European journal of preventive cardiology最新文献

{"title":"Impact of flavan-3-ols on blood pressure and endothelial function in diverse populations: a systematic review and meta-analysis of randomised controlled trials.","authors":"Vasiliki Lagou, Arno Greyling, Mario Ferruzzi, Simon S Skene, Joy Dubost, Ayse Demirkan, Inga Prokopenko, Julie Shlisky, Ana Rodriguez-Mateos, Christian Heiss","doi":"10.1093/eurjpc/zwaf173","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf173","url":null,"abstract":"<p><strong>Background and aims: </strong>Flavan-3-ols, found in cocoa, tea, and certain fruits, show promise in improving blood pressure (BP) and vascular function, but are currently not used for cardiovascular prevention. This meta-analysis evaluated the effects of flavan-3-ol-rich interventions on BP and endothelial function.</p><p><strong>Methods: </strong>PubMed was searched for randomized controlled trials (RCTs) published 1946-03/2024 on BP and flow-mediated dilation (FMD) after flavan-3-ol-rich food, beverage, or supplement intake. Random-effects meta-analysis of 109 publications including 145 RCTs and 5,205 participants was performed. (PROSPERO:CRD42023454691).</p><p><strong>Results: </strong>Flavan-3-ol interventions included epicatechin, epigallocatechin-gallate, cocoa products, tea, grape extract, and apples delivering 586 mg (95%CI 510,662) total flavan-3-ols. Interventions decreased office (-2.8 [95%CI -3.9, -1.7]/-2.0 [-2.6, -1.3] mmHg) and 24h-ambulatory BP (-3.7 [-5.8, -1.6]/-2.6 [-4.5, -0.8] mmHg) after chronic repetitive consumption. Effects were larger with elevated and hypertensive baseline BP or categorical hypertension (office: -5.9 [-10.0, -1.8]/-2.7 [-4.4, -1.0] mmHg, 24h-ABP: -6.8 [-16.3,2.8]/-5.1 [-12.5,2.2] mmHg). Meta-regression analysis confirmed that the magnitude of BP lowering was inversely related to baseline BP, but not to proportion of participants with CVD, diabetes mellitus, and study duration across all studies, and was dose-dependently related to epicatechin dose only in cocoa studies. FMD increased after acute (+2.0% [1.6,2.3]) and repetitive (+1.7% [1.3,2.2]) consumption independent of BP. Reported adverse events were minor and low (0.4%). The considerable heterogeneity of effect sizes (I2>50%) between studies was not explained by the investigated factors limiting the strength of evidence to 'moderate'.</p><p><strong>Conclusions: </strong>Flavan-3-ol-rich foods considerably reduce elevated BP and improve endothelial function independent of blood pressure supporting their use for cardiovascular prevention.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aerobic Exercise and Cardiovascular Outcomes in Patients with Diabetes Undergoing Percutaneous Coronary Intervention: A Nationwide Population-based Study.","authors":"Jung-Kyu Han, Kyungdo Han, You-Jeong Ki, Jin-Eun Song, Doyeon Hwang, Jeehoon Kang, Han-Mo Yang, Kyung Woo Park, Hyun-Jae Kang, Bon-Kwon Koo, Hyo-Soo Kim","doi":"10.1093/eurjpc/zwaf170","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf170","url":null,"abstract":"<p><strong>Aims: </strong>We investigated the impact of aerobic exercise on clinical outcomes in patients with diabetes undergoing percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>We analyzed a nationwide prospective population database from the Korean National Health Insurance System. We included 8,225 patients with diabetes who had undergone PCI and documented their aerobic exercise habits before and after the procedure (mean interval: 2.0 years). The patients were categorized into four groups: persistent non-exercisers, new exercisers, exercise discontinuers, and exercise maintainers. The primary outcome was major adverse cardiovascular events (MACE), a composite of all-cause death, myocardial infarction, revascularization, and heart failure. We assessed the risk of clinical events using inverse probability-weighted Cox proportional hazards models.</p><p><strong>Results: </strong>During a mean follow-up of 4.9 years, exercise maintainers, discontinuers, and new exercisers were associated with a significantly lower risk of MACE compared to non-exercisers. The lowest risk was observed in exercise maintainers (maintainers: aHR, 0.78; 95%CI, 0.71-0.86; discontinuers: aHR, 0.88; 95%CI, 0.79-0.98; new exercisers: aHR 0.89; 95%CI, 0.80-1.00). A J-curve relationship between the amount of aerobic exercise and adverse clinical outcomes was observed, with the lowest risk identified at 1,000-1,499 MET-min/week. Benefits diminished with exercise intensity ≥1500 MET-min/week.</p><p><strong>Conclusion: </strong>Aerobic exercise maintenance after PCI was associated with a reduced risk of cardiovascular events in patients with diabetes, with a moderate amount of exercise providing maximal benefit. Therefore, aerobic exercise is advisable for patients with diabetes undergoing PCI, and the optimal exercise dosage warrants further research.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise in carriers of truncated Titin variants: more evidence before the greenlight.","authors":"K M Karaye, K Sliwa","doi":"10.1093/eurjpc/zwaf161","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf161","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Ketone Bodies in Multi-Marker Risk Prediction of Incident Heart Failure in the Multi-Ethnic Study of Atherosclerosis (MESA).","authors":"Parag Anilkumar Chevli, Senthil Selvaraj, Byron C Jaeger, Aziz Hammoud, Margery A Connelly, Christopher deFilippi, Joao A C Lima, Sadiya S Khan, David M Herrington, Michael D Shapiro, Muthiah Vaduganathan","doi":"10.1093/eurjpc/zwaf168","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf168","url":null,"abstract":"<p><strong>Aims: </strong>Circulating ketone bodies (KB) have emerged as a potential adjunctive biomarker for incident heart failure (HF) risk and might provide incremental information beyond established biomarkers. A multi-marker risk score may improve risk stratification of incident HF in the community. The authors aim to develop a risk score using N-terminal proB-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin (hs-cTnT) and a unique systemic biomarker of KB to predict HF among participants without cardiovascular disease.</p><p><strong>Methods: </strong>A multi-marker score was developed incorporating NT-proBNP ≥ 125 pg/mL, hs-cTnT ≥ 14 ng/L, and total KB ≥ 75th percentile (316 μmol/L), with 1 point allocated for each abnormal marker among Multi-Ethnic Study of Atherosclerosis (MESA) participants. Multivariable Cox model was used to assess the association between multi-marker risk score and the risk of incident HF.</p><p><strong>Results: </strong>Among 6,748 participants, there were 383 incident HF events over a median follow-up of 15.7 years. The three biomarkers exhibited poor correlation with one another (r<0.06 for all). The addition of KB to NT-proBNP and hs-cTnT to identify incident HF improved 5- and 10-year risk prediction (C-statistic 0.74 vs. 0.77, p=0.02 and 0.70 vs. 0.73, p=0.02 respectively). There was no evidence of miscalibration using the multi-marker score for predicting 5- and 10-year HF risk (p>0.05). A graded association was observed between the multi-marker score and risk of HF independent of established clinical factors.</p><p><strong>Conclusions: </strong>The addition of plasma KB to a clinical risk score using biomarkers of cardiac injury and stress may further improve the prediction of incident HF.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Let's CLEAR things up: who benefits from low-dose colchicine?","authors":"Niekbachsh Mohammadnia, Cornelis Kramers, Aysun Cetinyurek-Yavuz, Saloua El Messaoudi","doi":"10.1093/eurjpc/zwaf166","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf166","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-modal interventions outperform nutritional or exercise interventions alone in reversing metabolic syndrome: a systematic review and network meta-analysis.","authors":"Bernice S Chan, Doris S F Yu, Cathy W Y Wong, Polly W C Li","doi":"10.1093/eurjpc/zwaf167","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf167","url":null,"abstract":"<p><strong>Aims: </strong>This review aimed to evaluate the comparative effectiveness of primary prevention interventions targeting therapeutic lifestyle changes on metabolic syndrome reversal and cardiometabolic outcomes in adults (≥ 18 years) with metabolic syndrome.</p><p><strong>Methods: </strong>A systematic search was conducted in seven electronic databases from inception to 28 April 2023 to identify randomised controlled trials (RCTs) of primary prevention interventions combating metabolic syndrome. Bayesian network meta-analyses were conducted to evaluate comparative effectiveness of active intervention components.</p><p><strong>Results: </strong>Total of 98 eligible RCTs involving 12 813 participants were included. The individual interventions were categorised as nutritional or exercise interventions and their combinations as multi-modal interventions. The behavioural change strategies were categorised according to the sources of behaviour (i.e., capability, opportunity and motivation). Pairwise meta-analysis demonstrated that multi-modal interventions outperformed exercise interventions in reversing metabolic syndrome. Network meta-analyses revealed the differences in the optimal active intervention components across outcomes. The consumption of a diet promoting moderate macronutrient intake (caloric restriction, DASH and Mediterranean diets) combined with supervised aerobic exercise training or professional physical activity advice or counselling consistently yielded superior beneficial effects on metabolic syndrome, which was supported by a low certainty of evidence. Between-study differences in body weight and blood pressure were significantly explained by the use of behavioural change strategies.</p><p><strong>Conclusion: </strong>Combining a moderate macronutrient diet with aerobic exercise training or physical activity advice or counselling demonstrated superior beneficial effects on metabolic syndrome and its defining characteristics. These findings could provide healthcare professionals with critical guidance for implementing lifestyle interventions to manage metabolic syndrome.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing the Translational Integration of Lifestyle Medicine in Cardiovascular-Kidney-Metabolic Syndrome.","authors":"Zacharias Papadakis","doi":"10.1093/eurjpc/zwaf169","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf169","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of inpatient and outpatient cardiac rehabilitation on the 5-year prognosis in patients with acute myocardial infarction.","authors":"Yasunori Suematsu, Akira Minei, Yoko Sumita, Koshiro Kanaoka, Michikazu Nakai, Yoshihiro Miyamoto, Hisatomi Arima, Koshi Nakamura, Tomoyuki Takura, Kazunori Shimada, Hirokazu Shiraishi, Nagaharu Fukuma, Masataka Sata, Hideo Izawa, Yoshihiro Fukumoto, Shigeru Makita, Yusuke Ohya, Shin-Ichiro Miura","doi":"10.1093/eurjpc/zwaf070","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf070","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac rehabilitation (CR) has been shown to improve the prognosis of patients with acute myocardial infarction (AMI). In Japan, the duration of hospitalization has shortened, resulting in a lower participation rate in CR among outpatients. Therefore, we evaluated the effects of CR, stratified into inpatient and outpatient phases, on the prognosis of patients with AMI in Japan.</p><p><strong>Methods and results: </strong>A multi-centre, retrospective, cohort study in which extracted 4411 AMI patients from 72 institutes throughout Japan who were identified from a Japanese Registry Of All cardiac and vascular Diseases (JROAD) in 2014 was performed. The JROAD is a database from Diagnosis Procedure Combination, and we additionally investigated the detailed information about severity, complications, treatment of AMI, the results of examinations, and the 5-year prognosis with respect to CR (JROAD-CR). The patients were divided into four groups, depending on their history of CR as inpatients and outpatients. The percentages of inpatients and outpatients who received CR were 66.1% (n = 2917) and 9.91% (n = 437), respectively. The groups in which only inpatients received CR [In(+)Out(-)] and in which both inpatients and outpatients received CR [In(+)Out(+)] showed significant reductions in composite major adverse cardiovascular events [In(+)Out(-) group; hazard ratio (HR): 0.751, 95% confidence interval (CI) (0.584-0.967) and In(+)Out(+) group; HR: 0.641, 95% CI (0.426-0.964)] and all-cause mortality [In(+)Out(-) group; HR: 0.720, 95% CI (0.546-0.950) and In(+)Out(+) group; HR: 0.575, 95% CI (0.338-0.977)].</p><p><strong>Conclusion: </strong>This JROAD-CR study revealed that even short periods of CR during hospitalization are important and continuing CR into the outpatient phase may further improve the prognosis of patients with AMI.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Common Cardiovascular Risk Factors in Aortic Valve Calcification in the Middle-aged General Population.","authors":"Anne Wang, Athena Adeli, David Kylhammar, Eva Swahn, Jan E Engvall, Lars Lind, Stefan Söderberg, Anders Blomberg, Gunnar Engström, Jonas Spaak, Henrik Löfmark, Carl Johan Östgren, Tomas Jernberg, Göran Bergström, Magnus Settergren, Bahira Shahim","doi":"10.1093/eurjpc/zwaf157","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf157","url":null,"abstract":"<p><strong>Aim: </strong>Aortic valve calcification (AVC) is an underlying pathophysiological mechanism for aortic stenosis which is common in the elderly, but less is known in younger individuals. The aim was to study the prevalence and associated characteristics of AVC in a middle-aged general population.</p><p><strong>Methods: </strong>Data were obtained from the Swedish CArdioPulmonary bioImage Study (SCAPIS) comprising 30,154 individuals 50 to 64 years from the general population recruited in Sweden between 2013-2018. AVC was assessed visually on computed tomography (CT) and categorized as evident or not. Population attributable risk proportion (PARP) was calculated for six modifiable risk factors (smoking, hypertension, hyperlipidemia, diabetes, BMI ≥median and kidney dysfunction [eGFR <60 ml/min/1.73 m2]).</p><p><strong>Results: </strong>In total, 29,221 individuals with CT images available were included (mean age 57.5 years, 51% female) and AVC was present in 2,053 (7%). The AVC prevalence increased with age (50-54 years: 3%; 55-59 years: 7%; 60-64 years: 11%). In analyses adjusted for age, sex, smoking and study site, male sex (OR 2.02, 95% CI 1.84-2.22), hyperlipidemia (1.88 [1.68-2.11]), hypertension (1.73 [1.57-1.91]), diabetes (1.66 [1.39-1.97]), kidney dysfunction (1.54 [1.10-2.11]), smoking (1.36 [1.24-1.50]), age (increment by one year) (1.12 [1.11-1.13]) and BMI (increment by one unit) (1.04 [1.03-1.05) were associated with AVC. The PARP of AVC associated with the six modifiable risk factors was 34.5% (95% CI 29.6-39.4).</p><p><strong>Conclusions: </strong>In this large, contemporary middle-aged general population, AVC was prevalent in as many as 7% and six cardiovascular risk factors contributed to one third of the prevalence of AVC.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between pain and incident arrhythmias in 422,654 individuals: evidence from the UK Biobank cohort.","authors":"Pei Qin, Barbara I Nicholl, Frederick K Ho, Peter Hanlon, Carlos A Celis-Morales, Jill P Pell","doi":"10.1093/eurjpc/zwaf153","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf153","url":null,"abstract":"<p><strong>Aims: </strong>Pain is associated with cardiovascular disease; however, its association with incident arrhythmias is unclear. We assessed associations between different pain characteristics (pain type, chronic pain, chronic widespread pain [chronic widespread pain], chronic musculoskeletal pain [chronic musculoskeletal pain], and number of chronic pain and chronic musculoskeletal pain sites) and incident cardiac arrhythmias, overall and by subtype.</p><p><strong>Methods: </strong>The study included 422,654 UK Biobank participants. Pain was ascertained via a touchscreen questionnaire. The outcomes were incident arrhythmias: all cardiac arrhythmias, atrial fibrillation (AF), other (non-AF) cardiac arrhythmias, bradyarrhythmias, and ventricular arrhythmias. Multivariable Cox-proportional regression was used to investigate the associations.</p><p><strong>Results: </strong>Over a mean (SD) follow-up of 13.19 (1.96) years, 36,860 (8.72%) participants developed arrhythmia. Compared with those without pain, those with chronic localized pain and chronic widespread pain had increased risk of all cardiac arrhythmias (hazard ratio [HR] 1.13, 95% confidence interval [CI], 1.10-1.17; 1.34, 1.19-1.51), AF (1.09, 1.05-1.14; 1.33, 1.15-1.55), and other cardiac arrhythmias (1.17, 1.12-1.22; 1.41, 1.20-1.66). There was evidence of a dose-relationship between number of chronic pain sites and risk of all cardiac arrhythmias, AF and bradyarrhythmias. Effect estimates were significantly larger among participants aged <60 years than those aged ≥60 years, and larger in women than men.</p><p><strong>Conclusions: </strong>Chronic pain was associated with cardiac arrhythmias. Whilst causation cannot be assumed in any observational study, there was evidence of both a temporal relationship and dose-relationship. These findings reinforce the need for pain management approaches that include a broad assessment of individuals' risk factors, wider health status, and appropriate vigilance for emerging conditions.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}