This apparent paradox likely reflects underlying differences in patient populations—stable coronary artery disease outpatients in Zhou et al. versus multimorbid inpatients in You et al. A recent study by Chammartin et al. [40] supports the interpretation that both abnormally low and high CD4/CD8 ratios may signal heightened cardiovascular risk under different clinical contexts [26]. The gene discussed is CD8A; the disease is coronary artery disorder.