American journal of preventive cardiology最新文献

{"title":"CARDIOVASCULAR REHABILITATION IN THE PUBLIC HEALTH SYSTEM. 10 YEARS OF EXPERIENCE IN A CENTER IN BUENOS AIRES - ARGENTINA","authors":"NORBERTO BORNANCINI M.D ,&nbsp;Laura Lopez Ph ,&nbsp;Lilian Arnold (Nurse) ,&nbsp;Marcelo Murillo MD","doi":"10.1016/j.ajpc.2025.101089","DOIUrl":"10.1016/j.ajpc.2025.101089","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Rehabilitation</div></div><div><h3>Background</h3><div>Cardiovascular rehabilitation (CR) is a tool already known worldwide. Today it is an IA indication in secondary cardiovascular prevention. The intention of this abstract is to show our 10 years of experience in CR within the public health system and the results obtained.</div></div><div><h3>Methods</h3><div>This is a single-center descriptive study. All recruited patients belong to the CR program of the Manuel Belgrano Hospital located in Buenos Aires, Argentina. This hospital belongs to the provincial public health system and does not have industry funding.</div><div>For 10 years, patients entered the CR program referred by cardiologists from the same hospital (90%) and specialists from other centers (10%). Upon admission, all patients had an interview and evaluation with the “Heart Team CR” made up of cardiologists, nutritionists, social workers and mental health professionals. Once the initial stage was over, they were assigned training days and times (2 to 3 times a week with 45-minute sessions). The average duration of CR was 6 months and patients moved on to stage IV of CR.</div><div>During the COVID-19 pandemic, we were forced to close our doors but continued virtually. Patients were able to choose virtual classes (via Zoom with audio and video) or receive a training program by mail. We were able to present this experience at other scientific meetings where we observed greater adherence in the Zoom session group.</div></div><div><h3>Results</h3><div>420 patients (45% women) with a mean age of 70 ± 2 years were included. Overall mortality was 1% and only 0.1% was due to cardiovascular causes (mostly associated with sepsis and advanced cancer). In the analysis by gender, men were included up to 6 days after discharge while women were admitted after 15 days after discharge from the hospital. Only 30% had health insurance, which allows the CR program to be self-funded, regardless of this, all patients received care within the program. A low dropout rate from the program was observed (only 2% of the total).</div></div><div><h3>Conclusions</h3><div>We are currently continuing to work and expand the network so that more patients can be included. We have gone through the pandemic and the change of 3 national democratic governments with different political ideas...and here we are.</div><div>The CR depends on us and this is our experience.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101089"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104953","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":"WHERE YOU LIVE MATTERS: COUNTY-LEVEL SOCIAL VULNERABILITY INDEX NEGATIVELY IMPACTS CARDIOVASCULAR DISEASE HOSPITALIZATIONS","authors":"Ewuradjoa Ayirebi-Acquah MD ,&nbsp;Acheliu Longla Terence MD ,&nbsp;Keti Solomnishvili MD ,&nbsp;Abena Agyekum MD ,&nbsp;Wendy Miranda MB CHB","doi":"10.1016/j.ajpc.2025.101173","DOIUrl":"10.1016/j.ajpc.2025.101173","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Therapeutic Area&lt;/h3&gt;&lt;div&gt;Preventive Cardiology Best Practices – clinic operations, team approaches, outcomes research&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Cardiovascular disease (CVD) is the leading cause of morbidity, hospitalization and mortality among adults in the United States (US): every 33 seconds, one person dies from a CVD. Social Vulnerability Index (SVI) is used to identify and prioritize communities that need more support during disasters. It has four main themes: socio economic status; household characteristics; racial and ethnic minority status; and housing type and transportation. Previous studies have shown a significant association between SVI and the prevalence and risk factors of cardiovascular disease (CVD), and heart failure readmissions, However, little is known about the collective impact of SVI and CVD-related hospitalization rate (CVDHR) in the United States (US).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To examine the association between county-level SVI and CVDHR among adults aged 35 years and older in terms of gender, race and state in the top 5 populated US states between 2019 to 2021.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a retrospective cross-sectional study of county-level CVDHR data between 2019-2021 for people aged 35 and older in the top 5 populated states in the US (California, Texas, Florida, New York, and Pennsylvania). The data were obtained from the Centers for Disease Control (CDC) and Prevention Interactive Atlas of Heart Disease and Stroke database. This data was linked to county-level SVI data obtained from the Agency for Toxic Substances and Disease Registry. The linked data wad divided into quartiles based on SVI percentile scores with SVI-Q1 (0-0.25, least vulnerable) to SVIQ4 (0.75-1, most vulnerable). The CVDHR per 100,000 persons and the 95% confidence interval (CI) were computed for the overall population and then stratified by gender, race, state of residence, and SVI quartile. The outcome was the rate difference between SVIQ4 and SVI-Q1 and a negative impact by SVI was characterized by a higher VCDHR within SVI-Q4 compared with SVI-Q1 and nonoverlapping Cis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The overall mean CVDHR (per 100,000) for SVI-Q4 (41.3; CI: 39.8-42.7) was significantly higher than that for SVI-Q1 (38.4: CI: 37.1-39.7) with an excess of 2.9 CVDH per 100,000. Similarly, the CVDHR was higher in SVI-Q4 than in SVI-Q1 among females [(36.8; CI:35.4-38.3 vs 33.1: CI:32.0-34.3); excess of 3.7];for Hispanics CVDHR was higher in SVI-Q4 than in SVI-Q1 [(33.9; CI:30.5-37.3 vs 32.0; CI:30.4-33.5); excess of 4.3] and in Whites [(41.4; CI:39.3-42.9 vs 40.1; CI:39.4-40.8);excess of 2.9] and in California, the number of hospitalizations for SVI-Q4 was significantly higher than that for SVI-Q1 [34.4; CI: 31.3-37.5 vs 28.2; CI:25.8-30.5); an excess of 6.2]. There was no significant difference between SVI-Q4 and SVI-Q1 for males, Black people, and the other states.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101173"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMPACT OF A DEDICATED CARDIOMETABOLIC CLINIC ON PRESCRIPTION OF INCRETIN-BASED THERAPIES – A US-BASED EXPERIENCE","authors":"Arpan Patel BSA ,&nbsp;Priyanka Satish MD ,&nbsp;Lakshya Trivedi MD ,&nbsp;Rachna Prasad MBBS ,&nbsp;Vu Nguyen MD ,&nbsp;Thomas Kurian MD ,&nbsp;Steve Alexander MD","doi":"10.1016/j.ajpc.2025.101158","DOIUrl":"10.1016/j.ajpc.2025.101158","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Preventive Cardiology Best Practices – clinic operations, team approaches, outcomes research</div></div><div><h3>Background</h3><div>Incretin-based therapies have shown benefits in patients with obesity and cardiometabolic comorbidities. Despite this, the implementation of incretins in eligible US patients is suboptimal due to therapeutic inertia, medication cost, and insurance coverage. We describe a dedicated cardiometabolic clinic for patients with obesity and comorbid cardiovascular disease.</div></div><div><h3>Methods</h3><div>Patients with a BMI (Body Mass Index) greater than 30 and a diagnosis of Type 2 Diabetes (T2DM), Coronary Artery Disease (CAD), Heart Failure (HFpEF), or Atrial Fibrillation (AF) were referred to a dedicated clinic at the Dell Seton Medical Center of Austin. The interdisciplinary team consisted of preventive cardiologists, a nurse practitioner, a dietician, and a clinic coordinator that conducted visits for enrolled patients.</div><div>We retrospectively collected patients seen from September 2023 to September 2024. The primary outcome was the prescription of a GLP-1 RA or a GIP/GLP-1 co- agonist in individuals. Two researchers independently verified the accuracy of coding by chart abstraction. Analyses were performed on Microsoft Excel.</div></div><div><h3>Results</h3><div>A total of 186 patients were referred to the program. All patients received individualized diet and exercise counseling, however 100 (53%) patients were excluded either due to insurance or opted-out voluntarily from medication-based weight management. Of the 86 patients, 50 patients were approved, and 40 patients completed at least one follow up visit and had data available for analysis, (Figure 1).</div><div>In our sample, 28 patients (70%) were started on Semaglutide, 11(27%) on Tirzepatide. Comorbidities varied: 19 (47%) of patients had T2DM, 34 (85%) had hypertension, 26 (65%) had OSA, 16 (40%) had CAD, 20 (50%) had AF, 5 (0.1%) patients had HFpEF. The median weight at baseline was 115 kg (IQR 102- 126 kgs) and median BMI was 39 (IQR 35 -45). Nine patients (22%) reported gastrointestinal side effects at their first follow up visit. No patients stopped therapy due to side effects.</div></div><div><h3>Conclusions</h3><div>We describe a multidisciplinary program that combines lifestyle and medical management to address obesity and comorbid cardiometabolic risk in high-risk patients. Our initial results demonstrate that an interdisciplinary care team can maximize incretin-based therapy use and address care fragmentation.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101158"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104251","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":"REASSESSING ASCVD RISK: COMPARING THE POOLED COHORT AND PREVENT EQUATIONS IN A PREDOMINANTLY HISPANIC COHORT","authors":"Shreya Arvind MBBS ,&nbsp;Sriram Sunil Kumar MBBS ,&nbsp;Hilary Wagner MD ,&nbsp;Sunil D'Cunha MD","doi":"10.1016/j.ajpc.2025.101146","DOIUrl":"10.1016/j.ajpc.2025.101146","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Assessment</div></div><div><h3>Background</h3><div>Cardiovascular disease is a leading cause of morbidity and mortality, highlighting the need for accurate risk assessment tools. The latest Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) equations include kidney health, metabolic factors, and social determinants in addition to some of the factors considered in the PCEs. The Hispanic population has been underrepresented in the development of the PREVENT equation and subsequent studies. This study aims to compare 10-year atherosclerotic CVD (ASCVD) risk estimates using PCEs and PREVENT in a predominantly Hispanic population at a resident clinic.</div></div><div><h3>Methods</h3><div>This cross-sectional study included adults aged 40 to 75 who attended an urban resident clinic within the last 48 months. Baseline demographic and clinical data were collected for all eligible patients without pre-existing CAD or heart failure and respective ASCVD risk was calculated using PCE and PREVENT website calculators.</div></div><div><h3>Results</h3><div>In a cohort of 57 patients, 82% were Hispanic, 9% Asian, 5% Black or African American, and 4% Caucasian. 43% were at least on statin therapy. The mean estimated 10-year ASCVD risk using the PCEs was 8.6% and PREVENT equations was 4.6%. A strong correlation was observed between the two risk estimates, with a correlation coefficient of R=0.84 (p &lt; 0.05). However, a mean difference of 3.94 was observed between the risk estimates, with the PCEs overestimating risk.</div></div><div><h3>Conclusions</h3><div>Despite the small sample size and limited generalizability, our findings in a Hispanic-majority cohort align with larger PREVENT validation studies, showing a strong correlation (R=0.84) but significant PCE overestimation (8.6% vs 4.6%) With PCEs tending to overestimate cardiovascular risk, further studies are warranted to see the performance of PREVENT in high metabolic risk subgroups and its ability to optimize statin eligibility by avoiding overestimation. Using the PREVENT equations in primary care may also increase appropriate screening for kidney and metabolic diseases and encourage adequate optimization of those factors thereby reducing overall ASCVD risk.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101146"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104366","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":"LONG TERM PHYSICAL AND MENTAL HEALTH OUTCOMES IN PATIENTS WHO PARTICIPATE IN CARDIAC REHABILITATION","authors":"Natalie Bracewell MD,&nbsp;Jonathan Lopez MD,&nbsp;Shawn Simek MD,&nbsp;Dhaval Naik MD,&nbsp;Jamie Conti MD,&nbsp;Ellen Keeley MD","doi":"10.1016/j.ajpc.2025.101094","DOIUrl":"10.1016/j.ajpc.2025.101094","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Rehabilitation</div></div><div><h3>Background</h3><div>Cardiac rehabilitation reduces hospitalizations and mortality long-term and improves the short-term quality of life for participants. Cardiac rehabilitation is also significantly underutilized. Our goal was to see if patients continue to have additional long-term benefits including less symptoms, increased activity levels and lower rates of depression at one year after completion of cardiac rehabilitation.</div></div><div><h3>Methods</h3><div>A total of 200 subjects were enrolled into cardiac rehabilitation and completed baseline questionaries. These surveys evaluated current symptoms, metabolic equivalents (METs) with the Duke Activity Status Index (DASI) and screened for depression with Patient Health Questionnaire-9 (PHQ-9). Follow-up phone surveys were conducted one year after graduation from cardiac rehabilitation and for those who did not complete the program, one year after their last attended session.</div></div><div><h3>Results</h3><div>There were 82 patients who were surveyed at one year follow up. A t-test was used to evaluate the demographics and questionaries results and a Wilcoxon Rank Sum Test was used to compare the DASI and PHQ9 results.</div><div>There was no difference in shortness of breath or chest pain at baseline, but patients who had completed cardiac rehabilitation had significantly less symptoms at follow up compared to those who did not complete the program (32% vs. 63%, p=0.007).</div><div>For patients who completed cardiac rehabilitation, the initial baseline METs were lower than those who did not complete the program 4.8 [4.1-7.1] vs. 6.1 [4.8-8.2] (p=0.021). However, at one year follow up there was a greater gain in METs from baseline 1.5 vs. 0.8 in cardiac rehab graduates (p=0.01).</div></div><div><h3>Conclusions</h3><div>Patients who completed the cardiac rehabilitation had less symptoms and a greater gain in activity levels one year after completion than those who did not finish the program. There were limitations to our study, including it being a small, single-centered study and having low retention (41%). The study started just before the COVID pandemic so many participants did not complete the program.</div><div>We saw a reduction in symptoms at one year follow up and increased gain of activity for those who graduated. This information can be used to inform patients that the benefits of cardiac rehabilitation improve everyday life and are long lasting.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101094"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104571","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":"TRENDS IN COMPLEMENTARY AND ALTERNATIVE MEDICINE USE IN CONGESTIVE HEART FAILURE","authors":"Kevin Kozakowski DO, MPH,&nbsp;Audrey Shawley MD, MBA,&nbsp;Najah Khan MD","doi":"10.1016/j.ajpc.2025.101128","DOIUrl":"10.1016/j.ajpc.2025.101128","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Alternative and Complimentary Approaches</div></div><div><h3>Background</h3><div>Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine 1. A systematic review of the existing literature found that the prevalence of CAM use ranges between 5% and 74.8% 2. This wide variation necessitates further investigation of CAM prevalence, particularly with disease stratification. There is an increasing interest in CAM use in patients with conditions such as congestive heart failure (CHF). This study strives to evaluate CAM use among adults with a history of CHF.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis using data from the Integrated Public Use Microdata Series - National Health Interview Survey from 2002 was performed to assess CAM use in adults with a history of CHF. This is the last year CAM data was known to be collected. Descriptive statistics and Fisher’s exact test for any single CAM modality vs demographic variables were performed.</div></div><div><h3>Results</h3><div>Among the 577 respondents who reported having been told they had heart failure, mean age was 68 with other demographic variations (Figure 1A). There were 13 respondents who reported using at least one CAM Modality (Figure 1B). The strongest association was noted for age and sex. Those above the age of 65 and men were 5 times and 3.6 times more likely to use CAM for CHF, respectively. No other associations were identified (Figure 1C).</div></div><div><h3>Conclusions</h3><div>Though the sample size was limited, this study highlights the potential trends and increased use of CAM in adults with a history of CHF, given that this data was collected over 15 years ago. One limitation of this study is the ethnic homogeneity of the population, and a more diverse demographic may uncover increased and broader uses of CAM in adults with a history of CHF. Healthcare providers should be cognizant of CAM use in patients with CHF and discuss the potential benefits and risks with their patients to ensure safe and well-coordinated care. More rigorous research is needed to determine the effects and long-term benefits on cardiovascular health with CAM usage in patients with a history of CHF.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101128"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104630","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":"EXCESS EPICARDIAL FAT VOLUME IS A NOVEL RISK MARKERFOR EARLY CARDIOVASCULAR DISEASE PREVENTION, AND AN EARLY PREDICTOR THAN THE CALCIUM SCORE","authors":"MAHFOUZ EL SHAHAWY MD, MS ,&nbsp;Antonella Sabatini MD ,&nbsp;Eisha Mohmed MD","doi":"10.1016/j.ajpc.2025.101132","DOIUrl":"10.1016/j.ajpc.2025.101132","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Assessment</div></div><div><h3>Background</h3><div>Abnormally high coronary calcium score has been promoted in the guidelines helpful for CV risk re-classification, particularly in the intermediate risk group, as recommended by ACC/AHA guidelines. Excess EFV has been reported in the recent years to be associated with excessive production of inflammatory adipokines which is a culprit for endothelial dysfunction, atherosclerosis and coronary calcification. Therefore, we elected to examine whether elevated epicardial fat volume in asymptomatic subjects with its associated structural and functional abnormalities ultimately contributing to significant coronary artery calcification.</div></div><div><h3>Methods</h3><div>389 asymptomatic subjects were screened for cardiovascular risk assessment using the Early Cardiovascular Disease Risk Scoring System (ECVDRS) known as Rasmussen Risk Score (RRS), previously published. The ECVDRS includes 7 vascular and 3 cardiac tests. Among the additional test, CRP. Coronary artery calcium score (CACS) and epicardial fat volume (EFV) were measured utilizing cardiac CT Siemens SOMATOM Definition Dual source CT scanner 64 × 2. Out of the 389, 183 (47%) below age 80 years had excess EFV. The 183 subjects were divided into 3 age-groups: Group1 &lt; 40 years. Group2 40-49 years. Group3 50-79 years, See Table.</div></div><div><h3>Results</h3><div>• In the asymptomatic group under evaluation, excess epicardial fat is prevalent (47%).</div><div>• As noted in table only few subjects in group 1 and 2 (1% and 7%) had very low calcium score while the remaining subjects in group 3 (92%) had significant elevated calcium score.</div><div>• Long standing excess EFV result in significant coronary artery classification as seen in group 3.</div><div>• Excess EFV precedes Coronary calcification as seen in the table.</div></div><div><h3>Conclusions</h3><div>Based on our study, Excess EFV appears to be a major culprit for the development of coronary calcification hence it is recommended to screen early for the excess epicardial fat and treat accordingly to avoid progression to coronary calcification. We recommend measuring EFV in every coronary calcium score images Early detect to protect!</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101132"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104634","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":"30-DAY MORTALITY AND STROKE RISKS IN NON-CARDIAC SURGERY PATIENTS WITH INTRACARDIAC THROMBUS: A NATIONWIDE ANALYSIS","authors":"Nawal Abdi MD ,&nbsp;Akiva Rosenzveig MD","doi":"10.1016/j.ajpc.2025.101164","DOIUrl":"10.1016/j.ajpc.2025.101164","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Ischemic Stroke</div></div><div><h3>Background</h3><div>Intracardiac thrombus (ICT) may increase risks in noncardiac surgery (NCS). This study compared 30-day mortality and stroke risks in NCS patients with and without ICT.</div></div><div><h3>Methods</h3><div>Using TriNetX, we analyzed 5,988 ICT patients (mean age 67.4 years, 66.1% male, 33.9% female) and propensity-matched 5,988 non-ICT patients (of 7,515,324 total patients) ≥45 years undergoing NCS (2020-2025), matched for age, gender, and comorbidities. 30-day mortality and stroke outcomes were assessed via risk percentages, p-values, and Kaplan Meier (KM) hazard ratios. Data was generated on March 20, 2025.</div></div><div><h3>Results</h3><div>The mean age was 67.4 years, 66.2% male, 33.8% female. The ICT cohort had a 30-day mortality risk of 9.7% vs. 4.1% in the non-ICT cohort (p&lt;0.001) and a stroke risk of 2.3% vs. 0.9% (p&lt;0.001), respectively. KM analysis showed a mortality HR of 2.44 (95% CI 2.10-2.83, p&lt;0.001), with survival probabilities of 90.0% (ICT) vs. 95.8% (non-ICT) at 30 days. For stroke, the HR was 2.64 (95% CI 1.92-3.62, p&lt;4e-10), with survival probabilities of 97.6% (ICT) vs. 99.1% (non-ICT).</div></div><div><h3>Conclusions</h3><div>ICT patients (mean age 67.4 years, 66.1% male) undergoing NCS face higher 30-day mortality (9.7% vs. 4.1%, p&lt;1.5e-34) and stroke risks (2.3% vs. 0.9%, p&lt;4e-10) than non-ICT patients (mean age 67.4 years, 66.2% male), with HRs of 2.44 (95% CI 2.10-2.83) for mortality and 2.64 (95% CI 1.92-3.62) for stroke. These findings highlight the need for targeted risk management.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101164"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104754","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 EFFECT OF PERSONAL PROTECTIVE AIDS ON HYPERTENSION AND DIABETES IN PEOPLE LIVING WITH HIGH LEVELS OF CHRONIC AIR POLLUTION: A RANDOMIZED CROSSOVER STUDY","authors":"Shreyas Yakkali MD ,&nbsp;Dweep Barbhaya MD ,&nbsp;Vittal Hejjaji MD, MSc ,&nbsp;Adam Gershon MD ,&nbsp;Aditya Khetan MD MPH","doi":"10.1016/j.ajpc.2025.101117","DOIUrl":"10.1016/j.ajpc.2025.101117","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>CVD Prevention – Primary and Secondary</div></div><div><h3>Background</h3><div>Air pollution is a leading cause of cardiometabolic diseases, especially in the Global South. Exposure to fine particulate matter (PM2.5) has been linked to an increased risk of hypertension (HTN) and type 2 diabetes mellitus (T2DM). Controlled studies show indoor air purifiers and N95 masks lower blood pressure and plasma glucose over short periods, but their real-world effectiveness is unclear. This study evaluates their impact on Systolic Blood Pressure (SBP) and Fasting Blood Glucose (FBG) with routine use.</div></div><div><h3>Methods</h3><div>A prospective, randomized crossover study was conducted in Dalkhola, India, a region with high ambient PM2.5 levels. Seventy-two participants with HTN and/or T2DM were recruited. The intervention included using an indoor air purifier at night and a N95 mask outdoors, while the control group used identical devices with sham filtration. Participants and assessors were blinded to study assignment, and primary outcomes assessed were changes in SBP and FBG (Figure 1).</div></div><div><h3>Results</h3><div>Pre-study controlled testing of the indoor air purifier demonstrated a 67% reduction in PM2.5 levels but real-world use showed no significant difference between groups. SBP decreased by 4.6 ± 11.9 mmHg in the control period and remained unchanged in the intervention period (0 ± 12.0 mmHg; difference: 4.6 mmHg, 95% CI: 0.9 to 8.9, p = 0.02). FBG decreased by 8.3 ± 23.5 mg/dL (control) vs. 2.2 ± 28.5 mg/dL (intervention; difference: 6.2 mg/dL, 95% CI: -4.7 to 17.2, p = 0.26). Focus group discussions revealed that participants opened windows at night due to heat in summer, turned off purifiers due to cold in winter or noise, and limited use over electricity cost concerns.</div></div><div><h3>Conclusions</h3><div>Routine use of indoor air purifiers and N95 masks did not significantly reduce indoor PM2.5 levels or improve SBP and FBG in an area of high ambient air pollution. Unlike regulated conditions, routine use is often suboptimal due to environmental, behavioral and economic factors, making air purifiers unlikely to improve cardiometabolic health in chronically polluted regions of the global south.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101117"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104847","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":"PREDICTING INCIDENT ADVERSE PREGNANCY OUTCOMES USING ESTABLISHED CARDIOVASCULAR RISK SCORES IN HISPANIC/LATINA WOMEN","authors":"Mariana Ramirez MD ,&nbsp;Christian W. Schmidt MS ,&nbsp;Danielle N. Tapp PhD ,&nbsp;Sylvia W. Smoller PhD ,&nbsp;Catherine J. Vladutiu PhD ,&nbsp;Linda C. Gallo PhD ,&nbsp;Odayme Quesada MD ,&nbsp;Carlos J. Rodriguez MD","doi":"10.1016/j.ajpc.2025.101112","DOIUrl":"10.1016/j.ajpc.2025.101112","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCD/CVD in Women</div></div><div><h3>Background</h3><div>Adverse pregnancy outcomes (APOs) are unique, sex-specific risk factors for future cardiovascular disease (CVD) in women. Whether established CVD risk scores can predict the development of APOs remains unexplored, we therefore aim to explore the association of CVD risk scores and incident APOs.</div></div><div><h3>Methods</h3><div>In the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we utilized visit 1 measures to examine the association between baseline CVD risk scores: A. Pooled Cohort Equations (PCE), B. Framingham Risk Score (FRS), and the C. Predicting Risk of cardiovascular disease EVENT (PREVENT) equations for c1. atherosclerotic CVD (ASCVD) and c2. Total CVD (ASCVD + heart failure) — and the development of incident APOs reported at visit 2. Women reporting at least 1 pregnancy between baseline (2008-2011) and visit 2 (2014-2017) were included. APOs included hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (gDM). Survey-weighted values and multivariable-adjusted logistic regression models were employed. Models were adjusted for age, center, background, parity, days between Visit, birth, and history of APOs, marital status and education.</div></div><div><h3>Results</h3><div>Among 555 Hispanic/Latina women, with a mean age of 25.9 ± 5.3 years, 20% developed an incident APO (mean time between visit 1 and birth 3.20 ± 1.83 years). Most women were classified as low CVD risk across all risk score calculators. A 1% increase in CVD risk as predicted by PREVENT-CVD and PREVENT-ASCVD scores was significantly associated with a 3 to 7-fold increased odds of incident APOs (Figure). APO component analyses showed 1% increase in PREVENT scores was associated with a 2-to-3.5-fold higher odds of incident HDP and a 2 to 5 increased odds of incident gDM. In contrast, PCE and FRS were not significantly associated with incident APOs.</div></div><div><h3>Conclusions</h3><div>Despite APOs being well-established risk enhancers for CVD, risk assessment tools do not incorporate nor identify sex-specific factors, such as APOs. Our results suggest that among low-risk young women, the PREVENT risk scores may identify Hispanic/Latina women at higher risk of APOs and therefore future CVD.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101112"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104822","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}