European journal of preventive cardiology最新文献

{"title":"Reappraisal of statin primary prevention trials: implications for identification of the statin-eligible primary prevention patient.","authors":"G B John Mancini, Arnold Ryomoto, Eunice Yeoh, Iulia Iatan, Liam R Brunham, Robert A Hegele","doi":"10.1093/eurjpc/zwaf048","DOIUrl":"10.1093/eurjpc/zwaf048","url":null,"abstract":"<p><strong>Aims: </strong>Identification of patients eligible for primary prevention statin therapy is complex, often relying upon risk algorithms that diverge internationally. Our goal was to develop a simpler global definition of statin-eligible primary prevention patients.</p><p><strong>Methods and results: </strong>Randomized clinical trials (RCTs) cited in North American and European dyslipidaemia guidelines justifying primary prevention statins for cardiovascular risk reduction were critically reappraised according to eligibility criteria and characteristics of actual enrollees. Statin-eligibility based on meeting minimal enrolment criteria vs. risks calculated using the Framingham risk score, the pooled cohort equation, and the systematic coronary risk estimate two were contrasted. Patient scenarios meeting minimal RCT eligibility criteria seldom attained high enough 10 year risk of events according to the algorithms tested and thus would not be eligible for statin therapy. Overall, enrollees were 63.9 ± 8.9 years (mean ± SD) with low density lipoprotein-cholesterol (LDL-C) 3.53 ± 0.91 mmol/L. Enrollees in trials studying the lowest LDL-C levels were generally older and had additional risk factors.</p><p><strong>Conclusion: </strong>Results of primary prevention RCTs justify treatment of more subjects and lower risk subjects than current risk algorithm-based guidelines. Based on a synthesis of RCT inclusion/exclusion criteria and the characteristics of enrollees, we propose that a statin-indicated primary prevention subject is one who is 40 to 70 years with a low density lipoprotein-cholesterol (LDL-C) ≥ 3.0 mmol/L or is 55 to 80 years with LDL-C ≥ 1.8 mmol/L and additional risk factors.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"1218-1231"},"PeriodicalIF":7.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491355","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":"Statins in primary prevention: a missed opportunity?","authors":"Pia R Kamstrup, Børge G Nordestgaard","doi":"10.1093/eurjpc/zwaf244","DOIUrl":"10.1093/eurjpc/zwaf244","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"1232-1234"},"PeriodicalIF":7.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973904","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":"Impaired HDL cholesterol function and high interleukin-1ß levels hold prognostic value after ST-elevation myocardial infarction.","authors":"Francesco Sbrana, Beatrice Dal Pino, Michele Emdin","doi":"10.1093/eurjpc/zwaf040","DOIUrl":"10.1093/eurjpc/zwaf040","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"1286-1287"},"PeriodicalIF":7.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052116","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":"Remnant cholesterol, plasma triglycerides, and risk of cardiovascular disease events in young adults: a prospective cohort study.","authors":"Eirik Aaseth, Sigrun Halvorsen, Ragnhild Helseth, Jørgen Gravning","doi":"10.1093/eurjpc/zwaf104","DOIUrl":"10.1093/eurjpc/zwaf104","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to investigate if elevated levels of cholesterol carried in triglyceride-rich lipoproteins, marked by remnant cholesterol or plasma triglycerides, are associated with increased risk of premature cardiovascular disease (CVD) events in young adults.</p><p><strong>Methods and results: </strong>This study is a prospective cohort study. In the year 2000, all 30-year-old inhabitants living in Oslo, Norway, were invited to the 'Oslo Health Study' including a clinical examination and routine blood tests. Follow-up with respect to CVD events (cardiovascular death, non-fatal myocardial infarction, non-fatal ischaemic stroke, coronary revascularization, or hospitalization for unstable angina) was obtained by linkage with national mandatory registries through 2022. We estimated the risk of CVD events in relation to levels of remnant cholesterol and plasma triglycerides at inclusion using Cox regression analysis. The risk of CVD events in relation to LDL cholesterol (LDL-C) levels was estimated as comparison. A total of 5939 participants were included (median age 31 years, 56% women). During a median follow-up time of 22 years, a CVD event occurred in 107 (1.8%) participants. The adjusted hazard ratio (aHR) for CVD events per 0.5 mmol/L increase in remnant cholesterol concentrations was 1.3 [95% confidence interval (CI): 1.1-1.5]. Per 1 mmol increase in plasma triglycerides and LDL-C concentrations, the aHR for CVD events was 1.2 (95% CI: 1.1-1.4) and 1.3 (95% CI: 1.1-1.6), respectively.</p><p><strong>Conclusion: </strong>Already at 31 years of age, higher concentrations of remnant cholesterol and plasma triglycerides were associated with increased risk of premature CVD events. We suggest that remnant cholesterol or plasma triglycerides are included in the risk assessment of young adults.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"1181-1189"},"PeriodicalIF":7.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499986","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":"Remnant cholesterol reduction for atherosclerotic cardiovascular disease prevention: modelling in the Copenhagen General Population Study.","authors":"Karen Hvid, Mie Balling, Shoaib Afzal, Børge G Nordestgaard","doi":"10.1093/eurjpc/zwaf203","DOIUrl":"10.1093/eurjpc/zwaf203","url":null,"abstract":"<p><strong>Aims: </strong>Elevated remnant cholesterol is a causal factor for atherosclerotic cardiovascular disease (ASCVD); however, whether aggressive lowering will reduce ASCVD is unclear. In women and men, we tested the hypothesis that aggressive lowering of remnant cholesterol has the potential for substantial ASCVD reduction. This was tested using modelling of cohort data.</p><p><strong>Methods and results: </strong>From the Copenhagen General Population Study, 56 422 women and 43 952 men without a history of ASCVD were recruited from 2003 through 2015. They were subsequently followed in national Danish health registries until December 2021 for incident ASCVD. During a median follow-up of 12 years, 4946 women and 6043 men developed ASCVD. In women at very-high cardiovascular risk, 2 mmol/L (77 mg/dL) lower levels of remnant cholesterol from 3 mmol/L (116 mg/dL) likely reduces absolute 10-year risk of ASCVD by 17 and 13% in statin users and non-users; corresponding values in men were 20 and 15%, respectively. Corresponding values by 1 mmol/L (39 mg/dL) lower remnant cholesterol were 10 and 7% in women and 11 and 9% in men, respectively. Similar values are also provided for lower starting remnant cholesterol levels, different lowering of remnant cholesterol, and lower baseline cardiovascular risk.</p><p><strong>Conclusion: </strong>In women and men, aggressive lowering of remnant cholesterol has the potential for substantial ASCVD reduction. Estimated absolute risk reduction was larger in statin users vs. non-users and in men vs. women, likely because statin users vs. non-user and men vs. women are at higher baseline absolute risk.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"1145-1154"},"PeriodicalIF":7.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802601","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":"Disparities in achieving low-density lipoprotein cholesterol goals after revascularization in a diverse real-world cohort.","authors":"Garred S Greenberg, Daniel Lorenzatti, Annalisa Filtz, Vita N Jaspan, Christine M Park, Bethany Kalich, Niranjan Kathe, Eduard Sidelnikov, Katherine E Di Palo, Constance Browne, Evan Lipsitz, Stephen Forest, Andrea Scotti, Azeem Latib, Mario J Garcia, Carlos J Rodriguez, Michael D Shapiro, Martha Gulati, Leandro Slipczuk","doi":"10.1093/eurjpc/zwaf235","DOIUrl":"10.1093/eurjpc/zwaf235","url":null,"abstract":"<p><strong>Aims: </strong>Low-density lipoprotein cholesterol (LDL-C) testing and the use of lipid-lowering therapies (LLTs) both reduce risk in patients with atherosclerotic cardiovascular disease (ASCVD). This study aims to assess LDL-C testing and the utilization of LLT in a diverse real-world cohort.</p><p><strong>Methods and results: </strong>This retrospective cohort study assessed 6405 patients who underwent percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), or a peripheral artery disease (PAD) revascularization between 2018 and 2023 at a New York City health system. Patient-level data were extracted from the electronic health record. Multivariable logistic regression analyses were employed to evaluate associations. Overall, 4319 patients (67%) had a follow-up LDL-C test. The median time to follow-up LDL-C testing was 11 months, with 35% having follow-up testing within 6 months. Early LDL-C testing (within 6 months) was associated with higher utilization of high-intensity statins, ezetimibe, and proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) monoclonal antibodies (mAbs). At follow-up, 2259 (52%) patients had an LDL-C < 70 mg/dL (1.8 mmol/L). Female sex (odds ratio [OR] 0.70; 95% confidence interval [CI] 0.61, 0.80) and non-Hispanic Black race/ethnicity (OR 0.57; 95% CI 0.49, 0.67) were independently associated with a lower likelihood of achieving a follow-up LDL-C < 70 mg/dL (1.8 mmol/L) after multivariable adjustment.</p><p><strong>Conclusion: </strong>Among patients with ASCVD who underwent revascularization, a large proportion did not have follow-up LDL-C testing, and in those who did, testing was delayed. Only half of patients achieved LDL-C levels below 70 mg/dL (1.8 mmol/L), with female and non-Hispanic Black patients less likely to attain this goal.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"1192-1201"},"PeriodicalIF":7.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005090","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":"Cardiovascular Diseases Epidemiology and Management in the Elderly and very Elderly.","authors":"Giuseppe Galati, Olga Germanova, Gianmarco Dacquino, Federico Ferrari Bravo, Luca Genovese, Roberto Franco Enrico Pedretti","doi":"10.1093/eurjpc/zwaf470","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf470","url":null,"abstract":"<p><p>The aim of this narrative review is to focus on the epidemiology and new advances in the management of cardiovascular diseases (CVD) in the elderly and very elderly, with particular emphasis on those CVD that are most relevant and have the greatest impact on morbidity and mortality, such as heart failure (HF), ischaemic heart disease, atrial fibrillation (AF) and stroke, valvular heart diseases and cardiomyopathies (CMP). The review highlight the specificities of CVD in this population and the special considerations that need to be made in the management of these patients to maximise benefit and avoid futility. Another major objective is to find a contemporary definition of the elderly, including functional capacity and the concept of vascular, biological and prospective age. A final aim is to review and discuss the definition and measurement of frailty and its impact on CVD management. The key points are that old and very old people are a peculiar growing population across the globe, in which CVD have a different impact and epidemiology compared to young people. Among CVD, HF is clearly the most relevant and impactful on quantity and quality of life. Each time we approach an elderly patient, a frailty multidisciplinary evaluation should be conducted, especially to avoid futile and aggressive invasive approaches with a risk-benefit balance in favor of harm.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112277","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":"Different Roads, Same Destination: American and European Hypertension Guidelines.","authors":"Eugene Yang, Dagnovar Aristizabal, Gianfranco Parati","doi":"10.1093/eurjpc/zwaf588","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf588","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091495","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":"Who Can Safely Stop Antihypertensives? Reflections on the STOP-Trial.","authors":"ShuYao Bai, YongMei Jin","doi":"10.1093/eurjpc/zwaf584","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf584","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091440","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":"Changes in depressive symptoms as predictors of incident cardiovascular disease: insights from four prospective cohorts.","authors":"Shuang Wu, Xu Yang, Yang Chen, Yimeng Wang, Hanyang Liang, Wei Xu, Juan Wang, Xinghui Shao, Han Zhang, Ziyi Zhong, Hongyu Liu, Bi Huang, Siqi Lyu, Lihui Zheng","doi":"10.1093/eurjpc/zwaf586","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf586","url":null,"abstract":"<p><strong>Aims: </strong>This study examines how changes in depressive symptoms influence cardiovascular disease (CVD) incidence in diverse aging populations.</p><p><strong>Methods and results: </strong>Data from four longitudinal cohorts were harmonized: CHARLS (China), ELSA (UK), HRS (US), and MHAS (Mexico). Depressive symptoms were assessed at baseline and follow-up using validated scales, and scores were standardized using z-scores. The primary outcome was incident CVD, defined as a composite of heart attack, angina, congestive heart failure, other physician-diagnosed heart conditions, and stroke. Cox proportional regression analyses assessed the associations between changes in depressive symptoms and CVD risk. Progression from no depression to mild depression was associated with a 28% increase in CVD risk (95% CI: 1.14-1.44), while progression to moderate-to-severe depression was associated with a 23% increase (95% CI: 1.04-1.46). Conversely, remission from mild depression to no depression significantly reduced CVD risk by 19% (95% CI: 0.68-0.98). Improvement from moderate-to-severe depression to mild depression decreased CVD risk by 25% (95% CI: 0.61-0.93), and remission from moderate-to-severe depression to no depression reduced it by 38% (95% CI: 0.50-0.76). Each 1-unit increase in the total depression score raised CVD risk by 12% (95% CI: 1.10-1.14), while each 1-unit increase in depression score change increased risk by 15% (95% CI: 1.11-1.19). Effects were stronger in participants aged <65 years than participants aged ≥65 years.</p><p><strong>Conclusion: </strong>This multinational cohort study demonstrates that worsening or progression of depressive symptoms increases CVD risk, while remission or improvement confers protective effects, highlighting the need to monitor depression symptom changes in CVD prevention.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091446","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}