American journal of preventive cardiology最新文献

{"title":"Deep learning-derived pericardial adipose tissue by electrocardiogram-gated cardiac computed tomography predicts cardiovascular events beyond coronary calcium score","authors":"Zahra Esmaeili ,&nbsp;Jose R. Medina-Inojosa ,&nbsp;Elham Mahmoudi ,&nbsp;Laura M. Ortega-Aviles ,&nbsp;Betsy J. Medina-Inojosa ,&nbsp;Bradley J Erickson ,&nbsp;Francisco Lopez-Jimenez","doi":"10.1016/j.ajpc.2026.101549","DOIUrl":"10.1016/j.ajpc.2026.101549","url":null,"abstract":"<div><h3>Background</h3><div>Pericardial adipose tissue (PAT) is an emerging imaging biomarker of cardiovascular disease (CVD) risk. We evaluated whether PAT volume improves prediction of cardiovascular events beyond Coronary Artery Calcium (CAC) score and the AHA Predicting Risk of Cardiovascular Disease Events (PREVENT™) equation.</div></div><div><h3>Methods</h3><div>We analyzed data of 11,897 Olmsted County, MN, residents without known history of heart failure and atherosclerotic cardiovascular disease (ASCVD) events who underwent non-contrast, ECG-gated CAC scans. PAT volume (cm³) and density (Hounsfield units) were measured using a validated automated deep learning (DL) segmentation model (Dice score 0.94). We stratified patients into groups based on PAT volume (cut-off: top quartile 319 cm³) and CAC score (cut-off: 100 Agatston units). Cox proportional hazard models evaluated associations with the composite outcome of total CVD (myocardial infarction, ischemic stroke, heart failure, and cardiovascular death), while adjusting for cardiovascular risk factors, and CAC score across PREVENT™ risk categories.</div></div><div><h3>Results</h3><div>Over a median of 16.4 years, 9.6% experienced total CVD events. Kaplan-Meier curves demonstrated progressively lower CVD-free survival across PAT and CAC groups (p &lt; 0.001). PAT volume stratified risk across CAC categories, with higher volume conferring incremental risk even at low CAC (HR = 1.24, 95% CI:1.05–1.48), and enhanced risk stratification within borderline and intermediate PREVENT™ categories.</div></div><div><h3>Conclusion</h3><div>PAT volume provides prognostic value for total CVD events beyond PREVENT™ and CAC scoring.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"27 ","pages":"Article 101549"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148196107","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":"Visceral adiposity and cardiovascular risk in the era of cardiovascular-kidney-metabolic syndrome","authors":"Michail Kokkorakis ,&nbsp;Evangelos K. Oikonomou","doi":"10.1016/j.ajpc.2026.101558","DOIUrl":"10.1016/j.ajpc.2026.101558","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"27 ","pages":"Article 101558"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148196108","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":"Artificial intelligence-enabled electrocardiography to triage echocardiography for structural heart disease diagnosis in a low-resource setting","authors":"Aline F. Pedroso ,&nbsp;Bruno Ramos Nascimento ,&nbsp;Lovedeep S Dhingra ,&nbsp;Sumukh V. Shankar ,&nbsp;Wanessa C. Vinhal ,&nbsp;Raldner Borges e Reges ,&nbsp;Clareci S. Cardoso ,&nbsp;Craig Sable ,&nbsp;Antonio L.P. Ribeiro ,&nbsp;Rohan Khera","doi":"10.1016/j.ajpc.2026.101539","DOIUrl":"10.1016/j.ajpc.2026.101539","url":null,"abstract":"<div><h3>Background</h3><div>Timely diagnosis of structural heart disease (SHD) is often constrained by limited access to echocardiography in low-resource settings. Although electrocardiography (ECG) is widely available, traditional interpretation poorly reflects underlying SHD risk, leading to inefficient referral for echocardiography.</div></div><div><h3>Methods</h3><div>We used data from PROVAR+, a large community-based cardiovascular screening program in operation since 2014 in Brazil. In this program, adults underwent 12-lead ECGs paired with either screening point-of-care ultrasound (POCUS) (screening cohort) or comprehensive transthoracic echocardiography (TTE) (imaging cohort). We evaluated the performance of a validated artificial intelligence model in identifying probable SHD from ECG images compared with Minnesota Code–defined major ECG abnormalities, with POCUS as a screening reference. We then assessed the health-system impact of AI-ECG–guided echocardiography referral using paired ECG–TTE data by simulating standard versus AI-prioritized referral strategies under an established health-system echocardiography capacity.</div></div><div><h3>Results</h3><div>Among 3282 individuals in the screening cohort, AI-ECG demonstrated substantially higher discrimination for probable SHD than Minnesota Code–based major ECG abnormalities (area under the curve 0.73 vs 0.52), with higher positive predictive value and significant net reclassification improvement (35%), driven primarily by improved identification of individuals without disease. Decision-curve analysis showed consistently greater net benefit for AI-ECG across clinically relevant referral thresholds. In the imaging cohort (<em>n</em> = 1475), AI-ECG–guided prioritization accelerated SHD diagnosis under a previously known system capacity of 200 echocardiograms per month. The time to identify 50% of SHD cases was shorter with AI-guided care, with 19 days using AI-ECG-based triage vs 81 days under standard referral, which was consistent across demographic and clinical subgroups.</div></div><div><h3>Conclusion</h3><div>AI-enabled ECG interpretation improved the identification of SHD beyond conventional ECG assessment. Applying AI-ECG to echocardiography referral workflows can substantially accelerate diagnosis under limited imaging capacity, supporting more efficient and equitable use of cardiovascular diagnostic resources.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"27 ","pages":"Article 101539"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148196120","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":"Circulating multiple metals and mortality after myocardial infarction: incremental value beyond GRACE","authors":"Minmin Wu ,&nbsp;Junhan Chen ,&nbsp;Zhijie Lin ,&nbsp;Ji Huang ,&nbsp;Ling Yu ,&nbsp;Lichuan Chen ,&nbsp;Fan Chen ,&nbsp;Xueli Yang ,&nbsp;Zhennan Lin ,&nbsp;Yansong Guo ,&nbsp;Kaiyang Lin","doi":"10.1016/j.ajpc.2026.101548","DOIUrl":"10.1016/j.ajpc.2026.101548","url":null,"abstract":"<div><h3>Background</h3><div>Metals such as arsenic, cadmium, and lead have been increasingly recognized as emerging cardiovascular risk factors, yet it is not considered in current clinical risk stratification for patients after myocardial infarction (MI).</div></div><div><h3>Methods</h3><div>This prospective study consecutively enrolled 1,283 post-MI patients undergoing percutaneous coronary intervention between 2017 and 2021, with follow-up through April 2024. Baseline plasma levels of 19 metals were measured by inductively coupled plasma mass spectrometry. Associations between metals and all-cause mortality were evaluated using multivariable Cox proportional hazards models. Models were adjusted for age, sex, body mass index, smoking status, diabetes, hypertension, hyperlipidemia, estimated glomerular filtration rate, peak troponin I, prior PCI, and stent implantation. To assess joint associations of multiple metals, we fitted elastic net regularized Cox models and derived environmental metal risk scores (ERSs), which were added to the GRACE risk score to assess incremental prognostic value via C-statistics, time-dependent receiver operating characteristic curves, and reclassification metrics.</div></div><div><h3>Results</h3><div>Among 1,283 patients, 122 all-cause mortality occurred during a median follow-up of 4.28 years. Higher plasma concentrations of copper, lead, and strontium were significantly associated with increased risks of all-cause mortality. Fully adjusted hazard ratios with 95% confidence intervals (per 1–standard deviation increase in log-transformed concentrations) were 1.67 (1.34–2.07) for copper, 1.26 (1.06–1.50) for lead, and 1.43 (1.20–1.71) for strontium. Higher ERS was also positively associated with all-cause mortality. Incorporation of ERS into the GRACE score improved discrimination at 5 years, increasing the area under the curve from 0.77 to 0.81 (<em>P</em> = 0.013), and significantly enhanced risk reclassification.</div></div><div><h3>Conclusions</h3><div>Plasma copper, lead, and strontium levels were associated with all-cause mortality after MI, and further validation in independent cohorts is warranted before clinical implementation.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"27 ","pages":"Article 101548"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148195747","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":"Ten-year trajectory of Life’s Essential 8 and aortic valve calcification","authors":"Zhijun Wu ,&nbsp;Man Gui ,&nbsp;Wei Huang ,&nbsp;Maoxiang Zhao ,&nbsp;Cheng Jin ,&nbsp;Shuohua Chen ,&nbsp;Shouling Wu","doi":"10.1016/j.ajpc.2026.101542","DOIUrl":"10.1016/j.ajpc.2026.101542","url":null,"abstract":"<div><h3>Background</h3><div>The American Heart Association developed Life’s Essential 8 (LE8) to improve the predictive ability of cardiovascular health (CVH).</div></div><div><h3>Aims</h3><div>We sought to investigate whether a 10-year CVH trajectory is associated with the prevalence of aortic valve calcification (AVC), an early manifestation of calcific aortic valve disease (CAVD).</div></div><div><h3>Methods</h3><div>The current study included 8047 participants who participated in the surveys at baseline (2006) and during follow-up periods (2008, 2010, 2012, 2014 and 2016). Repeated measurements of LE8 components including body mass index, cigarette smoking, diet quality, physical activity, sleep health, lipids, blood glucose and blood pressure, were used to construct the CVH trajectories. Ten-year CVH trajectory patterns from 2006 to 2016 were constructed using latent mixture models. AVC was diagnosed by echocardiography from 2016 to 2023.</div></div><div><h3>Results</h3><div>During an eight-year follow-up period, 1005 AVC cases were identified. Compared to the moderate-decrease trajectory, the low-stable trajectory was associated with higher odds of AVC (odd ratio (OR): 1.46; 95% confidence interval (CI): 1.17, 1.83). Participants in the groups of moderate-increasing trajectory (OR: 0.78; 95%CI: 0.62, 0.98), moderate-stable trajectory (OR: 0.62; 95%CI: 0.52, 0.74), and high-stable trajectory (OR: 0.30; 95%CI: 0.20, 0.43) had lower odds of AVC compared with those in the moderate-decreasing trajectory group. The association between the CVH trajectory and AVC prevalence was more pronounced in men, younger individuals and those without chronic kidney disease.</div></div><div><h3>Conclusions</h3><div>Maintaining or improving CVH was associated with lower odds of AVC. Our findings suggest optimizing CVH may provide a primordial preventive benefit against subclinical CAVD.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"27 ","pages":"Article 101542"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148195751","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":"Enhancing representation in cardiovascular trials: Lessons from Lp(a)FRONTIERS EXPANSION in United States Black and Hispanic patients with elevated lipoprotein(a) and established atherosclerotic cardiovascular disease","authors":"Keith C. Ferdinand ,&nbsp;Fatima Rodriguez ,&nbsp;Alok R. Amraotkar ,&nbsp;Subha Venkataraman ,&nbsp;Imran Ayaz ,&nbsp;Oliver Antequera ,&nbsp;Hui Cao ,&nbsp;Wenyue Zhu ,&nbsp;Jing Wang ,&nbsp;Michael D. Shapiro","doi":"10.1016/j.ajpc.2026.101467","DOIUrl":"10.1016/j.ajpc.2026.101467","url":null,"abstract":"<div><h3>Background</h3><div>Black and Hispanic individuals are disproportionately impacted by elevated levels of lipoprotein(a) [Lp(a)] and atherosclerotic cardiovascular disease (ASCVD). Despite this, these populations are underrepresented in cardiovascular clinical trials. Herein, the strategies aimed to improve minority representation during the study design and recruitment phase of the Lp(a)FRONTIERS EXPANSION trial are described. Baseline characteristics and study attrition to date are also presented.</div></div><div><h3>Methods</h3><div>Lp(a)FRONTIERS EXPANSION (NCT06267560) is a randomized, double-blind, phase 3b, placebo-controlled trial evaluating pelacarsen in United States (US) Black/African American and/or Hispanic individuals with elevated Lp(a) (≥125 nmol/L) and established ASCVD. Eligible individuals were randomized 2:1 to receive monthly subcutaneous injections of either pelacarsen 80 mg or placebo, for 12 months. Various design and operational strategies were employed to improve enrollment and retention under four key themes: study design, site selection and engagement, enrollment support, and barrier removal.</div></div><div><h3>Results</h3><div>Overall, 422 patients were randomized to receive pelacarsen or placebo, with enrollment completed 1 year ahead of schedule. Patients were randomized from 103 sites across 21 US states/territories (including Puerto Rico); 8 sites recruited ≥10 patients. At data cut-off (7 October 2025), 64 patients had completed the trial. The mean±standard deviation age was 63.2 ± 9.1 years, 50.7% (214/422) of patients were male, and 68.0% (287/422) identified as Black/African American. Median (Q1, Q3) Lp(a) levels were 110.3 (79.4, 143.7) mg/dL (226.6 [165.8, 299.7] nmol/L).</div></div><div><h3>Conclusion</h3><div>The Lp(a)FRONTIERS EXPANSION trial suggests that deliberate, culturally tailored design and operational strategies may improve cardiovascular trial participation by US minority populations. Results from Lp(a)FRONTIERS EXPANSION will provide critical insights into the efficacy and safety profile of pelacarsen in treating elevated Lp(a).</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"27 ","pages":"Article 101467"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148196008","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":"Use of plozasiran across a spectrum of hypertriglyceridemia: Long-term efficacy and safety data from the open-label extension period of SHASTA-2 and MUIR Trials","authors":"Christie M. Ballantyne ,&nbsp;Alexis Baass ,&nbsp;Robert S. Rosenson ,&nbsp;Robert A. Hegele ,&nbsp;Stephen J. Nicholls ,&nbsp;Szilard Vasas ,&nbsp;Peter Clifton ,&nbsp;Kathryn J. Lucas ,&nbsp;Denes Pall ,&nbsp;Rong Zhou ,&nbsp;Nicholas J. Leeper ,&nbsp;Jennifer Hellawell ,&nbsp;Lalitha Aiyer ,&nbsp;Gerald F. Watts ,&nbsp;Daniel Gaudet","doi":"10.1016/j.ajpc.2026.101523","DOIUrl":"10.1016/j.ajpc.2026.101523","url":null,"abstract":"<div><h3>Background</h3><div>Plozasiran, a hepatocyte-targeted siRNA against apolipoprotein C-III, has demonstrated substantial reductions in triglycerides (TGs) and related atherogenic lipoproteins across a spectrum of hypertriglyceridemia (HTG), leading to its approval for familial chylomicronemia syndrome in the United States, and subsequently in Canada and China. Long-term data suggest maintenance of these effects beyond the blinded treatment periods, supporting further evaluation of plozasiran across a broad spectrum of HTG.</div></div><div><h3>Methods</h3><div>Safety and efficacy were assessed in this open-label extension (OLE) of two phase 2b, randomized, double-blind trials, SHASTA-2 (<em>n</em> = 229) including patients with severe HTG (TG &gt;500 mg/dL) and MUIR (<em>n</em> = 353) including patients with mixed hyperlipidemia (TG 150–499 mg/dL, LDL-C ≥ 70 mg/dL or non-HDL-C ≥ 100 mg/dL). Participants initially received plozasiran at the assigned dose level in the randomized study before eventually transitioning to a regimen of 25 mg Q3M. Treatment-emergent adverse events (TEAEs), change in fasting TGs, and atherogenic lipoproteins were measured over a two-year follow-up.</div></div><div><h3>Results</h3><div>Plozasiran produced sustained TG reductions relative to baseline, over 24 months in the OLE. In SHASTA-2, mean TG reductions from baseline were -77% and -79% at Months 12 and 24, respectively, compared with -71%, at Month 6 of the index study (25 mg). In MUIR, reductions were -62% and -63%, versus -56% at Month 6, compared to baseline. Favorable effects were also observed for other secondary endpoints including remnant cholesterol, non-HDL-C, ApoB, HDL-C, and LDL-C. Common TEAEs included diabetes, COVID-19, upper respiratory tract infection, and back pain, consistent with prior studies; HbA1c levels remained stable.</div></div><div><h3>Conclusions</h3><div>Long-term open-label treatment with plozasiran resulted in sustained TG reductions compared to baseline, across a broad range of HTG, with a safety profile consistent with earlier trials. (Funded by Arrowhead Pharmaceuticals, Inc.; ClinicalTrials.gov number NCT05413135)</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"27 ","pages":"Article 101523"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148196010","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":"Silencing the noise: APOC3 inhibition and the long-overdue reckoning with triglycerides","authors":"Michael D. Shapiro,&nbsp;Khuram Nasir","doi":"10.1016/j.ajpc.2026.101551","DOIUrl":"10.1016/j.ajpc.2026.101551","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"27 ","pages":"Article 101551"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148196011","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":"Cholesteryl ester transfer protein inhibition with obicetrapib is associated with attenuated decline in kidney function in patients at high cardiovascular risk: Post hoc pooled results from the BROADWAY and BROOKLYN trials","authors":"Liffert Vogt ,&nbsp;Michael H. Davidson ,&nbsp;Michael Szarek ,&nbsp;Douglas Kling ,&nbsp;Mary R. Dicklin ,&nbsp;Danielle Curcio ,&nbsp;Marc Ditmarsch ,&nbsp;Andrew Hsieh ,&nbsp;Douglas L. Wicks ,&nbsp;Nancy Ortiz ,&nbsp;John J.P. Kastelein","doi":"10.1016/j.ajpc.2026.101532","DOIUrl":"10.1016/j.ajpc.2026.101532","url":null,"abstract":"<div><h3>Background</h3><div>Patients with cardiovascular disease have increased risk of chronic kidney disease progression. Low levels of high-density lipoprotein (HDL) or HDL dysfunction have been implicated in progressive deterioration of renal function. We investigated the impact on renal function of obicetrapib, a cholesteryl ester transfer protein (CETP) inhibitor that raises apolipoprotein A1 and HDL cholesterol (HDL-C) and improves HDL function.</div></div><div><h3>Methods</h3><div>BROADWAY (<em>N</em> = 2530) and BROOKLYN (<em>N</em> = 354) were double-blind, placebo-controlled trials of patients with heterozygous familial hypercholesterolemia and/or established atherosclerotic cardiovascular disease taking maximally tolerated lipid-lowering therapy assigned to 365-day treatment with the novel CETP inhibitor, obicetrapib 10 mg/d, or placebo. In a post hoc pooled trial analysis of randomized participants with at least 1 post-baseline renal assessment (estimated glomerular filtration rate [eGFR] <em>n</em> = 2832; urine albumin-to-creatinine ratio [UACR] <em>n</em> = 1897), renal function and its association with HDL-C were evaluated.</div></div><div><h3>Results</h3><div>Participants in BROADWAY and BROOKLYN had mean (±SD) baseline eGFR 84.4 ± 17.9 and 91.8 ± 17.8 mL/min/1.73 m² and median albumin-to-creatinine ratio 11.0 and 8.0 mg/g, respectively. Obicetrapib attenuated kidney function decline vs placebo (mean difference = 0.67 mL/min/1.73 m², nominal <em>P</em> = 0.02); on-treatment analysis strengthened this signal (0.82; nominal <em>P</em> = 0.0139). Obicetrapib-treated patients had nominally fewer cases of eGFR &lt;15 mL/min/1.73 m² (0 vs 0.2 %),≥40 % eGFR declines (1.3 vs 1.9 %), and a renal events composite (1.9 vs 3.0 %; hazard ratio 0.64, nominal <em>P</em> = 0.08). Higher achieved HDL-C was associated with lower renal composite event risk (spline nominal <em>P</em> &lt; 0.0001), independent of baseline HDL-C and eGFR. Annualized percent change in UACR was not significantly different between groups.</div></div><div><h3>Conclusion</h3><div>In patients at high cardiovascular risk, CETP inhibition with obicetrapib may attenuate kidney function decline, potentially through its HDL-raising effects.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"27 ","pages":"Article 101532"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148196012","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":"Repeat CRP measurements and incident myocardial infarction","authors":"Daniel Weiner ,&nbsp;Buu Truong ,&nbsp;Satoshi Koyama ,&nbsp;Kaavya Paruchuri ,&nbsp;Whitney Hornsby ,&nbsp;Michael Honigberg ,&nbsp;Pradeep Natarajan","doi":"10.1016/j.ajpc.2026.101486","DOIUrl":"10.1016/j.ajpc.2026.101486","url":null,"abstract":"<div><h3>Background</h3><div>Inflammation is a causal risk factor for cardiovascular disease. While individuals with elevated levels of inflammation may benefit from targeted therapy, population-level stability of inflammation over time is poorly defined, as is the relationship between repeated measures of inflammatory markers and incident myocardial infarction. C-reactive protein (CRP) is among the best-established inflammatory markers.</div></div><div><h3>Objectives</h3><div>To examine (i) the stability of CRP over repeat measurements and (ii) the association between patterns of repeated CRP and rates of first-time myocardial infarction.</div></div><div><h3>Methods</h3><div>The relationship between baseline and repeat assessment of CRP was analyzed in 14,960 individuals from the UK Biobank without a diagnosed underlying inflammatory condition. The association between baseline and repeat CRP and first-time myocardial infarction was estimated using a Cox proportional hazards model.</div></div><div><h3>Results</h3><div>Among the analyzed cohort, median (IQR) age was 58 (52–63) years, 7,564 (51%) were female, and median (IQR) CRP was 1.1 (0.6–2.3) mg/L at baseline. Baseline and repeat CRP were correlated (Spearman rho 0.64) across a median (IQR) follow-up interval of 4.4 (3.7–4.9) years. Among the 10,566 (71%) individuals with non-elevated CRP (&lt;2 mg/L) at baseline, 8,776 (83%) had non-elevated CRP at repeat, while among the 4,394 (29%) with elevated CRP at baseline, 3,127 (62%) had elevated CRP at repeat. Across median (IQR) follow-up 11.5 (11.4, 11.8) years after the repeat CRP measurement, 426 individuals (2.9%) sustained a first-time myocardial infarction. Relative to non-elevated CRP at baseline and repeat, elevated CRP at both baseline and repeat was associated with incident first-time myocardial infarction (HR = 1.66; 95% CI: 1.31–2.12; <em>P</em> = 3.1 × 10^–5), while elevated CRP during only baseline or repeat measurement was not (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Persistently elevated CRP was significantly associated with incident first-time myocardial infarction. This finding highlights the importance of repeated measurement of inflammatory markers for cardiovascular risk stratification.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"27 ","pages":"Article 101486"},"PeriodicalIF":5.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148196097","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}