European journal of preventive cardiology最新文献

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"title":"Prevention of acute coronary events: before… and thereafter.","authors":"Anastasios Apostolos, Victor Aboyans","doi":"10.1093/eurjpc/zwaf261","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf261","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":"32 8","pages":"619-621"},"PeriodicalIF":8.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208097","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":"Ninety days to predict a year: a Bayesian journey into medication adherence post-myocardial infarction.","authors":"Julien Magne, Jeremy Jost","doi":"10.1093/eurjpc/zwaf023","DOIUrl":"10.1093/eurjpc/zwaf023","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"659-660"},"PeriodicalIF":8.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002783","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":"Modalities and safety of cardiac rehabilitation in a population managed for spontaneous haematoma or coronary disruption: insights from the READAPT-DISCO study.","authors":"Clément Nguyen Ngoc, Nicolas Combaret, Hervé Douard, Marc Bonnet, Yann Valy, Nicolas Méneveau, Louis le Bivic, Gilles Rioufol, Grégoire Rangé, Philippe Brunel, Brahim Harbaoui, Benoît Lattuca, Johanne Silvain, Matthieu Godin, Thibault Lhermusier, Arnaud Fluttaz, Christophe Saint-Etienne, Grégory Ducrocq, Hakim Benamer, Vincent Roule, Didier Bresson, Norbert Mayaud, Geraud Souteyrand, Julien Nardoux, Pascal Motreff, Edouard Gerbaud","doi":"10.1093/eurjpc/zwaf071","DOIUrl":"10.1093/eurjpc/zwaf071","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"708-711"},"PeriodicalIF":8.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556352","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":"Severe infections as risk factors for acute myocardial infarction: a nationwide, Danish cohort study from 1987 to 2018.","authors":"Emilie Marie Juelstorp Pedersen, Harman Yonis, Gertrud Baunbæk Egelund, Nicolai Lohse, Christian Torp-Pedersen, Birgitte Lindegaard, Andreas Vestergaard Jensen","doi":"10.1093/eurjpc/zwae344","DOIUrl":"10.1093/eurjpc/zwae344","url":null,"abstract":"<p><strong>Aims: </strong>Infections have been associated with acute myocardial infarction (AMI), but differences in risk between infection types and age groups are unclear. This study aims to investigate whether infections are associated with subsequent AMI and whether the risk differs across infection sites and age groups.</p><p><strong>Methods and results: </strong>Nationwide registers were used to include 702 596 adults hospitalized between 1987 and 2018 with either pneumonia (n = 344 319), urinary tract infection (UTI) (n = 270 101), soft tissue/bone infection (n = 66 718), central nervous system (CNS) infection (n = 17 025), or endocarditis (n = 4433). Patients were sex and age matched with two unexposed controls. Outcome was first-time AMI within 10 years. A time-dependent Cox proportional hazards model with cut-offs at 30 and 90 days was used for calculating adjusted hazard ratios (HRs). Pneumonia, UTI, and soft tissue/bone infection were associated with increased relative rates of AMI compared to matched, unexposed controls. Highest relative rates were found within the first 0-30 days post-exposure: pneumonia: HR 3.39 [95% confidence interval (CI) 3.15-3.65]; UTI: HR 2.44 (95% CI 2.21-2.70); soft tissue/bone infection: HR 1.84 (95% CI 1.45-2.33). Relative rates decreased over time but remained significantly elevated throughout the follow-up period and were increased in all age groups. No association was found for CNS infection and for endocarditis only at 31-90 days, HR 2.28 (95% CI 1.20-4.33).</p><p><strong>Conclusion: </strong>Acute infections are associated with increased relative rates of AMI across different infection sites and age groups with higher relative rates found for pneumonia. This indicates that some infections may act as a trigger for AMI with a site and/or pathogen specific risk.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":"661-670"},"PeriodicalIF":8.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497603","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}