Prognosis estimation is the basis for establishing the personal interventions in sepsis patients. Serum biomarkers are potential tools for predicting the outcomes of sepsis patients admitted to the intensive care unit (ICU). Here, we plan to perform a prospective study to investigate the prognostic value of serum biomarkers. We named this study Hospital Outcome of Host Heterogeneity, Organ dysfunction and Trajectory in sepsis (HOHHOT).

This prospective cohort study is being performed in several hospitals in the Inner Mongolia Autonomous Region between 2025 and 2027. The inclusion criteria were adult sepsis patients admitted to the ICU. A serum specimen will be collected at the onset of sepsis and stored at –80°C for future use. The endpoint of the HOHHOT study includes, but is not limited to, hospital outcome (eg, mortality, occurrence of organ dysfunction, treatment response and the progression of sepsis). We will analyse the predictive value of serum biomarkers for outcomes using a receiver operating characteristic curve and decision curve analysis. The association between baseline characteristics and serum biomarkers will be estimated using a logistic regression model, net reclassification index and integrated discriminatory index. We will also construct some predictive models using machine learning algorithms.

The HOHHOT study has been approved by the Ethics Committee of the Affiliated Hospital of Inner Mongolia Medical University (NO: KY2025005). The findings derived from the HOHHOT study will be submitted to international academic journals.

Chinese Clinical Trial Registry (ChiCTR2500100770); pre-results.

Premature acute coronary syndrome (PACS) presents with a poor prognosis and significant risks. This study aimed to investigate the association between small-dense low-density lipoprotein cholesterol (sdLDL-C) levels and the severity of coronary lesions, as well as its potential role in risk stratification for PACS patients with multivessel disease (MVD).

Retrospective cross-sectional study.

First Affiliated Hospital of Xinjiang Medical University in China, between May 2022 and November 2023.

900 PACS patients with MVD confirmed by coronary angiography (CAG) and 600 age-matched and sex-matched controls with normal CAG results.

Patients with PACS and MVD were stratified by the Global Registry of Acute Coronary Events (GRACE) score, and sdLDL-C levels were compared among the different GRACE score groups. The association between sdLDL-C and the GRACE score was evaluated using Pearson’s correlation analysis. Multivariate logistic regression analysis was employed to identify factors associated with PACS and MVD. The discriminatory ability of sdLDL-C for PACS with MVD was assessed using receiver operating characteristic (ROC) curve analysis. Restriction cubic spline (RCS) analysis was used to examine the potential nonlinear association between sdLDL-C levels and the high-risk groups of PACS with MVD.

Patients with PACS and MVD exhibited significantly higher sdLDL-C levels compared with control group (p

Elevated sdLDL-C levels demonstrated a significant association with the risk of PACS and MVD. These findings indicate sdLDL-C may serve as a potential biomarker for risk stratification in this high-risk population. However, causal inferences require validation in prospective studies.

ChiCTR2300074166