{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T05:21:16Z","timestamp":1783833676832,"version":"3.55.0"},"reference-count":30,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81970392"],"award-info":[{"award-number":["81970392"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370440"],"award-info":[{"award-number":["82370440"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,10]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To develop a CERT SCORE utilising both odd-chain and even-chain ceramide species, and to evaluate its association with short-term and lifetime cardiovascular risk in patients with coronary atherosclerotic heart disease (CAD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A patients-based cohort in the Beijing Anzhen Hospital, Capital Medical University.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>CAD patients were defined as having at least one coronary artery stenosis of \u226550% as assessed by coronary angiography or CT angiography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcomes and measures<\/jats:title>\n                    <jats:p>Major adverse cardiac events (MACE) including all-cause death, myocardial infarction, heart failure, cerebral infarction and readmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We quantified 13 ceramide species and calculated the ratios of Cer(d18:1\/14:0) and Cer(d18:1\/24:0). Based on these measurements, Cer(d18:1\/19:0), Cer(d18:1\/19:0)\/Cer(d18:1\/14:0), Cer(d18:1\/19:0)\/Cer(d18:1\/24:0) and Cer(d18:1\/21:0)\/Cer(d18:1\/24:0) were selected to construct the CERT SCORE. Using this score, patients were classified into two distinct risk categories for MACE: low-risk (score 0\u20136) and high-risk (score 7\u201312). The high-risk group exhibited a significantly higher short-term risk of MACE (HR 2.10; 95% CI 1.50 to 2.94) compared with the low-risk group. The cumulative MACE risk in the low- and high-risk groups during the 1000-day follow-up was 25.45% and 44%, respectively. Subgroup analyses revealed that the presence of multivessel coronary artery lesions did not significantly modify the association between the CERT SCORE and short-term MACE risk (p value for interaction=0.967). Furthermore, in the age groups of 41\u201350 years, 51\u201360 years and 61\u201370 years, lifetime risk was significantly elevated in the high-risk group compared with the low-risk group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We have developed a ceramide-based risk stratification tool (CERT SCORE) that demonstrates robust predictive value for identifying high-risk MACE patients among CAD patients. This tool offers considerable clinical utility for guiding patient management and informing therapeutic decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-094100","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T07:00:32Z","timestamp":1761116432000},"page":"e094100","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association of plasma ceramides with short-term and lifetime risk of MACE in coronary atherosclerotic heart disease patients: a prospective cohort study"],"prefix":"10.1136","volume":"15","author":[{"given":"Xiaolu","family":"Li","sequence":"first","affiliation":[{"name":"Experimental Research Center, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, 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