American journal of preventive cardiology最新文献

{"title":"Associations between artificial sweeteners and cardiovascular disease, stroke, and diabetes: A Mendelian randomization study","authors":"Jinming Fan ,&nbsp;Yifei Hu ,&nbsp;Junzhu Zhang ,&nbsp;Jiawen Chen ,&nbsp;Yajun Yuan ,&nbsp;Benshuai Yu","doi":"10.1016/j.ajpc.2025.101325","DOIUrl":"10.1016/j.ajpc.2025.101325","url":null,"abstract":"<div><h3>Background</h3><div>Erythritol is a widely used artificial sweetener, yet its long-term impact on cardiometabolic health remains debated. This study aimed to investigate the genetic associations of erythritol with cardiovascular disease (CVD), stroke, and diabetes using a two-sample Mendelian randomization (TSMR) approach.</div></div><div><h3>Methods</h3><div>We utilized single-nucleotide polymorphisms (SNPs) associated with erythritol levels from genome-wide association studies (GWAS) as instrumental variables (IVs). The primary analysis employed the inverse-variance weighted (IVW) method. Robustness was assessed using multiple sensitivity analyses (including MR-Egger, weighted median, weighted multitude, and simple mode). Heterogeneity test, pleiotropy test, and sensitivity analysis were also conducted to further ensure the accuracy and stability of the research results.</div></div><div><h3>Results</h3><div>Erythritol showed positive associations with coronary heart disease (CHD) (OR = 1.0020, 95% CI: 1.0007–1.0034, <em>P</em> = 0.0034), myocardial infarction (MI) (OR = 1.0015, 95% CI: 1.0004–1.0026, <em>P</em> = 0.0090), and stroke (OR = 1.0463, 95% CI: 1.0010–1.0937, <em>P</em> = 0.0449) according to the IVW method. There was suggestive evidence of a positive association between erythritol and CHD, MI, and stroke. No significant causal association was observed between erythritol with heart failure (HF) and diabetes.</div></div><div><h3>Conclusions</h3><div>This TSMR study provides genetic evidence suggesting erythritol is associated with an increased risk of CHD, MI, and stroke, but not with HF or diabetes. Our findings could further clarify the effect of erythritol on CVD, stroke and diabetes, and thus be more beneficial in reducing the risk of disease. Clinical trial number: not applicable.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101325"},"PeriodicalIF":5.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268328","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":"Global, regional, and national burden of atrial fibrillation and atrial flutter in the working-age population from 1990 to 2021: A systematic analysis based on 2021 global burden of disease data","authors":"Chao Yang ,&nbsp;Youjin Kong ,&nbsp;Xiao Liu ,&nbsp;Xingxiao Huang ,&nbsp;Qiuliu Sun ,&nbsp;Hanxin Wang ,&nbsp;Minjun Yu ,&nbsp;Beibei Gao ,&nbsp;Jinyu Huang","doi":"10.1016/j.ajpc.2025.101322","DOIUrl":"10.1016/j.ajpc.2025.101322","url":null,"abstract":"<div><div>Atrial fibrillation and atrial flutter impose a significant global health burden, particularly among individuals aged 30–64 years. This study analyzed data from the Global Burden of Disease 2021 database to estimate disease burden trends from 1990 to 2021. Key metrics included age-standardized incidence, prevalence, mortality, and disability-adjusted life years rates, stratified by age, sex, and Socio-Demographic Index. The methodologies encompassed descriptive analysis, age-period-cohort modeling, decomposition techniques, and Bayesian forecasting. From 1990 to 2021, age-standardized incidence rates increased by an estimated annual percentage change of 0.14, prevalence rates by 0.20, and disability rates by 0.08, while mortality rates declined by 0.16. By 2021, global incidence reached 47.05 per 100,000 population, prevalence 397.94, mortality 0.49, and disability 48.46. High-SDI regions exhibited the highest burden, with incidence at 61.01 and prevalence at 515.73 per 100,000, whereas low-SDI regions recorded the lowest incidence and prevalence at 35.32 and 282.73, respectively. Males consistently showed higher incidence, prevalence, and disability rates than females, with disease burden peaking in the 60–64 age group. Population growth contributed 52 % to the rise in prevalent cases, surpassing aging and epidemiological factors. Projections to 2050 indicate declines in incidence to 45.18 and prevalence to 387.53 per 100,000, but mortality and disability rates are expected to rise to 0.51 and 49.29. High systolic blood pressure accounted for 13.04 % of disability-adjusted life years globally, with contributions from high body mass index increasing across all SDI quintiles. Health inequalities narrowed between high- and low-SDI countries, with the slope index of inequality decreasing from 21.41 to 15.41 per 100,000 years and the concentration index shifting from 0.04 to -0.02. Critical priorities include optimising screening programmes in high-SDI regions, expanding access to hypertension control and anticoagulant therapy in low-SDI areas, and implementing reasonable monitoring of consumption of highly processed foods high in salt and sugar. Multisectoral strategies integrating real-time burden monitoring, salt-sugar regulation policies, and equitable technology distribution are essential to align with Sustainable Development Goals. This study underscores the necessity of region-specific interventions to mitigate economic productivity losses linked to atrial fibrillation and atrial flutter in the working-age population.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101322"},"PeriodicalIF":5.9,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268326","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":"Beyond ‘low salt, low fat’: Reimagining nutrition advice in the cardiac discharge summary","authors":"Suvetha Kannappan ,&nbsp;Rajendiran Gopalan","doi":"10.1016/j.ajpc.2025.101321","DOIUrl":"10.1016/j.ajpc.2025.101321","url":null,"abstract":"<div><div>Despite strong evidence on the role of nutrition in secondary prevention of cardiovascular diseases, most cardiac discharge advises are generic and vague. This commentary advocates for a paradigm shift in post-discharge dietary counseling, positioning it as a critical, evidence-based tool for secondary prevention. Gathering evidence from global and interventional studies, we discuss the need for specific, prescriptive nutritional advice during discharge when patients are in the most receptive period. This commentary also briefs about the challenges that prevent clinicians from delivering meaningful dietary advice. We propose a multi-level strategy: integrating nutrition and behavior change counseling into medical education and licensing standards; building physician competence through experiential methods like culinary medicine; embedding structured dietary prescriptions into electronic health records; and ensuring consistent discharge summary quality through institutional policies and training. Furthermore, aligning policy reforms—including insurance coverage for nutrition counseling and food-is-medicine initiatives—will be essential to scale these interventions equitably. By redefining the role of nutrition in discharge planning, health systems can improve patient engagement, reduce readmissions, and contribute meaningfully to cardiovascular disease prevention and health system sustainability.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101321"},"PeriodicalIF":5.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268323","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":"Clinical, economic, and health care resource utilization burden of acute myocardial infarction and the role of systemic inflammation in US hospitals: A real-world study","authors":"Lei Lv ,&nbsp;Jeffrey R. Skaar ,&nbsp;Carey Robar ,&nbsp;Sunday Ikpe ,&nbsp;Shanthi Krishnaswami ,&nbsp;Zhun Cao ,&nbsp;Weilong Li ,&nbsp;Michael G. Nanna","doi":"10.1016/j.ajpc.2025.101320","DOIUrl":"10.1016/j.ajpc.2025.101320","url":null,"abstract":"<div><h3>Background</h3><div>Acute myocardial infarction (AMI), a leading cause of death in the US, is associated with significant clinical and economic burden. Systemic inflammation is a risk factor for worse cardiovascular outcomes, but the role of systemic inflammation in patients with AMI is not well established.</div></div><div><h3>Objective</h3><div>To evaluate clinical, health care resource utilization (HCRU), and economic outcomes in patients with type 1 AMI, and explore results based on systemic inflammation status.</div></div><div><h3>Methods</h3><div>Data from the Premier Healthcare Database were retrospectively analyzed, including adults with ≥1 inpatient hospitalization for type 1 AMI (using <em>ICD-10-CM</em> codes) from January 1, 2017, to August 31, 2023. Data were analyzed at index and within 30 and 90 days after index discharge. Demographics, clinical and HCRU outcomes, and costs were described for all patients with AMI and compared between those with and without evidence of systemic inflammation. Inflammation status was based on C-reactive protein (CRP) or high-sensitivity C-reactive protein (hsCRP) levels, such that patients with CRP/hsCRP between 2 and 10 mg/L were considered to have evidence of systemic inflammation. Patients with levels &lt;2 mg/L or without CRP/hsCRP test results were considered to have no evidence of systemic inflammation. CRP/hsCRP test results were available in a limited number of patients.</div></div><div><h3>Results</h3><div>Among patients with AMI (<em>N</em> = 1,078,572), in-hospital mortality was 7.6 % during index hospitalization. The mean index length of stay was 5 days, and average cost of care was $23,648. Readmission rates were 7.9 % and 12.9 % within 30 and 90 days after discharge, respectively. Patients with evidence of systemic inflammation (<em>n</em> = 1673) had higher mortality and longer index stays as well as increased readmission rates compared with patients without evidence of systemic inflammation (<em>n</em> = 1,076,899) (all, <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Patients experiencing AMI, and especially those with evidence of systemic inflammation, experience persistently high risk of mortality, morbidity, recurrence, and large economic burdens. Greater attention is needed to optimize the care of this at-risk population.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101320"},"PeriodicalIF":5.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268325","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":"Importance of Life’s Essential 8 in predicting short- and long-term incidence of cardiovascular disease: The atherosclerosis risk in communities study","authors":"Renjie Zou ,&nbsp;Zheqi Wen ,&nbsp;Chenyin Zhang ,&nbsp;Zhuoshan Huang ,&nbsp;Xiaodong Zhuang ,&nbsp;Zhen Wu","doi":"10.1016/j.ajpc.2025.101315","DOIUrl":"10.1016/j.ajpc.2025.101315","url":null,"abstract":"<div><h3>Background</h3><div>As is acknowledged that there is a strong negative association between Life’s Essential 8 (LE8) and the major adverse cardiovascular events (MACE). However, from the perspective of primary prevention of cardiovascular diseases (CVD), it is more valuable to discover the factors to predict the incidence of CVD. We intend to explore the predictive value of LE8 for the short-term and long-term incidence of CVD in the population without CVD at baseline.</div></div><div><h3>Methods</h3><div>Participants in the ARIC (Atherosclerosis Risk in Communities) study were studied. Logistic regression models estimated the relationship between LE8 and CVD, including coronary heart disease (CHD), atrial fibrillation (AF) and stroke. Cox proportional hazards regression models were employed to assess whether an increase in the LE8 score could reduce the short-term and long-term incidence of CVD.</div></div><div><h3>Results</h3><div>Among the 8083 participants studied at V2, 332 (4.1%) were diagnosed with CHD, 98 (1.8%) with stroke, and 24 (0.3%) with AF. LE8 was negatively associated with the prevalence of CHD, stroke, but without statistically significant association with AF. After adjusting for other cardiovascular-related risk factors, LE8 was still negatively associated with stroke (OR:0.959; 95%CI, 0.943-0.976; P&lt;0.001). During the short-term follow-up, for each 1-point increase in the LE8 score, the risks of CHD, stroke, and AF decreased by 6.5%, 5.4%, and 5.1% respectively (the hazard ratio values were 0.935, 0.946, and 0.949). Whether LE8 was used as a continuous variable or a categorical variable, the higher the score, the lower the likelihood of developing CHD at the long-term follow-up. Using the ROC curve, the area under the curve (AUC) of LE8 for predicting the 5-year, 15-year, and 25-year incidence of CHD was 0.77, 0.696, and 0.644, respectively.</div></div><div><h3>Conclusions</h3><div>A higher LE8 score is consistently associated with a lower probability of the incidence of CHD during both short-term and long-term follow-up periods.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101315"},"PeriodicalIF":5.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268327","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 discovery of PCSK9 as a pivotal point in the prevention of cardiovascular disease","authors":"Alexander C. Razavi ,&nbsp;Michael D. Shapiro","doi":"10.1016/j.ajpc.2025.101314","DOIUrl":"10.1016/j.ajpc.2025.101314","url":null,"abstract":"<div><div>Proprotein convertase subtilisin/kexin type 9 (PCSK9) is an important component in the regulation of low-density lipoprotein-cholesterol (LDL-C) metabolism, discovered more than two decades ago. The discovery of PCSK9 and subsequent development of PCSK9 inhibitors (PCSK9i) have helped usher a new era of non-statin lipid-lowering therapy for atherosclerotic cardiovascular disease (ASCVD) risk reduction. In addition to individuals with clinical ASCVD, there have been evolving recommendations for the clinical use of PCSK9i to extend to individuals with familial hypercholesterolemia as well as high-risk primary prevention patients, including those with advanced subclinical atherosclerosis. Beyond the initial development of PCSK9 monoclonal antibodies (mAb), this class of therapies has expanded to include several different modes of administration that are currently being studied for efficacy and safety, including small interfering RNA (siRNA), adnectins, oral, and potentially even CRISPR-based methods. Such scientific advancement and enthusiasm have been moderated by public health challenges involving cost and access of therapy, which we hope will continue to improve in an era emphasizing earlier and greater utilization of combination lipid-lowering therapy. In this review, we will summarize PCSK9 biology, followed by an assessment of completed and ongoing randomized controlled trials involving PCSK9i. This will then be followed by a review of current clinical recommendations for the utilization of PCSK9i, future directions, and concluded with clinical and public health impact. Through this process, we hope to highlight the integral role of PCSK9i in the prevention of ASCVD.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101314"},"PeriodicalIF":5.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221565","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 of estimated glucose disposal rate with all-cause and cardiovascular mortality in individuals with cardiovascular-kidney-metabolic syndrome: Two prospective cohorts","authors":"Yupeng Wei ,&nbsp;Jiangtao Li","doi":"10.1016/j.ajpc.2025.101312","DOIUrl":"10.1016/j.ajpc.2025.101312","url":null,"abstract":"<div><h3>Background</h3><div>Given evidence on cardiovascular disease (CVD) risks conferred by comorbidity risk factors, the American Heart Association (AHA) introduced a novel framework, named cardiovascular-kidney-metabolic (CKM) syndrome. Accumulative evidence suggested that the estimated glucose disposal rate (eGDR) was significantly associated with mortality risk. However, it remains unknown whether this association exists in individuals with CKM syndrome. This study aimed to investigate whether eGDR can predict all-cause and cardiovascular mortality risks among adults with CKM syndrome.</div></div><div><h3>Methods</h3><div>This study used data from two prospective cohorts: the National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS). The exposure was eGDR at baseline, which was calculated using a combination of waist circumference, hypertension, and hemoglobin A1c. Cox regression models and restricted cubic splines were used to calculate the hazard ratio (HR) and 95 % confidence interval (95 % CI) after adjusting for potential confounders. The main outcomes were all-cause and cardiovascular mortality.</div></div><div><h3>Results</h3><div>A total of 34,809 participants (female: 50.8 %, mean age: 46.7 years) and 9,036 from CHARLS (female: 53.3 %, mean age: 59.6 years) were included. The median follow-up periods were 8.3 years in NHANES and 9.0 years in CHARLS. Per 1-SD increase in eGDR was associated with 18 %-24 % lower risks of all-cause mortality after adjusting for confounders (NHANES, HR 0.76, 95 % CI 0.71-0.82; CHARLS: HR 0.82, 95 % CI 0.77-0.88). In NHANES, the adjusted HR (95 % CI) for per 1-SD increase in eGDR was 0.60 (0.53–0.68) for cardiovascular mortality. The dose-response curve between eGDR and mortality risks showed a negative linear relationship in individuals with CKM syndrome.</div></div><div><h3>Conclusion</h3><div>A higher level of eGDR was associated with reduced risk of all-cause and cardiovascular mortality among adults with CKM syndrome. eGDR can serve as a promising predictor and therapeutic target for reducing mortality risks among CKM adults in clinical practice.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101312"},"PeriodicalIF":5.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159149","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 proprotein convertase subtilisin/kexin type 9 targeted therapies and the risk of arrhythmias: a meta-analysis of randomized controlled trials","authors":"Vikash Jaiswal ,&nbsp;Aman Goyal ,&nbsp;Novonil Deb ,&nbsp;Nishat Shama ,&nbsp;Vivek Mittal ,&nbsp;Kripa Rajak ,&nbsp;Anupam Halder ,&nbsp;Sulochana Khadka ,&nbsp;Tushar Kumar ,&nbsp;Raheel Ahmed ,&nbsp;Ibadete Bytyçi ,&nbsp;Maciej Banach ,&nbsp;Lipid and Blood Pressure Meta-Analysis Collaboration (LBPMC) Group","doi":"10.1016/j.ajpc.2025.101311","DOIUrl":"10.1016/j.ajpc.2025.101311","url":null,"abstract":"<div><h3>Background</h3><div>Proprotein convertase subtilisin/kexin type 9 (PCSK9) targeted therapies effectively lower low-density lipoprotein cholesterol (LDL-C) and circulating PCSK9 levels. However, their effect on the risk of arrhythmias remains uncertain, and this meta-analysis aims to investigate the association.</div></div><div><h3>Methods</h3><div>We performed a systematic literature search on all electronic databases for relevant randomized controlled trials (RCTs) from inception until 16th August 2024. Primary clinical endpoint was atrial fibrillation (AFib), while the secondary endpoints were atrial flutter (AFL), ventricular fibrillation (VF), ventricular tachycardia (VT), supraventricular tachycardia (SVT), sudden cardiac death (SCD), cardiac arrest and atrioventricular blocks.</div></div><div><h3>Results</h3><div>28 RCTs with 95,520 patients were finally included in the analysis. The mean age of the group treated with PCSK9 inhibitors was similar to the control group (60.13 years vs. 60.06 years). At mean follow-up of 1.6 years the PCSK9i group had similar risk of AFib (OR, 0.88; 95 %CI: 0.75–1.03, <em>p</em> = 0.11), AFL (OR, 1.04; 95 %CI: 0.70–1.54, <em>p</em> = 0.84), VT (OR, 0.80; 95 %CI: 0.58–1.11, <em>p</em> = 0.18), VF (OR, 0.77;95 %CI: 0.40–1.47, <em>p</em> = 0.43) and SVT (OR, 0.94; 95 %CI: 0.56–1.58, <em>p</em> = 0.82) compared to control group. Similarly, the SCD (OR, 0.91; 95 %CI: 0.62–1.32, <em>p</em> = 0.61), and AV block (OR, 0.72; 95 %CI: 0.34–1.52, <em>p</em> = 0.39) did not differ between the groups.</div></div><div><h3>Conclusion</h3><div>This meta-analysis did not find a significant association between PCSK9i and arrhythmias.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101311"},"PeriodicalIF":5.9,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221727","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":"Relationship between interleukin-6, coronary artery calcium and risk of heart failure: Insights from MESA","authors":"Muhammad Imtiaz Ahmad ,&nbsp;Parag A. Chevli ,&nbsp;Saeid Mirzai ,&nbsp;Rishi Rikhi ,&nbsp;Neha Pagidipati ,&nbsp;Leandro Slipczuk ,&nbsp;Moyses Szklo ,&nbsp;Michael D. Shapiro","doi":"10.1016/j.ajpc.2025.101310","DOIUrl":"10.1016/j.ajpc.2025.101310","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated the joint association of interleukin-6 (IL-6) and coronary artery calcium (CAC) with the risk of heart failure (HF).</div></div><div><h3>Methods and Results</h3><div>Among 6592 participants in the Multi-Ethnic Study of Atherosclerosis (MESA), individuals were categorized into four groups based on CAC (0 vs &gt;0) and IL-6 (cutoff 1.32 pg/mL via Youden’s index): low CAC/low IL-6 (reference), low CAC/high IL-6, high CAC/low IL-6, and high CAC/high IL-6. Multivariable Cox models were used to assess the risk of total heart failure (HF), HF with reduced ejection fraction (HFrEF), and HF with preserved ejection fraction (HFpEF). Compared to the reference group, the hazard ratios (HRs) for total HF were 1.61 (95 % CI, 1.12–2.31) for high IL-6, 1.56 (95 % CI, 1.11–2.20) for high CAC, and 2.00 (95 % CI, 1.43–2.80) when both were elevated (multiplicative interaction <em>p</em> = 0.28). For HFrEF, the risk was significantly higher only when both markers were elevated: HR 2.34 (95 % CI, 1.44–3.81), compared to isolated CAC (1.11; 95 % CI, 0.65–1.87) or IL-6 (1.07; 95 % CI, 0.59–1.95) (multiplicative and additive interaction <em>p</em> = 0.05 and 0.008, respectively). Conversely, for HFpEF, the combined elevation of IL-6 and CAC was associated with a lower risk than either marker alone: HRs 2.13, 2.31, and 2.21, respectively (antagonistic multiplicative interaction, <em>p</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>Combined elevation of IL-6 and CAC was associated with increased HFrEF risk, with significant additive and multiplicative interactions. For HFpEF, combined elevation conferred less risk than either alone. Inflammation modifies the CAC<img>HFrEF relationship and merits further study.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101310"},"PeriodicalIF":5.9,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121286","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":"Efficacy and safety of obicetrapib in patients with dyslipidemia: An updated meta-analysis of randomized controlled trials","authors":"Beatriz Araújo ,&nbsp;Giang Son Arrighini ,&nbsp;Flávia Queiroga ,&nbsp;Ensieh Sadat Mansouri ,&nbsp;André Rivera ,&nbsp;Wellgner Fernandes Oliveira Amador ,&nbsp;Ivo Queiroz ,&nbsp;Maria Antônia Costa Cruz Akabane ,&nbsp;Leo N Consoli ,&nbsp;Milene Vitória Sampaio Sobral ,&nbsp;Lucas M. Barbosa ,&nbsp;Luciana Gioli-Pereira ,&nbsp;Erin D. Michos","doi":"10.1016/j.ajpc.2025.101303","DOIUrl":"10.1016/j.ajpc.2025.101303","url":null,"abstract":"<div><h3>Introduction</h3><div>Obicetrapib is a novel cholesteryl ester transfer protein (CETP) inhibitor with promising lipid-lowering effects. While earlier CETP inhibitors have shown inconsistent cardiovascular outcomes and safety concerns, the efficacy and safety of obicetrapib remain under active investigation.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, and Cochrane Central databases for randomized controlled trials (RCTs) comparing obicetrapib versus placebo in adults with dyslipidemia or at high cardiovascular risk. We pooled mean differences (MDs) with 95 % confidence intervals (CI) with a random effects model. We used R software version 4.4.2 for statistical analysis.</div></div><div><h3>Results</h3><div>We included 7 RCTs comprising 3381 participants, of whom 2151 (63 %) received obicetrapib. The mean age was 64.3 years, and 36 % were women. Compared with placebo, obicetrapib significantly reduced mean LDL-C (MD: -37.21 %; 95 % CI: -41.53 to -32.90; <em>p</em> &lt; 0.01; I²=64 %), lipoprotein(a) (MD: -37.16 %; 95 % CI: -43.63 to -30.70; <em>p</em> &lt; 0.01, I²=48 %), apolipoprotein B (MD: -24.65 %; 95 % CI: -28.71 to -20.59; <em>p</em> &lt; 0.01; I²=83 %), non-HDL-C (MD: -31.90 %; 95 % CI: -34.81 to -28.99; <em>p</em> &lt; 0.01; I²=0 %), and triglyceride levels (MD: -7.21 %; 95 % CI: -11.13 to -3.30; <em>p</em> &lt; 0.01; I²=0 %). Interestingly, obicetrapib also reduced the incidence of new-onset diabetes (RR: 0.88; 95 % CI: 0.80 to 0.97; <em>p</em> = 0.01; I²=0 %). In contrast, obicetrapib significantly increased HDL-C (MD: 142.17 %; 95 % CI: 117.56 to 166.78; <em>p</em> &lt; 0.01; I²=98.3 %), total cholesterol (MD: 11.94 %; 95 % CI: 5.61 to 18.28; <em>p</em> = 0.01; I²=91 %), and apolipoprotein A1 concentrations (MD: 52.76 %; 95 % CI: 41.87 to 63.66; <em>p</em> &lt; 0.01; I²=94 %). There were no significant differences in adverse events.</div></div><div><h3>Conclusion</h3><div>Among patients with dyslipidemia and/or high cardiovascular risk, obicetrapib significantly reduces LDL-C, lipoprotein(a), apolipoprotein B, and non-HDL-C. No significant differences were observed in adverse events, supporting the favorable safety profile of obicetrapib.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101303"},"PeriodicalIF":5.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221564","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}