2024年 · 第137卷第10期

Temporary mechanical circulatory support (tMCS) plays a pivotal role in managing severe or refractory cardiogenic shock (CS), furnishing essential hemodynamic support, and sustaining organ perfusion from hours to weeks, or to even months. In the past decade, the utilization of tMCS has witnessed a significant increase in American and European countries. Meanwhile in Asia, the newly developed concepts and devices constituting tMCS have also made rapid progress. Nevertheless, the absence of a consensus or standardized guidelines, especially for the Asian population considering inherited polymorphism, is evident. To address this knowledge gap, eight associations/societies and experts in this field came up with the present consensus after repeated discussions, more specifically for the Asian population. It comprehensively elucidates the commonly employed tMCS devices, criteria for patient selection, indications and contraindications, clinical management, and the optimal timing for implantation and weaning. The goal of this statement is to promote the standardized application of tMCS and make reasonable decisions in clinical practice. Full-length version of the consensus can be seen in Supplementary File, http://links. lww.com/CM9/B883.

Chimeric antigen receptor (CAR)-T cell therapy has achieved remarkable success in the treatment of hematological malignancies. Based on the immunomodulatory capability of CAR-T cells, efforts have turned toward exploring their potential in treating autoimmune diseases. Bibliometric analysis of 210 records from 128 academic journals published by 372 institutions in 40 countries/regions indicates a growing number of publications on CAR-T therapy for autoimmune diseases, covering a range of subtypes such as systemic lupus erythematosus, multiple sclerosis, among others. CAR-T therapy holds promise in mitigating several shortcomings, including the indiscriminate suppression of the immune system by traditional immunosuppressants, and non-sustaining therapeutic levels of monoclonal antibodies due to inherent pharmacokinetic constraints. By persisting and proliferating in vivo, CAR-T cells can offer a tailored and precise therapeutics. This paper reviewed preclinical experiments and clinical trials involving CAR-T and CAR-related therapies in various autoimmune diseases, incorporating innovations well-studied in the field of hematological tumors, aiming to explore a safe and effective therapeutic option for relapsed/refractory autoimmune diseases.

Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) is a well-established oncogenic long non-coding RNA, the higher expression of which is strongly correlated with cancer events such as tumorigenesis, progression, metastasis, drug resistance, and treatment outcome in solid cancers. Recently, a series of studies has highlighted its potential role in hematological malignancies in terms of these events. Similar to solid cancers, MALAT1 can regulate various target genes via sponging and epigenetic mechanisms, but the miRNAs sponged by MALAT1 differ from those identified in solid cancers. In this review, we systematically describe the role and underlying mechanisms of MALAT1 in multiple types of hematological malignancies, including regulation of cell proliferation, metastasis, stress response, and glycolysis. Clinically, MALAT1 expression is related to poor treatment outcome and drug resistance, therefore exhibiting potential prognostic value in multiple myeloma, lymphoma, and leukemia. Finally, we discuss the evaluation of MALAT1 as a novel therapeutic target against cancer in preclinical studies.

Prenatal and postnatal factors may have joint effects on cardiovascular health, and we aimed to assess the joint association of birth weight and ideal cardiovascular health metrics (ICVHMs) prospectively in adulthood with incident cardiovascular disease (CVD).

In the UK Biobank, 227,833 participants with data on ICVHM components and birth weight and without CVD at baseline were included. The ICVHMs included smoking, body mass index, physical activity, diet information, total cholesterol, blood pressure, and hemoglobin A1c. The Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) in men and women.

Over a median follow-up period of 13.0 years (2,831,236 person-years), we documented 17,477 patients with incident CVD. Compared with participants with birth weights of 2.5-4.0 kg, the HRs (95% CIs) of CVD among those with low birth weights was 1.08 (1.00-1.16) in men and 1.23 (1.16-1.31) in women. The association between having a birth weight <2.5 kg and CVD risk in men was more prominent for those aged <50 years than for those of older age (P for interaction = 0.026). Lower birth weight and non-ideal cardiovascular health metrics were jointly related to an increased risk of CVD. Participants with birth weights <2.5 kg and ICVHMs score 0-1 had the highest risk of incident CVD (HR [95% CI]: 3.93 [3.01-5.13] in men; 4.24 [3.33-5.40] in women). The joint effect (HR [95% CI]: 1.36 [1.17-1.58]) could be decomposed into 24.7% (95% CI: 15.0%-34.4%) for a lower birth weight, 64.7% (95% CI: 56.7%-72.6%) for a lower ICVHM score, and 10.6% (95% CI: 2.7%-18.6%) for their additive interaction in women.

Birth weight and ICVHMs were jointly related to CVD risk. Attaining a normal birth weight and ideal ICVHMs may reduce the risk of CVD, and a simultaneous improvement of both prenatal and postnatal factors could further prevent additional cases in women.

Whether the dynamic weight change is an independent risk factor for mortality remains controversial. This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial (NIT) cohort.

Body weight of 21,028 healthy residents of Linxian, Henan province, aged 40-69 years was measured two times from 1986 to 1991. Outcome events were prospectively collected up to 2016. Weight maintenance group (weight change <2 kg) or stable normal weight group was treated as the reference. Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) to estimate the risk of mortality.

A total of 21,028 subjects were included in the final analysis. Compared with the weight maintenance group, subjects with weight loss ≥2 kg had an increased risk of death from all-cause (HR_All-cause = 1.14, 95% CI: 1.09-1.19, P <0.001), cancer (HR_Cancer = 1.12, 95% CI: 1.03-1.21, P = 0.009), and heart disease (HR_{Heart diseases} = 1.21, 95% CI: 1.11-1.31, P <0.001), whereas subjects with weight gain ≥5 kg had 11% (HR_Cancer = 0.89, 95% CI: 0.79-0.99, P = 0.033) lower risk of cancer mortality and 23% higher risk of stroke mortality (HR_Stroke = 1.23,95% CI: 1.12-1.34, P <0.001). For the change of weight status, both going from overweight to normal weight and becoming underweight within 5 years could increase the risk of total death (HR_{Overweight to normal} = 1.18, 95% CI: 1.09-1.27; HR_{Becoming underweight} = 1.35, 95% CI: 1.25-1.46) and cancer death (HR_{Overweight to normal} = 1.20, 95% CI: 1.04-1.39; HR_{Becoming underweight} = 1.44, 95% CI: 1.24-1.67), while stable overweight could increase the risk of total death (HR_{Stable overweight} = 1.11, 95% CI: 1.05-1.17) and death from stroke (HR_{Stable overweight} = 1.44, 95% CI: 1.33-1.56). Interaction effects were observed between age and weight change on cancer mortality, as well as between baseline BMI and weight change on all-cause, heart disease, and stroke mortality (all P_interaction <0.01).

Weight loss was associated with an increased risk of all-cause, cancer, and heart disease mortality, whereas excessive weight gain and stable overweight were associated with a higher risk of stroke mortality. Efforts of weight management should be taken to improve health status.

https://classic.clinicaltrials.gov/, NCT00342654.

Influenza and pneumococcal vaccination are a priority in patients with chronic obstructive pulmonary disease (COPD). However, limited information is available on vaccination coverage among patients with acute exacerbations of COPD (AECOPD) in China. This study aimed to determine the rates and associated factors of influenza and pneumococcal vaccination in patients hospitalized with AECOPD.

Baseline data from a national, multicenter, hospital-based study that included adult inpatients with AECOPD between 2017 and 2021 were analyzed. The outcomes of interest were the influenza vaccination in the past year and the pneumococcal vaccination in the past 5 years. To ensure national representativeness, rates were weighted according to the distribution of hospital levels and types enrolled in this study. Multivariable Poisson regression based on mixed-effects models were used to determine the associated factors. The independent variables included the region and hospital features where the participants were located, sociodemographic characteristics (age, sex, rural/urban residence, education, etc.), and clinical indicators (COPD disease history, lung function parameters, comorbidities, etc.). The treatment profiles of the vaccinated and unvaccinated participants were compared.

Of 6949 eligible participants, the weighted rates of influenza/pneumococcal, influenza, and pneumococcal vaccination were 2.72% (95% confidence interval [CI]: 2.34%-3.10%), 2.09% (95% CI: 1.76%-2.43%), and 1.25% (95% CI: 0.99%-1.51%), respectively. In multivariable models, age ≥60 years (60-69 years, odds ratio [OR]: 1.90, 95% CI: 1.11-3.25; ≥80 years, OR: 2.00, 95% CI: 1.06-3.78), geographical regions (Northern China relative to Eastern China, OR: 5.09, 95% CI: 1.96-13.21), urban residence (OR: 1.69, 95% CI: 1.07-2.66), a higher education level (junior high school, OR: 1.77, 95% CI: 1.21-2.58; senior high school or above, OR: 2.61, 95% CI: 1.69-4.03), former smoking (OR: 1.79, 95% CI: 1.15-2.79), and regular inhaled medication treatment (OR: 3.28, 95% CI: 2.29-4.70) were positively associated with vaccination. Patients who had experienced severe exacerbations in the past year were less likely to be vaccinated (OR: 0.65, 95% CI: 0.45-0.96). Compared with unvaccinated participants, vaccinated participants adhered better to pharmacological and non-pharmacological treatment.

Influenza and pneumococcal vaccination coverage are extremely low. Urgent measures are necessary to increase vaccination coverage among inpatients with AECOPD in China.

There is a need for effective and safe therapies for psoriasis that provide sustained benefits. The aim of this study was to assess the efficacy and safety of tildrakizumab, an anti-interleukin-23p19 monoclonal antibody, for treating moderate-to-severe plaque psoriasis in Chinese patients.

In this multi-center, double-blind, phase III trial, patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned (1:1) to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4. Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12, 16, and every 12 weeks thereafter. Patients in the tildrakizumab group continued with tildrakizumab at week 16, and every 12 weeks until week 52. The primary endpoint was the Psoriasis Area and Severity Index (PASI 75) response rate at week 12.

At week 12, tildrakizumab demonstrated significantly higher PASI 75 response rates (66.4% [73/110] vs. 12.7% [14/110]; difference, 51.4% [95% confidence interval (CI), 40.72, 62.13]; P <0.001) and Physician’s Global Assessment (60.9% [67/110] vs. 10.0% [11/110]; difference, 49.1% [95% CI, 38.64, 59.62]; P <0.001) compared to placebo. PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups, reaching maximal efficacy after 28 weeks (86.8% [92/106] vs. 82.4% [89/108]) and maintained up to 52 weeks (91.3% [95/104] vs. 87.4% [90/103]). Most treatment-emergent adverse events were mild and not related to tildrakizumab.

Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.

ClinicalTrials.gov, NCT05108766.

Growth retardation is a common complication of chronic kidney disease in children, which can be partially relieved after renal transplantation. This study aimed to develop and validate a predictive model for growth patterns of children with end-stage renal disease (ESRD) after kidney transplantation using machine learning algorithms based on genomic and clinical variables.

A retrospective cohort of 110 children who received kidney transplants between May 2013 and September 2021 at the First Affiliated Hospital of Zhengzhou University were recruited for whole-exome sequencing (WES), and another 39 children who underwent transplant from October 2021 to March 2022 were enrolled for external validation. Based on previous studies, we comprehensively collected 729 height-related single-nucleotide polymorphisms (SNPs) in exon regions. Seven machine learning algorithms and 10-fold cross-validation analysis were employed for model construction.

The 110 children were divided into two groups according to change in height-for-age Z-score. After univariate analysis, age and 19 SNPs were incorporated into the model and validated. The random forest model showed the best prediction efficacy with an accuracy of 0.8125 and an area under curve (AUC) of 0.924, and also performed well in the external validation cohort (accuracy, 0.7949; AUC, 0.796).

A model with good performance for predicting post-transplant growth patterns in children based on SNPs and clinical variables was constructed and validated using machine learning algorithms. The model is expected to guide clinicians in the management of children after renal transplantation, including the use of growth hormone, glucocorticoid withdrawal, and nutritional supplementation, to alleviate growth retardation in children with ESRD.

With an increasing number of patients with hematological malignancies being treated with umbilical cord blood transplantation (UCBT), the correlation between immune reconstitution (IR) after UCBT and graft-versus-host disease (GVHD) has been reported successively, but reports on double-negative T (DNT) cell reconstitution and its association with acute GVHD (aGVHD) after UCBT are lacking.

A population-based observational study was conducted among 131 patients with hematological malignancies who underwent single-unit UCBT as their first transplant at the Department of Hematology, the First Affiliated Hospital of USTC, between August 2018 and June 2021. IR differences were compared between the patients with and without aGVHD.

The absolute number of DNT cells in the healthy Chinese population was 109 (70-157)/μL, accounting for 5.82 (3.98-8.19)% of lymphocytes. DNT cells showed delayed recovery and could not reach their normal levels even one year after transplantation. Importantly, the absolute number and percentage of DNT cells were significantly higher in UCBT patients without aGVHD than in those with aGVHD within one year (F = 4.684, P = 0.039 and F = 5.583, P = 0.026, respectively). In addition, the number of DNT cells in the first month after transplantation decreased significantly with the degree of aGVHD increased, and faster DNT cell reconstitution in the first month after UCBT was an independent protective factor for aGVHD (HR = 0.46, 95% confidence interval [CI]: 0.23-0.93; P = 0.031).

Compared to the number of DNT cells in Chinese healthy people, the reconstitution of DNT cells in adults with hematological malignancies after UCBT was slow. In addition, the faster reconstitution of DNT cells in the early stage after transplantation was associated with a lower incidence of aGVHD.

Ebstein’s anomaly (EA) is a rare and complex congenital heart anomaly, and the effect of surgical treatment is not ideal. This study aims to introduce our experience in management strategies, surgical techniques, and operative indications for patients with Ebstein’s anomaly.

A retrospective study of 258 operations was performed in 253 patients by the same cardiac surgeon in The First Hospital of Tsinghua University between March 2004 and January 2020. 32 patients had previously received cardiac surgery in other hospitals. The clinical data including diagnosis, operative indications, techniques, pathological changes, and survival rates were collected and analyzed.

Anatomical correction was performed in 203 (78.7%) operations, 1½ ventricle repair in 38 (14.7%) operations, tricuspid valve repair only in four operations (1.6%), tricuspid valve replacement in ten (3.9%), total cavopulmonary connection (TCPC) in two (0.8%), and Glenn operation in one operation (0.4%). Reoperation was performed in five patients (2.0%) during hospitalization. Among them, tricuspid valve replacement was performed in one patient, 1½ ventricle repair in two patients, and tricuspid valve annulus reinforcement in two patients. Five patients died with an early mortality rate of 2.0%. Complete atrioventricular conduction block was complicated in one patient (0.4%). A total of 244 patients was followed up (four in the 253 patients lost) with a duration of 3.0-168.0 (87.6 ± 38.4) months. Cardiac function of 244 patients improved significantly with mean New York Heart Association (NYHA) functional class recovery from 3.5 to 1.1. The mean grade of tricuspid valve regurgitation improved from 3.6 to 1.5. Three late deaths (1.2%) occurred. The survival rates at five and ten years after surgery were 98.6% and 98.2%, respectively. Reoperation was performed in five patients (2.0%) during the follow-up period.

Based on our management strategies and operative principles and techniques, anatomical correction of EA is capable of achieving excellent long-term results, and low rates of TCPC, 1½ ventricle repair and valvular replacement.

Uroflowmetry is an uroflow measurement technique used to record the voided volume (VV) and flow rate, which can help clinicians objectively evaluate lower urinary tract function. Currently, few uroflowmetry studies have focused on the female population,^[1]especially on the uroflow curve standard analysis. Hence, we sought to establish dependable uroflow reference values and nomograms for Chinese women and to evaluate the relationship between uroflow patterns and demographic data.

To the Editor: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been used as a bridge in patients with advanced heart failure (AdHF) while waiting for heart transplantation (HTx). Many studies reported by developed countries have confirmed the advantages of VA-ECMO in terms of bridge to left ventricular assist device (LVAD) or HTx, with stabilizing the condition and improving the possibility of further treatment of patients.^[1,2,3]Recent data from the Extracorporeal Life Support Organization (ELSO)^[4]indicated that ECMO used as a bridge has increased by 20.5% over a decade. However, to date, there are few studies on the bridge experience of VA-ECMO in the mainland of China.

To the Editor: Blindness and vision loss (BVL) constitute a growing concern affecting an ever-expanding global population.^[1]Globally, approximately 40% of the population relies on burning solid fuels for both cooking and heating. Household air pollution (HAP) predominantly arises from the incomplete combustion of solid fuels used for cooking. Nowadays, the adverse effects of HAP on eye health in human have ascended as a salient concern for environmental, ophthalmic, and public health.^[2]Gaining a comprehensive understanding of the burden and temporal trends of BVL due to HAP is the essential basis for health program planning.

To the Editor: Meat is an important source of protein and could be roughly classified into red and white meat. White meat, which encompasses poultry, seafood such as fish and shrimp, and reptiles, etc., is characterized by its pale color when uncooked. Red meat is basically mammalian meat, including domestic animal meats, such as pork, beef, lamb, and wild animal meat in certain regions, such as kangaroos, seals, and whales. Uncooked mammalian meat appears red due to the presence of myoglobin in skeletal muscles. The clinical presentations of mammalian meat allergy comprise two types of allergic reactions, immediate-type and delayed-type, although both are mediated by immunoglobulin E (IgE). The immediate-type hypersensitivity manifests as allergic symptoms occurring shortly after ingestion of red meat and is primarily triggered by serum albumin and immunoglobulin which are the major allergenic components. This is the classic pattern of food allergy. The delayed-type hypersensitivity is characterized by delayed onset of allergic symptoms 2-6 h after red meat ingestion and is mediated by oligosaccharide α-gal-specific IgE which is a recently discoveried pattern of food allergy.^[1]

To the Editor: Chronic obstructive pulmonary disease (COPD) is a global public health challenge without effective treatment currently available, affecting >300 million individuals worldwide. Comprehensively understanding the pathogenesis of this disease is required. Recently, ferroptosis, a form of cell death driven by iron-dependent lipid peroxidation, has been associated with the pathogenesis of COPD.^[1]Multiple signaling pathways, such as glutathione peroxidase 4 (GPX4), ferroptosis suppressor protein 1 (FSP1), and tetrahydrobiopterin-dependent pathways, as well as iron metabolism, are involved in regulating ferroptosis^[2,3][Figure 1A]. Here, we provide a comprehensive overview of recent advances in understanding the role of ferroptosis in COPD, highlighting potential therapeutic strategies targeting ferroptosis for treating the disease.

To the Editor: Pediatric and adolescent gynecology (PAG) is a specialized branch of gynecology that focuses on reproductive health issues of women from infancy to adolescence.^[1]In 1939, the Hungarian Dobszay first established the new branch. Since then, the PAG subject has begun to develop and gradually matured in the past 80 years. While PAG has witnessed significant development in western countries, a substantial unmet need persists in addressing specific health concerns among children and adolescents with gynecological disorders. In China, where the PAG discipline is still in its infancy, this situation becomes even more critical. The diseases young females experience in the gynecological field have own particularities.^[1]Also, PAG shares connections with various medical disciplines, notably surgery. Investigating the inpatient disease spectrum, prevalence rates, and clinical characteristics of PAG surgical disorders is of significant clinical importance, yet no previous research has addressed this in China or other countries. Therefore, the study retrospectively analyzed the clinical data of 512 PAG inpatients aged 0-18 years who received surgical treatment at Peking University First Hospital (PKUFH) from January 2010 to May 2022, so as to comprehensively outline the inpatient disease spectrum and clinical characteristics of surgical disorders in PAG, with the aim of offering management recommendations and evidential support for future clinical work. The study was approved by the Institutional Review Board of PKUFH (No. 2022[593]) and informed consent was waived due to the retrospective nature of the study. Non-normally distributed quantitative variables are shown as median (Q1, Q3), and categorical variables as count and percentage. Comparison tests were performed using chi-squared test and Fisher’s exact test.

To the Editor: 5q spinal muscular atrophy (5qSMA) is an autosomal recessive neuromuscular disorder caused by the lack of the survival motor neuron (SMN) protein encoded by theSMN1gene, located at 5q11.2-q13.3.^[1]The incidence is 1/10,000-1/6000 live births, and the mutation carrier rate in China is 1/42.^[1]Spinal muscular atrophy (SMA) is mainly divided into four subtypes: SMA type I, II, III, and IV, based on the motor milestones ever achieved. Types I-III occur in children,^[1]which often result in progressive muscular atrophy and weakness as well as multi-system dysfunction, including nutritional and metabolic issues.^[2]Children with SMA may have hidden nutritional and lipid imbalances, despite normal body appearance and anthropometric measurements, making it difficult to detect early and intervene. Fewer studies have elucidated both the nutritional status and lipid metabolism in SMA patients,^[2]especially in Asia, which may have some of the highest numbers of SMA patients in the world. To inform the development of targeted nutritional management strategies, this study aimed to investigate the nutritional status and serum lipid profile characteristics in children with SMA, based on a hospital-based case-control study in China. This study was approved by the Ethics Committee of Children’s Hospital of Zhejiang University School of Medicine (No. 2019-IRB-171). Written informed consent was obtained from all the patients and their legal guardians.

To the Editor: The global burden of premature coronary artery disease (CAD) is increasing among the young population. Premature CAD generally refers to the occurrence of obstructive coronary atherothrombotic lesions in men and women aged <55 years and <65 years, respectively, and particularly in those aged <45 years.^[1]The incidence of CAD in the younger population has remained stable or has increased, despite the declining incidence in older adults. Patients with premature CAD have a poor long-term prognosis, experiencing a high rate of recurrent ischemic events, rapid progression to multivessel disease, and frequent premature death.^[1]Thus, it is crucial to identify the underlying causes of premature CAD that are distinct from those of age-related CAD and improve patient outcomes through precise diagnosis and treatment.

To the Editor: Heart failure with preserved ejection fraction (HFpEF) is a clinical entity characterized by impaired diastolic function. Until recently, there have been few studies directly evaluating how volume status impacts future cardiac events for patients with HFpEF. Evidence supporting the application of spironolactone in HFpEF is mainly derived from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial. Even though primary analysis of the trial reached a neutral result, subgroup and subsequentpost hocanalyses have confirmed its efficacy in selected groups of patients, suggesting that identifying the potential subgroups of patients who would benefit from spironolactone treatment is important.^[1]Data regarding the impact of congestion status on the efficacy of spironolactone in HFpEF are lacking. A comprehensive evaluation of volume status could be complicated to some extent. Determining clinically overt congestion by physical signs is expected to be straightforward and practical. Nevertheless, not all physical signs of congestion are present in a patient simultaneously, which necessitates a comprehensive judgment in clinical practice. Latent class analysis (LCA) is a clustering statistical method that can achieve this goal. It has been used to identify potentially distinct subgroups within populations that share certain characteristics. In this study, by leveraging data from the TOPCAT trial, we identified the subgroup of patients with HFpEF with clinically overt congestion by selecting typical signs of congestion for LCA and explored the prognostic implications of baseline overt congestion and time-updated congestive status as well as its interaction with spironolactone treatment.

To the Editor: Primary Sjögren’s syndrome (pSS) is a multi-systemic autoimmune disease characterized by the exocrine gland (mainly salivary and lacrimal glands) involvement, leading to xerostomia and xerophthalmia.^[1]The course of pSS is relatively slow, but patients with pSS had higher risk of overall cancer, including malignant lymphoma (ML).^[2]It is widely known that all-cause mortality rates were not increased in pSS patients as compared with healthy controls. Nonetheless, secondary lymphoproliferative disease was an important cause of excess mortality.

To the Editor:Abdominal aortic aneurysm (AAA) is a life-threatening vascular disease. Surgical intervention is typically recommended when the maximum AAA diameter reaches a threshold of 5.5 cm for men and 5.0 cm for women, or when an AAA experiences a rapid expansion of greater than 1.0 cm/year.^[1]Survival after AAA repair is influenced by various factors, and the identification of independent prognostic factors and the development of accurate prediction models are crucial for optimal treatment planning, counseling, and postoperative follow-up. Although several scoring systems with varying degrees of accuracy have been developed to predict the risk of mortality after intervention for patients with ruptured AAA, conflicting results regarding their performance have been published.^[2,3]Ideally, prediction models should be user-friendly and widely applicable, providing quick and reliable estimates of outcomes based on only a few readily available preoperative parameters. Unfortunately, the number of clinical models assisting clinicians in estimating the long-term mortality of general AAA patients after aneurysm repair is limited, and there is a lack of scores focusing on the Chinese population. Therefore, the objectives of the present study were to explore potential biomarkers affecting the long-term mortality risk of patients who underwent AAA repair and to establish an easy-to-use and practical preoperative risk prediction model for all-cause mortality after AAA repair in Chinese population. This model might help stratify AAA patients into different groups according to their predicted life expectancy, informing decision-making, and implementing medical intervention in clinical trials.