Circulating CTRP9 and aortic valve calcification jointly predict coronary artery calcification in coronary heart disease patients

Figures

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  Figure 1. Flowchart of the clinical study design. A total of 900 subjects provided general clinical data, and 340 of them additionally consented to blood testing for CTRP9 measurement. These participants were grouped for analyses of aortic valve calcification (AVC), coronary artery calcification (CAC), and combined AVC plus CAC. CAC severity was further categorized by calcification score into lower-score and severe-score groups. The diagram shows the overall study workflow used to examine the relationships among serum CTRP9 levels, AVC status, and CAC severity in the study population.

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  Figure 2. Two-panel figure showing receiver operating characteristic (ROC) analyses for prediction of severe coronary artery calcification. Panel A shows a single ROC curve for CTRP9, plotting sensitivity against 1 minus specificity. Panel B compares three ROC curves representing CTRP9 alone, severe aortic valve calcification alone, and the combined model of CTRP9 plus severe aortic valve calcification. The combined model has the largest area under the curve and the best overall discriminative performance, indicating improved predictive value when the two indicators are used together.

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  Figure 3. Three-panel figure showing the effects of gCTRP9 treatment on aortic valve calcification in ApoeE−/− mice fed a Western diet. Panel (A) shows scatter plots of relative mRNA expression for ALP, BMP2, OPN, and RUNX2, with lower levels in the gCTRP9-treated group than in the vehicle group. Panel (B) shows Western blot bands and corresponding quantification for osteogenic proteins, also reduced after gCTRP9 treatment. Panel (C) shows histological staining images and quantification, demonstrating decreased calcification, fibrosis, and leaflet thickness in the gCTRP9-treated group compared with the vehicle group.