American heart journal plus : cardiology research and practice最新文献

{"title":"Sudden cardiac death in stable coronary artery disease: A literature review","authors":"Randa Tabbah ,&nbsp;Walid Saliba ,&nbsp;Bernard Abi-Saleh","doi":"10.1016/j.ahjo.2025.100674","DOIUrl":"10.1016/j.ahjo.2025.100674","url":null,"abstract":"<div><div>Sudden cardiac death (SCD) remains a leading cause of mortality in patients with stable coronary artery disease (CAD), despite advances in diagnosis, risk stratification, and therapy. This review synthesises current evidence on epidemiology, pathophysiology, clinical predictors, and preventive strategies for SCD in chronic coronary syndromes. Historical perspectives, including early autopsy observations, highlight the longstanding recognition of SCD as a complication of CAD. Contemporary data reveal that SCD often represents the first clinical manifestation of coronary heart disease, with a substantial proportion of cases occurring in individuals classified as low risk. Mechanistically, SCD is frequently triggered by acute ischemia or arrhythmogenic substrates in the context of structural and electrical remodeling. Key predictors include left ventricular dysfunction, ventricular arrhythmias, and specific electrocardiographic markers, though their predictive value in stable CAD remains limited. Preventive strategies range from optimal medical therapy and lifestyle interventions to device-based approaches, such as implantable cardioverter-defibrillators, in selected high-risk subgroups. Despite these measures, risk stratification tools lack sufficient sensitivity and specificity to guide widespread prophylactic interventions. Future research should focus on refining predictive models by integrating clinical, imaging, and biomarker data to enable more targeted prevention of SCD in stable CAD populations.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100674"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxidized low-density lipoprotein cholesterol and plaque vulnerability","authors":"Jun Goto ,&nbsp;Daisuke Kinoshita ,&nbsp;Yoichiro Otaki ,&nbsp;Seisei Ra ,&nbsp;Hiroe Ono ,&nbsp;Takafumi Mito ,&nbsp;Taku Shikama ,&nbsp;Shingo Tachibana ,&nbsp;Shigehiko Kato ,&nbsp;Tetsu Watanabe ,&nbsp;Ik-Kyung Jang ,&nbsp;Masafumi Watanabe","doi":"10.1016/j.ahjo.2025.100691","DOIUrl":"10.1016/j.ahjo.2025.100691","url":null,"abstract":"<div><h3>Background</h3><div>The oxidation of low-density lipoprotein cholesterol (LDL-C) plays a critical role in plaque inflammation and the subsequent high-risk plaque formation. However, the relationship between LDL-C oxidation and plaque morphology in patients with diabetes mellitus (DM) has not been systematically studied. The study aimed to investigate the association between LDL-C oxidation and plaque morphology assessed using optical coherence tomography (OCT).</div></div><div><h3>Methods</h3><div>A total of 138 patients with chronic coronary syndrome who underwent OCT were analyzed. Malondialdehyde-modified LDL-C (MDA-LDL), a representative form of oxidized LDL-C, was measured. Levels of LDL-C oxidation were assessed using the ratio of MDA-LDL to LDL-C ratio. Plaque morphology was assessed by OCT at the target lesions.</div></div><div><h3>Results</h3><div>Patients were divided into three groups according to the tertiles of LDL-C oxidation levels. Lipid index and macrophage grade were significantly higher in patients with higher levels of LDL-C oxidation in patients with DM (low vs. moderate vs. high; lipid index: 714 vs. 1226 vs. 2217, <em>p</em> for trend = 0.040; macrophage grade: 2 vs. 7 vs. 13, <em>p</em> for trend = 0.009). In contrast, no association was found in patients without DM (low vs. moderate vs. high; lipid index: 1109 vs. 1181 vs. 1436, <em>p</em> for trend = 0.633; macrophage grade: 8 vs. 5 vs. 8, <em>p</em> for trend = 0.748). Those associations remained significant even after adjusting for confounders in patients with DM but not in those without.</div></div><div><h3>Conclusions</h3><div>The levels of LDL-C oxidation were associated with plaque vulnerability, especially in patients with DM.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100691"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BUN-albumin ratio as a prognostic marker in decompensated heart failure with reduced ejection fraction","authors":"Bahy Abofrekha ,&nbsp;Mahmoud Shadi ,&nbsp;Jennifer Jdaidani ,&nbsp;Alaukika Agarwal ,&nbsp;Elie Bou Sanayeh ,&nbsp;Ahmad Zayed ,&nbsp;Hadi Itani ,&nbsp;Lee Un Jung ,&nbsp;Suzanne El-Sayegh ,&nbsp;Geurys R. Rojas-Marte","doi":"10.1016/j.ahjo.2025.100683","DOIUrl":"10.1016/j.ahjo.2025.100683","url":null,"abstract":"<div><h3>Background</h3><div>Decompensated heart failure with reduced ejection fraction (D-HFrEF) is a prevalent cause of hospitalization and mortality. Early risk stratification is crucial for targeted interventions. The blood urea nitrogen to serum albumin ratio (BAR) has shown prognostic value in critical illness, but its role in D-HFrEF is understudied.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the association of BAR calculated within 24 h of admission with length of hospital stay (LOS), in-hospital mortality, and 30-day readmissions in patients hospitalized with D-HFrEF and identify an optimal cut-off value for each outcome.</div></div><div><h3>Methods and results</h3><div>This was a multicenter retrospective cohort analysis of 2286 patients hospitalized in 2022 with D-HFrEF. The population's median age was 72.00 years, with 59.8 % being male. In the fully adjusted model, each one-unit increase in baseline BAR was associated with a 2.85 % increase in the length of hospital stay in days (IRR: 1.027, 95 % CI: 1.021–1.033, <em>p</em> &lt; 0.001) and significantly higher odds of in-hospital mortality (OR: 1.107, 95 % CI: 1.076–1.139, <em>p</em> &lt; 0.001) and prolonged LOS (≥30 days) (OR: 1.065, 95 % CI: 1.034–1.097, p &lt; 0.001). BAR was not significantly associated with 30-day readmission (<em>p</em> = 0.06). Receiver operating characteristic analysis identified optimal BAR cut-off points of 6.82 for mortality.</div></div><div><h3>Conclusions</h3><div>Our data show that an elevated BAR on admission is associated with increased in-hospital mortality and LOS &gt; 30 days in patients hospitalized for D-HFrEF. This readily available marker can aid in identifying patients at higher risk for adverse events. Prospective studies are needed to validate our findings.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100683"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pre-procedural requirements on time to aortic valve replacement: Transcatheter AVR vs surgical AVR","authors":"Curtiss Stinis ,&nbsp;Sean Tunis ,&nbsp;Sandra Lauck ,&nbsp;Aakriti Gupta ,&nbsp;Shannon Murphy ,&nbsp;Soumya Chikermane ,&nbsp;Seth Clancy ,&nbsp;Mark Russo","doi":"10.1016/j.ahjo.2025.100698","DOIUrl":"10.1016/j.ahjo.2025.100698","url":null,"abstract":"<div><h3>Background/objective</h3><div>This study aims to understand the extent that cardiac specialist visits and imaging requirements contribute to the difference in time to Aortic valve replacement (AVR) stratified by approach transcatheter AVR (TAVR) and surgical AVR (SAVR).</div></div><div><h3>Methods</h3><div>Optum Market Clarity Data was used to identify patients with clinically significant AS (CSAS) who received an AVR between 2016 and 2023 and whose AVR occurred within two years of their CSAS diagnosis. Patient characteristics were measured at baseline; pre-procedural factors, including the number of cardiac specialist visits and imaging events, were measured from CSAS diagnosis to AVR (TAVR vs SAVR). Stepwise generalized linear models were used to assess whether the number of cardiac specialist visits and imaging events contribute to the differences in time to TAVR and SAVR, after adjusting for baseline characteristics.</div></div><div><h3>Results</h3><div>Of the 14,225 patients in the cohort, 42 % received a TAVR. Compared to the SAVR cohort, the TAVR cohort was, on average, more male, older, sicker, and had more Medicare enrollees. TAVR patients had approximately two times more cardiac specialist visits (3.73 vs 6.37) and imaging events (1.18 vs 2.07) than SAVR patients. Time to TAVR is 65 days longer (RR = 1.77, 1.67–1.87) than SAVR, after adjustment for patient characteristics. This difference reduces to 11 days (RR = 1.12, 1.07–1.17) after accounting cardiac specialist encounters and imaging events.</div></div><div><h3>Discussion</h3><div>Pre-procedural encounters significantly contribute to the longer time to AVR for TAVR patients. Findings suggest a need for streamlining the pre-procedural process for TAVR to enhance timely care delivery for CSAS patients.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100698"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac troponin T elevation predicts mortality in hospitalized COVID-19 patients","authors":"Katelyn A. Bruno ,&nbsp;R. Scott Wright ,&nbsp;Joshua Culberson ,&nbsp;Mikolaj A. Wieczorek ,&nbsp;David O. Hodge ,&nbsp;Patrick W. Johnson ,&nbsp;Yomary A. Jimenez ,&nbsp;Emily R. Whelan ,&nbsp;Jose M. Malavet ,&nbsp;Kathryn F. Larson ,&nbsp;Jonathon W. Senefeld ,&nbsp;Chad C. Wiggins ,&nbsp;Stephen A. Klassen ,&nbsp;Jacob Ricci ,&nbsp;Taimur Sher ,&nbsp;Rickey E. Carter ,&nbsp;Michael J. Joyner ,&nbsp;DeLisa Fairweather ,&nbsp;Allan S. Jaffe","doi":"10.1016/j.ahjo.2025.100690","DOIUrl":"10.1016/j.ahjo.2025.100690","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate if cardiac troponin values predict poor outcomes in COVID-19 patients across the range of patients of different sex and age.</div></div><div><h3>Methods</h3><div>We examined high-sensitivity cardiac troponin T (hs-cTnT) levels in 1050 severely ill hospitalized COVID-19 patients who had hs-cTnT data available and participated in the Expanded Access Program for convalescent plasma study during the first wave (April–August 2020) of the COVID-19 pandemic.</div></div><div><h3>Results</h3><div>We observed a continuous relationship between hs-cTnT levels and mortality in hospitalized males and females with COVID-19. This finding was present regardless of sex or age.</div></div><div><h3>Conclusion</h3><div>These data indicate the prognostic ability of hs-cTnT to predict mortality in hospitalized COVID-19 patients across all relevant patient groups.</div><div>Clinical Trials registration number: <span><span>NCT04338360</span><svg><path></path></svg></span></div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100690"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality trends in heart failure and colon cancer: Insights into gender, ethnic, and regional disparities in the United States (1999–2020)","authors":"Hafsah Alim Ur Rahman ,&nbsp;Nimrah Iqbal ,&nbsp;Muhammad Ahmed Ali Fahim ,&nbsp;Fayza Salman ,&nbsp;Syed Hassan Ahmed ,&nbsp;Omama Asim ,&nbsp;Taha Mansoor ,&nbsp;Muhammad Zain Farooq ,&nbsp;Muhammad Sohaib Asghar","doi":"10.1016/j.ahjo.2025.100699","DOIUrl":"10.1016/j.ahjo.2025.100699","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) and colorectal cancer (CRC) are major public health concerns among the aging population in the United States. This study aimed to investigate temporal, regional, urbanization and racial trends in mortality among adults with HF and CRC aged ≥65 years.</div></div><div><h3>Methods</h3><div>Mortality data were sourced from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, utilizing ICD-10 codes to identify deaths related to colon cancer and heart failure from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated, along with Annual Percentage Changes (APCs) and their respective 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>The AAMRs remained relatively stable between 1999 (8.5) and 2004 (7.3) (APC: −2.61; 95 % CI: −3.86, 0.09). From 2004 to 2009, a significant decline to 5.0 was observed (APC: −7.08; 95 % CI: −9.28, −3.58). Subsequently, the rates stabilized by 2015 (3.8) (APC: −4.84; 95 % CI: −6.58 to 2.04) but demonstrated a modest increase to 4.4 by 2020 (APC: 2.55; 95 % CI: 0.08 to 8.19). Mortality rates were consistently higher among males (6.7 vs. 4.5 for females) and varied across racial/ethnic groups, with Non-Hispanic (NH) Whites (5.7) and NH Black/African Americans (5.4) exhibiting the highest rates, while Hispanics (2.8) and NH Asians/Pacific Islanders (2.3) had the lowest. Regional disparities showed that the Midwest had the highest AAMRs (6.5) followed by the Northeast (5.4), West (5.2), and South (4.8). Additionally, non-metropolitan areas exhibited significantly higher rates than metropolitan areas (7.1 vs. 5.0, respectively). The states in the 90th percentile for AAMRs were West Virginia, Mississippi, South Dakota, Nebraska, and North Dakota.</div></div><div><h3>Conclusion</h3><div>Although there was an overall decline in mortality rates during the study period, disparities remained evident, with higher mortality observed among males, non-Hispanic Whites, residents of the Midwest, and individuals in non-metropolitan areas. This highlights the need for targeted public health intervention.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100699"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of baseline anemia on outcomes following chronic total occlusion percutaneous coronary intervention","authors":"Chloe Kharsa ,&nbsp;Gal Sella ,&nbsp;Yasser Sammour ,&nbsp;Rody G. Bou Chaaya ,&nbsp;Mangesh Kritya ,&nbsp;Jerrin Philip ,&nbsp;Muhammad Hassan Masood Virk ,&nbsp;Muhammad Haisum Maqsood ,&nbsp;Neal S. Kleiman ,&nbsp;Alpesh R. Shah","doi":"10.1016/j.ahjo.2025.100708","DOIUrl":"10.1016/j.ahjo.2025.100708","url":null,"abstract":"<div><h3>Background</h3><div>Anemia is a common comorbidity in patients undergoing percutaneous coronary intervention (PCI) and may signal worse post-procedural outcomes. Its prognostic impact in the context of chronic total occlusion (CTO) PCI remains underexplored.</div></div><div><h3>Objectives</h3><div>To evaluate procedural and clinical outcomes following CTO PCI in patients with and without anemia using real-world data from a high-volume tertiary care center.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study using data from 504 patients who underwent CTO PCI between January 2018 and December 2023 at Houston Methodist. Patients were stratified by anemia status, defined using World Health Organization hemoglobin thresholds. Primary endpoints included procedural success, one-year all-cause mortality, and target lesion revascularization (TLR). Secondary endpoints included target lesion failure (TLF) and in-hospital complications.</div></div><div><h3>Results</h3><div>Of the cohort, 163 patients (32.3 %) had anemia. Patients with anemia were older, more often female, and had a greater burden of comorbidities, including CKD and heart failure. Despite similar lesion complexity and procedural success rates (80.4 % vs. 81.5 %; <em>p</em> = 0.79), patients with anemia had higher rates of in-hospital complications and one-year mortality (18.1 % vs. 5.0 %; HR = 4.0, <em>p</em> &lt; 0.001)one-year target lesion failure (HR = 1.9; 95 % CI [1.2–2.9]; <em>p</em> = 0.005). Multivariate analysis identified age, heart failure, anemia and multivessel PCI as independent predictors of mortality at one-year, while CKD, and ISR lesion were predictors of TLF at one-year. The severity of anemia was not independently associated with all-cause mortality.</div></div><div><h3>Conclusion</h3><div>Pre-procedural anemia is associated with markedly worse in-hospital and long-term outcomes in patients undergoing CTO PCI, despite comparable technical success. These findings highlight anemia as a marker of systemic vulnerability and underscore the need for comprehensive risk stratification and multidisciplinary care in this high-risk population.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100708"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of Id genes on pulmonary hypertension development in left heart failure","authors":"Christelle Lteif ,&nbsp;Paula Wachs ,&nbsp;Ravindra K. Sharma ,&nbsp;Julio D. Duarte","doi":"10.1016/j.ahjo.2025.100692","DOIUrl":"10.1016/j.ahjo.2025.100692","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the role of <em>Id</em> genes in the development of pulmonary hypertension (PH) in heart failure (HF) and evaluate genetic variants of the <em>ID</em> genes associated with HF-PH.</div></div><div><h3>Design</h3><div>Experimental study using an AKR/J mouse model of HF-PH and a genetic association study using the UK Biobank cohort.</div></div><div><h3>Setting</h3><div>Laboratory animal study and population-based cohort study.</div></div><div><h3>Participants</h3><div>AKR/J mice with HF-PH and participants with HF from the UK Biobank cohort.</div></div><div><h3>Interventions</h3><div>Administration of tacrolimus (Id signaling inducer) in the mouse model.</div></div><div><h3>Main outcome measures</h3><div>Tissue-specific gene expression of <em>Id1</em>, <em>Id2</em>, and <em>Id3</em> in HF-PH mice; severity of HF-PH after tacrolimus treatment; associations of single nucleotide polymorphisms of <em>ID1</em>, <em>ID2</em>, and <em>ID3</em> with PH development and mortality in participants with HF.</div></div><div><h3>Results</h3><div><em>Id1</em> was upregulated in the left ventricle (Fold Change (FC) = 1.65; <em>P</em> = 3.0 × 10⁻⁴) of HF-PH mice. In adipose tissue, <em>Id1</em> and <em>Id3</em> were downregulated (FC = 0.33; <em>P</em> = 5.2 × 10⁻³ and FC = 0.50; <em>P</em> = 0.01, respectively), while <em>Id2</em> was upregulated (FC = 1.78; <em>P</em> = 7 × 10⁻⁴). Tacrolimus worsened PH and diastolic dysfunction, upregulating only <em>Id2</em> in adipose tissue. In the clinical cohort, rs7425561 and rs10174593 (expression quantitative loci for <em>ID2</em>) trended toward reduced risk of PH in HF and all-cause mortality in participants with HF-PH.</div></div><div><h3>Conclusion</h3><div>The results suggest <em>ID1</em>, <em>ID2</em>, and <em>ID3</em> are involved in HF-PH pathogenesis, but more research is needed to characterize their exact role.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100692"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ‘obesity paradox’ in patients undergoing transcatheter aortic valve implantation. A specialized narrative review","authors":"Johao Escobar ,&nbsp;Iqra Riaz ,&nbsp;Muzamil Khawaja ,&nbsp;Hafeez Ul Hassan Virk ,&nbsp;Joshua Hahn ,&nbsp;Fu'’ad Al-Azzam ,&nbsp;Zhen Wang ,&nbsp;Mahboob Alam ,&nbsp;Markus Strauss ,&nbsp;Chayakrit Krittanawong","doi":"10.1016/j.ahjo.2025.100695","DOIUrl":"10.1016/j.ahjo.2025.100695","url":null,"abstract":"<div><div>Obesity has long been identified as a noteworthy risk factor for cardiovascular diseases, including aortic stenosis. Nevertheless, an unexplained phenomenon known as the obesity paradox has arisen in the context of transcatheter aortic valve implantation (TAVI), inquiring conventional beliefs. The obesity paradox refers to better clinical outcomes observed in obese individuals undergoing TAVI. These include reduced all-cause mortality, lower rates of procedural complications, and improved long-term survival rates compared to their lean counterparts. Several theories have been proposed to explain the obesity paradox in TAVI. One of the most popular is the adipose tissue-mediated cardioprotective effect hypothesis. It is known that adipose tissue could offer both protective and harmful effects on the cardiovascular system. These effects can be linked to the adipose tissue's distribution, extension, and intrinsic biological characteristics. Obesity has been associated with adipose tissue malfunction, leading to proinflammatory and deleterious effects on the cardiovascular system. As opposed to what is believed, it is suggested that a healthy obese phenotype might be facilitated by exercise, leading to outstanding cardiovascular benefits. A healthy obese phenotype is also associated with a secretome profile that has unique adipose tissue features like adequate fat storage and formation of lipid droplets, a significant capacity for adipogenesis, minimal extracellular matrix fibrosis, potential for angiogenesis, adipocyte browning, and limited infiltration or activation of macrophages. This article is presented as a specialized narrative review, synthesizing current evidence on the relationship between obesity and outcomes in patients undergoing TAVI.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100695"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between a reduction in triglyceride levels and risk of cardiovascular events","authors":"Izuki Yamashita ,&nbsp;Masanobu Ishii ,&nbsp;Tatsuya Tokai ,&nbsp;So Ikebe ,&nbsp;Yoshinori Yamanouchi ,&nbsp;Taishi Nakamura ,&nbsp;Kenichi Tsujita","doi":"10.1016/j.ahjo.2025.100647","DOIUrl":"10.1016/j.ahjo.2025.100647","url":null,"abstract":"<div><h3>Background</h3><div>Previous analyses have reported that low triglyceride (TG) levels were associated with a reduced risk of cardiovascular events in a primary prevention cohort. However, it remains unclear whether a reduction in TG levels directly contributes to cardiovascular risk reduction.</div></div><div><h3>Objective</h3><div>To investigate whether a reduction in TG levels is associated with a decreased risk of cardiovascular events in primary and secondary prevention cohorts.</div></div><div><h3>Methods</h3><div>This retrospective study was conducted with a nationwide health insurance claims database, with medical checkups between January 2005 and August 2020 in Japan. We included patients with baseline TG levels ≥150 mg/dL and classified them into primary or secondary prevention of cardiovascular events. TG levels at one year were used to stratify patients into four groups: low (≤100 mg/dL), normal (100–149 mg/dL), high (150–499 mg/dL), and very high (≥500 mg/dL). The primary outcome was major adverse cardiovascular events (MACE).</div></div><div><h3>Results</h3><div>In the primary prevention cohort, a reduction TG levels to ≤150 mg/dL was significantly associated with a reduced risk of MACE. No significant association was observed in the secondary prevention cohort. In subgroup analyses stratified by LDL-C target achievement, patients with elevated LDL-C showed a trend toward lower event risk with decreasing TG levels.</div></div><div><h3>Conclusion</h3><div>A weak association was found between a reduction in TG levels and a reduced risk of cardiovascular events in the primary prevention population. However, prospective, randomized, placebo-controlled, and large cardiovascular outcomes trials are needed to prove that substantial reductions in TG levels correlate with cardiovascular event risk reduction.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"60 ","pages":"Article 100647"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}