Objective To construct and evaluate a prediction model for in-hospital mortality in el-derly patients with heart failure(HF).Methods After the establishment of inclusion criteria,clinical data of 767 elderly HF patients were extracted from the MIMIC-Ⅳ database.They were randomly divided into a training set(n=628)and a validation set(n=139)in an 8∶2 ratio.Least Absolute Shrinkage and Selection Operator(LASSO)regression analysis was employed to screen variables and identify independent risk factors for in-hospital mortality.Subsequently,multivariate logistic regression analysis was utilized to develop a risk prediction model and create a nomogram.ROC curve analysis was conducted to evaluate the AUC value of the model,calibration curve was used to assess the calibration.Additionally,decision curve analysis(DCA)was conducted to evalu-ate the clinical applicability of the model.Results ROC curve analysis showed that the prediction model achieved an AUC value of 0.749(95％CI:0.701-0.800)in the training set and of 0.725(95％CI:0.622-0.829)in the validation set.DCA indicated that the nomogram prediction model demonstrated good clinical applicability.Conclusion Our nomogram effectively predicts in-hospital mortality in elderly HF patients.

Objective To construct and evaluate a prediction model for in-hospital mortality in el-derly patients with heart failure(HF).Methods After the establishment of inclusion criteria,clinical data of 767 elderly HF patients were extracted from the MIMIC-Ⅳ database.They were randomly divided into a training set(n=628)and a validation set(n=139)in an 8∶2 ratio.Least Absolute Shrinkage and Selection Operator(LASSO)regression analysis was employed to screen variables and identify independent risk factors for in-hospital mortality.Subsequently,multivariate logistic regression analysis was utilized to develop a risk prediction model and create a nomogram.ROC curve analysis was conducted to evaluate the AUC value of the model,calibration curve was used to assess the calibration.Additionally,decision curve analysis(DCA)was conducted to evalu-ate the clinical applicability of the model.Results ROC curve analysis showed that the prediction model achieved an AUC value of 0.749(95％CI:0.701-0.800)in the training set and of 0.725(95％CI:0.622-0.829)in the validation set.DCA indicated that the nomogram prediction model demonstrated good clinical applicability.Conclusion Our nomogram effectively predicts in-hospital mortality in elderly HF patients.

Objective To investigate the effects and possible mechanisms of the growth differentia-tion factor 15(GDF-15)/glial-derived neurotrophic factor receptor alpha-like(GFRAL)pathway on the progression of atherosclerosis in ApoE-/-mice.Methods Eight 8-week-old male ApoE-/-mice were randomly divided into control group and rGDF-15 group.The mice in the control group received an injection of phosphate-buffered saline via tail vein once a week after 4 weeks of high-fat diet feeding,and those in the rGDF-15 group received an injection of recombinant GDF-15(0.05 mg/kg)via tail vein once a week after 4 weeks of high-fat diet feeding.The mice were fed with high-fat diet for another 8 weeks,the body weight was monitored during this period.After 12 weeks'feeding,the mice were euthanized.Another 4 normal mice(at the same age,20 weeks old)were subjected and served as normal control group.The levels of fasting blood glucose,blood lip-ids,cortisol,and aldosterone were compared among the three groups.Oil red O staining was used to evaluate plaque size in the aorta,and immunohistochemistry was employed to assess the expression of GDF-15 and GFRAL in the brain tissue.Results The serum level of GDF-15 was higher in the rGDF-15 group than in the control group(52.59±2.90 ng/ml vs 20.09±1.27 ng/ml,P＜0.01).The weight of mice was significantly lower in the rGDF-15 group than the con-trol group during Week 11(28.60±0.22 g vs 29.47±0.25 g,P＜0.01)and 12(28.98±0.22 g vs 30.35±0.13 g,P＜0.01).The rGDF-15 group had a statistically lower level of triglycerides(0.22±0.02 mmol/L vs 0.38±0.09 mmol/L,P＜0.05),lighter plaque burden[(22.22±2.58)％vs(31.61±3.51)％,P＜0.01],and enhanced expression levels of GDF-15 and GFRAL in the brain tissue(0.088±0.007 vs 0.030±0.006,0.031±0.003 vs 0.010±0.001,P＜0.01).The levels of cor-tisol and aldosterone in the control group and rGDF-15 group were significantly higher than those in the normal group(P＜0.01).The aldosterone level in the rGDF-15 group was significantly re-duced compared to the control group(22.013.67 mg/ml vs 87.29±8.63 mg/ml,P＜0.01).Conclusion GDF-15 may regulate body weight and triglyceride and aldosterone levels through GFRAL,and then affect the progression of atherosclerosis.