predictor in patients with high-grade glioma, an experience at two centers in China
  144. Luteolin alleviates cerebral ischemia/reperfusion injury by regulating cell pyroptosis
  145. Therapeutic role of respiratory exercise in patients with tuberculous pleurisy
  146. Effects of CFTR-ENaC on spinal cord edema after spinal cord injury
  147. Irisin-regulated lncRNAs and their potential regulatory functions in chondrogenic differentiation of human mesenchymal stem cells
  148. DMD mutations in pediatric patients with phenotypes of Duchenne/Becker muscular dystrophy
  149. Combination of C-reactive protein and fibrinogen-to-albumin ratio as a novel predictor of all-cause mortality in heart failure patients
  150. Significant role and the underly mechanism of cullin-1 in chronic obstructive pulmonary disease
  151. Ferroptosis-related prognostic model of mantle cell lymphoma
  152. Observation of choking reaction and other related indexes in elderly painless fiberoptic bronchoscopy with transnasal high-flow humidification oxygen therapy
  153. A bibliometric analysis of Prader-Willi syndrome from 2002 to 2022
  154. The causal effects of childhood sunburn occasions on melanoma: A univariable and multivariable Mendelian randomization study
  155. Oxidative stress regulates glycogen synthase kinase-3 in lymphocytes of diabetes mellitus patients complicated with cerebral infarction
  156. Role of COX6C and NDUFB3 in septic shock and stroke
  157. Trends in disease burden of type 2 diabetes, stroke, and hypertensive heart disease attributable to high BMI in China: 1990–2019
  158. Purinergic P2X7 receptor mediates hyperoxia-induced injury in pulmonary microvascular endothelial cells via NLRP3-mediated pyroptotic pathway
  159. Investigating the role of oviductal mucosa–endometrial co-culture in modulating factors relevant to embryo implantation
  160. Analgesic effect of external oblique intercostal block in laparoscopic cholecystectomy: A retrospective study
  161. Elevated serum miR-142-5p correlates with ischemic lesions and both NSE and S100β in ischemic stroke patients
  162. Correlation between the mechanism of arteriopathy in IgA nephropathy and blood stasis syndrome: A cohort study
  163. Risk factors for progressive kyphosis after percutaneous kyphoplasty in osteoporotic vertebral compression fracture
  164. Predictive role of neuron-specific enolase and S100-β in early neurological deterioration and unfavorable prognosis in patients with ischemic stroke
  165. The potential risk factors of postoperative cognitive dysfunction for endovascular therapy in acute ischemic stroke with general anesthesia
  166. Fluoxetine inhibited RANKL-induced osteoclastic differentiation in vitro
  167. Detection of serum FOXM1 and IGF2 in patients with ARDS and their correlation with disease and prognosis
  168. Rhein promotes skin wound healing by activating the PI3K/AKT signaling pathway
  169. Differences in mortality risk by levels of physical activity among persons with disabilities in South Korea
  170. Review Articles
  171. Cutaneous signs of selected cardiovascular disorders: A narrative review
  172. XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis
  173. A narrative review on adverse drug reactions of COVID-19 treatments on the kidney
  174. Emerging role and function of SPDL1 in human health and diseases
  175. Adverse reactions of piperacillin: A literature review of case reports
  176. Molecular mechanism and intervention measures of microvascular complications in diabetes
  177. Regulation of mesenchymal stem cell differentiation by autophagy
  178. Molecular landscape of borderline ovarian tumours: A systematic review
  179. Advances in synthetic lethality modalities for glioblastoma multiforme
  180. Investigating hormesis, aging, and neurodegeneration: From bench to clinics
  181. Frankincense: A neuronutrient to approach Parkinson’s disease treatment
  182. Sox9: A potential regulator of cancer stem cells in osteosarcoma
  183. Early detection of cardiovascular risk markers through non-invasive ultrasound methodologies in periodontitis patients
  184. Advanced neuroimaging and criminal interrogation in lie detection
  185. Maternal factors for neural tube defects in offspring: An umbrella review
  186. The chemoprotective hormetic effects of rosmarinic acid
  187. CBD’s potential impact on Parkinson’s disease: An updated overview
  188. Progress in cytokine research for ARDS: A comprehensive review
  189. Utilizing reactive oxygen species-scavenging nanoparticles for targeting oxidative stress in the treatment of ischemic stroke: A review
  190. NRXN1-related disorders, attempt to better define clinical assessment
  191. Lidocaine infusion for the treatment of complex regional pain syndrome: Case series and literature review
  192. Trends and future directions of autophagy in osteosarcoma: A bibliometric analysis
  193. Iron in ventricular remodeling and aneurysms post-myocardial infarction
  194. Case Reports
  195. Sirolimus potentiated angioedema: A case report and review of the literature
  196. Identification of mixed anaerobic infections after inguinal hernia repair based on metagenomic next-generation sequencing: A case report
  197. Successful treatment with bortezomib in combination with dexamethasone in a middle-aged male with idiopathic multicentric Castleman’s disease: A case report
  198. Complete heart block associated with hepatitis A infection in a female child with fatal outcome
  199. Elevation of D-dimer in eosinophilic gastrointestinal diseases in the absence of venous thrombosis: A case series and literature review
  200. Four years of natural progressive course: A rare case report of juvenile Xp11.2 translocations renal cell carcinoma with TFE3 gene fusion
  201. Advancing prenatal diagnosis: Echocardiographic detection of Scimitar syndrome in China – A case series
  202. Outcomes and complications of hemodialysis in patients with renal cancer following bilateral nephrectomy
  203. Anti-HMGCR myopathy mimicking facioscapulohumeral muscular dystrophy
  204. Recurrent opportunistic infections in a HIV-negative patient with combined C6 and NFKB1 mutations: A case report, pedigree analysis, and literature review
  205. Letter to the Editor
  206. Letter to the Editor: Total parenteral nutrition-induced Wernicke’s encephalopathy after oncologic gastrointestinal surgery
  207. Erratum
  208. Erratum to “Bladder-embedded ectopic intrauterine device with calculus”
  209. Retraction
  210. Retraction of “XRCC1 and hOGG1 polymorphisms and endometrial carcinoma: A meta-analysis”
  211. Corrigendum
  212. Corrigendum to “Investigating hormesis, aging, and neurodegeneration: From bench to clinics”
  213. Corrigendum to “Frankincense: A neuronutrient to approach Parkinson’s disease treatment”
  214. Special Issue The evolving saga of RNAs from bench to bedside - Part II
  215. Machine-learning-based prediction of a diagnostic model using autophagy-related genes based on RNA sequencing for patients with papillary thyroid carcinoma
  216. Unlocking the future of hepatocellular carcinoma treatment: A comprehensive analysis of disulfidptosis-related lncRNAs for prognosis and drug screening
  217. Elevated mRNA level indicates FSIP1 promotes EMT and gastric cancer progression by regulating fibroblasts in tumor microenvironment
  218. Special Issue Advancements in oncology: bridging clinical and experimental research - Part I
  219. Ultrasound-guided transperineal vs transrectal prostate biopsy: A meta-analysis of diagnostic accuracy and complication rates
  220. Assessment of diagnostic value of unilateral systematic biopsy combined with targeted biopsy in detecting clinically significant prostate cancer
  221. SENP7 inhibits glioblastoma metastasis and invasion by dissociating SUMO2/3 binding to specific target proteins
  222. MARK1 suppress malignant progression of hepatocellular carcinoma and improves sorafenib resistance through negatively regulating POTEE
  223. Analysis of postoperative complications in bladder cancer patients
  224. Carboplatin combined with arsenic trioxide versus carboplatin combined with docetaxel treatment for LACC: A randomized, open-label, phase II clinical study
  225. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part I
  226. Comprehensive pan-cancer investigation of carnosine dipeptidase 1 and its prospective prognostic significance in hepatocellular carcinoma
  227. Identification of signatures associated with microsatellite instability and immune characteristics to predict the prognostic risk of colon cancer
  228. Single-cell analysis identified key macrophage subpopulations associated with atherosclerosis
Jetzt anmelden und 20% sparen
Institutioneller Zugang
Wie funktioniert Authentifizierung?
Haben Sie eine Idee, wie wir unsere Website verbessern können?
Bitte schreiben Sie uns.
© 2025 De Gruyter Brill
Heruntergeladen am 30.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/med-2024-1045/html
Button zum nach oben scrollen