Journal of the American Heart Association最新文献

{"title":"Associations Between Metabolic Score for Visceral Fat and Venous Thromboembolism Among 118 619 Participants With Metabolic Syndrome: Insights From Epidemiology to Genetic Susceptibility.","authors":"Lei Liu, Hongxuan Fan, Zhaoyu Ren, Rong Luo, Huihui Ma, Hongqiang Ren, Xiaoping Li","doi":"10.1161/JAHA.125.044744","DOIUrl":"https://doi.org/10.1161/JAHA.125.044744","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome substantially elevates venous thromboembolism (VTE) risk, increasing health care burdens. The Metabolic Score for Visceral Fat (METS-VF) offers a novel, simplified approach to assess visceral fat. This study evaluates METS-VF's association with VTE risk and its utility for risk stratification in patients with metabolic syndrome.</p><p><strong>Methods: </strong>Using UK Biobank data, we included 118 619 participants with metabolic syndrome free of VTE at baseline. Time-dependent area under the curve analysis with bootstrap validation identified the strongest VTE predictor. Multivariable Cox models assessed associations of METS-VF, a VTE-specific polygenic risk score, and their combination with incident VTE. Mediation analysis evaluated potential mediators. Robustness was assessed through subgroup and sensitivity analyses, including competing risk of death.</p><p><strong>Results: </strong>Over a median 12-year follow-up, 5162 participants developed VTE. METS-VF demonstrated stronger association with VTE than traditional metabolic indicators. Highest quartile participants showed significantly increased risks of VTE (hazard ratio [HR], 1.46 [95% CI, 1.33-1.61]), pulmonary embolism (HR, 1.50 [95% CI, 1.33-1.70]), deep vein thrombosis (HR, 1.52 [95% CI, 1.34-1.73]), and lower-extremity deep vein thrombosis (HR, 1.59 [95% CI, 1.38-1.82]). Stratified analysis revealed synergistic interaction between METS-VF and genetic susceptibility. CRP (C-reactive protein) and estimated glomerular filtration rate significantly mediated the METS-VF-VTE association.</p><p><strong>Conclusions: </strong>METS-VF is a significant, independent risk indicator for VTE in patients with metabolic syndrome, demonstrating synergistic effects with genetic risk. The CRP- and estimated glomerular filtration rate-mediated association supports METS-VF's clinical utility in VTE risk stratification.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e044744"},"PeriodicalIF":5.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Reteplase Versus Alteplase in Acute Ischemic Stroke Based on Fibrinogen Levels: The RAISE Trial Subgroup.","authors":"Jiaqing Wang, Dandan He, Hongqiu Gu, Zixiao Li, Yilong Wang, Xingquan Zhao, Yongjun Wang, Shuya Li","doi":"10.1161/JAHA.125.047832","DOIUrl":"https://doi.org/10.1161/JAHA.125.047832","url":null,"abstract":"<p><strong>Background: </strong>The effects of intravenous thrombolytic agents on fibrinogen differ due to structural differences among the agents. Using data from the RAISE (Reteplase Versus Alteplase for Acute Ischemic Stroke) trial, we aimed to investigate the impact of differences in baseline plasma fibrinogen levels on the efficacy and safety of reteplase versus alteplase within 4.5 hours of acute ischemic stroke symptom onset.</p><p><strong>Methods: </strong>This post hoc subgroup analysis of the multicenter RAISE trial categorized participants by baseline fibrinogen levels: low (<2 g/L), normal (2-4 g/L), and high (>4 g/L). The primary efficacy outcome was excellent functional outcome at 90 days (modified Rankin scale score of 0 or 1). The primary safety outcome was symptomatic intracranial hemorrhage within 36 hours.</p><p><strong>Results: </strong>A total of 1373 patients with acute ischemic stroke were included. Ninety-two in the low fibrinogen group (<2 g/L), 1178 in the normal fibrinogen group (2-4 g/L), and 103 in the high fibrinogen group (>4 g/L). Adjusted risk ratios of primary efficacy outcome were 1.13 (95% CI, 0.97-1.32) for the low fibrinogen group, 1.13 (95% CI, 1.04-1.23) for the normal fibrinogen group, and 1.09 (95% CI, 0.84-1.42) for the high fibrinogen group. The primary safety outcome showed no difference between reteplase and alteplase in the 3 fibrinogen subgroups.</p><p><strong>Conclusions: </strong>Among patients with acute ischemic stroke who were treated with either reteplase or alteplase within 4.5 hours after symptom onset, there was no difference observed in the relative efficacy and safety between the 2 groups across the 3 fibrinogen subgroups. However, these findings should be interpreted cautiously and require validation in larger, adequately powered prospective studies. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05295173.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e047832"},"PeriodicalIF":5.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Dependent Association between Heart Failure and Stroke Risk in Atrial Fibrillation: A Nationwide Cohort Study.","authors":"Eero Jalli, Ville Langén, Jussi Jaakkola, K E Juhani Airaksinen, Olli Halminen, Jukka Putaala, Pirjo Mustonen, Jari Haukka, Juha Hartikainen, Miika Linna, Elis Kouki, Mika Lehto, Konsta Teppo","doi":"10.1161/JAHA.125.047961","DOIUrl":"https://doi.org/10.1161/JAHA.125.047961","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a major contributor to ischemic stroke, with risk influenced by age and comorbidities. Age is the strongest risk factor and appears to also modify others, such as vascular disease and female sex. However, data on its impact on additional key risk factors remain limited. We conducted a nationwide retrospective cohort study to examine whether the association between heart failure (HF) and ischemic stroke in patients with AF is age dependent.</p><p><strong>Methods: </strong>The FinACAF (Finnish Anticoagulation in Atrial Fibrillation) study includes all patients with AF in Finland from 2007 to 2018. Data were collected from healthcare registries encompassing all levels of care. Incidence rate ratios for stroke were calculated comparing patients with HF to those without HF across the entire age spectrum.</p><p><strong>Results: </strong>We identified 229 565 patients with new-onset AF. The prevalence of HF was higher among older patients compared with younger patients (38.7% versus 4.3%, respectively). The association between HF and ischemic stroke was highest among younger patients (incidence rate ratio, ≥2.0 for those aged <60 years) and gradually diminished with advancing age, approaching an incidence rate ratio of ≈1.0 in the oldest group (<i>P</i><0.001, for interaction between age and incidence rate ratio). The adjusted absolute rate difference between patients with and without HF remained stable, at ≈1 event per 100 patient-years, across all age categories.</p><p><strong>Conclusions: </strong>HF was more strongly associated with ischemic stroke in younger patients than in older individuals with AF, highlighting the importance of considering HF in the decision making about oral anticoagulation, particularly in younger patients.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e047961"},"PeriodicalIF":5.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Adherence Trajectories to Statins and Antithrombotic Therapy After Ischemic Stroke and Their Impact on Low-Density Lipoprotein Control and Cardiovascular Outcomes.","authors":"Shih-Wei Wang, Hung-Sheng Lin, Che-Wei Hsu, Chung-Yu Chen, Hiroshi Saito, Fu-Shih Chen","doi":"10.1161/JAHA.125.048456","DOIUrl":"https://doi.org/10.1161/JAHA.125.048456","url":null,"abstract":"<p><strong>Background: </strong>Adherence to secondary prevention therapies after ischemic stroke or transient ischemic attack is often suboptimal, and the clinical implications of adherence patterns remain unclear. This study identified adherence trajectories to statins and antithrombotic agents and evaluated their associations with lipid control and cardiovascular outcomes.</p><p><strong>Methods: </strong>Using the Chang Gung Research Database linked to Taiwan's population claims data, we identified patients with first-ever acute ischemic stroke/transient ischemic attack between 2012 and 2018 who survived ≥1 year and initiated secondary prevention. Monthly adherence was measured by proportion of days covered and classified using group-based multitrajectory modeling. The primary outcome was a composite of recurrent ischemic stroke, systemic embolism, and myocardial infarction; secondary outcomes included individual components and all-cause death.</p><p><strong>Results: </strong>Among 13 299 eligible patients (mean age, 65.6 years; 60.3% men), 4 adherence trajectories were identified: dual high adherence (46.7%), antithrombotic-only adherence (35.1%), early dual discontinuation (12.2%), and gradual dual decline (6.0%). Dual high adherence achieved the greatest low-density lipoprotein cholesterol reduction (-24.3%) and lowest mortality rate. Early dual discontinuation was associated with higher risks of the composite outcome (adjusted hazard ratio [aHR], 1.57 [95% CI, 1.31-1.88], recurrent ischemic stroke/systemic embolism (aHR, 1.60 [95% CI, 1.31-1.95]), myocardial infarction (aHR, 1.48 [95% CI, 1.02-2.14]), and all-cause death (aHR, 1.56 [95% CI, 1.36-1.79]). Poor adherence had greater adverse impact among patients with baseline low-density lipoprotein cholesterol ≥100 mg/dL, younger adults, and men.</p><p><strong>Conclusions: </strong>Adherence trajectories were strongly associated with low-density lipoprotein cholesterol and major cardiovascular outcomes. Sustained dual adherence conferred substantial protection, whereas early discontinuation markedly increased recurrent ischemic and mortality risks.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e048456"},"PeriodicalIF":5.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive, Echocardiography-Guided Mouse Model of Degenerative Mitral Regurgitation Recapitulates Cardiac Remodeling and Arrhythmogenesis.","authors":"Wei-Ting Chang, Nan-Chun Wu, Chin-Yu Chen, Zhih-Cherng Chen, Wei-Jan Chen, Jhih-Yuan Shih","doi":"10.1161/JAHA.125.047092","DOIUrl":"https://doi.org/10.1161/JAHA.125.047092","url":null,"abstract":"<p><strong>Background: </strong>Degenerative mitral regurgitation (MR) is a progressive valvular disorder that causes atrial enlargement, cardiac remodeling, heart failure, and arrhythmias. Current rodent models are limited by thoracotomy or intubation, which increase procedural risk and reduce reproducibility.</p><p><strong>Methods and results: </strong>We established a minimally invasive, transthoracic echocardiography-guided mouse model of MR by puncturing the anterior mitral leaflet with a 27G needle introduced through the left ventricular apex. Ten-week-old C57BL/6J mice underwent baseline imaging before MR induction, and sham controls received apical puncture without leaflet disruption. Color Doppler confirmed regurgitant jets and increased vena contracta width, with procedural survival exceeding 90%. At 2 weeks, MR mice exhibited significant left heart enlargement, reduced fractional shortening, and myocardial fibrosis compared with sham. Pressure-volume loop analysis demonstrated increased end-diastolic volume and reduced compliance. RNA sequencing of left atrial tissues revealed enrichment of calcium signaling, apoptosis, and shear stress pathways. Histology confirmed increased cardiomyocyte apoptosis, accompanied by Connexin-43 downregulation and elevated ryanodine receptor 2 phosphorylation. Programmed atrial pacing induced atrial fibrillation in MR mice, consistent with enhanced arrhythmogenicity and calcium-handling abnormalities.</p><p><strong>Conclusions: </strong>This closed-chest, echo-guided murine model reliably induces MR, avoids thoracotomy, and recapitulates key features of human disease, including chamber dilation, fibrosis, and arrhythmia susceptibility. It provides a scalable platform for mechanistic studies, genetic interventions, and drug testing in valvular heart disease.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e047092"},"PeriodicalIF":5.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vericiguat Attenuates Vascular Calcification by Cyclic Guanosine Monophosphate-Protein Kinase G Pathway Mediated Suppression of Matrix Metalloproteinase 10.","authors":"Qing-Yun Hao, Yu-Hong Zeng, Zi-Bin Zhan, Xue-Wen Liu, Jing-Bin Guo, Kun-Hao Bai, Jun Weng, Jing-Wei Gao, Ze-Hua Li","doi":"10.1161/JAHA.125.046542","DOIUrl":"https://doi.org/10.1161/JAHA.125.046542","url":null,"abstract":"<p><strong>Background: </strong>Vascular calcification (VC), a pathological process driven by the osteogenic transdifferentiation of vascular smooth muscle cells (VSMCs), markedly increases cardiovascular mortality. Vericiguat, a soluble guanylate cyclase stimulator, has shown vascular protective properties, but its role in modulating VC remains poorly investigated.</p><p><strong>Methods: </strong>VC models were generated using the nephrectomy method or an adenine diet. Calcification in rat VSMCs and aortic rings was induced by high phosphate. VC was evaluated by Alizarin Red staining, calcium quantification, alkaline phosphatase activity, and imaging. Transcriptomic profiling and viral vector approaches were used to investigate the role of MMP-10 (matrix metalloproteinase 10) in vericiguat-regulated VC.</p><p><strong>Results: </strong>Vericiguat treatment significantly reduced aortic calcification and osteogenic markers of VSMCs both in nephrectomy-induced rats and adenine-induced mice. It also inhibited calcium deposition and the phenotypic switch of VSMCs from a contractile to an osteoblastic state in both aortic ring and VSMC cultures. Transcriptomic profiling identified MMP-10 as a key mediator; MMP-10 was upregulated in VC models, and vericiguat reduced its expression. Overexpression of MMP-10 reversed the protective effects of vericiguat, and lentiviral-mediated MMP-10 knockdown confirmed its procalcific role. Mechanistically, vericiguat increased cGMP-PKG (cyclic guanosine monophosphate-protein kinase G) signaling, including phosphorylated vasodilator-stimulated phosphoprotein and phosphorylated c-Jun (transcription factor Jun), ultimately downregulating MMP-10.</p><p><strong>Conclusions: </strong>Vericiguat inhibits VSMC osteogenic differentiation and attenuates VC by modulating the cGMP-PKG-MMP-10 axis. These findings support vericiguat as a potential therapeutic candidate for VC.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e046542"},"PeriodicalIF":5.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an Intervention to Improve Guideline-Directed Medications for Patients With Acute Heart Failure: A Randomized Clinical Trial.","authors":"Jung-Woo Son, Dong-Hyuk Cho, Se-Eun Kim, Jimi Choi, Dong-Ju Choi, Hyun-Jai Cho, Chan Joo Lee, Jin Oh Choi, Sang Eun Lee, Eung Ju Kim, Wook-Jin Chung, Jong-Chan Youn, Dae-Hwan Bae, Jae-Hyeong Park, Kye Hun Kim, In-Cheol Kim, Jung-Hyun Choi, Sunki Lee, Hokon Kim, Byung-Su Yoo","doi":"10.1161/JAHA.125.044747","DOIUrl":"https://doi.org/10.1161/JAHA.125.044747","url":null,"abstract":"<p><strong>Background: </strong>Guideline-directed medical therapy during the transitional period is crucial for improving outcomes in heart failure with reduced ejection fraction. We investigated whether a simplified transitional care intervention could increase guideline-directed medical therapy adherence in patients with acute heart failure (HF).</p><p><strong>Methods: </strong>This multicenter, open-label randomized trial enrolled 982 patients with acute HF. The transitional care intervention included a discharge checklist, HF education, and telephone monitoring. The primary outcome was achievement of high guideline adherence indicator, defined as the prescription of all 3 guideline-directed medical therapy drugs (renin-angiotensin system blockades, beta blockers, and mineralocorticoid receptor antagonists) at 6 months. Both modified intention-to-treat and per-intervention analyses were conducted to evaluate the effectiveness of intervention components.</p><p><strong>Results: </strong>Among 982 participants (mean age, 62.4±15.5 years; 64.5% male), there was no statistical difference in the proportion achieving a high guideline adherence indicator between the intervention and control groups (49.6% versus 44.6%; OR, 1.12; 95% CI, 0.86-1.45; <i>P</i>=0.37). No significant differences were observed in the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score or clinical outcomes. In the per-intervention analysis, patients who received all components showed significantly higher guideline adherence indicator achievement compared with those who received no components (adjusted odds ratio [OR], 1.56 [95% CI, 1.07-2.27], <i>P</i>=0.02).</p><p><strong>Conclusions: </strong>In this randomized trial of patients with acute HF, although the simplified transitional care intervention did not increase high guideline adherence indicator achievement, implementation of all intervention components was associated with improved guideline adherence. Our findings emphasize that implementation fidelity is the key challenge in optimizing transitional care for HF management.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04900584.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e044747"},"PeriodicalIF":5.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Brain Morphology and Cognitive Function With Ambulatory Estimated Pulse Wave Velocity.","authors":"Yi-Bang Cheng, Qian-Hui Guo, Yi Chen, Jin Zhang, Yuan-Yuan Kang, Ting-Yan Xu, Yan Li, Ji-Guang Wang","doi":"10.1161/JAHA.125.049028","DOIUrl":"https://doi.org/10.1161/JAHA.125.049028","url":null,"abstract":"<p><strong>Background: </strong>Inconsistent links between arterial stiffness and cognition may reflect limited cognitive tests and unaccounted diurnal pulse wave velocity variation. To bridge this knowledge gap, we investigated 24-hour ambulatory estimated pulse wave velocity (ePWV) and its association with dementia-related neuroimaging and cognitive function in hypertension.</p><p><strong>Methods: </strong>We assessed 893 patients with hypertension aged ≥50 years (mean age, 67.2 years; 52.3% women), including brain magnetic resonance imaging (n=545), global cognitive testing (n=623), and ambulatory ePWV measurements. White matter hyperintensity and hippocampus were quantified via Computational Anatomy Toolbox 12 and Statistical Parametric Maps 12. Cognition was assessed via the Mini-Mental State Examination and Montreal Cognitive Assessment.</p><p><strong>Results: </strong>Among 623 tested participants, the prevalence of mild cognitive impairment was 10% (Mini-Mental State Examination, n=62) and 18.5% (Montreal Cognitive Assessment, n=115). Cognitive scores decline with higher white matter hyperintensity burden and lower hippocampal volume (<i>P</i>≤0.024). Higher 24-hour ePWV quartiles showed graded associations with higher white matter hyperintensity volume and lower hippocampal volume (both <i>P</i><0.001) and lower cognitive scores (<i>P</i>≤0.037). Multivariable models showed each 1-SD (+1.2 m/s) increment in 24-hour ePWV were associated with 2.00±1.74 mL greater white matter hyperintensity volume (<i>P</i>=0.004), and 0.54±0.14 mL smaller hippocampal volume (<i>P</i><0.001), independent of age, systolic blood pressure, and other confounders. These associations persisted after further adjustment for carotid-femoral PWV, which itself showed no independent association (<i>P</i>≥0.18). Results were consistent for daytime and nighttime ePWV and across key subgroups.</p><p><strong>Conclusions: </strong>Ambulatory ePWV is an independent risk factor for dementia-related brain pathology. Targeting arterial stiffness represents a promising strategy for dementia prevention.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e049028"},"PeriodicalIF":5.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Funders' Expectations for Open Science in Cardiovascular Research: A Scoping Review of the Largest Cardiovascular Research Funders.","authors":"Anna Catharina Vieira Armond, Al Mamoune Alaoui, David Moher, Jean Rouleau, Kelly D Cobey","doi":"10.1161/JAHA.125.048584","DOIUrl":"https://doi.org/10.1161/JAHA.125.048584","url":null,"abstract":"<p><p>Open science practices, including data sharing, open access, and prospective study registration, have been increasingly recognized to improve transparency, reproducibility, and accessibility in research, yet their uptake and implementation by cardiovascular research funders is unclear. We conducted a scoping review of publicly available policies, guidance, and grant instructions from 12 members of the Global Cardiovascular Research Funders Forum to assess expectations, monitoring, and support for open science in cardiovascular research. We included 105 documents from 9 funders; no relevant documents were identified for 3 funders. Data sharing (67%) and open access (58%) were the most common mandates by funders, followed by prospective registration (50%) and patient and public involvement (50%). Requirements for other practices, including code sharing, use of reporting guidelines, preprints, and open peer review, were uncommon. Monitoring compliance was inconsistent, with many funders not specifying any mechanisms, even for widely required practices. Where available, support was most often provided through financial assistance, guidance, or infrastructure, particularly for open access, data sharing, and patient and public involvement. These findings suggest that while cardiovascular funders are engaging with open science, policies remain uneven in scope, monitoring, and support. Coordinated efforts to strengthen and harmonize open science expectations, particularly around compliance monitoring and researcher training, will be essential to realizing the full potential of open science in cardiovascular research.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e048584"},"PeriodicalIF":5.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Prediction of Peripheral Artery Disease Using Plasma Proteomics Among Individuals Without Diabetes.","authors":"Meng-Yuan Miao, Jie-Qiong Lyu, Fei Fang, Zhong-Yue Liu, Miao Xu, Hong-Jun Zhang, Xing-Qiang Pan, Li-Qiang Qin, Hai-Peng Wang, Guo-Chong Chen","doi":"10.1161/JAHA.125.047797","DOIUrl":"https://doi.org/10.1161/JAHA.125.047797","url":null,"abstract":"<p><strong>Background: </strong>Although peripheral artery disease (PAD) is an important diabetes complication, a substantial proportion of cases occur among individuals without diabetes. This study aimed to assess the predictive value of plasma proteomics in the long-term risk of PAD among individuals initially free of diabetes.</p><p><strong>Methods: </strong>Included were 46 508 participants (6046 with prediabetes) without diabetes or major cardiovascular disease at recruitment of the UK Biobank. Using multivariable Cox regression models, a total of 2923 unique plasma proteins were assessed for the associations with incident PAD. Significant proteins were subsequently processed by a trained light gradient boosting machine classifier to determine important proteins. Using receiver operating characteristic analyses, the performance of these important proteins in predicting incident PAD were evaluated, in the whole sample and by glycemic status (normoglycemia and prediabetes).</p><p><strong>Results: </strong>During a median follow-up of 12.7 years, 461 participants developed PAD. There were 107 proteins associated with incident PAD, with 103 positive associations. The LGBM approach identified 9 proteins (eg, WFDC2 [WAP 4-disulfide core domain protein 2], MMP12 [macrophage metalloelastase], and GDF15 [growth differentiation factor 15]) as the top-ranked proteins based on their importance ordering. Whereas glycated hemoglobin showed very modest predictive accuracy, a panel incorporating these top proteins showed good performance in the prediction of PAD risk (area under the curve 0.820), and it significantly enhanced the prediction beyond traditional risk factors (raising area under the curve from 0.803 to 0.837, DeLong test <i>P</i>=5.21×10^-3). These observations were consistent for participants with normoglycemia or prediabetes.</p><p><strong>Conclusions: </strong>Plasma protein biomarkers enhance the prediction of long-term risk for PAD among individuals without diabetes, regardless of glycemic status.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e047797"},"PeriodicalIF":5.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}