Acta Cardiologica Sinica最新文献

{"title":"2025 Update Consensus of ^99mTc-Pyrophosphate Scintigraphy in the Transthyretin Cardiac Amyloidosis from the Taiwan Society of Cardiology and the Society of Nuclear Medicine of the Republic of China.","authors":"Shan-Ying Wang, Yih-Hwen Huang, Yi-Chieh Chen, Cheng-Hsuan Tsai, Chi-Lun Ko, Yen-Hung Lin, Wen-Jone Chen, Wen-Chung Yu, Lien-Hsin Hu, Jing-Uei Hou, Tzu-Pei Su, Ting-Yen Lee, Mei-Fang Cheng, Yen-Wen Wu","doi":"10.6515/ACS.202501_41(1).20241027A","DOIUrl":"https://doi.org/10.6515/ACS.202501_41(1).20241027A","url":null,"abstract":"<p><p>This 2025 updated consensus outlines the diagnostic strategy for transthyretin amyloid cardiomyopathy (ATTR-CM). Given that ATTR-CM is a significant contributor to heart failure, this article emphasizes the importance of making an early and precise diagnosis, particularly as new therapeutic options become available. Highlighting the critical importance of an early and accurate diagnosis, particularly in light of emerging therapeutic modalities, this consensus underscores the central role of ^99mTc-pyrophosphate (PYP) scintigraphy as a non-invasive diagnostic tool. The consensus calls for the adoption of standardized imaging protocols and interpretation criteria to ensure consistency and reliability across diverse clinical settings. The integration of qualitative and quantitative imaging techniques within a structured diagnostic framework places particular focus on the use of single-photon emission computed tomography/computed tomography (SPECT/CT) imaging to enhance diagnostic precision by minimizing blood pool activity and eliminating overlapping interference. Three-hour imaging is considered to be critical for accurate evaluations and to reduce false-positive findings, and it is recommended for its superior diagnostic accuracy. Moreover, quantitative assessments are also considered to be essential for evaluating myocardial amyloid deposition. This updated consensus provides comprehensive guidelines for clinicians, with the aim of optimizing patient outcomes through precise diagnosis and effective management of ATTR-CM. The consensus concludes by advocating for continued research and refinement of imaging methodologies, particularly to enhance the clinical applicability of ^99mTc-PYP scintigraphy and other future developments in nuclear molecular imaging.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 1","pages":"55-71"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942436","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":"How To Perform Comprehensive Transthoracic Echocardiography?","authors":"Kuang-Tso Lee, Chun-Li Wang","doi":"10.6515/ACS.202501_41(1).20241128A","DOIUrl":"https://doi.org/10.6515/ACS.202501_41(1).20241128A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 1","pages":"50-54"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942375","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":"2025 Expert Consensus Recommendations for the Diagnostic Requirements in Routine Practices of Transthoracic Echocardiography.","authors":"Meiling Chen, Wen-Huang Lee, Cheng-Hui Lu, Hao-Chih Chang, Cheng-Chang Tung, Yih-Ying Siow, Hsiang-Chun Lee, Chun-Li Wang, Kuo-Chun Hung, Wei-Chuan Tsai, Wen-Chung Yu, Lung-Chun Lin, Hsin-Yueh Liang","doi":"10.6515/ACS.202501_41(1).20240722C","DOIUrl":"10.6515/ACS.202501_41(1).20240722C","url":null,"abstract":"<p><p>Transthoracic echocardiography plays a crucial role in clinical diagnosis and is increasingly being used around the world. Comprehensive echocardiographic examinations require accurate measurements and the operators to have excellent technical skills. Despite the availability of several published echocardiographic guidelines, the absence of recommended operational manuals in daily practice has resulted in significant variation in the content of echocardiography reports across different medical institutions. This variability has created communication barriers between medical institutions and also hampered the development of a national echocardiography database in Taiwan. Balancing quality and efficiency is a critical concern in echocardiography, and most published guidelines for echocardiography primarily focus on disease categorization. In the current document, we focus on information about the scanning sequence, including scanning techniques, common pitfalls, simple disease interpretation, and the recommended intensity. Based on a growing body of research, we particularly emphasize right-sided imaging and measurement information. We also discuss equipment settings, which have often been overlooked but are essential to obtaining good imaging and accurate measurements. Our recommendations could enhance clinicians' and sonographers' understanding of the core aspects of echocardiography and were developed with consideration of the health-care payment system in Taiwan. Implementing our recommendations may subsequently enable the establishment of a national echocardiography database in Taiwan.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 1","pages":"1-49"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942434","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 the COVID-19 Pandemic on Door-to-Device Time Segments and Clinical Outcomes for STEMI Patients in Northern Taiwan.","authors":"San-Fang Chou, Chun-Yu Hsieh, Kuang-Chau Tsai, Yuan-Hung Liu, Chieh-Min Fan, Jie-Ren Mi Le, Fu-Shan Jaw, Chung-Ta Chang, Shyh-Shyong Sim, Yen-Wen Wu, Ting-Li Tai, Kuan-Chang Chen, Yuan-Hui Wu, Chien-Chieh Hsieh","doi":"10.6515/ACS.202501_41(1).20241021A","DOIUrl":"https://doi.org/10.6515/ACS.202501_41(1).20241021A","url":null,"abstract":"<p><strong>Background: </strong>Prompt primary percutaneous coronary intervention (pPCI) is crucial for the prognosis and reduction of myocardial damage in ST-segment elevation myocardial infarction (STEMI) patients. The Coronavirus Disease 2019 (COVID-19) pandemic had multifaceted impacts on healthcare. This study assessed the effects of the pandemic on pPCI procedures and clinical outcomes in emergency STEMI patients.</p><p><strong>Methods: </strong>This retrospective, single-center study analyzed STEMI patients who underwent pPCI from February 2019 to January 2022. The COVID-19 pandemic was categorized into three periods: pre-COVID-19 (Period-I), early-pandemic (Period-II), and epidemic (Period-III). The impacts on Door-to-Device time, its segments, and clinical outcomes were analyzed using Statistical Package for the Social Sciences.</p><p><strong>Results: </strong>A total of 404 STEMI patients were included, with a reduced number in Period-III. Compared to Period-I, the time intervals of Door-to-electrocardiogram (ECG), ECG-to-Cardiac Catheterization Laboratory Activation (CCLA), and CCLA-to-Cardiac Catheterization Laboratory Door in Period III were extended by 0.62 minutes (p = 0.006), 3.30 minutes (p = 0.009), and 9.65 minutes (p < 0.001), respectively. In contrast, the Angio-to-Device time was shorter in Period- II and III by 2.60 and 4.08 minutes (p < 0.001), respectively. Overall Door-to-Device time increased by 10.06 minutes (p < 0.001) in Period-III but decreased by 3.67 minutes in Period-II (p = 0.017). The odds of achieving a Door-to-Device time ≤ 90 minutes decreased by 70% in Period-III (p = 0.002). Clinical outcomes, including intensive care unit stay, hospital stay, in-hospital mortality, and 30-day readmission rate, remained stable across periods.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic had various effects on different segments of the Door-to-Device procedure, and they were influenced by the complex interplay between infection control measures and clinical workflow. The stability of clinical outcomes reflects the resilience and effective adaptations of the healthcare system during the pandemic.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 1","pages":"121-129"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942377","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":"The Impact of Insulin Resistance on the Development of Post-PCI Contrast-Induced Nephropathy in Non-Diabetic STEMI.","authors":"Aslıhan Mete Yıldırım, Adil Bayramoglu","doi":"10.6515/ACS.202501_41(1).20241018B","DOIUrl":"https://doi.org/10.6515/ACS.202501_41(1).20241018B","url":null,"abstract":"<p><strong>Aims: </strong>Contrast-induced nephropathy (CIN) is a condition characterized by rapidly decreasing renal funciton following by the application of contrast material. Precutaneous coronary intervention (PCI) is a life-saving treatment method that should be applied under emergent conditions. Unfortunately, the incidence of CIN after PCI is common. Patients with insulin resistance or diabetes have a greater risk of developing CIN than most of the population. Therefore, studies on the predictive effects of insulin resistance indicators on CIN are gaining momentum. One of the most popular indicators is triglyceride/glucose-body mass index (TyG-BMI). In this study we aimed to evaluate the effect of TyG-BMI index on CIN.</p><p><strong>Materials and methods: </strong>A total of 960 patinets who underwent emergency PCI due to ST elevation myocardial infarction (STEMI) between 2020 and 2023 were included in the study. Laboratory and demographic parameters were compared between the patients who did and did not develop CIN.</p><p><strong>Results: </strong>While CIN developed in 120 of the 980 patients included in the study, it did not develop in 860 patients. There were significant differences between the groups in terms of age (p < 0.001), gender (p = 0.005), presence of hypertension (p = 0.021), heart rate (p = 0.049), amount of contrast material (p < 0.001), left ventricular ejection fraction (p < 0.001), stent length (p = 0.022), SYNTAX score (p < 0.001), fasting plasma glucose (p < 0.001), baseline creatinine (p < 0.001), glomerular filtration rate (p < 0.001), uric acid (p < 0.001), C reactive protein (CRP) (p < 0.001), baseline creatin kinase myocard band (CKMB) (p = 0.019), CKMB peak (p = 0.030), triglyceride (p = 0.017), and TyG-BMI (p < 0.001). CRP, creatinine, uric asid, amount of contrast material, and TyG-BMI were independent predictors for the development of CIN.</p><p><strong>Conclusions: </strong>TyG-BMI was a predictor of CIN in STEMI patient who underwent PCI under emergency conditions. In addition, the predicitive power of TyG-BMI was stronger than triglyceride-glucose index.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 1","pages":"130-137"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942440","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":"2023 TSOC-TACVPR-TACPAH Consensus Statement of the Rehabilitation on Patients with Pulmonary Hypertension.","authors":"Wei-Chun Huang, Yuan-Yang Cheng, Chih-Hsin Hsu, Yih-Jer Wu, Chin-Chang Cheng, Wan-Jing Ho, Hung-Jui Chuang, Chun-Yuan Chu, Ko-Long Lin, Lin-Yi Wang, Yu-Wei Chiu, Kuan-Cheng Chen, Sheng-Ying Chung, Yi-Jen Chen, Chun-Hsien Wu, Ssu-Yuan Chen, Wei-Shin Liu, Cho-I Lin, Fu-Chun Chiu, Hsin-Shui Chen, Shih-Hsien Sung, Li-Wei Chou, Shu-Hao Wu, Yen-Hung Lin, Chun-Yi Wu, Chiung-Hung Lin, Ming-Chih Lin, Cheng-Chung Hung, Chao Chuan Lei, Chia-Hsin Chen, Mei-Tzu Wang, Willy Chou, Charles Jia-Yin Hou, Wen-Jone Chen","doi":"10.6515/ACS.202411_40(6).20240729A","DOIUrl":"10.6515/ACS.202411_40(6).20240729A","url":null,"abstract":"<p><p>In the past, patients with pulmonary hypertension (PH) were advised to avoid exercise due to concerns that it might strain cardiac function and exacerbate symptoms. However, recent evidence indicates that structured exercise programs can enhance outcomes and improve health-related quality of life for these patients. Consequently, exercise rehabilitation is now recommended in international guidelines as a key component of PH management. This consensus statement, developed by experts from the Taiwan Society of Cardiology Pulmonary Hypertension and Circulation Committee, the Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation, and the Taiwan Association of Caring for pulmonary arterial hypertension, emphasizes the significance of rehabilitation and tailored exercise programs for PH patients. This article aims to raise awareness and promote the adoption of these practices among healthcare professionals treating patients with PH.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"716-728"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708975","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":"Clinical Implication of Ivabradine in Patients with Atrial Fibrillation-Related Tachycardia.","authors":"Naoya Kataoka, Teruhiko Imamura","doi":"10.6515/ACS.202411_40(6).20240909B","DOIUrl":"10.6515/ACS.202411_40(6).20240909B","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"818"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708988","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":"Empagliflozin Ameliorates Atrial and Ventricular Remodeling and Arrhythmogenesis in an Overweight Rabbit Model.","authors":"Wen-Han Cheng, Li-Wei Lo, Yu-Hui Chou, Shin-Huei Liu, Wei-Lun Lin, Shih-Ann Chen","doi":"10.6515/ACS.202411_40(6).20240722B","DOIUrl":"10.6515/ACS.202411_40(6).20240722B","url":null,"abstract":"<p><strong>Background: </strong>Overweight is associated with dysrhythmia and sudden cardiac death, while sodium glucose co-transporter-2 inhibitors (SGLT2-is) have been shown to possess cardioprotective effects in patients with hyperglycemia.</p><p><strong>Objectives: </strong>The aim of this study was to investigate the impact of overweight on cardiac remodeling and the potential effect of SGLT2-is.</p><p><strong>Methods: </strong>Twenty-four rabbits were randomized into 4 groups: controls (Group 1), high-fat diet (HFD) (Group 2), controls treated with empagliflozin (Group 3), and HFD treated with empagliflozin (Group 4). All rabbits underwent electrophysiologic studies and ventricular tachycardia/ventricular fibrillation (VF) inducibility tests (maximal output with shortest 1:1 cycle length pacing). Atrial and ventricular myocardium were harvested for Western blot and Trichrome staining.</p><p><strong>Results: </strong>Among all groups, Group 2 had the longest atrial effective refractory periods (ERPs) in both left and right atria, as well as the longest ventricular ERPs in both left and right ventricles. VF inducibility was highest in Group 2. The degree of fibrosis in both atria and ventricles was most severe in Group 2 and similar to that in Group 4. Enhanced calcium handling protein (CaV 1.2) expressions were noted in Group 2 compared to those in Group 1 and Group 3, respectively, and returned to baseline in Group 4.</p><p><strong>Conclusions: </strong>Overweight causes atrial and ventricular remodeling with prolongation of effective refractoriness, increased vulnerability to VF induction, upregulation of calcium handling proteins, and advanced fibrosis. Empagliflozin attenuates these remodeling effects, leading to decreased cardiac arrhythmogenicity and a reduced risk of sudden cardiac death.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"729-739"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708993","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":"Investigating Serum Cortisol Dynamics and Cardiovascular Impacts Amid University Exam Stress: A Pre-Post Cohort Study.","authors":"Burhan Abdullah Zaman, Suzan Omer Rasool, Saeed Mohammed Sabri, Dunya Muttaleb Dhahir, Esra Abdulrahman Rasheed, Guli Manaf Ahmed, Maryam Akram Hussein, Zaytoun Abdulrahman Tegir","doi":"10.6515/ACS.202411_40(6).20240913A","DOIUrl":"10.6515/ACS.202411_40(6).20240913A","url":null,"abstract":"<p><strong>Objective: </strong>Our objective was to investigate the perceived stress levels among pharmacy students enrolled at the University of Duhok both prior to and following examination periods, with a concurrent assessment of potential cardiovascular effects.</p><p><strong>Methods: </strong>The study included 49 participants from the College of Pharmacy at the University of Duhok and utilized a pre-post cohort design. High-stress pre-examination assessments were scheduled at 8:30 AM on the day of the examination, and low-stress post-examination assessments were also conducted at 8:30 AM over a two-week period without academic examinations.</p><p><strong>Results: </strong>The pre-exam serum cortisol level was significantly higher compared to the post-exam period (16.66 vs. 14.04 μg/dL; p = 0.013). Elevated levels of non-high-density lipoprotein (HDL) cholesterol, and cholesterol/HDL ratio were recorded during high-stress periods. Remarkably, social media emerged as the sole significant predictor (p = 0.038) with a negative impact on serum cortisol levels during the pre-exam phase. Additionally, we observed that females had higher stress levels during both periods, as indicated by the regression model.</p><p><strong>Conclusions: </strong>This investigation revealed a significant elevation in serum cortisol levels during the pre-examination phase, likely attributable to the stress induced by impending examinations.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"781-792"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708999","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":"2024 Guidelines of the Taiwan Society of Cardiology on the Primary Prevention of Atherosclerotic Cardiovascular Disease --- Part II.","authors":"Ting-Hsing Chao, Tsung-Hsien Lin, Cheng-I Cheng, Yen-Wen Wu, Kwo-Chang Ueng, Yih-Jer Wu, Wei-Wen Lin, Hsing-Ban Leu, Hao-Min Cheng, Chin-Chou Huang, Chih-Cheng Wu, Chao-Feng Lin, Wei-Ting Chang, Wen-Han Pan, Pey-Rong Chen, Ke-Hsin Ting, Chun-Hung Su, Chih-Sheng Chu, Kuo-Liong Chien, Hsueh-Wei Yen, Yu-Chen Wang, Ta-Chen Su, Pang-Yen Liu, Hsien-Yuan Chang, Po-Wei Chen, Jyh-Ming Jimmy Juang, Ya-Wen Lu, Po-Lin Lin, Chao-Ping Wang, Yu-Shien Ko, Chern-En Chiang, Charles Jia-Yin Hou, Tzung-Dau Wang, Yen-Hung Lin, Po-Hsun Huang, Wen-Jone Chen","doi":"10.6515/ACS.202411_40(6).20240724B","DOIUrl":"10.6515/ACS.202411_40(6).20240724B","url":null,"abstract":"<p><p>For the primary prevention of atherosclerotic cardiovascular disease (ASCVD), the recommended treatment target for each modifiable risk factor is as follows: reducing body weight by 5-10%; blood pressure < 130/80 mmHg (systolic pressure < 120 mmHg in high-risk individuals); low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL in high-risk individuals, LDL-C < 115 mg/dL in moderate-risk individuals, LDL-C < 130 mg/dL in low-risk individuals, and LDL-C < 160 mg/dL in those with a minimal; complete and persistent abstinence from cigarette smoking; hemoglobin A1C < 7.0%; fulfilling recommended amounts of the six food groups according to the Taiwan food guide; and moderate-intensity physical activity 150 min/wk or vigorous physical activity 75 min/wk. For the primary prevention of ASCVD by pharmacological treatment in individuals with modifiable risk factors/clinical conditions, statins are the first-line therapy for reducing LDL-C levels; some specific anti-diabetic drugs proven to be effective in randomized controlled trials for the primary prevention of ASCVD are recommended in patients with type 2 diabetes mellitus; pharmacological treatment is recommended to assist in weight management for obese patients with a body mass index ≥ 30 kg/m² (or 27 kg/m² who also have at least one ASCVD risk factor or obesity-related comorbidity); an angiotensin-converting enzyme inhibitor, a glucagon-like peptide-1 receptor agonist, a sodium-dependent glucose cotransporter-2 inhibitor, and finerenone can be used in diabetic patients with chronic kidney disease for the primary prevention of ASCVD. Of note, healthcare providers are at full discretion in clinical practice, owing to the diversity of individuals and practice, and the availability of resources and facilities.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 6","pages":"669-715"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708976","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}