An Viet Tran

Background: Patients hospitalized for heart failure (HF) face a high-risk early postdischarge period. Objective: We aimed to develop and internally validate the soluble ST2, age, and estimated glomerular filtration rate–heart failure (SAGE-HF) score, a simplified risk model incorporating soluble suppression of tumorigenicity 2 (sST2), age, and renal function, for predicting 30-day postdischarge major adverse cardiovascular events (MACE). Methods: This two-center prospective cohort study included 218 patients hospitalized with acute decompensated heart failure (ADHF) and/or heart failure with reduced ejection fraction (HFrEF) and 59 non-HF controls in Vietnam (July 2025-January 2026). Serum sST2 concentrations were measured at admission using enzyme-linked immunosorbent assay and compared between the ADHF/HFrEF cohort and controls, with adjustment for clinical covariates. Among the ADHF/HFrEF cohort, the primary endpoint was 30-day MACE, defined as a composite of all-cause death or HF rehospitalization. Candidate predictors were considered based on clinical relevance, biological plausibility, and exploratory univariable associations, and prespecified parsimonious logistic regression models were evaluated using discrimination (area under the receiver operating characteristic curve [AUC]), calibration, Brier score, and Akaike information criterion. Internal validation was performed using 1000 bootstrap resamples, and model robustness was assessed using Firth penalized logistic regression. The SAGE-HF score was derived from the final model. All data were analyzed using the R environment (version 4.5.5; R Foundation for Statistical Computing). Results: Among 277 participants, sST2 concentrations were significantly higher in patients with HF than in non-HF controls after adjustment. Among 218 patients, 47 (21.6%) experienced 30-day MACE. In multivariable analysis, age (odds ratio [OR] 1.04 per year, 95% CI 1.01‐1.07; P =.02), sST2 (OR 1.06 per ng/mL, 95% CI 1.01‐1.11; P =.01), and estimated glomerular filtration rate (OR 0.98 per unit, 95% CI 0.97‐1.00; P =.02) were independently associated with MACE. The final model demonstrated acceptable discrimination (AUC 0.741, 95% CI 0.664‐0.819) and good calibration, with stable performance after bootstrap validation (corrected AUC 0.725). Firth analysis yielded consistent results. The SAGE-HF score showed progressive risk stratification, with predicted 30-day MACE ranging from 7.0% to 60.1% and maintained acceptable discrimination and calibration. Conclusions: The SAGE-HF score, incorporating age, sST2, and estimated glomerular filtration rate, demonstrated acceptable performance for predicting 30-day MACE after HF hospitalization and may support early risk stratification, pending external validation.

Objective: We evaluated whether admission Galectin-3 (Gal-3) was associated with higher apparent discrimination and reclassification when added to the TIMI, HEART and GRACE scores for 12-month major adverse cardiovascular events (MACE) in Vietnamese patients with acute coronary syndrome (ACS). Methods: This prospective observational cohort included 103 adults with ACS diagnosed according to the 2023 European Society of Cardiology criteria between August 2024 and April 2025. Patients were followed for 12 months, with final follow-up completed in April 2026. Serum Gal-3 was measured at admission. The primary endpoint was MACE, comprising all-cause death, nonfatal myocardial infarction, nonfatal stroke, unplanned hospitalization for heart failure or unplanned coronary revascularization. Discrimination of the TIMI, HEART and GRACE scores, with and without Gal-3, was assessed by area under the receiver operating characteristic curve (AUC). Reclassification was evaluated using continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI), with 95% confidence intervals estimated from 1,000 bootstrap resamples. Results: During follow-up, 16 patients (15.5%) experienced MACE. Admission Gal-3 was higher in patients with MACE than in those without MACE (median 28.7 vs 15.4 ng/mL) and the adjusted median difference remained significant (p=0.034). Adding Gal-3 yielded higher apparent AUCs for TIMI (0.584 vs 0.804), HEART (0.580 vs 0.802) and GRACE (0.620 vs 0.797), with optimism-corrected AUCs of 0.785, 0.789 and 0.783, respectively. Given the limited number of outcome events, these estimates remain exploratory and potentially optimistic. Conclusions: Higher admission Gal-3 levels were associated with 12-month MACE. Adding Gal-3 to established risk scores yielded higher apparent discrimination and secondary exploratory reclassification metrics; however, the magnitude of these differences remains uncertain and may still be optimistic despite bootstrap correction. These analyses should be regarded as hypothesis-generating rather than as the development of candidate clinical prediction models, and external validation in larger multicenter cohorts is required.

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Summary The association between body weight and vertebral fracture is established, but whether muscle mass or fat mass drives this relationship remains unclear. In Vietnamese adults, our study demonstrates that muscle mass, rather than fat mass, predicts vertebral fracture risk. Both low and excessive muscle mass significantly increase this risk, indicating a U-shaped relationship. Purpose The purpose is to examine the relationship between various body composition measures and vertebral fracture in a Vietnamese population. Methods This cross-sectional study included 1,372 Vietnamese adults aged ≥ 50 years from the Vietnam Osteoporosis Study. Body composition was measured using dual-energy X-ray absorptiometry to derive lean body mass index (LBMI), appendicular skeletal muscle mass index (ASMI), body fat mass index (BFMI), and percentage-based indices. Vertebral fractures were identified via thoracolumbar radiographs using Genant’s semiquantitative method. Adjusted logistic regression models and restricted cubic splines were used to assess associations and explore nonlinear relationships. Results Vertebral fractures were diagnosed in 173 participants (12.6%). Compared with those without fractures, affected participants were older (63.4 ± 9.6 vs 58.8 ± 7.3 years; p < 0.001) and more often male (38.7% vs 29.4%; p = 0.017). Both LBMI and ASMI showed U-shaped associations with fracture risk, with higher odds at the extremes; for ASMI, the lowest and highest quartiles had increased odds of fracture (OR 1.72; 95% CI 1.02–2.95 and OR 2.59; 95% CI 1.36–5.02, respectively). In contrast, BFMI was not significantly associated with fracture risk (p = 0.365). Higher trunk lean percentage was consistently related to fracture (ORs 1.82–2.54 across non-reference quartiles), whereas total body and leg lean percentages were associated with increased risk only in the highest quartile (OR 2.18; 95% CI 1.07–4.45 and OR 2.06; 95% CI 1.03–4.12). Conclusions In Vietnamese adults, extremes of muscle mass (low and high), rather than fat mass, are associated with higher vertebral fracture risk. This emphasizes incorporating muscle mass evaluation into fracture risk assessment beyond reliance on BMI alone.

Background: Cardiovascular disease (CVD) is the leading cause of mortality worldwide, while depression is highly prevalent in this patient population and has long been regarded as an independent risk factor for increased mortality. However, recent evidence suggests that this association may be influenced by symptom overlap and residual confounding that has not been fully accounted for. Objectives: This study aimed to evaluate the association between clinically significant depressive symptoms and the risk of all-cause, cardiovascular and non-cardiovascular mortality in adults with CVD. Methods: We conducted a secondary analysis of 2064 adults with a history of CVD using data from the National Health and Nutrition Examination Survey 2011–2018 linked with the National Death Index. Depression was defined using the Patient Health Questionnaire-9 with a cut-off score of 10 or higher. Primary outcomes were all-cause, cardiovascular and non-cardiovascular mortality. Statistical analyses were performed using R software. We employed multivariable Cox regression models as well as propensity score matching and inverse probability weighting to control for potential confounders. Results: Over a median follow-up of 4.67 years, 403 deaths were recorded. In an adjusted multivariable Cox model controlling for age, sex and race, depression was associated with an increased risk of all-cause mortality (HR 1.33; 95% CI 1.02 to 1.75) and non-cardiovascular mortality (HR 1.46; 95% CI 1.04 to 2.05). However, after applying propensity score matching and inverse probability weighting, these associations were no longer statistically significant for any mortality outcome. Conclusions: After rigorous adjustment for confounders and comorbidities, depression was no longer identified as an independent risk factor for mortality among patients with CVD.

Intravenous iron supplementation, particularly ferric carboxymaltose (FCM), has emerged as an effective therapeutic strategy for correcting iron deficiency (ID) in patients with heart failure with reduced ejection fraction (HFrEF). However, the enhancement related to the quality of life (QoL) and functional capacity remains unclear, specifically in the Vietnam population. This study assesses the enhancement of QoL and functional capacity in intravenous FCM therapy in heart failure patients with ID. We conducted a cross-sectional analysis study in patients with chronic HFrEF. Eligible patients diagnosed with ID were treated with FCM. Endpoint was the improvement in QoL, assessed by the European Quality of Life 5 Dimensions 5 Level Version questionnaire, and functional capacity, measured by the change in the 6-minute walk test and New York Heart Association Functional Classification. A total of 132 patients with chronic HFrEF, with 35.60% of patients with ID. The study population had a mean age of 65.7 ± 9.4 years, males accounted for 56.8%. Female, New York Heart Association ≥3 and poor QoL significantly associated with ID. Notably, 12 weeks after intervention, patients with poor QoL decreased from 48.9% to 34.0% (P < .001). Functional capacity, assessed by the 6-minute walk test, improved with the median distance increasing from 239.90 (198.80–291.70) m at baseline to 262.60 (219.50–309.70) m (P < .01). Nausea was reported by a small minority at 4.25%. Our study highlights the significant burden of ID in patients with HFrEF, emphasizing its strong association with symptom severity, functional impairment, and reduced QoL. Intravenous FCM therapy demonstrated significant improvements in iron parameters, functional capacity, and QoL, with a favorable safety profile.

Background: Apolipoprotein B (APOB) rs676210 polymorphism has been associated with altered lipid metabolism and cardiovascular risk in various populations; however, data from Vietnamese populations remain limited. Objective: This study aimed to investigate the association of the APOB rs676210 variant with lipid profiles among Vietnamese individuals newly diagnosed with elevated low-density lipoprotein cholesterol (LDL-C). Methods: A cross-sectional study was conducted among 69 Vietnamese adults newly diagnosed with elevated LDL-C (≥130 mg/dL) at a tertiary hospital in Southern Vietnam. Participants were genotyped for APOB rs676210 using real-time polymerase chain reaction (PCR) with allele-specific probes. Lipid profile components, including LDL-C, high-density lipoprotein cholesterol (HDL-C), non–HDL-C, and ApoB, were compared across genotype groups (AA vs GA/GG) and alleles (A vs G). Statistical analyses involved t tests, chi-square tests, and multivariable linear regression adjusted for age, sex, the BMI, and diabetes. P<.05 was considered statistically significant. Results: Of the 69 participants, 32 (46.4%) carried the AA genotype, while 37 (53.6%) carried the GA or the GG genotype. The AA genotype was associated with significantly higher LDL-C (mean 5.19, SD 0.95, vs mean 4.37, SD 0.97, mmol/L; P<.001), non–HDL-C (mean 5.94, SD 1.08, vs mean 5.31, SD 1.22 mmol/L; P=.03), and ApoB (mean 149.5, SD 26.3, vs mean 136.9, SD 15.2, mg/dL; P=.02) and lower HDL-C (mean 1.26, SD 0.31, vs mean 1.44, SD 0.39, mmol/L; P=.03) compared to the GA/GG genotype. Allele-based analysis showed that carriers of the A allele (98/138, 71%) also had higher LDL-C (mean 4.91, SD 1.02, vs mean 4.36, SD 0.97, mmol/L; P=.004) and ApoB (mean 145.6, SD 23.2, vs mean 135.9, SD 16.0, mg/dL; P=.02) than G allele carriers (40/138, 29%). These associations remained significant after multivariate adjustment. Conclusions: APOB rs676210 polymorphism is associated with significant differences in lipid profiles among Vietnamese adults with elevated LDL-C. Specifically, the A allele and the AA genotype confer a more atherogenic profile, suggesting potential utility as a genetic marker in lipid screening and personalized cardiovascular risk management in this population.

Đặt vấn đề: Galectin-3 là một dấu ấn sinh học liên quan đến tiến trình viêm và xơ hóa trong bệnh tim mạch. Việc xác định mối liên quan giữa Galectin-3 và tổn thương mạch vành có thể góp phần nâng cao hiệu quả phân tầng nguy cơ ở bệnh nhân hội chứng vành cấp (HCVC). Mục tiêu: Khảo sát nồng độ galectin-3 huyết thanh và mối liên quan với đặc điểm tổn thương mạch vành ở bệnh nhân HCVC. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang được thực hiện trên 64 bệnh nhân HCVC tại Bệnh viện Hoàn Mỹ Cửu Long từ tháng 6/2024 đến tháng 3/2025. Kết quả: Tuổi trung bình bệnh nhân là 69,6 ± 9,8 tuổi, đa phần là nữ giới (69,4%). Tỷ lệ tăng huyết áp chiếm 98,4%, rối loạn lipid máu 85,5%, đái tháo đường 33,9%, và tiền căn có bệnh mạch vành trước đó là 80,6%. Tổn thương mạch vành chủ yếu ở hai nhánh (45,2%) và ba nhánh (19,4%), mức độ hẹp từ vừa đến nặng chiếm 80,7%. Dòng chảy TIMI chủ yếu ở mức 2 (58,1%) và 3 (22,6%). Nồng độ galectin-3 trung bình là 20,01 ± 7,43 ng/mL, dao động từ 10,60 đến 45,70 ng/mL. Nồng độ galectin-3 tăng theo số nhánh mạch vành bị tổn thương, với sự khác biệt có ý nghĩa thống kê (p < 0,001). Kết luận: Galectin-3 có liên quan đến số nhánh tổn thương động mạch vành ở bệnh nhân HCVC, cho thấy tiềm năng ứng dụng trong đánh giá nguy cơ và định hướng can thiệp sớm.

Introduction: Heart failure with reduced ejection fraction (HFrEF) is a severe clinical condition associated with high mortality and morbidity rates. The –786T/C (rs2070744) polymorphism in the NOS3 gene may influence nitric oxide production and alter cardiovascular outcomes in HFrEF patients. Methods: A cross-sectional descriptive study was conducted at Bac Lieu General Hospital, Vietnam from April 2023 to June 2024. Ninety patients with HFrEF (LVEF pppvia modulation of nitric oxide production, endothelial dysfunction, and autonomic dysregulation. Conclusion: The rs2070744 polymorphism in the NOS3 gene may serve as a prognostic biomarker for poor outcomes in HFrEF. Patients with CC/CT genotypes and dyslipidemia have higher risks of readmission and mortality.

Đặt vấn đề: Tỷ số apoB/apoA1 được chứng minh có khả năng dự báo sự hiện diện và mức độ nặng của hẹp động mạch vành trong một số nghiên cứu. Tuy nhiên, tại Việt Nam, chưa có nhiều nghiên cứu khám phá về dấu ấn sinh học này. Mục tiêu: Mô tả giá trị của APOB/APOA1 và tìm hiểu mối liên quan với tổn thương hẹp động mạch vành trong đau thắt ngực không ổn định. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang trên 54 bệnh nhân đau thắt ngực không ổn định tại Bệnh viện Đa khoa Thống Nhất Đồng Nai. Kết quả: Về đặc điểm chung, tỷ lệ nam/nữ = 1,45; độ tuổi trung bình là 64,04±11,34, phần lớn từ 60 tuổi trở lên. Chỉ số khối cơ thể có trung bình là 22,83±4,12 kg/m2, tỷ lệ thừa cân-béo phì là 42,6%. Tỷ lệ hút thuốc lá là 35,2%. Về bệnh nền, tỷ lệ tăng huyết áp là 100%, đái tháo đường chiếm 38,9%. Nồng độ ApoB trung bình là 77,07±25,04 mg/dL. Nồng độ ApoA1 trung bình là 115,97±23,29 mg/dL. Tỷ số ApoB/ApoA1 phân phối chuẩn, trung bình là 0,68±0,24. Điểm Gensini trung bình là 15,93±15,75. Tỷ lệ tổn thương hẹp 1 nhánh và 3 nhánh mạch vành cùng là 37,0%, tổn thương hẹp 2 nhánh là 25,9%. Hầu hết là hẹp nhẹ, chiếm 85,2%. Tỷ số ApoB/ApoA1 ở nhóm tổn thương hẹp 3 nhánh mạch vành cao hơn ở nhóm tổn thương 1 và 2 nhánh mạch vành (0,77±0,31 vs. 0,63±0,18, p=0,043). Ngoài ra, ApoB/ApoA1 cao hơn ở nhóm Gensini trung bình-nặng (0,85±0,45 vs. 0,65±0,18, p=0,029). Có mối tương quan thuận giữa tỷ số ApoB/ApoA1 và điểm Gensini (p=0,01, r=0,34). Kết luận: Tỷ số ApoB/ApoA1 cho thấy có liên quan đến số nhánh và mức độ tổn thương hẹp mạch vành ở bệnh nhân đau thắt ngực không ổn định.