American journal of preventive cardiology最新文献

{"title":"Cost-effectiveness of cardiovascular risk assessment and management among adults with hypertension in China: A modelling study","authors":"Siqi Lin ,&nbsp;Liming Lin ,&nbsp;Wenyao Peng ,&nbsp;Xuan Liu ,&nbsp;Xi Li ,&nbsp;Jiapeng Lu ,&nbsp;Shouling Wu","doi":"10.1016/j.ajpc.2025.101007","DOIUrl":"10.1016/j.ajpc.2025.101007","url":null,"abstract":"<div><h3>Objective</h3><div>Blood pressure reduction alone is insufficient for significant cardiovascular risk improvement in patients with hypertension. Cardiovascular risk assessment and management are recommended to prevent and control cardiovascular diseases (CVD), but their cost-effectiveness in real-world Chinese settings is unclear. This study evaluated the benefits and cost-effectiveness of two strategies based on cardiovascular risk in Chinese hypertensive patients aged ≥35 years: statin treatment and lifestyle management + statin treatment.</div></div><div><h3>Methods</h3><div>A decision-analytic Markov cohort model was constructed to estimate health benefits and incremental cost-effectiveness ratios between two interventions and no intervention over 10-year and lifetime horizons. Parameters including stroke/myocardial infarction (MI) incidence, all-cause mortality, costs, and health utilities were extracted from the Kailuan study, published literature, or public datasets. Sensitivity analyses assessed the influence of parameter uncertainty on the results of base-case analysis.</div></div><div><h3>Results</h3><div>Statin treatment alone in hypertensive patients with high cardiovascular risk was projected to avert 847,350 stroke cases, 1412,250 MI cases and 564,900 all-cause deaths over a 10-year time horizon. Lifestyle management combined with statin treatment could prevent more cardiovascular and death events and was highly cost-effective ($1219.76/quality-adjusted life-year vs. gross domestic product per capita $12,680.83). Over a lifetime horizon, it was highly cost-effective regardless of the age when the combined intervention was started, with earlier initiation yielding greater benefits in preventing cardiovascular events. Sensitivity analyses confirmed robust results.</div></div><div><h3>Conclusion</h3><div>Cardiovascular risk assessment and combined management in hypertensive individuals aged ≥35 years would generate substantial health gains and represent a highly cost-effective CVD prevention strategy in China.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101007"},"PeriodicalIF":4.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071183","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":"Causal relationship between physical activity, sleep duration, sedentary behavior, and hypertension: A Mendelian randomisation study","authors":"Chunmei Wang ,&nbsp;Jianting Zeng ,&nbsp;Hongduan Liu ,&nbsp;Li Zhang","doi":"10.1016/j.ajpc.2025.101005","DOIUrl":"10.1016/j.ajpc.2025.101005","url":null,"abstract":"<div><h3>Background</h3><div>Lifestyle behaviors may be an important means of preventing hypertension. The causal relationship between physical activity, sleep duration, sedentary behavior, and hypertension remains unclear. The aim of this study was to examine these associations by using Mendelian randomization (MR) analysis.</div></div><div><h3>Materials and methods</h3><div>Single nucleotide polymorphisms associated with sedentary behavior patterns (including length of mobile phone use, time spent driving, time spent watching television, and time spent playing computer games), duration of walks, sleep duration, and moderate-to-vigorous intensity physical activity (MVPA) at genome-wide significance (<em>P</em> &lt; 5 × 10^–8) were selected as instrumental variables (IVs) from a genome-wide association study. These IVs represented exposure factors in the subsequent analysis. Summary statistics for hypertension were obtained from the FinnGen Biobank study. In MR analysis, inverse-variance weighting (IVW), weighted median, and MR-Egger regression were employed for causal inference. In addition, multivariate MR analysis was applied to explore the potential confounding effects of smoking and education on the causal relationships between exposure factors and hypertension. A mediation analysis was conducted to assess whether body mass index (BMI) and waist-hip ratio (WHR) mediated the associations between exposure factors and hypertension.</div></div><div><h3>Results</h3><div>The IVW analysis indicated that increased time spent watching television was associated with an increased risk of hypertension (OR: 1.831; 95 %CI: 1.482–2.262; <em>P</em> = 1.99E-08). The multivariate MR analysis demonstrated that the effect of television viewing time on hypertension remained significant after adjusting for smoking. However, after adjusting for education level, no significant association was observed between television viewing time and hypertension. Mediation analysis revealed that BMI and WHR mediated the causal relationship between television viewing time and hypertension. Genetically predicted other sedentary behavior factors, duration of walks, sleep duration, and MVPA were not significantly associated with hypertension.</div></div><div><h3>Conclusion</h3><div>In conclusion, this MR study revealed that a lifestyle of increased time spent watching television may contribute to an elevated risk of hypertension.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101005"},"PeriodicalIF":4.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948623","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 arterial stiffness and MASLD in US young adults: base on NHANES 2005-2018","authors":"Qing-zhong Li ,&nbsp;Jia-xin Tan ,&nbsp;Quan-Zhi Qin ,&nbsp;Guo-tian Ruan ,&nbsp;Teng Deng ,&nbsp;Yi-zhen Gong","doi":"10.1016/j.ajpc.2025.101003","DOIUrl":"10.1016/j.ajpc.2025.101003","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) impacts &gt;30 % of the world's population, imposing significant societal and familial burdens. Arterial stiffness is a known risk factor for various metabolic disorders, and early-onset MASLD may be linked to heightened arterial stiffness. However, studies investigating the link between arterial stiffness and MASLD are limited.</div></div><div><h3>Methods</h3><div>This study utilized data from the NHANES database, focusing on young adults aged 20 to 45 years, spanning from 2005 to 2018. The Fatty Liver Index (FLI) was used to diagnose MASLD, and the estimated Pulse Wave Velocity (ePWV) was utilized to assess arterial stiffness. The association between MASLD and arterial stiffness was analyzed using weighted multiple logistic regression models and restricted cubic splines. Sensitivity analyses were performed to evaluate the stability of the observed relationship.</div></div><div><h3>Results</h3><div>The study included 5 522 participants, with 3 415 serving as controls and 2 107 diagnosed with MASLD. The two groups differed significantly in age, income, and comorbidities, including hypertension and diabetes. The mean ePWV was 6.79 (<em>SD</em> = 0.71) in the MASLD group and 6.33 (<em>SD</em> = 0.57) in the control group, respectively. Adjusted weighted logistic regression models revealed that individuals in the high ePWV group (ePWV ≥ 6.559) had a 2.39-fold increased risk of onset compared to those in the low ePWV group (ePWV &lt; 6.559), with statistical significance (<em>P</em> &lt; 0.05). Restricted cubic splines (RCS) also demonstrated a positive linear correlation between ePWV and MASLD. Sensitivity analysis validated the strong correlation between ePWV and MASLD, while subgroup analysis demonstrated a positive association between ePWV and MASLD across most subgroups (OR &gt; 1).</div></div><div><h3>Conclusion</h3><div>The study indicates a strong association between arterial stiffness, as measured by ePWV, and MASLD in young adults. The results suggest that targeting arterial stiffness could aid in preventing and managing MASLD.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101003"},"PeriodicalIF":4.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906591","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":"Cardiovascular disease risk factors in newly diagnosed rheumatoid arthritis: A retrospective cohort study","authors":"Avi G. Aronov ,&nbsp;Yoo Jin Kim ,&nbsp;Salman Zahid ,&nbsp;Erin D. Michos ,&nbsp;Noreen T. Nazir","doi":"10.1016/j.ajpc.2025.101002","DOIUrl":"10.1016/j.ajpc.2025.101002","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Patients with rheumatoid arthritis (RA) face an increased risk of cardiovascular disease (CVD) that traditional risk factors alone cannot fully explain. Chronic inflammation may influence lipid profiles and contribute to this risk. This study evaluates predictors of incident CVD in RA and explores how erythrocyte sedimentation rate (ESR) modifies the relationship between lipid levels and CVD outcomes.</div></div><div><h3>Design, settings, participants, and measurements</h3><div>This retrospective cohort study included 1,802 RA patients aged 40-79 years, diagnosed between 2015 and 2022, and free of CVD at diagnosis. We evaluated the association between traditional cardiovascular risk factors—including current smoking, diabetes mellitus, systolic blood pressure, body mass index (BMI), HDL cholesterol, and LDL cholesterol—and RA-specific inflammatory markers, including ESR and C-reactive protein (CRP), with the incidence of CVD. Cox proportional hazards models adjusted for age, sex, race/ethnicity, antihypertensive medications, lipid-lowering medications, and antiplatelet medications.</div></div><div><h3>Results</h3><div>During a median follow-up of 3.5 years, 187 patients (10.4 %) developed CVD. The mean BMI was 32 kg/m² (standard deviation [SD] 10), HDL cholesterol was 53 mg/dL (SD 17), and LDL cholesterol was 104 mg/dL (SD 37). The median ESR was 21 mm/hr (interquartile range [IQR] 11–42) and CRP was 6 mg/L (IQR 3–12). Higher LDL cholesterol was inversely associated with CVD risk (HR 0.77 per SD increase, 95 % CI 0.63–0.94), with this association weakening with increasing ESR levels (interaction term HR 0.84, 95 % CI 0.71–0.99). Elevated HDL cholesterol also showed significantly decreased CVD risk (HR 0.82 per SD increase, 95 % CI 0.68–0.97). Smoking and diabetes were associated with increased risks (HR 1.52, 95 % CI 1.07–2.17 and HR 2.08, 95 % CI 1.39–3.10, respectively).</div></div><div><h3>Conclusion</h3><div>This study highlights the complex interplay between lipid levels and inflammation in RA, highlighting the nuances of CVD risk assessment in RA.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101002"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068554","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":"Employment status as a predictor of adverse outcomes in patients with coronary artery disease","authors":"Travis M. Wilson ,&nbsp;Adithya K. Yadalam ,&nbsp;Shaimaa Sakr ,&nbsp;Matthew E. Gold ,&nbsp;Vardhmaan Jain ,&nbsp;Alexander C. Razavi ,&nbsp;Nishant Vatsa ,&nbsp;Daniel A. Gold ,&nbsp;Yi-An Ko ,&nbsp;Yunyun Chen ,&nbsp;Chang Liu ,&nbsp;Nisreen Haroun ,&nbsp;Muhammad Owais ,&nbsp;Ishan Nadkarni ,&nbsp;Ozair Khawaja ,&nbsp;Hassan Allaqaband ,&nbsp;Laurence S. Sperling ,&nbsp;ArshedA. Quyyumi","doi":"10.1016/j.ajpc.2025.100997","DOIUrl":"10.1016/j.ajpc.2025.100997","url":null,"abstract":"<div><h3>Background</h3><div>Lack of employment is associated with a poorer prognosis when compared to employment in the general population. Whether this association is present in patients with coronary artery disease (CAD) and similarly extends to adverse cardiovascular outcomes in those with CAD remains unknown. Herein, we analyzed the association of employment status and adverse outcomes in patients with CAD.</div></div><div><h3>Methods</h3><div>Non-retired participants enrolled in the Emory Cardiovascular Biobank during the years 2003–2023 were divided into employed and non-employed cohorts and analyzed for the primary composite outcome of cardiovascular death or non-fatal myocardial infarction (MI) by competing-risk regression, while accounting for non-cardiovascular death. The secondary outcome of all-cause death was assessed by Cox regression. Sensitivity analyses were performed to explore for heterogeneity of effect.</div></div><div><h3>Results</h3><div>The study sample consisted of 2809 participants with a mean age of 57 years, 35 % women, and 27 % Black. During a median follow-up of 5.1 years, 406 (14 %) cardiovascular death or non-fatal MI events and 537 (19 %) all-cause death events occurred. After adjustment for demographics, educational attainment level (EAL), and traditional cardiovascular risk factors, non-employment was found to be a significant predictor of cardiovascular death or non-fatal MI (sHR 1.78, 95 % CI 1.41–2.19, <em>P</em> &lt; 0.001) and all-cause death (HR 2.46, 95 % CI 2.02–2.99, <em>P</em> &lt; 0.001), when compared to employed participants.</div></div><div><h3>Conclusions</h3><div>Non-employment is associated with adverse outcomes in non-retired individuals with CAD, independent of demographics, EAL, and traditional cardiovascular risk factors. Non-employment due to disability was associated with the highest risk of adverse cardiovascular outcomes, highlighting a particularly vulnerable subgroup.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100997"},"PeriodicalIF":4.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902424","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":"Chronic kidney disease prevalence and outcomes in patients with type 2 diabetes or prediabetes at high cardiovascular risk: results from the CINEMA program","authors":"Sanjana Datla ,&nbsp;Zainab Albar ,&nbsp;Elke Eaton ,&nbsp;Jodie Porges ,&nbsp;Matthew Nennstiel ,&nbsp;Claire Sullivan ,&nbsp;Lloyd Greene ,&nbsp;Sadeer G. Al-Kindi ,&nbsp;Elizabeth Montgomery ,&nbsp;Aparna Padiyar ,&nbsp;Mikhail Kosiborod ,&nbsp;Melissa L. Magwire ,&nbsp;Mahboob Rahman ,&nbsp;Sanjay Rajagopalan ,&nbsp;Ian J. Neeland","doi":"10.1016/j.ajpc.2025.101004","DOIUrl":"10.1016/j.ajpc.2025.101004","url":null,"abstract":"<div><h3>Background</h3><div>Chronic kidney disease (CKD) is a global health concern, particularly among patients with type 2 diabetes mellitus (T2DM) and prediabetes who are at high risk of cardiovascular disease (CVD). The Center for Integrated and Novel Approaches in Vascular-Metabolic Disease (CINEMA) program aims to address these challenges through a multidisciplinary, patient-centered intervention. This study evaluates the CKD prevalence and outcomes in the CINEMA program, with a focus on risk for CVD and CKD progression and guideline-directed treatments.</div></div><div><h3>Methods and Results</h3><div>Patients with T2DM or prediabetes at high-risk for cardiovascular events, including those with established atherosclerotic CVD, elevated coronary artery calcium score ≥100, chronic heart failure, ischemic stroke, peripheral arterial disease, CKD (defined as eGFR&lt;60mL/min/1.73 m and/or by the presence of urine-albumin creatinine ratio, UACR, ≥30 mg/g) and obesity with metabolic syndrome were included. From May 2020 to September 2022, 454 patients were enrolled in the CINEMA program with 45 % having a diagnosis of CKD. Among those with CKD, the median age was 64 years, 48 % were women, and 47 % were Black. 93 % had T2DM, 82 % had HTN, 52 % had established coronary artery disease, and 39 % had heart failure. Median eGFR was 49 mL/min/1.73 m and median UACR was 42 mg/g. Persons with CKD were more likely to be older, Black, have diabetes and heart failure (<em>p</em> &lt; 0.05 for all). From August 2020 to June 2022, the CINEMA intervention was associated with statistically significant improvements in cardiometabolic risk factors with reductions in body weight (-3.49 lbs), BMI (-0.54 kg/m2), systolic blood pressure (-2.65 mmHg), Hb A1c (-0.63 %), total cholesterol (-9.01 mg/dL) and LDL cholesterol (-8.29 mg/dL), <em>p</em> &lt; 0.05 for all. There was a trend toward lower UACR (<em>p</em> = 0.41) and no significant change in eGFR (<em>p</em> = 0.58). There was a significant increase in prescription rates of SGLT2i (25 % to 55 %) and GLP-1RA (14 % to 38 %) in the CKD population from baseline to follow-up (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>In high-risk patients with T2DM or prediabetes and CKD, the CINEMA program is effective in improving cardiovascular risk factors and shows promise in addressing CKD outcomes. Enhanced screening for CKD, appropriate risk stratification, and aggressive implementation of guideline-directed medical therapies may lead to improved long-term outcomes.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101004"},"PeriodicalIF":4.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912720","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":"Advanced biologic therapies and cardiovascular events in patients with inflammatory bowel disease","authors":"Lara Chaaban ,&nbsp;Tarek Harb ,&nbsp;Gary Gerstenblith ,&nbsp;Thorsten M. Leucker ,&nbsp;Joanna Melia","doi":"10.1016/j.ajpc.2025.100991","DOIUrl":"10.1016/j.ajpc.2025.100991","url":null,"abstract":"<div><h3>Aims</h3><div>Atherosclerotic cardiovascular disease (ASCVD) risk is increased in patients with Inflammatory Bowel Disease (IBD). The impact of advanced biologic therapies (ABT) on ASCVD risk in patients with IBD has not been reported. This study tests the hypothesis of a protective effect of immune modulation with ABT on ASCVD risk in patients with IBD.</div></div><div><h3>Methods</h3><div>Retrospective cohort study using the TriNetX Network</div></div><div><h3>Results</h3><div>This analysis included 72,650 individuals in each of two matched cohorts with IBD: one receiving ABT and one receiving non-ABT (NABT). The probabilities of experiencing an ischemic cardiovascular, cerebrovascular, or peripheral vascular event were all significantly lower in the ABT group, than in the NABT group. The probabilities of any ASCVD event at one, three, and five years in the ABT group were also lower than in the NABT group (8.3 % vs. 11.9 %, OR 0.67; 13.0 % vs. 17.9 %, OR 0.69; and 15.0 % vs. 21.2 %, OR 0.68; respectively, all <em>p</em> &lt; 0.01). The reduced risk was strongest with the interleukin 12/23 inhibitors when compared with the other drug subclasses with an OR of 0.37 [0.32–0.42] when compared to the NABT group.</div></div><div><h3>Conclusions</h3><div>ABT were associated with significantly fewer ASCVD events than NABT in the IBD patient population. Among drug subclasses, interleukin 12/23 inhibitors were associated with the strongest benefit. Future prospective, randomized studies examining the efficacy and safety as well as the differential benefit of drug subclasses on ASCVD outcomes and mechanisms responsible for the ABT benefit are needed.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100991"},"PeriodicalIF":4.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912721","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":"Coronary computed tomography angiography versus guideline-recommended clinical risk assessment for statin allocation in outpatients with suspected coronary artery disease","authors":"Jianan Zheng ,&nbsp;Zhihui Hou ,&nbsp;Yang Gao ,&nbsp;Weihua Yin ,&nbsp;Yanan Ma ,&nbsp;Yunqiang An ,&nbsp;Yang Wang ,&nbsp;Lei Song ,&nbsp;Bin Lu","doi":"10.1016/j.ajpc.2025.100995","DOIUrl":"10.1016/j.ajpc.2025.100995","url":null,"abstract":"<div><h3>Aims</h3><div>The purpose of this study was to compare coronary computed tomography angiography (CCTA) and guideline-recommended clinical risk assessment for the value in statin allocation in outpatients with suspected coronary artery disease (CAD).</div></div><div><h3>Methods</h3><div>For the 7860 eligible outpatients with suspected CAD who underwent CCTA, we evaluate hard atherosclerotic cardiovascular disease (ASCVD) and major adverse cardiac and cerebrovascular event (MACCE) stratified by guideline-recommended clinical risk assessment, and CCTA. For intermediate risk patients, we also compared the predictive value of CCTA and CAC.</div></div><div><h3>Results</h3><div>Over a median follow-up period of 3.6 years, a total of 83 (1.1 %) hard ASCVD and 170 (2.2 %) MACCE occurred. The event rate increased with both the intensity of statin recommendation (e.g., hard ASCVD: 1.5 per 1000 person-years [PY] for statin not recommended, 4.1 per 1000 PY for moderate-intensity statin, and 8.9 per 1000 PY for high-intensity statin) and the severity of coronary stenosis (e.g., hard ASCVD: 0.7 per 1000 PY for no plaque, 5.1 per 1000 PY for non-obstructive CAD, and 11.2 per 1000 PY for obstructive CAD). When stratified by CCTA, higher intensity statin recommendation was not a statistically significant independent risk factor, both for hard ASCVD and MACCE. For the predictive value of hard ASCVD in intermediate risk patients, there was no statistically significant difference between CCTA and CAC (the area under the receiver operating characteristic curve: 0.692 versus 0.702; <em>P</em> = 0.78).</div></div><div><h3>Conclusions</h3><div>CCTA played a more important role in statin allocation compared to guideline-recommended clinical risk assessment in outpatients who underwent CCTA.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100995"},"PeriodicalIF":4.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912719","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":"South Asians and cardiometabolic health: A framework for comprehensive care for the individual, community, and population - An American society for preventive cardiology clinical practice statement","authors":"Anand Rohatgi ,&nbsp;Sonia S. Anand ,&nbsp;Meghana Gadgil ,&nbsp;Unjali P. Gujral ,&nbsp;Sneha S. Jain ,&nbsp;Zulqarnain Javed ,&nbsp;Manish Jha ,&nbsp;Parag H. Joshi ,&nbsp;Venkat Sanjay Manubolu ,&nbsp;Khurram Nasir ,&nbsp;Pradeep Natarajan ,&nbsp;Neha Pagidipati ,&nbsp;Latha Palaniappan ,&nbsp;Aniruddh P. Patel ,&nbsp;Priyanka Satish ,&nbsp;Nilay S. Shah ,&nbsp;Garima Sharma ,&nbsp;Madhukar H. Trivedi ,&nbsp;Salim S. Virani ,&nbsp;Martha Gulati ,&nbsp;Jaideep Patel","doi":"10.1016/j.ajpc.2025.101000","DOIUrl":"10.1016/j.ajpc.2025.101000","url":null,"abstract":"<div><div>South Asians (SAs) represent an increasing proportion of North American populations and demonstrate excess cardiometabolic risk. Multiple factors likely contribute; however, much is not yet known about what leads to this excess risk. Diet composition, physical activity, and mental health are important lifestyle contributors. Specific adverse pregnancy outcomes are higher in SA women and represent an early opportunity for intervention. More broadly, comprehensive assessments of adiposity, diabetes, hypertension, dyslipidemia, coronary atherosclerosis via imaging, and genetic risk may improve detection and awareness among SAs and those treating SAs. At an individual level, culturally tailored preventive clinics may foster awareness and detection, leading to improved prevention and management of cardiometabolic risk. At a community and population level, assessments of the impact of social determinants, acculturation, and the environment may lead to broader initiatives to improve health in SAs. Lastly, supporting expanded investigation, policy, and other health and science measures at an institutional and societal level may lead to broad but impactful changes across the North American diaspora. In this clinical practice statement, we aim to provide a roadmap of the path forward in each of these domains for health care providers and health systems, community outreach groups, and stakeholders invested in investigation and policy to mitigate risk and empower SAs to lead healthy lives.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101000"},"PeriodicalIF":4.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932127","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":"Chronic statin-use before PCI in acute coronary syndromes and in-hospital outcomes: ACCNCDR registry in India","authors":"Rajeev Gupta ,&nbsp;Prashant Dwivedi ,&nbsp;Krishna K Sharma ,&nbsp;Sanjeev K Sharma ,&nbsp;Jitender S Makkar ,&nbsp;Atul Kasliwal ,&nbsp;Vishnu Natani ,&nbsp;Raghubir S Khedar ,&nbsp;Samin K Sharma ,&nbsp;Soneil Guptha","doi":"10.1016/j.ajpc.2025.100999","DOIUrl":"10.1016/j.ajpc.2025.100999","url":null,"abstract":"<div><h3>Objective</h3><div>To compare in-hospital major cardiovascular adverse outcomes among chronic statin-user and statin-naïve acute coronary syndrome(ACS) patients following percutaneous coronary intervention(PCI).</div></div><div><h3>Methods</h3><div>Successive patients with ACS who underwent PCI from Sep’17 to Dec’23 were enrolled in a prospective registry. Details of risk factors, presentation, angiography, interventions, and in-hospital outcomes were recorded. Chronic statin use was defined as &gt; 1-month intake before presentation. Primary outcomes were in-hospital all-cause and cardiovascular deaths. Univariate and multivariate odds ratios(OR) and 95 % confidence intervals(CI) were calculated.</div></div><div><h3>Results</h3><div>8296 patients were enrolled, and ACS was in 7892(STEMI-ST elevation myocardial infarction 3222, non-STEMI/unstable angina 4670). Prior chronic statin use was in 2949(37.4 %), and 4943(62.6 %) were statin naïve. Statin-user vs. statin-naïve patients were older(62±10 vs. 60±11y), with more hypertension(61 vs. 48 %), diabetes(36 vs. 32 %), prior PCI(20 vs 8 %), CABG(5 vs 2 %), beta-blockers(61.7 vs 8.3 %), anti-platelets(92.8 vs 5.3 %), and lower mean total-, LDL-, and non-HDL-cholesterol(<em>p</em> &lt; 0.001); chronic statin users had less STEMI(30 % vs 47 %) and better LVEF(46.5 ± 10 vs 44.5 ± 10 %) at presentation and median hospitalization was shorter(66.3 vs 68.6 h)(<em>p</em> &lt; 0.001). In statin-user vs. statin-naïve groups, the incidence of all-cause deaths: 33(1.12 %) vs 85(1.72 %) (OR 0.65, CI 0.43–0.97) and CV deaths: in 29(0.98 %) vs 73(1.47 %) (OR 0.67, CI 0.43–1.02) were lower. The ORs attenuated following multivariate adjustments for risk factors, previous treatments, clinical features, angiographic findings and interventions.</div></div><div><h3>Conclusions</h3><div>Acute coronary syndrome patients taking pre-admission statins and other cardioprotective medicines have lower in-hospital all-cause deaths. This is associated with less STEMI, better LVEF, and shorter hospitalization in prior statin users.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100999"},"PeriodicalIF":4.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874716","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}