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Prognostic value of triglyceride-glucose index on predicting major adverse cardiovascular events in hypertensive patients: a systematic review and meta-analysis
IF 4.3
American journal of preventive cardiology Pub Date : 2025-04-19 DOI: 10.1016/j.ajpc.2025.100996
Iwan Dakota , Wilbert Huang , Matthew Aldo Wijayanto , Apridya Nurhafizah , Alya Roosrahima Khairunnisa , Shela Rachmayanti , Enny Yuliana , Angela Felicia Sunjaya , Bambang Budi Siswanto
{"title":"Prognostic value of triglyceride-glucose index on predicting major adverse cardiovascular events in hypertensive patients: a systematic review and meta-analysis","authors":"Iwan Dakota ,&nbsp;Wilbert Huang ,&nbsp;Matthew Aldo Wijayanto ,&nbsp;Apridya Nurhafizah ,&nbsp;Alya Roosrahima Khairunnisa ,&nbsp;Shela Rachmayanti ,&nbsp;Enny Yuliana ,&nbsp;Angela Felicia Sunjaya ,&nbsp;Bambang Budi Siswanto","doi":"10.1016/j.ajpc.2025.100996","DOIUrl":"10.1016/j.ajpc.2025.100996","url":null,"abstract":"<div><h3>Background</h3><div>Triglyceride- glucose (TyG) index, a marker of insulin resistance, has been shown to be associated with the incidence of cardiometabolic diseases including hypertension. However, the prognostic role of TyG index is unknown. Hence, we aim to determine the association of TyG index with major adverse cardiovascular events (MACE) in hypertensive patients.</div></div><div><h3>Methods</h3><div>Systematic searching was conducted on 3 databases up till November 2024. We included studies with hypertensive patients despite their comorbidities. Outcome measured is MACE and its individual components. Random effect model meta-analysis is done to pool the results with similar reference point.</div></div><div><h3>Results</h3><div>Twenty observational studies with a total of 451,455 patients of 40 – 70 years old are included. Meta-analysis result shows that higher TyG index is associated with a statistically significant increased risk of MACE (HR 1.90, CI: 1.41 – 2.57, I<sup>2</sup> 88 %), myocardial infarction (HR 1.55, CI: 1.27 – 1.88, I<sup>2</sup> 0 %), stroke (HR 1.84, CI: 1.41 – 2.39, I<sup>2</sup> 62 %), all- cause mortality (HR 1.86, CI: 1.70 – 2.03, I<sup>2</sup> 0 %) and cardiovascular mortality (HR 1.08, CI: 1.04 – 1.11, I<sup>2</sup> 0 %). Subgroups of older and younger population, male and female gender, diabetic and non- diabetic population, and higher BMI patients retains the statistically significant risk of MACE (<em>p</em> &lt; 0.05). U- shaped phenomena of TyG index is also demonstrated with the risk of all- cause mortality.</div></div><div><h3>Conclusion</h3><div>TyG index is a reliable prognostic marker of MACE in hypertensive patients and can be utilized in population despite their age, diabetic status, and gender.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100996"},"PeriodicalIF":4.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848146","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}
引用次数: 0
Independent and joint associations of sedentary behaviour and physical activity with risk of recurrent cardiovascular events in 40,156 Australian adults with coronary heart disease
IF 4.3
American journal of preventive cardiology Pub Date : 2025-04-17 DOI: 10.1016/j.ajpc.2025.100998
Amanda Lönn , Suzanne J Carroll , Theo Niyonsenga , Adrian Bauman , Rachel Davey , Robyn Gallagher , Nicole Freene
{"title":"Independent and joint associations of sedentary behaviour and physical activity with risk of recurrent cardiovascular events in 40,156 Australian adults with coronary heart disease","authors":"Amanda Lönn ,&nbsp;Suzanne J Carroll ,&nbsp;Theo Niyonsenga ,&nbsp;Adrian Bauman ,&nbsp;Rachel Davey ,&nbsp;Robyn Gallagher ,&nbsp;Nicole Freene","doi":"10.1016/j.ajpc.2025.100998","DOIUrl":"10.1016/j.ajpc.2025.100998","url":null,"abstract":"<div><h3>Objective</h3><div>Explore the independent and joint associations between sedentary behaviour and physical activity with cardiovascular events, among individuals with coronary heart disease (CHD).</div></div><div><h3>Methods</h3><div>Cohort study including Australians ≥45 years with CHD (2006–2020). Time in sedentary behaviour, walking, moderate-, and vigorous- physical activity were self-reported. Cardiovascular events were identified using health registers (2006–2022). Cox proportional hazard regressions explored the association. Restricted cubic splines explored the shape of the association.</div></div><div><h3>Results</h3><div>There were 40,156 individuals included, with a mean age of 70 (SD=10) years old, 62 % men. During a median of 8.3 (IQR = 10.03) years, 3260 non-fatal-, 5161 total cardiac events, and 14,383 major adverse cardiovascular events (MACE) were recorded. Sedentary behaviour of 7–10.4 h/day was associated with a 15 % lower risk of total cardiac events and MACE compared to ≥ 10.5 h/day. A higher level of moderate-to-vigorous physical activity was associated with a lower risk of cardiovascular events, with 14–21 % lower risk for 1–149 min/week compared to 0 min/week. A similar pattern was seen for walking and activities at a moderate- or vigorous intensity. The joint association of ≥150 min/week of moderate-to-vigorous physical activity and &lt;7 h/day in sedentary behaviour had the lowest risk (29–48 % lower) for cardiovascular events compared to the reference group. However, moderate-to-vigorous physical activity seems to be of greater importance and partly modifies the risk of sedentary behaviour in the joint association. Sedentary behaviour hours were linearly associated with risks of non-fatal and total cardiac events. Meanwhile time in physical activity had a curvilinear association with cardiovascular events, with the greatest benefits at the beginning of the curve.</div></div><div><h3>Conclusion</h3><div>More time in physical activity and less time in sedentary behaviour are associated with a lower risk of cardiovascular events. This emphasizes the importance of providing recommendations for both physical activity and sedentary behaviour to people with CHD.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100998"},"PeriodicalIF":4.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864095","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}
引用次数: 0
Implementation strategies for improving the care of familial hypercholesterolaemia from the International Atherosclerosis Society: next steps in implementation science and practice
IF 4.3
American journal of preventive cardiology Pub Date : 2025-04-14 DOI: 10.1016/j.ajpc.2025.100993
Mitchell N. Sarkies , Gerald F. Watts , Samuel S. Gidding , Raul D. Santos , Robert A. Hegele , Frederick J. Raal , Amy C. Sturm , Khalid Al-Rasadi , Dirk J. Blom , Magdalena Daccord , Sarah D. de Ferranti , Emanuela Folco , Peter Libby , Pedro Mata , Hapizah M. Nawawi , Uma Ramaswami , Kausik K. Ray , Shizuya Yamashita , Jing Pang , Gilbert R. Thompson , Laney K. Jones
{"title":"Implementation strategies for improving the care of familial hypercholesterolaemia from the International Atherosclerosis Society: next steps in implementation science and practice","authors":"Mitchell N. Sarkies ,&nbsp;Gerald F. Watts ,&nbsp;Samuel S. Gidding ,&nbsp;Raul D. Santos ,&nbsp;Robert A. Hegele ,&nbsp;Frederick J. Raal ,&nbsp;Amy C. Sturm ,&nbsp;Khalid Al-Rasadi ,&nbsp;Dirk J. Blom ,&nbsp;Magdalena Daccord ,&nbsp;Sarah D. de Ferranti ,&nbsp;Emanuela Folco ,&nbsp;Peter Libby ,&nbsp;Pedro Mata ,&nbsp;Hapizah M. Nawawi ,&nbsp;Uma Ramaswami ,&nbsp;Kausik K. Ray ,&nbsp;Shizuya Yamashita ,&nbsp;Jing Pang ,&nbsp;Gilbert R. Thompson ,&nbsp;Laney K. Jones","doi":"10.1016/j.ajpc.2025.100993","DOIUrl":"10.1016/j.ajpc.2025.100993","url":null,"abstract":"<div><div>Familial hypercholesterolaemia (FH) is the most common monogenic condition associated with premature atherosclerotic cardiovascular disease. Early detection and initiation of cholesterol lowering therapy combined with lifestyle changes improves the prognosis of patients with FH significantly. The International Atherosclerosis Society (IAS) published a new guidance for implementing best practice in the care of FH. Previous guidelines and position statements seldom provided implementation recommendations. To address this, an implementation science approach was used to generate implementation strategies for the clinical recommendations made. This process entailed the generation by consensus of strong implementation recommendations according to the Expert Recommendations for Implementing Change (ERIC) taxonomy. A total of 80 general and specific implementation recommendations were generated, addressing detection (screening, diagnosis, genetic testing and counselling) and management (risk stratification, treatment of adults or children with heterozygous or homozygous FH, therapy during pregnancy and use of apheresis) of patients with FH. We describe here the IAS guidance core implementation strategies to assist with the adoption of clinical recommendations into routine practice for at-risk patients and families worldwide. We summarise the IAS guidance core implementation strategies as operative statements.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100993"},"PeriodicalIF":4.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842635","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}
引用次数: 0
Association of Life's Essential 8 with risk of incident cardiovascular disease and mortality among adults with chronic kidney disease
IF 4.3
American journal of preventive cardiology Pub Date : 2025-04-12 DOI: 10.1016/j.ajpc.2025.100994
Zhenyu Huo , Jinfeng Li , Shunming Zhang , Liuxin Li , Jingdi Zhang , Yiran Xu , Aitian Wang , Shuohua Chen , Jun Feng , Zhangling Chen , Shouling Wu , Tingting Geng , Zhe Huang , Jingli Gao
{"title":"Association of Life's Essential 8 with risk of incident cardiovascular disease and mortality among adults with chronic kidney disease","authors":"Zhenyu Huo ,&nbsp;Jinfeng Li ,&nbsp;Shunming Zhang ,&nbsp;Liuxin Li ,&nbsp;Jingdi Zhang ,&nbsp;Yiran Xu ,&nbsp;Aitian Wang ,&nbsp;Shuohua Chen ,&nbsp;Jun Feng ,&nbsp;Zhangling Chen ,&nbsp;Shouling Wu ,&nbsp;Tingting Geng ,&nbsp;Zhe Huang ,&nbsp;Jingli Gao","doi":"10.1016/j.ajpc.2025.100994","DOIUrl":"10.1016/j.ajpc.2025.100994","url":null,"abstract":"<div><h3>Background</h3><div>The American Heart Association recently released an updated algorithm for evaluating cardiovascular health (CVH), Life's Essential 8 (LE8). However, few studies have examined the association of LE8 with risk of cardiovascular disease (CVD) and mortality among individuals with chronic kidney disease (CKD). We investigated whether LE8 was associated with subsequent risk of CVD and mortality in the Chinese population of adults with CKD.</div></div><div><h3>Methods</h3><div>This prospective study included 18,716 adults (55.4 ± 14.0 years, 77.9 % men) with CKD free of CVD at baseline from the Kailuan study. A LE8 score (range 0–100 points) was constructed based on diet, physical activity, smoking, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure. Incident CVD and mortality were identified by electronic health records and registers. Multivariable Cox regression models were used to compute hazard ratios (HRs) and 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>During a median follow-up of 14.0 and 14.4 years, 2117 cases of CVD and 4190 deaths were documented. After adjusting for potential confounders, comparing the high LE8 score (80–100 points) to the low LE8 score (&lt;50 points), the multivariable HRs (95 % CIs) were 0.28 (0.20, 0.40) for CVD, 0.14 (0.06, 0.34) for myocardial infarction, 0.35 (0.25, 0.50) for total stroke, and 0.68 (0.56, 0.83) for all-cause mortality, respectively.</div></div><div><h3>Conclusions</h3><div>Among patients with CKD, greater adherence to CVH, as defined by LE8, was significantly associated with a lower risk of CVD and all-cause mortality.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100994"},"PeriodicalIF":4.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850159","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}
引用次数: 0
Disparities in statin use following identification of coronary artery calcium 发现冠状动脉钙化后他汀类药物使用的差异
IF 4.3
American journal of preventive cardiology Pub Date : 2025-04-11 DOI: 10.1016/j.ajpc.2025.100990
Charlotte C. Ellberg , Kavenpreet Bal , Edward Duran , Michael H. Criqui , Michael D. Shapiro , Harpreet S. Bhatia
{"title":"Disparities in statin use following identification of coronary artery calcium","authors":"Charlotte C. Ellberg ,&nbsp;Kavenpreet Bal ,&nbsp;Edward Duran ,&nbsp;Michael H. Criqui ,&nbsp;Michael D. Shapiro ,&nbsp;Harpreet S. Bhatia","doi":"10.1016/j.ajpc.2025.100990","DOIUrl":"10.1016/j.ajpc.2025.100990","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery calcium (CAC) scoring is a useful tool for risk stratification in asymptomatic individuals, and current clinical practice is to utilize statins in individuals with CAC. A growing body of research has aimed to identify and mitigate health disparities and their relation to cardiovascular disease (CVD) risk. Likewise, studies have highlighted social determinants of health (SDOH) that contribute to health disparities in CVD.</div></div><div><h3>Objectives</h3><div>We aimed to evaluate whether disparities exist with regards to statin use after identification of CAC within the Multi-Ethnic Study of Atherosclerosis (MESA).</div></div><div><h3>Methods</h3><div>The associations between race/ethnicity, age, sex, primary language, and an aggregate SDOH score (calculated using previously defined methods) with statin use at short- and long-term follow-up were evaluated in logistic regression models with adjustment for traditional CVD risk factors in individuals with baseline CAC&gt;0 without baseline statin use.</div></div><div><h3>Results</h3><div>In the overall cohort, 3416 participants had CAC = 0, 1794 CAC 1–99, 757 CAC 100–300, and 847 CAC&gt;300 AU Mean age was 62 (10.2) years, 53 % (<em>n</em> = 3601) were women, 38.5 % (<em>n</em> = 2622) were non-Hispanic White, 27.8 % (<em>n</em> = 1892) were non-Hispanic Black, 22.0 % (<em>n</em> = 1892) were Hispanic and 11.8 % (<em>n</em> = 1892) were Chinese. At short-term follow up (median 1.6 years, <em>n</em> = 2665), those with a higher SDOH score (worse burden) (OR 0.39, 95 % CI 0.16–0.91), Hispanic (OR 0.59, 95 % CI 0.40–0.85) and Spanish speaking individuals (OR 0.51, 95 % CI 0.30–0.83) were less likely to report statin use following CAC identification. At long-term follow up (median 9.4 years, <em>n</em> = 2533), Black individuals (OR 0.71, 95 % CI 0.52–0.96), Chinese (OR 0.58, 95 % CI 0.39–0.86) and Chinese speaking individuals (OR 0.50, 95 % CI 0.33–0.76) were also less likely to report statin use following CAC identification, and a trend was noted for SDOH score (OR 0.53, 95 % CI 0.26–1.09).</div></div><div><h3>Conclusions</h3><div>This study identifies disparities in statin use by race/ethnicity, language, and social determinants of health after identification of CAC. While CAC is an effective tool for identifying atherosclerosis in asymptomatic individuals, more equitable use of subsequent therapy is needed.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100990"},"PeriodicalIF":4.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833980","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}
引用次数: 0
Prevalence of American heart association's ¨ Life's Essential 8¨ in a cohort of Latino women
IF 4.3
American journal of preventive cardiology Pub Date : 2025-04-09 DOI: 10.1016/j.ajpc.2025.100988
Paola Varleta , Mónica Acevedo , Giovanna Valentino , Carolina Casas-Cordero , Amalia Berríos , Rosario López-Infante
{"title":"Prevalence of American heart association's ¨ Life's Essential 8¨ in a cohort of Latino women","authors":"Paola Varleta ,&nbsp;Mónica Acevedo ,&nbsp;Giovanna Valentino ,&nbsp;Carolina Casas-Cordero ,&nbsp;Amalia Berríos ,&nbsp;Rosario López-Infante","doi":"10.1016/j.ajpc.2025.100988","DOIUrl":"10.1016/j.ajpc.2025.100988","url":null,"abstract":"<div><div>The ideal cardiovascular health (CVH) construct has recently been updated to ¨ Life's Essential 8¨(LE8).</div></div><div><h3>Objective</h3><div>to determine LE8′s prevalence and its association with sociodemographic and socioeconomic determinants in a Latino women cohort in Santiago de Chile.</div></div><div><h3>Methods</h3><div>Cross-sectional study on 619 women between 35 and 70 years old, representing 1.359.509 women (after expansion factors). LE8 was assessed through a survey on demographic and CV risk factors, as well as anthropometric, blood pressure, and biochemical measurements. The overall LE8 score was estimated for all participants, ranging from 0 to 100 (≥80 points, high CVH and &lt; 50 points, low CVH). Besides, the score for each metric was determined. A descriptive analysis was performed with sample weights for the overall sample, and stratified by age, education, family income level and civil status. A regression analysis was performed adjusted by age group, family income and education level to determine the association of sociodemographic variables with LE8 score.</div></div><div><h3>Results</h3><div>The mean overall LE8 score was 62.7 points. Only 11.5 % had a high LE8, while 18.2 % had a low score. The best-accomplished metrics were blood glucose and physical activity (PA); the worst were diet and nicotine exposure. The adjusted regression analysis showed significantly higher scores for younger age (+3.2 points for &lt;45yo, p &lt; 0.05) and higher education level (+5 points, p &lt; 0.01 and +12 points, p = 0.000,1 for high school and tertiary education, respectively). Higher LE8 scores in women with high education level were significantly driven by improvements in 5 metrics (lipids, blood pressure, body mass index, diet and PA).</div></div><div><h3>Conclusion</h3><div>Nearly 1 out of 9 women from Santiago had an ideal LE8 score. Years of education are crucial determinants in the fight to get an ideal CVH.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100988"},"PeriodicalIF":4.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833817","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}
引用次数: 0
Evidence-based SGLT2 inhibitor and GLP-1 receptor agonist use by race in the VA healthcare system
IF 4.3
American journal of preventive cardiology Pub Date : 2025-04-07 DOI: 10.1016/j.ajpc.2025.100966
Demetria M. Bolden , Vanessa Richardson , Taufiq Salahuddin , Kamal Henderson , Paul L. Hess , Sridharan Raghavan , David R. Saxon , P. Michael Ho , Stephen W. Waldo , Gregory G. Schwartz
{"title":"Evidence-based SGLT2 inhibitor and GLP-1 receptor agonist use by race in the VA healthcare system","authors":"Demetria M. Bolden ,&nbsp;Vanessa Richardson ,&nbsp;Taufiq Salahuddin ,&nbsp;Kamal Henderson ,&nbsp;Paul L. Hess ,&nbsp;Sridharan Raghavan ,&nbsp;David R. Saxon ,&nbsp;P. Michael Ho ,&nbsp;Stephen W. Waldo ,&nbsp;Gregory G. Schwartz","doi":"10.1016/j.ajpc.2025.100966","DOIUrl":"10.1016/j.ajpc.2025.100966","url":null,"abstract":"<div><h3>Importance</h3><div>Adoption of novel therapeutics often lags for Black versus non-Hispanic White patients. Seminal clinical trials established the cardiovascular efficacy of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) in patients with type 2 diabetes (T2D) and established atherosclerotic cardiovascular disease. However, it is uncertain whether race influences the evidence-based prescription of these agents.</div></div><div><h3>Objective</h3><div>To determine whether evidence-based prescription of SGLT2i or GLP-1RA differs by Black versus White race in the Veterans Affairs (VA) healthcare system.</div></div><div><h3>Design, Setting, and Participants</h3><div>Retrospective cohort study of US Veterans with T2D and angiographically confirmed coronary artery disease (CAD) at 84 VA medical centers over the period 2015–2023. Data from the VA Clinical Assessment, Reporting, and Tracking Program were used to construct cohorts eligible for SGLT2i or GLP-1RA treatment based on eligibility criteria for the seminal Empagliflozin, Cardiovascular Outcomes, and Mortality in T2D (EMPA-REG OUTCOME) or the Liraglutide Effect and Action in Diabetes (LEADER) trial, respectively. Multivariable logistic regression estimated adjusted odds of trial-concordant SGLT2i or GLP-1RA prescription by race.</div></div><div><h3>Exposures</h3><div>Self-identified race.</div></div><div><h3>Main Outcomes and Measures</h3><div>SGLT2i or GLP-1RA prescription among those with an evidence-based (trial-concordant) indication.</div></div><div><h3>Results</h3><div>Of 63,561 Veterans with T2D and CAD, 3527 Black and 18,668 White patients met criteria for trial-concordant SGLT2i treatment and 2020 Black and 10,103 White patients for GLP1-RA treatment. Trial-concordant prescription of both classes increased over time for both races but reached only 42 % for SGLT2i and 15 % for GLP1-RA in 2023. Black versus White race was not associated with evidence-based SGLT2i prescription (adjusted odds ratio [OR] 0.96, 95 % CI 0.89–1.04, <em>P</em> = 0.32). However, Black Veterans were less likely than White to be provided with a trial-concordant GLP1-RA prescription (adjusted OR 0.85, 95 % CI 0.74–0.98, <em>P</em> = 0.025).</div></div><div><h3>Conclusions and Relevance</h3><div>Among patients with T2D and CAD in the VA healthcare system, evidence-based SGLT2i and GLP1-RA prescription increased over time, but many eligible patients remained untreated. Although SGLT2i prescription did not differ by race, Black versus White Veterans were less likely to receive evidence-based GLP1-RA prescription. Racial disparities in evidence-based cardiovascular drug prescription exist even in a healthcare system with few economic barriers and may be drug class-specific.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100966"},"PeriodicalIF":4.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823693","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}
引用次数: 0
Onboarding obesity management in cardiovascular care: A cardiologist's guide to latest advances
IF 4.3
American journal of preventive cardiology Pub Date : 2025-04-03 DOI: 10.1016/j.ajpc.2025.100987
François Schiele , François Dievart , David Jacobi , Denis Angoulvant , Sebastien Czernichow , Etienne Puymirat , Pierre Sabouret , Victor Aboyans
{"title":"Onboarding obesity management in cardiovascular care: A cardiologist's guide to latest advances","authors":"François Schiele ,&nbsp;François Dievart ,&nbsp;David Jacobi ,&nbsp;Denis Angoulvant ,&nbsp;Sebastien Czernichow ,&nbsp;Etienne Puymirat ,&nbsp;Pierre Sabouret ,&nbsp;Victor Aboyans","doi":"10.1016/j.ajpc.2025.100987","DOIUrl":"10.1016/j.ajpc.2025.100987","url":null,"abstract":"<div><div>In recent decades, the prevalence of obesity has escalated markedly, becoming a serious epidemic and public health crisis requiring urgent and sustained attention. Obesity is associated with a large number of health conditions, including cardiovascular diseases (CVDs), which contribute to an increase in mortality and overall global health challenge. Despite its high morbidity and mortality, most healthcare practitioners perceive obesity as an outcome of unhealthy lifestyle rather than a disease by itself. As such, obesity is either overlooked or considered a minor risk factor for CVD in clinical practice, among others. Since cardiovascular (CV) causes remain the leading cause of death in patients with obesity, cardiologists are among the most frequently visited healthcare professionals and can play an essential role in addressing this disease. Obesity is a complex, chronic, relapsing yet treatable disease that stems from the disruption in the body's homeostatic, hedonic, and cognitive systems, as a result of an interplay between genetic, metabolic, inflammatory, vascular, environmental and behavioral, and pharmacological factors. With early recognition and assessment, management of this disease can successfully improve life expectancy and reduce CV risk. In this review, a concise overview of obesity was provided, focusing on its pathophysiology, diagnosis, and management. The correlation between obesity and CVDs was further discussed, highlighting the significance of obesity education and management among cardiologists to improve patient outcomes and prevent the progression of obesity and its related comorbidities.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100987"},"PeriodicalIF":4.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842636","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}
引用次数: 0
Associations between visceral adipose and renal artery calcification: Results from the multi-ethnic study of atherosclerosis
IF 4.3
American journal of preventive cardiology Pub Date : 2025-04-02 DOI: 10.1016/j.ajpc.2025.100979
Harsimran Bajwa , Michael Criqui , Ron Blankstein , Siddique Abbasi , Joao Lima , Jingzhong Ding , Tara Shrout Allen , Matthew Allison
{"title":"Associations between visceral adipose and renal artery calcification: Results from the multi-ethnic study of atherosclerosis","authors":"Harsimran Bajwa ,&nbsp;Michael Criqui ,&nbsp;Ron Blankstein ,&nbsp;Siddique Abbasi ,&nbsp;Joao Lima ,&nbsp;Jingzhong Ding ,&nbsp;Tara Shrout Allen ,&nbsp;Matthew Allison","doi":"10.1016/j.ajpc.2025.100979","DOIUrl":"10.1016/j.ajpc.2025.100979","url":null,"abstract":"<div><h3>Background</h3><div>Visceral adipose tissue (VAT) has been associated with higher levels of atherosclerosis. Renal artery calcification (RAC) secondary to atherosclerosis has been found to be associated with an increase in all-cause mortality.</div></div><div><h3>Methods</h3><div>1 978 participants underwent CT imaging to measure VAT and RAC. Rate ratio regression was used to estimate prevalence ratios (PRs) for the presence of RAC, while linear regression was used to estimate linear coefficients for the severity of RAC.</div></div><div><h3>Results</h3><div>1 196 participants had complete VAT and RAC measurements. In adjusted models, VAT area was not associated with RAC presence (PR 1.02, 95 % CI 0.89, 1.16, <em>p</em> = 0.80), while greater VAT density was inversely, but not significantly, associated with RAC presence (PR 0.89, 95 % CI 0.78, 1.02, <em>p</em> = 0.10). Among 354 participants with RAC &gt; 0, VAT area was significantly associated with RAC severity (slope 63.32, 95 % CI 11.84, 114.81, <em>p</em> = 0.02), while VAT density was not associated (slope 9.78, 95 % CI -40.87, 60.44, <em>p</em> = 0.71).</div></div><div><h3>Conclusions</h3><div>VAT area and density are not significantly associated with RAC presence, while greater VAT area is significantly associated with RAC severity among those with RAC &gt; 0. Our results are the first describing the relationship between VAT and RAC, and are in contrast to previous literature demonstrating a significant association between VAT and coronary artery calcification.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100979"},"PeriodicalIF":4.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823689","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}
引用次数: 0
Improving outcomes in acute coronary syndrome: A meta-analysis of home-based compared to hospital-based cardiac rehabilitation and usual care
IF 4.3
American journal of preventive cardiology Pub Date : 2025-03-31 DOI: 10.1016/j.ajpc.2025.100982
Eva Marti , Anggoro Budi Hartopo , Haryani , Margareta Hesti Rahayu , Riris Diana , Ninik Yunitri
{"title":"Improving outcomes in acute coronary syndrome: A meta-analysis of home-based compared to hospital-based cardiac rehabilitation and usual care","authors":"Eva Marti ,&nbsp;Anggoro Budi Hartopo ,&nbsp;Haryani ,&nbsp;Margareta Hesti Rahayu ,&nbsp;Riris Diana ,&nbsp;Ninik Yunitri","doi":"10.1016/j.ajpc.2025.100982","DOIUrl":"10.1016/j.ajpc.2025.100982","url":null,"abstract":"<div><h3>Aim</h3><div>To assess the effectiveness of home-based cardiac rehabilitation (HBCR) in improving health-related quality of life (HRQoL) and other outcomes in patients with acute coronary syndrome (ACS), compared to hospital-based cardiac rehabilitation (CR) and usual care.</div></div><div><h3>Methods</h3><div>This systematic review followed PRISMA guidelines and included a comprehensive search across MEDLINE, CINAHL, ProQuest, Cochrane Library, Clinical Key, PubMed, Embase, and ClinicalTrials.gov up to June 2023. A total of 19 studies with 2822 participants were included. Eligible RCTs assessed the impact of HBCR on ACS patients, comparing it with hospital-based CR or usual care. The primary outcome was QoL, with secondary outcomes including cardiovascular capacity, cardiovascular disease risk factors, and rehospitalization rates. Statistical analysis was conducted using a random-effects model in R Statistic.</div></div><div><h3>Results</h3><div>HBCR improves QoL compared to all comparators (hospital-based CR and usual care) (SMD 0.17, 95 % CI 0.00 to 0.33). HBCR was equally effective as hospital-based CR in enhancing QoL, peak VO<sub>2</sub>, 6-min walk distance (6 MWD), lipid profiles, and blood pressure. Compared to usual care, HBCR significantly improved QoL (SMD 0.29, 95 % CI 0.11 to 0.46) and HDL-cholesterol level (SMD 0.18, 95 % CI 0.02 to 0.34), while reducing triglyceride level more effectively (SMD −0.34, 95 % CI −0.57 to −0.11). However, no significant differences were observed between HBCR and usual care in terms of peak VO<sub>2</sub>, rehospitalization rates, LDL-cholesterol, total cholesterol, or blood pressure.</div></div><div><h3>Conclusions</h3><div>HBCR significantly improves QoL and is equally effective as hospital-based CR across all measured outcomes. Compared to usual care, HBCR leads to significant improvements in specific aspects of QoL as a primary outcome, as well as in HDL-cholesterol and triglyceride levels. However, its impact on other outcomes, such as peak VO<sub>2</sub>, LDL-cholesterol, total cholesterol, and blood pressure, is not consistently significant.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100982"},"PeriodicalIF":4.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820489","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}
引用次数: 0
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