{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:47:53Z","timestamp":1765885673489,"version":"3.48.0"},"reference-count":31,"publisher":"BMJ","issue":"7","funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Key Research and Development Programme"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,5,30]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Ceramides are associated with coronary plaque vulnerability. We aim to investigate the potential diagnostic value of ceramides for acute coronary syndrome (ACS) in Chinese patients with chest pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective observational survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Shanghai, China, 2016\u20132017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 2773 patients with chest pain from four hospitals in Shanghai, China, between August 2016 and October 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Performance of metabolites model in detection of ACS cases including ST-elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) and unstable angina.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Plasma levels of 12 ceramide molecules and corresponding ratios were compared between patients diagnosed with ACS and those without. Cer(d18:1\/24:1(15Z))\/Cer(d18:1\/24:0) ratio, Cer(d18:1\/14:0) and Cer(d18:1\/22:0) were independent predictors of ACS after adjustment of traditional risk factors and high-sensitivecardiac troponin T. Receiver operating characteristic curve analysis showed a significant improvement in detecting ACS in the multivariable model with ceramides compared with that without (0.865 (0.840 to 0.889) vs 0.808 (0.776 to 0.841), p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Distinct plasma ceramides are independent diagnostic predictors of ACS among patients with chest pain. Ceramides together with high-sensitive troponin and traditional factors showed great potential in identifying ACS among patients with chest pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-028211","type":"journal-article","created":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T09:09:06Z","timestamp":1564132146000},"page":"e028211","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Effect of combined testing of ceramides with high-sensitive troponin T on the detection of acute coronary syndrome in patients with chest pain in China: a prospective observational study"],"prefix":"10.1136","volume":"9","author":[{"given":"Kang","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Cardiology, Zhongshan Hospital, Fudan University. Shanghai Institute of Cardiovascular Diseases, Shanghai, China"},{"name":"Department of Cardiology, Xiamen Branch, Zhongshan Hospital Fudan University, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanzhong","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Population Health and Environmental Sciences, Kings College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Demin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgey, Zhongshan Hospital, Fudan University, Shanghai, \u200bChina"},{"name":"Department of Cardiac Surgey, Xiamen Branch, Zhongshan HospitalFudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuebo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tongji Hospital, Tongji University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengxing","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People\u2019s Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Minhang Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhe","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhongshan Hospital, Fudan University. Shanghai Institute of Cardiovascular Diseases, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Runda","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhongshan Hospital, Fudan University. Shanghai Institute of Cardiovascular Diseases, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianglin","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhongshan Hospital, Fudan University. Shanghai Institute of Cardiovascular Diseases, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aijun","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhongshan Hospital, Fudan University. Shanghai Institute of Cardiovascular Diseases, Shanghai, China"},{"name":"Shanghai Institute of Biomedical Science, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunzeng","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhongshan Hospital, Fudan University. Shanghai Institute of Cardiovascular Diseases, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juying","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhongshan Hospital, Fudan University. Shanghai Institute of Cardiovascular Diseases, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangyu","family":"Wu","sequence":"additional","affiliation":[{"name":"Qlife Lab Co., Ltd., Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Guo","sequence":"additional","affiliation":[{"name":"Qlife Lab Co., Ltd., Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoliang","family":"Cheng","sequence":"additional","affiliation":[{"name":"Qlife Lab Co., Ltd., Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8765-4941","authenticated-orcid":false,"given":"Junbo","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhongshan Hospital, Fudan University. Shanghai Institute of Cardiovascular Diseases, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,7,26]]},"reference":[{"key":"2025121603405912000_9.7.e028211.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000350"},{"key":"2025121603405912000_9.7.e028211.2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/suw030"},{"key":"2025121603405912000_9.7.e028211.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200004203421603"},{"key":"2025121603405912000_9.7.e028211.4","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr236"},{"key":"2025121603405912000_9.7.e028211.5","doi-asserted-by":"publisher","DOI":"10.4065\/84.10.917"},{"key":"2025121603405912000_9.7.e028211.6","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.111.234096"},{"key":"2025121603405912000_9.7.e028211.7","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.108.179739"},{"key":"2025121603405912000_9.7.e028211.8","doi-asserted-by":"publisher","DOI":"10.1038\/nrm2329"},{"key":"2025121603405912000_9.7.e028211.9","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12944-015-0053-y","article-title":"Sphingolipids in cardiovascular diseases and metabolic disorders","volume":"14","author":"Borodzicz","year":"2015","journal-title":"Lipids Health Dis"},{"key":"2025121603405912000_9.7.e028211.10","doi-asserted-by":"publisher","DOI":"10.1172\/JCI118934"},{"key":"2025121603405912000_9.7.e028211.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2015.10.022"},{"key":"2025121603405912000_9.7.e028211.12","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.273.26.16521"},{"key":"2025121603405912000_9.7.e028211.13","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.271.22.13094"},{"key":"2025121603405912000_9.7.e028211.14","doi-asserted-by":"publisher","DOI":"10.1038\/sj.cdd.4401438"},{"key":"2025121603405912000_9.7.e028211.15","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000136995.83451.1D"},{"key":"2025121603405912000_9.7.e028211.16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0021817","article-title":"Hypertension is associated with marked alterations in sphingolipid biology: a potential role for ceramide","volume":"6","author":"Spijkers","year":"2011","journal-title":"PLoS One"},{"key":"2025121603405912000_9.7.e028211.17","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1038\/oby.2011.107","article-title":"Gastric bypass surgery reduces plasma ceramide subspecies and improves insulin sensitivity in severely obese patients","volume":"19","author":"Huang","year":"2011","journal-title":"Obesity"},{"key":"2025121603405912000_9.7.e028211.18","doi-asserted-by":"publisher","DOI":"10.2337\/db08-1228"},{"key":"2025121603405912000_9.7.e028211.19","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw148"},{"key":"2025121603405912000_9.7.e028211.20","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000133"},{"key":"2025121603405912000_9.7.e028211.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.08.001"},{"key":"2025121603405912000_9.7.e028211.22","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-2559"},{"key":"2025121603405912000_9.7.e028211.23","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.118.311199"},{"key":"2025121603405912000_9.7.e028211.24","unstructured":"Ambroise GJMAD. Analyzing Microarray Gene Expression Data. 2005."},{"key":"2025121603405912000_9.7.e028211.25","doi-asserted-by":"crossref","unstructured":"Kuhn M , Johnson K . Applied Predictive Modeling. 2013.","DOI":"10.1007\/978-1-4614-6849-3"},{"key":"2025121603405912000_9.7.e028211.26","doi-asserted-by":"crossref","unstructured":"James G , Witten D , Hastie T , et al . An Introduction to Statistical Learning. 2013.","DOI":"10.1007\/978-1-4614-7138-7"},{"key":"2025121603405912000_9.7.e028211.27","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.024261"},{"key":"2025121603405912000_9.7.e028211.28","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.P081281"},{"key":"2025121603405912000_9.7.e028211.29","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jacbts.2017.12.005","article-title":"Plasma ceramides as prognostic biomarkers and their arterial and myocardial tissue correlates in acute\u00a0myocardial infarction","volume":"3","author":"de Carvalho","year":"2018","journal-title":"JACC Basic Transl Sci"},{"key":"2025121603405912000_9.7.e028211.30","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu178"},{"key":"2025121603405912000_9.7.e028211.31","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.5809"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-028211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:41:08Z","timestamp":1765885268000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-028211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":31,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7,26]]},"published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1136\/bmjopen-2018-028211"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-028211","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2019,7]]}}}