American journal of preventive cardiology最新文献

{"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}

{"title":"Prognostic value of triglyceride-glucose index on predicting major adverse cardiovascular events in hypertensive patients: a systematic review and meta-analysis","authors":"Iwan Dakota ,&nbsp;Wilbert Huang ,&nbsp;Matthew Aldo Wijayanto ,&nbsp;Apridya Nurhafizah ,&nbsp;Alya Roosrahima Khairunnisa ,&nbsp;Shela Rachmayanti ,&nbsp;Enny Yuliana ,&nbsp;Angela Felicia Sunjaya ,&nbsp;Bambang Budi Siswanto","doi":"10.1016/j.ajpc.2025.100996","DOIUrl":"10.1016/j.ajpc.2025.100996","url":null,"abstract":"<div><h3>Background</h3><div>Triglyceride- glucose (TyG) index, a marker of insulin resistance, has been shown to be associated with the incidence of cardiometabolic diseases including hypertension. However, the prognostic role of TyG index is unknown. Hence, we aim to determine the association of TyG index with major adverse cardiovascular events (MACE) in hypertensive patients.</div></div><div><h3>Methods</h3><div>Systematic searching was conducted on 3 databases up till November 2024. We included studies with hypertensive patients despite their comorbidities. Outcome measured is MACE and its individual components. Random effect model meta-analysis is done to pool the results with similar reference point.</div></div><div><h3>Results</h3><div>Twenty observational studies with a total of 451,455 patients of 40 – 70 years old are included. Meta-analysis result shows that higher TyG index is associated with a statistically significant increased risk of MACE (HR 1.90, CI: 1.41 – 2.57, I² 88 %), myocardial infarction (HR 1.55, CI: 1.27 – 1.88, I² 0 %), stroke (HR 1.84, CI: 1.41 – 2.39, I² 62 %), all- cause mortality (HR 1.86, CI: 1.70 – 2.03, I² 0 %) and cardiovascular mortality (HR 1.08, CI: 1.04 – 1.11, I² 0 %). Subgroups of older and younger population, male and female gender, diabetic and non- diabetic population, and higher BMI patients retains the statistically significant risk of MACE (<em>p</em> &lt; 0.05). U- shaped phenomena of TyG index is also demonstrated with the risk of all- cause mortality.</div></div><div><h3>Conclusion</h3><div>TyG index is a reliable prognostic marker of MACE in hypertensive patients and can be utilized in population despite their age, diabetic status, and gender.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100996"},"PeriodicalIF":4.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and impact of abnormal blood pressure on left ventricular hypertrophy in adolescents with congenital heart disease","authors":"Aaron T Walsh ,&nbsp;Kan N Hor ,&nbsp;Mariah Eisner ,&nbsp;Chance Alvarado ,&nbsp;Mahmoud Kallash ,&nbsp;John David Spencer ,&nbsp;Andrew H Tran","doi":"10.1016/j.ajpc.2025.101001","DOIUrl":"10.1016/j.ajpc.2025.101001","url":null,"abstract":"<div><h3>Background</h3><div>Left ventricular hypertrophy (LVH) secondary to hypertension is associated with cardiovascular events in adulthood. Prevalence of abnormal blood pressure and LVH in youths with congenital heart disease (CHD) is understudied despite childhood hypertension predicting adult hypertension. This study aimed to describe the prevalence of hypertension and LVH in adolescents with CHD and factors associated with LVH in this population.</div></div><div><h3>Methods</h3><div>This was a retrospective analysis of echocardiogram reports from patients with CHD aged 13–17 years with documented systolic blood pressure (SBP), height, weight, and left ventricular mass (LVM) indexed to body size (LVMI-ht^2.7). Patients were stratified by SBP and CHD type. Hypertension and LVH prevalence were calculated; linear regression models assessed factors associated with LVH.</div></div><div><h3>Results</h3><div>Of 853 patients (mean age 15.5 ± 1.5 years, 57.1 % male), 25.1 % had elevated SBP, whereas 11.6 % and 5.7 % had stage 1 and stage 2 hypertension, respectively. LVH was more prevalent with higher SBP (37.4 % elevated, 32.3 % stage 1 hypertension, and 40.7 % stage 2 hypertension) versus 19.6 % normotensive. BMI percentile and SBP were significantly associated with LVMI-ht^2.7; for 10 % BMI percentile and 10 mmHg SBP increases, LVMI-ht^2.7 increased by 1.2 g/m^2.7 and 0.93 g/m^2.7, respectively, after adjustment for age, sex, race, SBP, BMI, and CHD lesion.</div></div><div><h3>Conclusions</h3><div>Adolescents with CHD have a high prevalence of abnormal SBP and LVH. BMI percentile and SBP were associated with LVMI-ht^2.7. Findings support screening for BMI and hypertension in youths with CHD as this population has increased baseline cardiovascular risk that may be compounded by obesity and chronic hypertension.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101001"},"PeriodicalIF":4.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874717","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":"Independent and joint associations of sedentary behaviour and physical activity with risk of recurrent cardiovascular events in 40,156 Australian adults with coronary heart disease","authors":"Amanda Lönn ,&nbsp;Suzanne J Carroll ,&nbsp;Theo Niyonsenga ,&nbsp;Adrian Bauman ,&nbsp;Rachel Davey ,&nbsp;Robyn Gallagher ,&nbsp;Nicole Freene","doi":"10.1016/j.ajpc.2025.100998","DOIUrl":"10.1016/j.ajpc.2025.100998","url":null,"abstract":"<div><h3>Objective</h3><div>Explore the independent and joint associations between sedentary behaviour and physical activity with cardiovascular events, among individuals with coronary heart disease (CHD).</div></div><div><h3>Methods</h3><div>Cohort study including Australians ≥45 years with CHD (2006–2020). Time in sedentary behaviour, walking, moderate-, and vigorous- physical activity were self-reported. Cardiovascular events were identified using health registers (2006–2022). Cox proportional hazard regressions explored the association. Restricted cubic splines explored the shape of the association.</div></div><div><h3>Results</h3><div>There were 40,156 individuals included, with a mean age of 70 (SD=10) years old, 62 % men. During a median of 8.3 (IQR = 10.03) years, 3260 non-fatal-, 5161 total cardiac events, and 14,383 major adverse cardiovascular events (MACE) were recorded. Sedentary behaviour of 7–10.4 h/day was associated with a 15 % lower risk of total cardiac events and MACE compared to ≥ 10.5 h/day. A higher level of moderate-to-vigorous physical activity was associated with a lower risk of cardiovascular events, with 14–21 % lower risk for 1–149 min/week compared to 0 min/week. A similar pattern was seen for walking and activities at a moderate- or vigorous intensity. The joint association of ≥150 min/week of moderate-to-vigorous physical activity and &lt;7 h/day in sedentary behaviour had the lowest risk (29–48 % lower) for cardiovascular events compared to the reference group. However, moderate-to-vigorous physical activity seems to be of greater importance and partly modifies the risk of sedentary behaviour in the joint association. Sedentary behaviour hours were linearly associated with risks of non-fatal and total cardiac events. Meanwhile time in physical activity had a curvilinear association with cardiovascular events, with the greatest benefits at the beginning of the curve.</div></div><div><h3>Conclusion</h3><div>More time in physical activity and less time in sedentary behaviour are associated with a lower risk of cardiovascular events. This emphasizes the importance of providing recommendations for both physical activity and sedentary behaviour to people with CHD.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100998"},"PeriodicalIF":4.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation strategies for improving the care of familial hypercholesterolaemia from the International Atherosclerosis Society: next steps in implementation science and practice","authors":"Mitchell N. Sarkies ,&nbsp;Gerald F. Watts ,&nbsp;Samuel S. Gidding ,&nbsp;Raul D. Santos ,&nbsp;Robert A. Hegele ,&nbsp;Frederick J. Raal ,&nbsp;Amy C. Sturm ,&nbsp;Khalid Al-Rasadi ,&nbsp;Dirk J. Blom ,&nbsp;Magdalena Daccord ,&nbsp;Sarah D. de Ferranti ,&nbsp;Emanuela Folco ,&nbsp;Peter Libby ,&nbsp;Pedro Mata ,&nbsp;Hapizah M. Nawawi ,&nbsp;Uma Ramaswami ,&nbsp;Kausik K. Ray ,&nbsp;Shizuya Yamashita ,&nbsp;Jing Pang ,&nbsp;Gilbert R. Thompson ,&nbsp;Laney K. Jones","doi":"10.1016/j.ajpc.2025.100993","DOIUrl":"10.1016/j.ajpc.2025.100993","url":null,"abstract":"<div><div>Familial hypercholesterolaemia (FH) is the most common monogenic condition associated with premature atherosclerotic cardiovascular disease. Early detection and initiation of cholesterol lowering therapy combined with lifestyle changes improves the prognosis of patients with FH significantly. The International Atherosclerosis Society (IAS) published a new guidance for implementing best practice in the care of FH. Previous guidelines and position statements seldom provided implementation recommendations. To address this, an implementation science approach was used to generate implementation strategies for the clinical recommendations made. This process entailed the generation by consensus of strong implementation recommendations according to the Expert Recommendations for Implementing Change (ERIC) taxonomy. A total of 80 general and specific implementation recommendations were generated, addressing detection (screening, diagnosis, genetic testing and counselling) and management (risk stratification, treatment of adults or children with heterozygous or homozygous FH, therapy during pregnancy and use of apheresis) of patients with FH. We describe here the IAS guidance core implementation strategies to assist with the adoption of clinical recommendations into routine practice for at-risk patients and families worldwide. We summarise the IAS guidance core implementation strategies as operative statements.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100993"},"PeriodicalIF":4.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of PREVENT equations for cardiovascular risk prediction in young patients with myocardial infarction: From the MGB YOUNG-MI registry","authors":"Avinainder Singh ,&nbsp;Arthur Shiyovich ,&nbsp;Camila Veronica Freire ,&nbsp;Gary Peng ,&nbsp;Stephanie A. Besser ,&nbsp;Adam N. Berman ,&nbsp;Brittany N. Weber ,&nbsp;Daniel M. Huck ,&nbsp;Rhanderson Cardoso ,&nbsp;Cian P. McCarthy ,&nbsp;Khurram Nasir ,&nbsp;Marcelo F. DiCarli ,&nbsp;Deepak L. Bhatt ,&nbsp;Ron Blankstein","doi":"10.1016/j.ajpc.2025.100992","DOIUrl":"10.1016/j.ajpc.2025.100992","url":null,"abstract":"<div><h3>Background</h3><div>Predicting cardiovascular risk in young adults remains challenging. The newly developed PREVENT equations offers several advantages for short and long-term cardiovascular risk prediction.</div></div><div><h3>Objective</h3><div>To determine how often PREVENT equations identify increased cardiovascular risk among young adults who experience premature myocardial infarction compared with existing risk calculators</div></div><div><h3>Methods</h3><div>The YOUNG-MI registry is a retrospective cohort from two large academic centers, which included individuals who experienced an MI at age ≤ 50 years. Study physicians adjudicated diagnosis of Type 1 MI. Cardiovascular risk was estimated by pooled cohort equations and PREVENT equations based on data available prior to MI or at the time of presentation.</div></div><div><h3>Results</h3><div>The study cohort included 1149 individuals with a median age of 45 years and 19 % women. The median 10-year ASCVD risk calculated by pooled cohort equations and 2023 PREVENT equations was 4.6 % and 2.3 %, respectively. Using the 10-year ASCVD risk estimates from the 2023 PREVENT equations, only 33 (3 %) individuals met the 7.5 % threshold while 93 (8 %) met the 5 % threshold and 333 (29 %) met the 3 % threshold. For 30-year ASCVD risk using PREVENT, 827 (72 %) met a threshold of ≥ 10 %.</div></div><div><h3>Conclusion</h3><div>The PREVENT equations may lead to undertreatment of young adults who experienced an MI. Using the 30-year risk PREVENT equations may improve long-term risk assessment in this population.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100992"},"PeriodicalIF":4.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874715","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 Life's Essential 8 with risk of incident cardiovascular disease and mortality among adults with chronic kidney disease","authors":"Zhenyu Huo ,&nbsp;Jinfeng Li ,&nbsp;Shunming Zhang ,&nbsp;Liuxin Li ,&nbsp;Jingdi Zhang ,&nbsp;Yiran Xu ,&nbsp;Aitian Wang ,&nbsp;Shuohua Chen ,&nbsp;Jun Feng ,&nbsp;Zhangling Chen ,&nbsp;Shouling Wu ,&nbsp;Tingting Geng ,&nbsp;Zhe Huang ,&nbsp;Jingli Gao","doi":"10.1016/j.ajpc.2025.100994","DOIUrl":"10.1016/j.ajpc.2025.100994","url":null,"abstract":"<div><h3>Background</h3><div>The American Heart Association recently released an updated algorithm for evaluating cardiovascular health (CVH), Life's Essential 8 (LE8). However, few studies have examined the association of LE8 with risk of cardiovascular disease (CVD) and mortality among individuals with chronic kidney disease (CKD). We investigated whether LE8 was associated with subsequent risk of CVD and mortality in the Chinese population of adults with CKD.</div></div><div><h3>Methods</h3><div>This prospective study included 18,716 adults (55.4 ± 14.0 years, 77.9 % men) with CKD free of CVD at baseline from the Kailuan study. A LE8 score (range 0–100 points) was constructed based on diet, physical activity, smoking, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure. Incident CVD and mortality were identified by electronic health records and registers. Multivariable Cox regression models were used to compute hazard ratios (HRs) and 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>During a median follow-up of 14.0 and 14.4 years, 2117 cases of CVD and 4190 deaths were documented. After adjusting for potential confounders, comparing the high LE8 score (80–100 points) to the low LE8 score (&lt;50 points), the multivariable HRs (95 % CIs) were 0.28 (0.20, 0.40) for CVD, 0.14 (0.06, 0.34) for myocardial infarction, 0.35 (0.25, 0.50) for total stroke, and 0.68 (0.56, 0.83) for all-cause mortality, respectively.</div></div><div><h3>Conclusions</h3><div>Among patients with CKD, greater adherence to CVH, as defined by LE8, was significantly associated with a lower risk of CVD and all-cause mortality.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100994"},"PeriodicalIF":4.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in statin use following identification of coronary artery calcium","authors":"Charlotte C. Ellberg ,&nbsp;Kavenpreet Bal ,&nbsp;Edward Duran ,&nbsp;Michael H. Criqui ,&nbsp;Michael D. Shapiro ,&nbsp;Harpreet S. Bhatia","doi":"10.1016/j.ajpc.2025.100990","DOIUrl":"10.1016/j.ajpc.2025.100990","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery calcium (CAC) scoring is a useful tool for risk stratification in asymptomatic individuals, and current clinical practice is to utilize statins in individuals with CAC. A growing body of research has aimed to identify and mitigate health disparities and their relation to cardiovascular disease (CVD) risk. Likewise, studies have highlighted social determinants of health (SDOH) that contribute to health disparities in CVD.</div></div><div><h3>Objectives</h3><div>We aimed to evaluate whether disparities exist with regards to statin use after identification of CAC within the Multi-Ethnic Study of Atherosclerosis (MESA).</div></div><div><h3>Methods</h3><div>The associations between race/ethnicity, age, sex, primary language, and an aggregate SDOH score (calculated using previously defined methods) with statin use at short- and long-term follow-up were evaluated in logistic regression models with adjustment for traditional CVD risk factors in individuals with baseline CAC&gt;0 without baseline statin use.</div></div><div><h3>Results</h3><div>In the overall cohort, 3416 participants had CAC = 0, 1794 CAC 1–99, 757 CAC 100–300, and 847 CAC&gt;300 AU Mean age was 62 (10.2) years, 53 % (<em>n</em> = 3601) were women, 38.5 % (<em>n</em> = 2622) were non-Hispanic White, 27.8 % (<em>n</em> = 1892) were non-Hispanic Black, 22.0 % (<em>n</em> = 1892) were Hispanic and 11.8 % (<em>n</em> = 1892) were Chinese. At short-term follow up (median 1.6 years, <em>n</em> = 2665), those with a higher SDOH score (worse burden) (OR 0.39, 95 % CI 0.16–0.91), Hispanic (OR 0.59, 95 % CI 0.40–0.85) and Spanish speaking individuals (OR 0.51, 95 % CI 0.30–0.83) were less likely to report statin use following CAC identification. At long-term follow up (median 9.4 years, <em>n</em> = 2533), Black individuals (OR 0.71, 95 % CI 0.52–0.96), Chinese (OR 0.58, 95 % CI 0.39–0.86) and Chinese speaking individuals (OR 0.50, 95 % CI 0.33–0.76) were also less likely to report statin use following CAC identification, and a trend was noted for SDOH score (OR 0.53, 95 % CI 0.26–1.09).</div></div><div><h3>Conclusions</h3><div>This study identifies disparities in statin use by race/ethnicity, language, and social determinants of health after identification of CAC. While CAC is an effective tool for identifying atherosclerosis in asymptomatic individuals, more equitable use of subsequent therapy is needed.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100990"},"PeriodicalIF":4.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}