The progression of acute coronary syndrome (ACS) is primarily determined by the transition from stable to vulnerable atherosclerotic plaque. The primary objective of this study was to investigate the mechanism of SLC25A25 antisense RNA 1 (SLC25A25-AS1) in ACS. The level of SLC25A25-AS1 was determined using reverse transcription quantitative real-time PCR (RT-qPCR) in serum samples from healthy controls (n = 81) and ACS patients (n = 162). The clinical relevance of SLC25A25-AS1 in ACS was evaluated through correlation, receiver operating characteristic (ROC), and logistic regression analyses. SLC25A25-AS1 was significantly downregulated in ACS patients. Overexpression of SLC25A25-AS1 protected oxidized low-density lipoprotein (ox-LDL) treated human coronary artery smooth muscle cells (HCASMCs) from damage in an in vitro atherosclerosis model. Specifically, these protective effects were against abnormal cell proliferation, inflammatory responses, cell migration, and maintenance of the contractile phenotype in HCASMCs. Both bioinformatics analyses and experimental validation confirmed the existence of the SLC25A25-AS1/ microRNA‑34a‑5p (miR-34a-5p)/Forkhead box P1 (FOXP1) regulatory axis. Collectively, SLC25A25-AS1 modulated ox-LDL-induced atherosclerotic responses in HCASMCs through the miR-34a-5p/FOXP1 pathway. These findings suggested that SLC25A25-AS1 may play a protective role in ACS by alleviating ox-LDL-induced HCASMC dysfunction and inflammation via the miR-34a-5p/FOXP1 axis.

Stable angina pectoris is a common manifestation of chronic coronary syndrome, and simple physical examination findings may provide additional information for cardiovascular risk assessment. This study investigated the association between bilateral anterior tragal crease (ATC) and coronary revascularization in patients presenting with stable angina pectoris. A total of 862 consecutive patients underwent standardized assessment for bilateral ATC. Coronary angiography and subsequent management were performed according to contemporary guidelines when clinically indicated. The primary outcome was coronary revascularization. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed. Coronary revascularization was performed in 134 patients (15.5%). Bilateral ATC was significantly more common among patients who underwent revascularization and remained independently associated with revascularization after adjustment for conventional cardiovascular risk factors (odds ratio [OR] 1.67, 95% confidence Interval [CI] 1.02- 2.73; P = .041). ATC alone demonstrated modest discrimination (area under the curve [AUC] 0.614). A clinical model showed good discrimination (AUC 0.744), with a minimal improvement after adding ATC (AUC 0.746; P = .732). ATC may represent a simple physical examination finding associated with coronary atherosclerotic burden, although its clinical utility requires further validation.