American journal of preventive cardiology最新文献

{"title":"EVALUATING THE QUALITY, ACCURACY AND HEALTH IMPACT OF CHOLESTEROL-RELATED CONTENT ON TIKTOK: A SOCIAL MEDIA ANALYSIS","authors":"Khush Kharidia MD,&nbsp;Niyanta Joshi BS,&nbsp;Abel Thomas BS,&nbsp;Ali Sadek BS,&nbsp;Gabrielle Schwab MD,&nbsp;Colby Ayers MS,&nbsp;Amit Khera MD, MSc","doi":"10.1016/j.ajpc.2025.101139","DOIUrl":"10.1016/j.ajpc.2025.101139","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD /CVD Risk Reduction</div></div><div><h3>Background</h3><div>Hypercholesterolemia affects 86 million US adults, but only 54% are on cholesterol-lowering medications. Social media platforms like TikTok with over 1 billion users worldwide, offer both educational opportunities and risks of misinformation. This study evaluates the quality, accuracy, and health impact of cholesterol-related videos on social media through a TikTok analysis.</div></div><div><h3>Methods</h3><div>We searched #highcholesterol and #cholesterol on a new TikTok account on August 11, 2024. Of the 14,200 and 58,000 videos identified from each search term respectively, we evaluated the top 150 videos in each. Of the 300 total videos, 200 met inclusion criteria and were analyzed. Video analysis included engagement metrics, content, PEMAT-AV understandability and actionability scores, quality (GQS, mDISCERN), accuracy, and harm-benefit scores. Video content creators were classified as cardiologists, non-cardiologist physicians, other healthcare professionals, and lay creators. Evaluations were standardized with a grading rubric and a cardiologist-led training. Each video was graded for quality, accuracy, and harm-benefit by 2 independent reviewers. Videos with discrepant scores were graded by an expert cardiologist.</div></div><div><h3>Results</h3><div>The 200 videos had a total of 85,355,400 views, 3,264,000 likes, and 1,009,200 shares. 12% were made by cardiologists, 11.5% by other physicians, and 32.0% by other healthcare professionals. Diet (54%) and pathophysiology (59%) were the most discussed topics; exercise (4%) was the least discussed. 53% were advisory, 37% educational, and 18% promotional. Mean GQS, mDISCERN, PEVAT understandability, and PEVAT actionability (65% ± 39%) scores by content creator type were significantly different (Figure 1, p &lt; 0.05), with higher scores noted in physician creators. Of the videos, 41% were deemed inaccurate and 36% were deemed potentially harmful. Videos by cardiologists and other physicians had significantly higher accuracy and health benefit scores than those by non-physicians (Figure 2).</div></div><div><h3>Conclusions</h3><div>The quality of content related to cholesterol on TikTok is low. Cholesterol misinformation is prevalent on TikTok. Videos by non-physician creators have lower quality, inaccuracies, and potential for harm. As video sharing social media platforms gain traction, clinician awareness of inaccuracies in patient-accessed cholesterol information is vital and strategies for credible content creation are necessary to combat this issue.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101139"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104507","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 LIPID LEVELS AND WHOLE HEART ATHEROSCLEROTIC PLAQUE VOLUME ON CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY","authors":"Adithya K. Yadalam MD, MSc ,&nbsp;Rebecca Fisher MD ,&nbsp;Melissa Aquino ,&nbsp;Tami Crabtree MS ,&nbsp;Edward A. Fisher MD ,&nbsp;Allan Sniderman MD ,&nbsp;James K. Min MD","doi":"10.1016/j.ajpc.2025.101096","DOIUrl":"10.1016/j.ajpc.2025.101096","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Factors</div></div><div><h3>Background</h3><div>Cardiovascular disease remains a leading cause of morbidity and mortality worldwide, with coronary artery disease (CAD) representing a major contributor. Despite circulating lipid biomarkers being widely utilized to prognosticate on the presence and severity of underlying CAD, the extent to which traditional lipid metrics correlate with coronary plaque volume remains unclear. Herein, we sought to assess the relationship between circulating lipid levels and whole heart coronary atherosclerotic plaque volume by leveraging artificial intelligence-enabled quantitative coronary computed tomography angiography (AIQCT) in statin-naïve general cardiology clinic patients referred for coronary computed tomography angiography (CCTA) due to suspected CAD.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study of 271 statin-naïve patients recruited from a single-center, general cardiology clinic undergoing AI-QCT for suspected CAD. Circulating lipid levels (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], lipoprotein(a) [Lp(a)], and apolipoprotein B [apoB]) were measured within one month of CCTA. AI-QCT was utilized to quantify total, calcified, and non-calcified plaque volumes (TPV, CPV, NCPV), as well as high-risk plaque features (remodeling index and low-attenuation plaque percent). The number of participants in each TPV category (&lt;250, 250-750, &gt;750 mm3) across lipid level tertiles was calculated, and the significance of between-tertile differences was assessed with Fisher’s exact test. Associations between continuous lipid levels and continuous AI-QCT features were evaluated using Spearman correlation.</div></div><div><h3>Results</h3><div>No significant difference was observed in clinical coronary TPV categories across TC (P=0.31), LDL-C (P=0.21), Lp(a) (P=0.57), or apoB (P=0.26) level tertiles. A significant difference in the distribution of coronary TPV categories was observed across HDL-C tertiles (P=0.034). No significant correlations were observed between continuous TC, LDL-C, or Lp(a) levels and continuous measures of coronary plaque volume or high-risk plaque features. ApoB levels were significantly, albeit weakly, positively correlated with NCPV (ρ=0.15, P=0.032), and HDL-C levels were weakly negatively correlated with TPV (ρ=-0.12, P=0.042) and NCPV (ρ=-0.16, P=0.008).</div></div><div><h3>Conclusions</h3><div>Traditional lipid biomarkers may not reliably reflect coronary atherosclerotic burden in statin-naïve individuals. These findings highlight the potential value of integrating AI-QCT-based measures of coronary plaque volume to improve patient-specific diagnosis of CAD.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101096"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104614","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":"EVALUATING LIPOPROTEIN(A) TESTING PATTERNS AND ASSOCIATED CLINICAL CARE IMPACT IN A LARGE ACADEMIC HEALTH CENTER","authors":"Aida Roman MD, MS ,&nbsp;John Glenn Tiu MD, FACC, RPVI","doi":"10.1016/j.ajpc.2025.101181","DOIUrl":"10.1016/j.ajpc.2025.101181","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Factors</div></div><div><h3>Background</h3><div>Lipoprotein(a) [Lp(a)] is a strong culprit for cardiovascular disease (CVD) risk. Lp(a) promotes atherosclerosis by increasing vascular inflammation, atherogenesis, calcification and thrombosis. Despite this knowledge, Lp(a) testing remains infrequent and unrecognized. This project aims to understand the current Lp(a) testing patterns and the clinical care impact in a real-world setting, with the ultimate goal of improving testing and CVD risk mitigation.</div></div><div><h3>Methods</h3><div>Retrospective observational study of a diverse cohort from several clinics across the UConn Health Center from January 1^st, 2019 to June 31st, 2022. We obtained patients’ demographics, comorbidities, laboratory results, and medication initiation history as well as ordering provider demographics and specialty. A Fisher’s exact test was employed to evaluate the correlation between elevated Lp(a) levels and intensification of lipid-lowering therapy (LLT), initiation of anti-hypertensive agents, or GLP-1 receptor agonists (GLP-1 RAs).</div></div><div><h3>Results</h3><div>In our cohort of 215 patients, most were women (55%) with a mean age of 56 (43-69) and mean BMI of 30(24-36). Self-reported race and ethnicity were 73% White, 9 % African Americans, 8% Hispanic and 7% Asians. Most patients with an Lp(a) test had hyperlipidemia, hypertension, obesity or ASCVD. The majority of Lp(a) testing was ordered in the outpatient setting. Cardiology, primary care and neurology were the most common specialties ordering Lp(a) testing. Female providers were more likely to order testing than male counterparts. Among patients with Lp(a) test, 61.4% were normal (&lt;75nmol/L or &lt;30mg/dL), 11.6% were intermediate risk (75-125nmol/L or 30-50mg/dL) and 26.9% were high risk (≥125nmol/L or ≥50mg/dL). There was a strong correlation (p&lt;0.001) between elevated Lp(a) and intensification of treatment. Additionally, patients with elevated Lp(a) were 8 times more likely (95% CI: 3.89-17.29) to have intensification of LLT, initiation of new anti-hypertensive agents or GLP-1 RAs.</div></div><div><h3>Conclusions</h3><div>Lp(a) remains an underrecognized, easily missed and poorly addressed CVD risk factor. Despite lack of current targeted therapy, our cohort showed that elevated Lp(a) was associated with aggressive CVD risk factor mitigation that is important to explore. Strategies to increase Lp(a) testing across disciplines should guide future implementation efforts.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101181"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104868","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":"FIRST DEMONSTRATION BY CARDIAC COMPUTED TOMOGRAPHY THAT ELEVATED LIPOPROTEIN(A) IS ASSOCIATED WITH HIGH-RISK PARTIALLY CALCIFIED PLAQUE, EXTENSIVE PLAQUE BURDEN, AND LUMINAL STENOSIS, INDEPENDENT OF APOLIPOPROTEIN B LEVELS","authors":"Szilard Voros Dr. ,&nbsp;Wess Boatwright Dr. ,&nbsp;Mahmoud Al Rifai Dr. ,&nbsp;Marc R. Dweck Dr. ,&nbsp;Bradley O. Brown Dr. ,&nbsp;Dr. David S Watson ,&nbsp;Dr. Anthony Lozama ,&nbsp;Dr. Denise P. Yates ,&nbsp;Dr. Sarah Rinehart ,&nbsp;Dr. Arshed A Quyyumi","doi":"10.1016/j.ajpc.2025.101178","DOIUrl":"10.1016/j.ajpc.2025.101178","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Assessment</div></div><div><h3>Background</h3><div>Lipoprotein(a) [Lp(a)] is an inherited, causal and independent driver of cardiovascular risk (or atherosclerotic cardiovascular disease). The GLOBAL study utilized multi-omic analyses and deep phenotyping of coronary atherosclerosis by coronary computed tomography angiography (CCTA) to unravel the underlying pathology of atherosclerotic coronary artery disease (CAD). The study evaluated the association between Lp(a) and the plaque characteristics. The objective of the sub-analysis was to determine the prevalence of high-risk (partially calcified plaque [PCP]) versus lower-risk (non-calcified plaque [NCP] and calcified plaque [CAP]), coronary plaque burden, and risk of luminal stenosis (≥70%) assessed by CCTA in patients with elevated Lp(a).</div></div><div><h3>Methods</h3><div>We analyzed data from patients enrolled in the GLOBAL clinical study who were referred for CCTA for suspected CAD. Lp(a) mass, molar concentration, Lp(a)-cholesterol, Lp(a)-kringle IV-2 and percentage of apo(a) isoforms and apolipoprotein B (ApoB) were measured. Plaque type was evaluated in each segment and measure of plaque burden and computed tomography (CT)-Leaman score, were calculated for each patient. Statistical associations were determined by Pearson’s correlation and compared across patients by analysis of variance (ANOVA).</div></div><div><h3>Results</h3><div>Overall, 340 patients were included (53% female; mean age±SD 55.6±9.8 years), 62% had ‘normal’/non-obstructive plaque. In patients with predominantly PCP, versus NCP or CAP, Lp(a)-cholesterol and small apo(a) isoforms were significantly higher. Plaque burden was significantly correlated with Lp(a) molar concentration (rho 0.16, P=0.003), Lp(a) mass (rho 0.18, P=0.001), Lp(a)-cholesterol (rho 0.16, P=0.003), and small apo(a) isoforms (rho 0.14, P=0.009). CT-Leaman score was significantly correlated with Lp(a) mass (ANOVA P=0.03). Patients with ≥70% vs &lt;70% luminal stenosis had significantly higher Lp(a) molar concentration (44.75 vs 22.1 nmol/L, respectively; ANOVA P=0.015). When modeled over the range of ApoB, the association between Lp(a) and coronary plaque was strongest for PCP (rho 0.248, P&lt;0.001) versus NCP or CAP. Lp(a) mass was a significant predictor of CT-Leaman score (rho 0.75, P&lt;0.001).</div></div><div><h3>Conclusions</h3><div>Premature cardiovascular events seen in patients with high-Lp(a) appears to be driven through its association with high-risk PCP phenotypes and the magnitude of effect of Lp(a) was independent of apoB levels. Lp(a)-driven CAD is characterized by more extensive plaque burden and represents a unique high-risk phenotype.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101178"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104861","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":"PATIENT JOURNEY AND HEALTHCARE PROFESSIONALS’ PERSPECTIVES OF INFLAMMATION IN ATHEROSCLEROTIC CARDIOVASCULAR DISEASE","authors":"Brittany Weber MD, PhD ,&nbsp;Delilah McCarty PharmD, BCACP, CDCES ,&nbsp;Carey Robar MD ,&nbsp;Udi Fainberg MD ,&nbsp;Marat Fudim MD, MHS ,&nbsp;Katherine Byrne MS ,&nbsp;Ty Gluckman MD, FACC","doi":"10.1016/j.ajpc.2025.101115","DOIUrl":"10.1016/j.ajpc.2025.101115","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>CVD Prevention – Primary and Secondary</div></div><div><h3>Background</h3><div>Few surveys have focused on the patient journey in the management of secondary prevention of atherosclerotic cardiovascular disease (ASCVD) or healthcare professionals’ (HCP) perspectives on the role of systemic inflammation in ASCVD.</div></div><div><h3>Methods</h3><div>This 30-minute, self-administered, IRB-exempt, US survey was conducted between June 7 to August 6, 2024. It comprised ASCVD patients (n=200) self-diagnosed with myocardial infarction (n=61), stroke (n=72), or peripheral artery disease (n=67), and HCPs (n=204), including cardiologists, cardiology specialists, and cardiology nurse practitioners or physicians’ assistants.</div></div><div><h3>Results</h3><div>Patient participants were aged 19 to 75 years, 58% male, and primarily White (74%) or Black/African American (18%) and diagnosed with ASCVD 3 months to 5 years earlier. Most common comorbidities in ASCVD patients according to HCPs were hyperlipidemia (60%), hypertension (56%), obesity (44%), and diabetes (38%). According to HCPs, ASCVD patients most often were receiving statins (78%) and antiplatelet therapy (65%). Only 18% of ASCVD patients believed their treatment was working extremely well; 82% reported persistent symptoms, including chest pain (28%), issues walking (28%), or breathing issues and/or cough (26%). Most HCPs (87%) believed that a residual CV risk remained after modifying traditional risk factors in ASCVD. Approximately 66% of HCPs agreed that systemic inflammation is a key underlying cause of ASCVD and not sufficiently addressed by current treatments, and 58% reported being satisfied with current ASCVD treatments. Approximately 30% of cardiologists sampled often or always test for hsCRP, and of those, 79% did so due to the presence or suspicion of an inflammatory comorbidity. Most HCPs (61%) agreed with the statement that IL-1 and IL-6 are not routinely tested in ASCVD patients and are not included in guidelines or considered standard of care.</div></div><div><h3>Conclusions</h3><div>Unmet needs remain, and gaps exist in diagnosing and managing systemic inflammation in ASCVD patients. Most patients reported persistent symptoms and only ∼20% believed their treatment was working well. 66% of HCPs believed systemic inflammation is not sufficiently addressed by current treatments.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101115"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104831","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 POST-TRAUMATIC STRESS DISORDER (PTSD) ON PATIENTS WITH CORONARY ARTERY DISEASE (CAD): INSIGHTS FROM THE NATIONAL INPATIENT DATABASE 2021-2022","authors":"Rajat Gupta MD,&nbsp;Gabriel Velez Oquendo MD,&nbsp;Sana Ahmed MD,&nbsp;Yash Garg MD","doi":"10.1016/j.ajpc.2025.101167","DOIUrl":"10.1016/j.ajpc.2025.101167","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD in Special Populations</div></div><div><h3>Background</h3><div>While common modifiable factors for coronary artery disease (CAD) have been well studied, the data on impact of post-traumatic stress disorder (PTSD) on cardiovascular outcomes remains limited. Our study aims to assess the impact of PTSD on the mortality and secondary outcomes in CAD population.</div></div><div><h3>Methods</h3><div>Data was obtained from the Healthcare Cost and Utilization Project National Inpatient Sample (NIS) 2021-2022 database using ICD-10-CM codes to assess the impact of PTSD on mortality and other variables including length of stay in hospital, cardiac arrest, and acute coronary syndrome, in CAD patients. Multivariable logistic regression analysis was applied to analyze the above outcomes.</div></div><div><h3>Results</h3><div>A total of 1,111,533 patients with CAD were identified in the NIS database, of which 12,107 patients had a diagnosis of PTSD. Patients in the PTSD cohort belonged to the 18-34 age group [OR = 22.57, (95% CI: 19.10, 26.68), p &lt; 0.001], predominantly male [OR = 1.27, (95% CI: 1.22, 1.32), p &lt;0.001], and Native Americans [OR = 6.01, (95% CI: 4.54, 7.96), p &lt;0.001]. The presence of PTSD was associated with lower in-hospital mortality [OR = 0.46, (95% CI: 0.41, 0.53), p &lt; 0.001], no change in length of stay [OR = 1.00, (95% CI: 1.00, 1.00), p = 0.995]. Moreover, secondary outcomes including cardiac arrest and acute coronary syndrome decreased odds (p &lt; 0.001 and 0732, respectively) in patients with PTSD.</div></div><div><h3>Conclusions</h3><div>PTSD was associated with early onset CAD (as average age in the PTSD cohort was 18-34 years) compared to average onset of CAD at around 55 years in males. This may indicate increased risk of CAD in patients with PTSD, especially native Americans, however, other confounding social and lifestyle factors need to be studied. It was also interesting to find PTSD associated with CAD had decreased in hospital mortality compared to the control cohort. We do not feel that PTSD is protective in coronary artery disease, but rather the patient cohort with PTSD and CAD had smaller population and possibly increased healthcare utilization over a period of time. However, this will need to be further elucidated in future prospective clinical trials.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101167"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104902","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":"URBAN-RURAL DISPARITIES IN THE PRESCRIPTION OF NOVEL LIPID-LOWERING THERAPIES","authors":"Jimin Hwang MD MPH,&nbsp;Emily Decicco MD,&nbsp;Eric Peterson MD, MPH,&nbsp;Anand Gupta MBBS, MPH,&nbsp;Evelyn Sarnes PharmD, MPH,&nbsp;Ann Marie Navar MD, PhD","doi":"10.1016/j.ajpc.2025.101090","DOIUrl":"10.1016/j.ajpc.2025.101090","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>Rural areas in the U.S. face a disproportionate burden of atherosclerotic cardiovascular disease (ASCVD) and face limited access to specialist care. Because specialists more commonly prescribe novel therapies, this can also impact access to new medications. In this study, we sought to examine rural-urban differences in the presence and characteristics of prescribers of novel lipid lowering therapies (LLT).</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed pharmacy transaction data from Symphony Health Solutions (2018–2022) for all prescriptions of any lipid lowering therapy. Prescribers were identified from the Symphony database and cross-matched with their National Provider Identifier number. Prescriber address was linked to census tract-level data, which were classified as rural or urban based on Health Resources and Services Administration definitions. At the census-tract level, the presence of prescribers for novel LLTs overall and by prescriber specialty was assessed.</div></div><div><h3>Results</h3><div>Among 85,396 census tracts (20.3% rural), 62.9% had at least one prescriber of LLT, including 66.7% of urban and 59.7% of rural census tracts. Of these with any LLT prescriber, at least one prescriber of novel LLT (PCSK9i or Bempedoic acid) was present in 42.7% of rural census tracks and 36% of urban census tracks. In urban areas, 67.7% of cardiology LLT prescribers and 50.2% of primary care prescribers had prescribed at least one novel LLT. In rural areas, 80.0% of cardiologists and 52.9% of primary care prescribers had prescribed at least one novel LLT. In multivariable modeling, the presence of a cardiologist was associated with greater likelihood of the presence of a prescriber of novel LLT (OR 11.6, 95%CI 10.2–11.6), but there was no difference in the odds of the presence at least one prescriber of novel LLT between urban and rural areas (OR 1.0, 95%CI 0.9–1.0).</div></div><div><h3>Conclusions</h3><div>Specialists and primary care providers in rural areas were more likely to prescribe a novel LLT than those in urban areas. As a result, despite differences in access to specialist care, among census tracts with at least one prescriber of LLT, rural areas were not less likely to have a prescriber of novel LLT.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101090"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104955","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":"HEART SMART: DEVELOPING SURVIVING AND THRIVING WITH HEART DISEASE – A COMPREHENSIVE HEART DISEASE BOOK AND IOS MOBILE APPLICATION FOR CARDIOVASCULAR MONITORING AND EDUCATION","authors":"Fah Sysavanh B.S. (current OMS-II),&nbsp;Ermin Tale B.S. (current OMS-IV),&nbsp;Alicia Purtell B.S. (current OMS-II),&nbsp;William Gao B.S. (current OMS-II),&nbsp;Todd Cohen MD","doi":"10.1016/j.ajpc.2025.101168","DOIUrl":"10.1016/j.ajpc.2025.101168","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>Cardiovascular disease is a leading cause of death worldwide, with professional societies emphasizing risk reduction and health literacy. Evidence-based, comprehensive heart disease books and a user-friendly iOS mobile application can be used to empower patients to learn about and monitor their cardiovascular health. The objective of this project is to develop a comprehensive heart disease book on heart disease prevention and treatment in conjunction with an iOS mobile application to track cardiovascular metrics, while providing interactive educational content for healthcare workers and patients alike.</div></div><div><h3>Methods</h3><div>The book <em>Surviving and Thriving with Heart Disease</em> will expand on <em>A Patient’s Guide to Heart Rhythm Problems</em> (Johns Hopkins University Press), which is narrower in scope and outdated. The authors sought information on preventing and treating heart disease from a world-renowned preventative cardiologist and guest doctors to provide insight on multifactorial management strategies. An accompanying iOS mobile application, developed using the Waterfall method and Native app approach, was built using Xcode software version 15.2, programmed in Swift 5.8.1, and tested on the iPhone 13 Pro Max (iOS 17.6.1) to ensure quality and performance.</div></div><div><h3>Results</h3><div>The expanded book includes updated medical information on treatment strategies, alternative medicine, osteopathy, mindfulness, artificial intelligence, telemedicine, and coping strategies for healthcare workers and patients. It features a “Surviving and Thriving” card, available in the book, mobile application, and Long Island Heart Rhythm Center website, to help patients track key health information (Plan B, Figure 1). The mobile application also offers interactive features: cardiovascular metrics widgets and graphs, a language model for user inquiries, a Framingham Risk score calculator, and educational animations of cardiovascular conditions (Figure 2a and 2b).</div></div><div><h3>Conclusions</h3><div>This book, to be published via Springer Publishing, is an important resource for healthcare workers and patients. It highlights the importance of having a Plan B and provides a way to track important heart-related numbers using the “Surviving and Thriving” card, complemented by a mobile application to improve health literacy. Future developments include integrating the American Heart Association’s <em>Predicting Risk of cardiovascular disease EVENTs</em> model and conducting a longitudinal study on the application’s benefits.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101168"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104987","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 long-term prognostic value of the framingham risk scoring in patients with myocardial infarction with nonobstructive coronary arteries","authors":"Hao Zhang ,&nbsp;Sizhuang Huang ,&nbsp;Yanwen Fang ,&nbsp;Side Gao ,&nbsp;Jiansong Yuan ,&nbsp;Mengyue Yu","doi":"10.1016/j.ajpc.2025.101269","DOIUrl":"10.1016/j.ajpc.2025.101269","url":null,"abstract":"<div><h3>Background</h3><div>The Framingham Risk Score for Cardiovascular Disease (FRSCVD), based on the Framingham Heart Study, serves as a foundation for many prediction models. However, its applicability in predicting the long-term prognosis of patients experiencing myocardial infarction with nonobstructive coronary arteries (MINOCA) remains uncertain.</div></div><div><h3>Methods</h3><div>A cohort of 1158 MINOCA patients was enrolled and stratified into three groups based on 10-year FRSCVD risk. The primary endpoint was defined as major adverse cardiovascular events (MACE), which included all-cause mortality, non-fatal myocardial infarction, ischemic stroke, revascularization, and hospitalizations due to unstable angina or heart failure. Cox regression models, Kaplan-Meier survival curves, and receiver-operating characteristic (ROC) curve analyses were conducted.</div></div><div><h3>Results</h3><div>Over the median follow-up of 47.4 months, the incidence of MACE increased significantly in MINOCA patients with higher FRSCVD risk stratification (9.6 % vs. 12.5 % vs. 20.8 %; <em>P</em> &lt; 0.001). Increased FRSCVD was independently associated with a higher risk of MACE after adjustment for relevant risk factors (HR 1.108, 95 % CI: 1.053–1.166, <em>p</em> &lt; 0.001). The Kaplan-Meier curves also demonstrated a higher risk of MACE events in the high-risk FRSCVD group (log-rank <em>P</em> &lt; 0.001). Time-dependent ROC analyses revealed that the area under the curve (AUC) of FRSCVD for predicting distant MACE in MINOCA patients was 0.687 (AUC at 1 year), 0.641 (AUC at 3 years), and 0.610 (AUC at 5 years).</div></div><div><h3>Conclusions</h3><div>FRSCVD demonstrates a significant association with long-term prognosis in MINOCA patients, exhibiting particular predictive value for heart failure progression while serving as a potential tool for early risk stratification.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101269"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920159","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":"NEW-ONSET AND PRE-EXISTING CARDIOVASCULAR COMORBIDITIES AND SURVIVAL OF LUNG CANCER PATIENTS IN KOREA","authors":"Kui Son CHOI ,&nbsp;Dong-Woo CHOI Ph.D. ,&nbsp;Hye Jin YOON MPH","doi":"10.1016/j.ajpc.2025.101151","DOIUrl":"10.1016/j.ajpc.2025.101151","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD in Special Populations</div></div><div><h3>Background</h3><div>Lung cancer patients exhibit the highest incidence of cardiovascular comorbidities among all cancer types. However, the impact of the timing of cardiovascular disease (CVD) onset on mortality risk in lung cancer patients remains unclear. This study aimed to assess the role of pre-existing and new-onset CVD in survival of patients with non-small cell lung cancer (NSCLC).</div></div><div><h3>Methods</h3><div>3,144 patients with non-small cell lung cancer (NSCLC) who visited the National Cancer Center in Korea (2012-2017) were analyzed. CVD status was categorized into “none”, “pre-existing”, and “new-onset”, defined by hospitalization for myocardial infarction (I21–I23, MI), ischemic stroke (I63, G45, STR), or heart failure (I50, HF) within 1 year before or after NSCLC diagnosis, using the International Classification of Diseases, 10th Revision (ICD-10). Cox regression analysis using landmark approach (1 year landmark period) and A time-dependent Cox regression analysis were performed to confirm the consistency of the results. Furthermore, the pre-existing group was subdivided into “stable pre-existing” (CVD diagnosed only before cancer) and “recurrent” (CVD events recurring after cancer diagnosis) groups.</div></div><div><h3>Results</h3><div>Of 3,144 NSCLC patients (mean age 64.2 years; 36.9% women), 92.8% had no CVD, 3.6% had pre-existing CVD, and 3.7% had new-onset CVD. Mortality was highest in the new-onset group (61.7%), followed by pre-existing (54.5%), and none (47.8%). New-onset CVD was associated with increased mortality risk compared to non-CVD group (adjusted Hazard Ratio [aHR]: 1.90, 95% Confidence Interval [CI]: 1.47-2.45), In contrast, the pre-existing or recurrent CVD groups did not show a significant increase in mortality risk. This pattern was consistent across each CVD component analyzed. Moreover, time-dependent Cox regression analysis produced consistent results, thereby supporting the robustness of the findings. Additionally, the highest mortality risk in the new-onset group occurred at 1 year (aHR: 2.29, 95% CI: 1.65-3.18). Subgroup analysis revealed heterogeneity in mortality risks among women, patients with BMI &lt;25 kg/m², and smokers.</div></div><div><h3>Conclusions</h3><div>Among patients with NSCLC, new-onset CVD was strongly associated with increased mortality, particularly within the first year after diagnosis. These findings highlight the critical importance of early cardiovascular risk detection and proactive management in NSCLC patients, underscoring the need for integrated cardio-oncology approaches.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101151"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104240","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}