Reviews in cardiovascular medicine最新文献

{"title":"Metformin and Risks of Aortic Aneurysm and Aortic Dissection: A Mendelian Randomization Study.","authors":"Lei Wang, Ziyan Lin, Yuzuo Lin, Qingtong Wu, Guodong Zhong, Liangwan Chen","doi":"10.31083/RCM27734","DOIUrl":"https://doi.org/10.31083/RCM27734","url":null,"abstract":"<p><strong>Background: </strong>Previous research has suggested that metformin may inhibit the dilation of an abdominal aortic aneurysm (AAA); however, these findings are controversial. Additionally, limited reporting exists on the relationships between metformin and thoracic aortic aneurysm (TAA) and aortic dissection (AD). Therefore, this study aimed to assess the potential relationship between metformin and the risk of aortic aneurysm (AA)/AD using the Mendelian randomization (MR) analysis.</p><p><strong>Methods: </strong>Genome-wide association studies and FinnGen summary data were utilized for the MR analysis. The causal relationship between metformin and AA/AD was primarily assessed using the inverse-variance weighted (IVW) method. Sensitivity analyses were conducted to detect heterogeneity and pleiotropy.</p><p><strong>Results: </strong>The results indicated a negative correlation between metformin treatment and the risk of both AA and AD, with odds ratios(ORs) reported as follows: OR = 0.010, 95% confidence interval (CI):0.000-0.212, <i>p</i> = 0.003 for AA, OR = 0.004, 95% CI: 0.000-0.220, <i>p</i> = 0.007 for abdominal aortic aneurysm (AAA); OR = 0.017, 95% CI: 0.000-0.815, <i>p</i> = 0.039 for thoracic aortic aneurysm (TAA); and OR = 0.001, 95% CI: 0.000-0.531, <i>p</i> = 0.032 for AD using the IVW method. These findings suggested that metformin might act as a protective factor against the occurrence of AA/AD. Furthermore, sensitivity analyses validated the robustness of these findings.</p><p><strong>Conclusions: </strong>This MR analysis identified a potential genetic causal relationship between metformin use and the risks of AA/AD, suggesting that metformin could serve as a protective agent in decreasing the incidences of these conditions.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"27734"},"PeriodicalIF":1.9,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between the Platelet Lymphocyte Ratio and Albumin with Plaque Calcification in Patients with Acute Coronary Syndrome: An Optical Coherence Tomography Study.","authors":"Kexin Song, Wenjing Yao, Haihao Yan, Yan Zhang, Yanhong Li, Tianxing Li, Qian Yang, Feifei Zhang, Yi Dang","doi":"10.31083/RCM28167","DOIUrl":"https://doi.org/10.31083/RCM28167","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery calcification (CAC) is a robust independent predictor of cardiovascular events. Therefore, it is essential to elucidate the factors that influence CAC progression to enhance the outcomes of patients diagnosed with acute coronary syndrome (ACS). This study aimed to investigate the relationship between prevalent laboratory parameters and the calcification of coronary artery plaques in patients diagnosed with ACS by applying optical coherence tomography (OCT).</p><p><strong>Methods: </strong>This single-center, cross-sectional study retrospectively evaluated patients with ACS who underwent percutaneous coronary intervention and OCT examinations at the Hebei General Hospital. Baseline data, laboratory parameters, and OCT imaging were analyzed. Comprehensive statistical analyses were conducted to elucidate the relationship between prevalent laboratory parameters and coronary artery plaque calcification.</p><p><strong>Results: </strong>In this study involving 130 patients, the platelet to lymphocyte ratio (PLR) demonstrated a significant positive correlation with coronary artery plaque calcification (r_s = 0.373, <i>p</i> < 0.001), whereas albumin exhibited a significant negative correlation (r_s = -0.585, <i>p</i> < 0.001). Both the PLR (odds ratios (OR) 1.011, 95% CI 1.002-1.019, <i>p</i> = 0.014) and albumin levels (OR 0.642, 95% CI 0.539-0.764, <i>p</i> < 0.001) emerged as significant independent predictors of plaque calcification. Receiver operating characteristic curve analysis identified a cutoff point for albumin at <40.65, yielding a sensitivity of 75.8% and a specificity of 77.9%, Comparatively, a PLR >145.04 demonstrated a sensitivity of 61.3% and a specificity of 76.5% for predicting plaque calcification.</p><p><strong>Conclusions: </strong>Albumin and the PLR were significantly associated with plaque calcification in patients with ACS, serving as independent predictors of coronary artery plaque calcification. These parameters may significantly contribute to risk stratification and the future development of preventive strategies to mitigate adverse cardiovascular events.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"28167"},"PeriodicalIF":1.9,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Assisted Echocardiographic Image-Analysis for the Diagnosis of Fetal Congenital Heart Disease: A Systematic Review and Meta-Analysis.","authors":"Yaduan Gan, Lin Yang, Jianmei Liao","doi":"10.31083/RCM28060","DOIUrl":"https://doi.org/10.31083/RCM28060","url":null,"abstract":"<p><strong>Background: </strong>To assess the precision of artificial intelligence (AI) in aiding the diagnostic process of congenital heart disease (CHD).</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane, and Web of Science databases were searched for clinical studies published in English up to March 2024. Studies using AI-assisted ultrasound for diagnosing CHD were included. To evaluate the quality of the studies included in the analysis, the Quality Assessment Tool for Diagnostic Accuracy Studies-2 scale was employed. The overall accuracy of AI-assisted imaging in the diagnosis of CHD was determined using Stata15.0 software. Subgroup analyses were conducted based on region and model architecture.</p><p><strong>Results: </strong>The analysis encompassed a total of 7 studies, yielding 19 datasets. The combined sensitivity was 0.93 (95% confidence interval (CI): 0.88-0.96), and the specificity was 0.93 (95% CI: 0.88-0.96). The positive likelihood ratio was calculated as 13.0 (95% CI: 7.7-21.9), and the negative likelihood ratio was 0.08 (95% CI: 0.04-0.13). The diagnostic odds ratio was 171 (95% CI: 62-472). The summary receiver operating characteristic (SROC) curve analysis revealed an area under the curve of 0.98 (95% CI: 0.96-0.99). Subgroup analysis found that the ResNet and DenNet architecture models had better diagnostic performance than other models.</p><p><strong>Conclusions: </strong>AI demonstrates considerable value in aiding the diagnostic process of CHD. However, further prospective studies are required to establish its utility in real-world clinical practice.</p><p><strong>The prospero registration: </strong>CRD42024540525, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=540525.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"28060"},"PeriodicalIF":1.9,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Central Event Adjudication on the PLATO Trial Results.","authors":"Victor L Serebruany, Wendy Ziai, Hector A Cabrera-Fuentes, Brendon Pokov, Isabella Hwang, Thomas Marciniak","doi":"10.31083/RCM36733","DOIUrl":"https://doi.org/10.31083/RCM36733","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the impact of central adjudication of site-reported events in patients with acute coronary syndromes treated with ticagrelor or clopidogrel in addition to aspirin within the frame of indication-seeking The PLATelet Inhibition and Clinical Outcomes (PLATO) trial. Adjudication in randomized outcome-driven trials is supposed to maintain integrity by applying uniform rules for the quality assessment of clinical events. Some preliminary data suggest an imbalance between central and site diagnoses in PLATO. We gained access to the Food and Drug Administration (FDA)-issued adjudication dataset and analyzed the evidence.</p><p><strong>Methods: </strong>Death, myocardial infarction (MI), stroke/ transient ischemic attack (TIA), bleeding, arterial thrombotic events, and cardiac ischemic events underwent central adjudication. We assessed geography, timing, impact of disagreements, and primary endpoint composition.</p><p><strong>Results: </strong>Among 18,624 trial enrollees, 10,704 central adjudications occurred across 7171 patients in 43 countries. There were 938 deaths, 2751 cases of MI, 359 strokes/TIAs, 2680 cardiac events, 130 thrombotic events, and 3782 bleeding events. The match occurred for 5451 events, while mismatches favoring clopidogrel (n = 2535) or ticagrelor (n = 2706) (<i>p</i> = 0.79) were common for major (n = 1797), moderate (n = 942), or minor (n = 735) disagreements. The central decision prevailed in 2945 cases. There was a significant (HR = 0.84; 95% confidence intervals (CI): 0.75-0.95; <i>p</i> = 0.004) adjudication delay in the 2007-2008 events but finalized in 2009. Ticagrelor was significantly less favored in 2009 than in 2007-2008 (HR = 1.19; 95% CI: 1.05-1.34; <i>p</i> = 0.005). There was a remarkably consistent match for bleeding adjudication (HR = 1.02; 95% CI: 0.83-1.25; <i>p</i> = 0.859) between treatment arms. The primary endpoint in the PLATO trial exhibited highly significant disagreement favoring ticagrelor for vascular death (HR = 2.02; 95% CI: 1.1-3.64; <i>p</i> = 0.019); MI (HR = 2.31; 95% CI: 2.79-43.94; <i>p</i> = 0.034); stroke (HR = 1.37; 95% CI: 2.66-63.28; <i>p</i> = 0.036); total events (HR = 2.51; 95% CI: 1.86-3.39; <i>p</i> = 0.01).</p><p><strong>Conclusion: </strong>Central adjudication in the PLATO trial was delayed and impacted the primary endpoint by inflating the ticagrelor benefit, resulting in drug approval. The regulatory authorities should consider independent audits when unblinding is suspected in the indication-seeking clinical trials.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"36733"},"PeriodicalIF":1.9,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Stop Device Closure for Ventricular Septal Defect with Atrial Septal Defect Guided by Transesophageal Echocardiography.","authors":"Jinghao Song, Yuekun Sun, Huaixue Mi, Shibin Sun, Hongxin Li","doi":"10.31083/RCM26279","DOIUrl":"https://doi.org/10.31083/RCM26279","url":null,"abstract":"<p><strong>Background: </strong>Ventricular septal defect (VSD) with atrial septal defect (ASD) is a common complex congenital heart disease. This study aimed to evaluate the clinical efficacy and safety of transesophageal echocardiography (TEE)-guided percardiac or combined percutaneous techniques for treating VSD with ASD in patients with varying anatomies.</p><p><strong>Methods: </strong>This retrospective cohort study reviewed 40 cases of VSD with ASD treated in our center from June 2015 to July 2023. Under TEE guidance, peratrial, perventricular, or combined percardiac/percutaneous approaches were used based on the VSD type and secundum-type ASD. Follow-up examinations, including electrocardiography, transthoracic echocardiography, and X-ray, were performed after surgery at 24 hours, 1, 3, 6, and 12 months, and yearly.</p><p><strong>Results: </strong>All patients underwent surgery successfully (100%), with 24, 5, and 11 patients undergoing simultaneous closure via the peratrial, perventricular, and combined percardiac/percutaneous approaches, respectively. Among them, there were six cases of a mild residual shunt, three instances of a mild tricuspid regurgitation, two cases of a mild aortic valve regurgitation, one case of a mild mitral regurgitation, and three cases of an incomplete right bundle branch block, all observed after VSD closure; all had resolved within 6 months of the operation. The chi-square test showed no significant differences in adverse event rates among the three surgical approaches (χ² = 0.09, <i>df</i> = 2, <i>p</i> = 0.957). The Friedman test compared the preoperative and postoperative left ventricular end-diastolic diameter for the three approaches, providing <i>p</i> < 0.001, <i>p</i> = 0.589, and <i>p</i> = 0.445, respectively. None of the patients required reoperation during the follow-up period.</p><p><strong>Conclusions: </strong>Under TEE guidance, using diverse percardiac or combined percutaneous device closure techniques for the one-stop treatment of different types of VSDs combined with ASD is safe, effective, and feasible. These approaches can be performed as a valuable alternative therapy for selected patients.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"26279"},"PeriodicalIF":1.9,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Carotid Stiffness and Strain Parameters Using Speckle Tracking Strain Ultrasonography in Rheumatoid Arthritis Patients.","authors":"Volkan Tasci, Ali Fuat Tekin, Huseyin Baygin, Alparslan Unsal, Mustafa Gok","doi":"10.31083/RCM27092","DOIUrl":"https://doi.org/10.31083/RCM27092","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease characterized by progressive joint deformity and increased mortality. RA patients typically exhibit elevated plasma levels of inflammatory markers, contributing to endothelial dysfunction and increased arterial wall stiffness-a recognized marker of subclinical atherosclerosis and heightened cardiovascular risk. This study aimed to evaluate carotid arterial wall stiffness in RA patients using ultrasound (US) imaging modality with speckle tracking carotid strain (STCS) software, a non-invasive method for assessing subclinical cardiovascular disease indicators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This analytical case-control study was conducted at Aydin Adnan Menderes University Hospital Department of Radiology and Department of Rheumatology. Patients who met the inclusion criteria were enrolled in the study. Data collection tools included an 11-item case report form developed by the researcher based on relevant literature and carotid US examinations performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 143 participants: 75 RA patients (60 female and 15 male) and 68 control subjects (54 female and 14 male). The mean age was 50.9 ± 11.4 years (range: 25.0-74.0) for the RA group and 53.1 ± 12.6 years (range: 20.0-77.0) for the control group. Systolic blood pressure (SBP) and C-reactive protein (CRP) levels (mean ± SD) were 7.4 ± 11.5 in the RA group and 8.6 ± 22.2 in the control group. However, due to a few outliers in the control group, the median CRP was 3.3 mg/L (range: 2.0-71.9) in the RA group versus 2.0 mg/L (range: 0.8-145.0) in the controls. This nonparametric comparison showed significantly higher typical CRP levels in the RA group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). All stiffness and strain parameters in axial and longitudinal planes showed statistically significant differences between the two groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), except the circumferential strain parameter \"displacement (DP)\" (&lt;i&gt;p&lt;/i&gt; = 0.074). Although no significant correlation was found between the disease activity score (DAS) and any strain or stiffness parameter, the carotid intima-media thickness (CIMT) exhibited a significant positive correlation with disease duration (&lt;i&gt;p&lt;/i&gt; = 0.001). After adjusting for confounding factors (age, gender, body mass index (BMI), and smoking status) using multivariate linear regression analysis, RA remained a significant predictor for all stiffness and strain parameters, except for the circumferential strain parameter DP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Applying functional parameters to assess arterial wall stiffness and tension levels provides valuable insights for early detection of cardiovascular disease risk, preceding classical US findings such as increased intima-media thickness (IMT) and plaque formation. While preliminary, our findings from STCS measurements in RA patients show promise in evaluating cardiovascular disease risk in this population an","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"27092"},"PeriodicalIF":1.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities and Challenges of Cardiovascular Disease Risk Prediction for Primary Prevention Using Machine Learning and Electronic Health Records: A Systematic Review.","authors":"Tianyi Liu, Andrew J Krentz, Zhiqiang Huo, Vasa Ćurčin","doi":"10.31083/RCM37443","DOIUrl":"https://doi.org/10.31083/RCM37443","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cardiovascular disease (CVD) remains the foremost cause of morbidity and mortality worldwide. Recent advancements in machine learning (ML) have demonstrated substantial potential in augmenting risk stratification for primary prevention, surpassing conventional statistical models in predictive performance. Thus, integrating ML with Electronic Health Records (EHRs) enables refined risk estimation by leveraging the granularity and breadth of longitudinal individual patient data. However, fundamental barriers persist, including limited generalizability, challenges in interpretability, and the absence of rigorous external validation, all of which impede widespread clinical deployment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This review adheres to the methodological rigor of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Scale for the Assessment of Narrative Review Articles (SANRA) guidelines. A systematic literature search was performed in March 2024, encompassing the Medline and Embase databases, to identify studies published since 2010. Supplementary references were retrieved from the Institute for Scientific Information (ISI) Web of Science, and manual searches were curated. The selection process, conducted via Rayyan, focused on systematic and narrative reviews evaluating ML-driven models for long-term CVD risk prediction within primary prevention contexts utilizing EHR data. Studies investigating short-term prognostication, highly specific comorbid cohorts, or conventional models devoid of ML components were excluded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Following an exhaustive screening of 1757 records, 22 studies met the inclusion criteria. Of these, 10 were systematic reviews (four incorporating meta-analyses), while 12 constituted narrative reviews, with the majority published post-2020. The synthesis underscores the superiority of ML in modeling intricate EHR-derived risk factors, facilitating precision-driven cardiovascular risk assessment. Nonetheless, salient challenges endure heterogeneity in CVD outcome definitions, undermine comparability, data incompleteness and inconsistency compromise model robustness, and a dearth of external validation constrains clinical translatability. Moreover, ethical and regulatory considerations, including algorithmic opacity, equity in predictive performance, and the absence of standardized evaluation frameworks, pose formidable obstacles to seamless integration into clinical workflows.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Despite the transformative potential of ML-based CVD risk prediction, it remains encumbered by methodological, technical, and regulatory impediments that hinder its full-scale adoption into real-world healthcare settings. This review underscores the imperative circumstances for standardized validation protocols, stringent regulatory oversight, and interdisciplinary collaboration to bridge the translational divide. Our findings establ","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"37443"},"PeriodicalIF":1.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Alirocumab and Evolocumab on Cardiovascular Mortality and LDL-C: Stratified According to the Baseline LDL-C Levels.","authors":"Hui Ma, Wenfang Ma, Yang Liu, Lixing Chen, Peng Ding","doi":"10.31083/RCM26980","DOIUrl":"https://doi.org/10.31083/RCM26980","url":null,"abstract":"<p><strong>Background: </strong>A meta-analysis was conducted to determine whether the cardiovascular mortality and lipid-lowering effects of alirocumab and evolocumab are influenced by various baseline low-density lipoprotein cholesterol (LDL-C) levels.</p><p><strong>Methods: </strong>We searched for literature published before June 2023. Eligible randomized controlled trials (RCTs) included adults treated with alirocumab or evolocumab and reported LDL-C changes and cardiovascular deaths. The primary endpoints were cardiovascular mortality and percent changes in LDL-C from baseline.</p><p><strong>Results: </strong>Forty-one RCTs were included in the meta-analysis. Evolocumab did not significantly affect the outcome of cardiovascular mortality whether the baseline data were greater than 100 mg/dL or less than 100 mg/dL. However, the stratified result showed that alirocumab decreased the risk of cardiovascular mortality in patients with a baseline LDL-C level of ≥100 mg/dL (relative risk (RR) 0.45; 95% CI: 0.22 to 0.92; <i>p</i> = 0.03). In terms of lipid-lowering efficacy, alirocumab (mean difference (MD) -56.62%; 95% CI: -60.70% to -52.54%; <i>p</i> < 0.001) and evolocumab (MD -68.10%; 95% CI: -74.85% to -61.36%; <i>p</i> < 0.001) yielded the highest percentage reduction in LDL-C level when baseline levels were 70-100 mg/dL, while the smallest reduction in alirocumab (MD -37.26%; 95% CI: -44.06% to -30.46%; <i>p</i> < 0.001) and evolocumab (MD -37.55%; 95% CI: -40.47% to -34.63%; <i>p</i> < 0.001) occurred with baseline LDL-C levels of ≥160 mg/dL.</p><p><strong>Conclusions: </strong>Alirocumab and evolocumab presented a better lipid-lowering effect when the baseline LDL-C levels were <100 mg/dL. Alirocumab was associated with a significant reduction in cardiovascular mortality at baseline LDL-C levels of ≥100 mg/dL. This finding can have significant implications for the development of personalized drug therapy.</p><p><strong>The prospero registration: </strong>CRD42023446723, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023446723.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"26980"},"PeriodicalIF":1.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incremental Prognostic Value of Admission Blood Glucose to Albumin Ratio in Patients with Acute Coronary Syndrome: A Retrospective Observational Cohort Study.","authors":"Maoling Jiang, Qiang Chen, Qiao Feng, Xiufen Peng, Juan Liu, Hui He, Hong Su, Dongyue Jia, Lin Tong, Jing Tian, Shiqiang Xiong, Lin Cai","doi":"10.31083/RCM26567","DOIUrl":"https://doi.org/10.31083/RCM26567","url":null,"abstract":"<p><strong>Background: </strong>Blood glucose and serum albumin can be biomarkers at admission since they are easily accessible and demonstrate correlations with cardiovascular diseases. The predictive ability of the admission blood glucose to albumin ratio (AAR) for long-term prognosis in patients with acute coronary syndrome (ACS) and its potential to elevate the predictive value of the Global Registry of Acute Coronary Events (GRACE) risk score in ACS patients post-percutaneous coronary intervention (PCI) remains unknown. Hence, this study aimed to investigate the incremental prognostic value of the AAR in patients with ACS undergoing PCI.</p><p><strong>Methods: </strong>A rigorous development-validation approach was implemented to optimize the GRACE risk score, utilizing the AAR parameter in 1498 patients suffering from ACS after PCI at the Third People's Hospital of Chengdu, Sichuan, China.</p><p><strong>Results: </strong>Over a median of 31.25 (27.53, 35.10) months, the incidence of major adverse cardiac events (MACEs), defined as a composite outcome encompassing all-cause death, cardiac death, nonfatal myocardial infarction, nonfatal stroke, and unplanned repeat revascularization, was higher in individuals with higher AARs. Thus, the AAR was an independent predictor of long-term prognosis in ACS patients undergoing PCI (HR, 1.145; 95% CI: 1.045-1.255; <i>p</i> = 0.004). The integration of the AAR score with the GRACE risk score increased the C statistic from 0.717 (95% CI: 0.694-0.740) to 0.733 (95% CI: 0.690-0.776) (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>The AAR is an independent predictor of prognosis in ACS patients and significantly increased the predictive value of the GRACE risk score.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"26567"},"PeriodicalIF":1.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Dietary Antioxidant Potential with Sarcopenia in Hypertension.","authors":"Yufan Wang, Li Liu, Shandi Yang, Bingquan Xiong, Xumin Xin","doi":"10.31083/RCM27138","DOIUrl":"https://doi.org/10.31083/RCM27138","url":null,"abstract":"<p><strong>Background: </strong>The high prevalence of sarcopenia among hypertensive adults is a global health issue. Growing literature demonstrates that a high antioxidant diet can protect against sarcopenia. However, little attention has been paid to the association between the dietary composite antioxidant intake and sarcopenia in hypertension. To investigate the potential efficacy of the composite dietary antioxidant index (CDAI) on sarcopenia among hypertensive adults.</p><p><strong>Methods: </strong>This study included 6995 hypertensive adults from the National Health and Nutrition Examination Survey (NHANES) 2001-2006 and 2013-2018, with 3212 (45.92%) females and 3783 (54.08%) males. Appendicular lean mass (ALM) and sarcopenia were assessed by dual-energy X-ray absorptiometry (DEXA). All hypertensive adults participating in NHANES were eligible to participate in dietary interviews, and the average intake of six antioxidants over two days was used to calculate the CDAI. Logistic regression was conducted to determine odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses and restricted cubic spline (RCS) regressions were additionally utilized.</p><p><strong>Results: </strong>The mean age was 48.47 ± 0.27 years old, and 1059 (15.14%) were considered to have sarcopenia. The highest quartile had a 61% decreased risk of sarcopenia (OR = 0.39, 95% CI: 0.25, 0.60) compared with the lowest quartile of CDAI. RCS revealed a linear association between CDAI with sarcopenia and ALM. Subgroup analyses demonstrated a more pronounced inverse correlation between CDAI and sarcopenia in females.</p><p><strong>Conclusions: </strong>In summary, our results indicated a reverse correlation between CDAI and sarcopenia in hypertension. These findings highlighted the beneficial role of an antioxidant-rich diet in prevention and provided a valid method for managing sarcopenia in hypertensive adults.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"27138"},"PeriodicalIF":1.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}