European journal of preventive cardiology最新文献

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Individual response to lifestyle interventions: a pooled analysis of three long-term weight loss trials. 个人对生活方式干预的反应:三个长期减肥试验的汇总分析。
IF 8.4 2区 医学
European journal of preventive cardiology Pub Date : 2025-06-05 DOI: 10.1093/eurjpc/zwaf308
Anat Yaskolka Meir, Gal Tsaban, Ehud Rinott, Hila Zelicha, Dan Schwarzfuchs, Yftach Gepner, Assaf Rudich, Ilan Shelef, Matthias Blüher, Michael Stumvoll, Uta Ceglarek, Berend Isermann, Nora Klöting, Maria Keller, Peter Kovacs, Lu Qi, Dong D Wang, Liming Liang, Frank B Hu, Meir J Stampfer, Iris Shai
{"title":"Individual response to lifestyle interventions: a pooled analysis of three long-term weight loss trials.","authors":"Anat Yaskolka Meir, Gal Tsaban, Ehud Rinott, Hila Zelicha, Dan Schwarzfuchs, Yftach Gepner, Assaf Rudich, Ilan Shelef, Matthias Blüher, Michael Stumvoll, Uta Ceglarek, Berend Isermann, Nora Klöting, Maria Keller, Peter Kovacs, Lu Qi, Dong D Wang, Liming Liang, Frank B Hu, Meir J Stampfer, Iris Shai","doi":"10.1093/eurjpc/zwaf308","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf308","url":null,"abstract":"<p><strong>Aims: </strong>We explored the manifestations of individual weight loss (WL) response to long-term lifestyle interventions on cardiometabolic risk.</p><p><strong>Methods and results: </strong>We pooled data from three large long-term lifestyle WL-intervention trials: 24-month DIRECT (ClinicalTrials.gov: NCT00160108; n = 322; 87% adherence), 18-month CENTRAL (ClinicalTrials.gov: NCT01530724; n = 278; 86% adherence), and 18-month DIRECT PLUS (ClinicalTrials.gov: NCT03020186; n = 294; 89% adherence). We analyzed longitudinal changes in cardiometabolic risk markers, including anthropometrics, blood biomarkers, and magnetic-resonance-imaging-assessed fat depots, and measured DNA-methylation, proteomics, and metabolomics. Among trial completers (n = 761, mean age = 50.4 years; 89% men, baseline body-mass-index = 30.1 kg/m2), mean WL was -3.3 kg (-3.5%). We classified participants as Successful-WL (36%) with relative-WL > 5%, WL-Resistant (28%) who did not lose or gained weight, and Moderate-WL (36%) with WL between 0% and 5%. Successful-WL achieved the greatest improvements in multiple health indicators. However, the WL-Resistant also showed some significant improvements, with increased high-density-lipoprotein-cholesterol (HDLc) and decreased leptin and visceral fat (P < 0.05 vs. baseline). Overall, each 1 kg sustained lifestyle-induced WL was associated with improvements in lipid markers and insulin resistance [HDLc (+1.44%), triglycerides (-1.37%), insulin (-2.46%), HOMA-IR (-2.71%), leptin (-2.79%)] and intrahepatic-fat regression (-0.49 absolute-units)] and modest but significant change in systolic and diastolic blood pressures (-0.26% and -0.36%). We identified 12 significant methylation sites that are associated with Successful-WL (FDR < 0.05; AUC = 0.73).</p><p><strong>Conclusion: </strong>While only ∼one-third of individuals achieved long-term WL, the Moderate-WL and WL-Resistant individuals could benefit improvements in visceral adiposity and cardiometabolic risk by shifting towards a healthy lifestyle pattern, beyond WL. Site-pecific DNA methylation may predict an individual's likelihood of successful WL.</p><p><strong>Registration: </strong>NCT00160108, NCT01530724, NCT03020186.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233589","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}
引用次数: 0
Safety of beta-blocker discontinuation after acute coronary syndromes with preserved or mildly reduced left ventricular ejection fraction: a target trial emulation from a real-world cohort. 左心室射血分数保留或轻度降低的急性冠状动脉综合征后停用β-受体阻滞剂的安全性:来自真实世界队列的目标试验模拟。
IF 8.4 2区 医学
European journal of preventive cardiology Pub Date : 2025-06-03 DOI: 10.1093/eurjpc/zwae346
Nicolas Johner, Mattia Branca, David Carballo, Stéphanie Baggio, David Nanchen, Elena Tessitore, Lorenz Räber, Thomas Felix Lüscher, Christian M Matter, Stephan Windecker, Nicolas Rodondi, François Mach, Baris Gencer
{"title":"Safety of beta-blocker discontinuation after acute coronary syndromes with preserved or mildly reduced left ventricular ejection fraction: a target trial emulation from a real-world cohort.","authors":"Nicolas Johner, Mattia Branca, David Carballo, Stéphanie Baggio, David Nanchen, Elena Tessitore, Lorenz Räber, Thomas Felix Lüscher, Christian M Matter, Stephan Windecker, Nicolas Rodondi, François Mach, Baris Gencer","doi":"10.1093/eurjpc/zwae346","DOIUrl":"10.1093/eurjpc/zwae346","url":null,"abstract":"<p><strong>Aims: </strong>The benefit of long-term beta-blocker therapy after acute coronary syndromes (ACS) without heart failure in the reperfusion era is uncertain. Two recent randomized trials found conflicting results. The present study assessed the safety of beta-blocker discontinuation within 12 months following ACS with left ventricular ejection fraction (LVEF) ≥40%.</p><p><strong>Methods and results: </strong>In a multicentre prospective real-world cohort (n = 3762) of patients hospitalized for ACS, patients with LVEF ≥40% and beta-blockers at discharge were included. Patients who continued beta-blockers at 1 year were compared with those who discontinued beta-blockers within 12 months post-ACS using target trial emulation and inverse probability weighting over an additional 4-year follow-up. The primary endpoint was major adverse cardiovascular events (MACE), a composite of 4-year cardiovascular death, myocardial infarction, stroke, transient ischaemic attack, unplanned coronary revascularization, or unstable angina hospitalization. Of 2077 patients, 1758 (85%) continued beta-blockers and 319 (15%) had discontinued beta-blockers at 1 year. The risk of the primary endpoint was similar in both groups [14.1 vs. 14.3% with beta-blocker discontinuation vs. continuation; adjusted hazard ratio (aHR) = 0.98; 95% confidence interval, 0.72-1.34, P = 0.91]. Subgroup analysis suggested a higher risk of primary endpoint with beta-blocker discontinuation after STEMI [aHR = 1.46 (0.99-2.16)] compared with NSTEMI [aHR = 0.70 (0.40-1.22), Pinteraction = 0.033], whereas there was no interaction with LVEF (Pinteraction = 0.68).</p><p><strong>Conclusion: </strong>Beta-blocker discontinuation within 12 months following ACS with LVEF ≥40% was not associated with an increased risk of MACE compared with long-term beta-blocker therapy. Subgroup analysis suggested potential risk in STEMI patients. Discontinuing beta-blockers 12 months after ACS appears safe in patients with LVEF ≥40%, particularly after NSTEMI.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"622-632"},"PeriodicalIF":8.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497602","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}
引用次数: 0
Beta-blockers for secondary prevention following myocardial infarction in patients without reduced ejection fraction or heart failure: an updated meta-analysis. β-受体阻滞剂用于无射血分数降低或心力衰竭患者心肌梗死后的二级预防:最新的 Meta 分析。
IF 8.4 2区 医学
European journal of preventive cardiology Pub Date : 2025-06-03 DOI: 10.1093/eurjpc/zwae298
Kuan-Yu Chi, Pei-Lun Lee, Ishmum Chowdhury, Zafer Akman, Sridhar Mangalesh, Junmin Song, Vikyath Satish, Golsa Babapour, Yi-No Kang, Rachel Schwartz, Yu Chang, Pawel Borkowski, Michele Nanna, Abdulla A Damluji, Michael G Nanna
{"title":"Beta-blockers for secondary prevention following myocardial infarction in patients without reduced ejection fraction or heart failure: an updated meta-analysis.","authors":"Kuan-Yu Chi, Pei-Lun Lee, Ishmum Chowdhury, Zafer Akman, Sridhar Mangalesh, Junmin Song, Vikyath Satish, Golsa Babapour, Yi-No Kang, Rachel Schwartz, Yu Chang, Pawel Borkowski, Michele Nanna, Abdulla A Damluji, Michael G Nanna","doi":"10.1093/eurjpc/zwae298","DOIUrl":"10.1093/eurjpc/zwae298","url":null,"abstract":"<p><strong>Aims: </strong>The 2023 ESC guidelines for acute coronary syndrome note that contemporary data are heterogenous regarding beta-blocker (BB) use post-myocardial infarction (MI) in patients without reduced ejection fraction (EF) or heart failure (HF). We aimed to address the heterogeneity in contemporary data around BB post-MI in this population.</p><p><strong>Methods and results: </strong>We searched six databases from 1 January 2000 to 1 September 2024 to identify contemporary studies enrolling MI patients without reduced EF (≤40%) or history of HF receiving BB at index MI and comparing outcomes between BB users and non-users. The primary outcome was all-cause mortality. Secondary outcomes included major adverse cardiac and cerebrovascular events (MACCE) and cardiovascular (CV) mortality. Random-effects meta-analysis was conducted using the restricted maximum likelihood method. There were 24 studies including 290 349 patients enrolled in the contemporary era. Overall, BB use was associated with a significant 11% reduction in all-cause mortality [hazard ratio (HR), 0.89; 95% confidence interval (CI), 0.81-0.97; I2 = 40], however with moderate-to-high statistical heterogeneity. Pre-specified subgroup analyses demonstrate comparable all-cause mortality (HR, 0.99; 95% CI, 0.94-1.06; I2 = 0%), CV mortality (HR, 0.99; 95% CI, 0.85-1.15; I2 = 0%), and MACCE (HR, 1.24; 95% CI, 1.01-1.52; I2 = 0%) in patients with a 1-year event-free period, defined as no death, recurrent MI, or HF while on BB following index MI. In patients with no event-free period, meta-regression revealed that BB mortality benefits were modified by the study inclusion period (P = 0.01), reflecting a temporal trend of decreasing BB mortality benefits over time. Based on the temporal trend, in patients with preserved EF post-2010, BB exhibited no reduction in all-cause mortality (HR, 0.97; 95% CI, 0.90-1.04; I2 = 0%), but a non-significant trend towards increased CV mortality (HR, 1.29; 95% CI, 0.96-1.72; I2 = 0%) and a significant increase in MACCE (HR, 1.24; 95% CI, 1.01-1.52; I2 = 0%).</p><p><strong>Conclusion: </strong>In the contemporary reperfusion era, BB may not confer additional mortality benefits beyond a 1-year event-free period post-MI in patients without reduced EF. Moreover, post-MI BB use was associated with detrimental effects in patients with preserved EF.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"633-646"},"PeriodicalIF":8.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The next step in cardio-vascular risk reduction: Targeting remnant-cholesterol. 降低心血管风险的下一步:针对残余胆固醇。
IF 8.4 2区 医学
European journal of preventive cardiology Pub Date : 2025-06-03 DOI: 10.1093/eurjpc/zwaf315
Klaus G Parhofer
{"title":"The next step in cardio-vascular risk reduction: Targeting remnant-cholesterol.","authors":"Klaus G Parhofer","doi":"10.1093/eurjpc/zwaf315","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf315","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208095","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}
引用次数: 0
Familial risk of myocardial infarction with non-obstructive and obstructive coronary arteries: a nation-wide cohort study. 非阻塞性冠状动脉和阻塞性冠状动脉家族性心肌梗死风险 - 一项全国性队列研究。
IF 8.4 2区 医学
European journal of preventive cardiology Pub Date : 2025-06-03 DOI: 10.1093/eurjpc/zwae313
Felicia H K Hakansson, Per Svensson, Hans J Pettersson, Ewa Ehrenborg, Jonas Spaak, Anna M Nordenskjold, Kai M Eggers, Per Tornvall
{"title":"Familial risk of myocardial infarction with non-obstructive and obstructive coronary arteries: a nation-wide cohort study.","authors":"Felicia H K Hakansson, Per Svensson, Hans J Pettersson, Ewa Ehrenborg, Jonas Spaak, Anna M Nordenskjold, Kai M Eggers, Per Tornvall","doi":"10.1093/eurjpc/zwae313","DOIUrl":"10.1093/eurjpc/zwae313","url":null,"abstract":"<p><strong>Aims: </strong>The familial risk among patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) is unknown. Previous studies of family history in myocardial infarction (MI) have not made a distinction between MINOCA and MI due to coronary artery disease (MI-CAD), based on angiographic findings. We therefore sought to investigate familial risk of MI without and with obstructive coronary arteries.</p><p><strong>Methods and results: </strong>Register-based cohort study with a total of 15 462 MINOCA cases, 204 424 MI-CAD cases, 38 220 control subjects without MI, and with non-obstructive coronary arteries. First-degree relatives were identified in 1995-2020. Cox proportional hazard regression models were used to compare familial risk in MINOCA and MI-CAD with control subjects. During a mean follow-up of 8.1 ± 4.2 years, MINOCA occurred in 1.0% of first-degree relatives with MINOCA whereas MI-CAD occurred in 9.7% of first-degree relatives of MINOCA. The age- and sex-adjusted hazard ratio (HR) for a MINOCA relative experiencing MINOCA and MI-CAD, compared to control subjects, was 0.99 [95% confidence interval (CI) 0.80-1.23] and 1.10 (95% CI 1.03-1.18), respectively. During a mean follow-up of 8.5 ± 4.8 years, MI-CAD occurred in 12.2% of first-degree relatives with MI-CAD with age- and sex-adjusted HR 1.43 (95% CI 1.37-1.49).</p><p><strong>Conclusion: </strong>No increased familial risk of MINOCA was observed for MINOCA patients whereas there was an increased familial risk for MI-CAD when compared to control subjects. These results may indicate that genetic factors and shared environmental factors within a family leading to CAD are important also for MINOCA, thus MI-CAD and MINOCA could share underlying mechanisms.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"671-679"},"PeriodicalIF":8.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380374","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}
引用次数: 0
Occupational exposure to diesel engine exhaust and first-time acute myocardial infarction: a nationwide register-based cohort study 1976-2018. 职业暴露于柴油机废气和首次急性心肌梗死——1976- 2018年全国基于登记的队列研究。
IF 8.4 2区 医学
European journal of preventive cardiology Pub Date : 2025-06-03 DOI: 10.1093/eurjpc/zwaf022
Regitze Sølling Wils, Esben Meulengracht Flachs, Zara Ann Stokholm, Per Gustavsson, Nils Plato, Henrik A Kolstad, Camilla Sandal Sejbæk, Charlotte Brauer, Vivi Schlünssen, Karin Sørig Hougaard, Ida E H Madsen, Reiner Rugulies, Matthias Ketzel, Johnni Hansen, Casper Niels Furbo Bang, Hans Kromhout, Ingrid Sivesind Mehlum, Jens Peter Bonde
{"title":"Occupational exposure to diesel engine exhaust and first-time acute myocardial infarction: a nationwide register-based cohort study 1976-2018.","authors":"Regitze Sølling Wils, Esben Meulengracht Flachs, Zara Ann Stokholm, Per Gustavsson, Nils Plato, Henrik A Kolstad, Camilla Sandal Sejbæk, Charlotte Brauer, Vivi Schlünssen, Karin Sørig Hougaard, Ida E H Madsen, Reiner Rugulies, Matthias Ketzel, Johnni Hansen, Casper Niels Furbo Bang, Hans Kromhout, Ingrid Sivesind Mehlum, Jens Peter Bonde","doi":"10.1093/eurjpc/zwaf022","DOIUrl":"10.1093/eurjpc/zwaf022","url":null,"abstract":"<p><strong>Aims: </strong>Exposure to air pollution including diesel engine exhaust (DEE) is associated with increased risk of acute myocardial infarction (AMI). Few studies have investigated the risk of AMI according to occupational exposure to DEE. The aim of this study was to evaluate the association between occupational exposure to DEE and the risk of first-time AMI.</p><p><strong>Methods and results: </strong>The study was a register-based cohort study of the Danish working population and included 903 415 individuals aged 35-50 years in 1995. Exposure estimates of DEE were assigned by linking a quantitative DEE job exposure matrix with the individual job history (1976-2017). National registers provided data on AMI throughout the follow-up period (1996-2018). The incidence rate ratios (IRRs) for AMI were computed using Poisson regression while adjusting for demographics, comorbidities, socioeconomic factors, ambient air pollution and occupational exposure to noise, physically demanding work, and job strain. A total of 35 511 cases of AMI occurred during the follow-up period of 19 357 326 person-years. Incidence rate ratios for cumulative exposure to DEE in the fully adjusted model were 1.04 [95% confidence intervals (CI): 1.00-1.08] for exposure levels between the 50th and 75th percentiles, and 1.08 (95% CI: 1.04-1.12) for exposure levels ≥75th percentile. Recent exposure to DEE was associated with an increased IRR in the highest exposed quartile [IRR = 1.15 (95% CI: 1.05-1.27)], but only when compared within exposed workers.</p><p><strong>Conclusion: </strong>Increasing exposure to DEE was associated with increasing IRR for first-time AMI across different exposure measures. The results indicate that AMI should be included in the risk assessment of DEE when establishing occupational exposure limits.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"682-695"},"PeriodicalIF":8.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002849","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}
引用次数: 0
Evaluating the Role of Lipoprotein(a) in Enhancing Risk Stratification for the Presence and Extent of Subclinical Coronary Artery Disease Burden - A BioHEART-CT Study. 评估脂蛋白(a)在加强亚临床冠状动脉疾病负担存在和程度的风险分层中的作用——一项生物心脏ct研究
IF 8.4 2区 医学
European journal of preventive cardiology Pub Date : 2025-06-03 DOI: 10.1093/eurjpc/zwaf323
Sina Fathieh, Owen Tang, Michael P Gray, Christian Zanchin, Stephen T Vernon, Elijah Genetzakis, Collin Tran, David R Sullivan, Stephen J Nicholls, David S Celermajer, Peter J Psaltis, Stuart M Grieve, Gemma A Figtree
{"title":"Evaluating the Role of Lipoprotein(a) in Enhancing Risk Stratification for the Presence and Extent of Subclinical Coronary Artery Disease Burden - A BioHEART-CT Study.","authors":"Sina Fathieh, Owen Tang, Michael P Gray, Christian Zanchin, Stephen T Vernon, Elijah Genetzakis, Collin Tran, David R Sullivan, Stephen J Nicholls, David S Celermajer, Peter J Psaltis, Stuart M Grieve, Gemma A Figtree","doi":"10.1093/eurjpc/zwaf323","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf323","url":null,"abstract":"<p><strong>Aims: </strong>Lipoprotein(a) [Lp(a)] has regained attention as an independent cardiovascular risk factor, particularly given emerging therapies entering late-phase clinical trials. Here, we aim to examine the association of Lp(a) with CAD and the potential of Lp(a) as an enrichment criterion for identifying individuals more likely to benefit from screening for subclinical CAD with CT imaging.</p><p><strong>Methods: </strong>We analysed data from 1,718 adults undergoing CTCA for suspected CAD enrolled in the BioHEART study. Lp(a) levels were measured, and CAD burden was assessed using coronary artery calcium score (CACS) and Gensini scores. Plaque morphology for the most stenotic plaque of each Gensini segment was classified as calcified, non-calcified or mixed. Youden's index with 10,000 bootstraps was used to identify the optimal threshold for increased risk of clinically actionable CAD.</p><p><strong>Results: </strong>Lp(a) was strongly associated with all CTCA measures of CAD examined. Elevated Lp(a) above 22 nmol/L was linked to more advanced multi-segment (ordinal OR = 1.14 [1.03-1.25]) and multivessel disease (ordinal OR = 1.11 [1.02-1.20]), with a 2.6% increased risk of a CACS >100 for every 10 nmol/L increment. Lp(a) was most strongly associated with mixed plaque burden even after adjusting for traditional risk factors (β = 4.75, p=0.001), but not with non-calcified or calcified plaque. Adding Lp(a) to standard risk models resulted in an overall NRI of 16% [0.06-0.27] and 42% [0.16-0.70] in patients without standard modifiable risk factors.</p><p><strong>Conclusion: </strong>Our findings suggest Lp(a)'s role in a new clinical pathway: screening patients considered low or intermediate risk, particularly those without standard modifiable risk factors for non-invasive imaging to detect subclinicalCAD.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208094","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}
引用次数: 0
Sex differences in myocardial infarction care and outcomes: a longitudinal Scottish National Data-Linkage Study. 心肌梗死护理和预后的性别差异:苏格兰国家数据链接纵向研究。
IF 8.4 2区 医学
European journal of preventive cardiology Pub Date : 2025-06-03 DOI: 10.1093/eurjpc/zwae333
Tiberiu A Pana, Mamas A Mamas, Phyo K Myint, Dana K Dawson
{"title":"Sex differences in myocardial infarction care and outcomes: a longitudinal Scottish National Data-Linkage Study.","authors":"Tiberiu A Pana, Mamas A Mamas, Phyo K Myint, Dana K Dawson","doi":"10.1093/eurjpc/zwae333","DOIUrl":"10.1093/eurjpc/zwae333","url":null,"abstract":"<p><strong>Aims: </strong>We investigate sex disparities in management and outcomes of myocardial infarction (MI) in contemporary practice in Scotland.</p><p><strong>Methods and results: </strong>This was a longitudinal cohort study including all MI admissions aged 45-80 years across Scotland between 2010-2016 and 2:1 age, sex, and general practice-matched general population controls. Participants were followed up until the end of 2021. We analysed in-hospital outcomes (percutaneous coronary intervention, secondary prevention and mortality) using Poisson regressions, adjusting for age, comorbidities, and ST-elevation. We used Royston-Parmar models for long-term outcomes (all-cause and cardiovascular mortality, incident cardiovascular events), adjusting for age, comorbidities, and secondary prevention. Of a total 47 063 MI patients, 15 776 (33.5%) were women. Median (inter-quartile range) age was 66 (57, 73) years. Compared to men, women were older and more comorbid, but were less likely to undergo percutaneous coronary intervention [risk ratio (95% confidence interval) - 0.87 (0.86 - 0.89)] or receive secondary prevention at discharge [0.94 (0.93-0.95)]. No in-hospital mortality difference was observed between sexes [1.06 (0.99-1.13) after adjustment]. Over a median follow-up of 8.2 (6.7, 10.1) years, women had higher crude rates of adverse outcomes. After full adjustment, this translated into a lower risk for women compared to men of all-cause mortality [hazard ratio, 0.92 (0.89-0.95)], cardiovascular mortality [0.82 (0.78-0.87)], and cardiovascular events [0.92 (0.88-0.95)]. The female survival advantage seen in general population controls was attenuated in MI patients.</p><p><strong>Conclusion: </strong>Women were undertreated compared to men after MI. Their survival and outcome benefits may be improved further. Poor outcomes in men despite better receipt of secondary prevention require further attention.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"696-707"},"PeriodicalIF":8.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727360","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}
引用次数: 0
Prevention of acute coronary events: before… and thereafter. 预防急性冠状动脉事件:之前和之后。
IF 8.4 2区 医学
European journal of preventive cardiology Pub Date : 2025-06-03 DOI: 10.1093/eurjpc/zwaf261
Anastasios Apostolos, Victor Aboyans
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引用次数: 0
Ninety days to predict a year: a Bayesian journey into medication adherence post-myocardial infarction. 90天预测一年:心肌梗死后药物依从性的贝叶斯之旅。
IF 8.4 2区 医学
European journal of preventive cardiology Pub Date : 2025-06-03 DOI: 10.1093/eurjpc/zwaf023
Julien Magne, Jeremy Jost
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引用次数: 0
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