American journal of preventive cardiology最新文献

{"title":"THE IMPACT OF SOCIAL MEDIA ON A CARDIOVASCULAR FOCUSED DIET","authors":"AnneMarie Arcidiacono DO ,&nbsp;Jeris Abuhouran MD ,&nbsp;James Arcidiacono MD ,&nbsp;Farah Deshmukh MD","doi":"10.1016/j.ajpc.2025.101148","DOIUrl":"10.1016/j.ajpc.2025.101148","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Nutrition/Exercise</div></div><div><h3>Background</h3><div>Social media has become a powerful, influential platform that is saturated in health-related information. Heart healthy diets have recently gained interest prompting a wave of content creation and engagement. This increased visibility raises important questions about the nature, sentiment, and trends that may influence public perception and dietary behaviors.</div></div><div><h3>Methods</h3><div>We conducted a sentiment analysis and content review using a pretrained BERT-based Natural Language Processing (NLP) model to classify social media posts based on diet keywords to classify interests. We analyzed over 450 social media posts from websites including TikTok, YouTube, and Instagram that included “heart-healthy foods”, “low sodium diet”, “DASH diet”, and “Mediterranean diet” using NLP posts were then classified unto positive, neutral or negative with analysis of amount of engagement of each post. This was then compared to search-engine trends of diet related searches by analyzing Google data between 2018-2023.</div></div><div><h3>Results</h3><div>An analysis of TikTok posts, YouTube videos, and Instagram posts revealed positive ratings of 85%, 70%, and 80% respectively. Unfortunately, health advice by influencers significantly contradicted evidence-based practice with inaccurate data ranging from “miracle foods” (e.g., blood pressure lowering celery), to oversimplified diet recommendations (“eat butter for heart health” in ketogenic circles), to promoting unregulated dietary supplements and detox programs. Only 36% of nutrition related posts on TikTok and Instagram were found to be fully accurate. The Mediterranean diet has had consistently strong interest, accounting for 33.9% of Google searches. Interest in fad diets such as keto and intermittent fasting peaked during the pandemic (2020-2021) but later declined, although there are regular yearly spikes in diet-searches in January and February.</div></div><div><h3>Conclusions</h3><div>By comprehensively analyzing volume, content, and sentiment towards heart-healthy diets on these different platforms, we can gain insights into the role they are playing in shaping dietary habits, highlighting potential haps and opportunities to improve health education and preventative medicine. Given the influence of social media on nutrition information, healthcare professionals have an obligation to use evidence-based practices to closely monitor, guide, and engage patients in discussions regarding the best practices for heart-healthy diets.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101148"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104372","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":"RECOGNIZING SILENT ATRIAL FIBRILLATION IN A HIGH-RISK POPULATION","authors":"Mohsin Saniya,&nbsp;Peem Lorvidhaya MD,&nbsp;Syeda Huda MD","doi":"10.1016/j.ajpc.2025.101141","DOIUrl":"10.1016/j.ajpc.2025.101141","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>Silent atrial fibrillation (AF) is a major risk factor for <strong>stroke, heart failure, and cognitive decline</strong>, often remaining undiagnosed until a thromboembolic event occurs. Standard <strong>12-lead ECG and 24-hour Holter monitoring</strong> frequently miss paroxysmal episodes. <strong>Prolonged ECG monitoring (≥7 days) improves detection rates</strong>, yet its clinical implementation remains limited. This study evaluates <strong>AF detection rates across various monitoring durations</strong> in a high-risk population.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed <strong>patients aged ≥65 years</strong> with <strong>CHA₂DS₂-VASc ≥2</strong> who underwent <strong>12-lead ECG, 24-hour Holter, 7-day, 14-day, or 30-day patch ECG monitoring</strong> at a single center from <strong>January 2023 to December 2023</strong>. The primary endpoint was <strong>silent AF detection rate</strong>, comparing different monitoring modalities. The secondary outcome was the proportion of <strong>newly diagnosed AF patients eligible for anticoagulation</strong>.</div></div><div><h3>Results</h3><div><ul><li><span>•</span><span><div><strong>12-lead ECG:</strong> Detected AF in <strong>4%</strong>of high-risk patients.</div></span></li><li><span>•</span><span><div><strong>24-hour Holter:</strong> Identified <strong>12%</strong>, missing intermittent episodes.</div></span></li><li><span>•</span><span><div><strong>7-day Patch ECG:</strong> Improved detection to <strong>23%</strong>.</div></span></li><li><span>•</span><span><div><strong>14-day Patch ECG:</strong> Further increased yield to <strong>29%</strong>.</div></span></li><li><span>•</span><span><div><strong>30-day Patch ECG:</strong> Provided the highest detection at <strong>34%</strong>.</div></span></li><li><span>•</span><span><div><strong>Clinical Impact: 82% of newly diagnosed silent AF patients met anticoagulation criteria</strong>, reinforcing the need for early intervention.</div></span></li></ul></div></div><div><h3>Conclusions</h3><div>Silent AF is <strong>significantly underdiagnosed</strong>, and <strong>longer monitoring durations correlate with higher detection rates. Short-term ECG and Holter monitoring are insufficient</strong>, while <strong>30-day patch ECG provides the highest diagnostic yield</strong>. These findings support routine <strong>≥14-day ECG monitoring</strong> for high-risk individuals. Wearable ECG and AI-based arrhythmia detection tools may further enhance early diagnosis, guiding <strong>timely anticoagulation therapy and stroke prevention</strong>.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101141"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104511","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":"EFFECT OF PLOZASIRAN TARGETING APOC3 ON LIPOPROTEIN PARTICLE NUMBER AND SIZE MEASURED BY NMR IN PATIENTS WITH HYPERTRIGLYCERIDEMIA (HTG)","authors":"Christie M Ballantyne MD ,&nbsp;Daniel Gaudet MD ,&nbsp;Robert Rosenson MD ,&nbsp;Robert Hegele MD ,&nbsp;Ran Fu PhD ,&nbsp;Stacey Melquist PhD ,&nbsp;Jennifer Hellawell MD ,&nbsp;Nicholas J. Leeper MD","doi":"10.1016/j.ajpc.2025.101138","DOIUrl":"10.1016/j.ajpc.2025.101138","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD /CVD Risk Reduction</div></div><div><h3>Background</h3><div>Plozasiran, an investigational siRNA targeting hepatic APOC3, reduces TG-rich lipoproteins (TRLs). The impact of plozasiran on lipoprotein (LP) particle numbers and size distributions is unknown; but reductions in the number of TRL particles (TRL-P) and a shift to possibly less atherogenic large LDL particles is expected.</div></div><div><h3>Methods</h3><div>Impact of plozasiran on LP particle concentration and size was measured by NMR in two phase 2 studies. 454 patients from SHASTA-2 (severe HTG) and MUIR (mixed hyperlipidemia) were administered 2 SQ doses of plozasiran (10, 25, or 50 mg) or placebo at baseline and week 12.</div></div><div><h3>Results</h3><div>In SHASTA-2, there was a dose-dependent reduction in TRL-P. With 25 mg PZN, total TRL-P level was reduced by -49%, with reductions across all particles. While total LDL-P was unchanged, large LDL-P concentration increased by +44%; medium by +84% while small LDL-P decreased by -20%. Total HDL-P increased by +7%, primarily driven by a +40% increase in large HDL-Ps. There was significant improvement in insulin resistance (IR) index of -24%.</div><div>In MUIR, dose-dependent reductions in TRL-P were also observed. In the 25 mg group, total TRL-P was significantly reduced by -51%, with reductions across all particles. While total LDL-P was unchanged, large and medium LDL-P levels increased by +103% and +55%, respectively, while small LDL-Ps decreased by -22%. Total HDL-Ps increased by +10%, driven by a +88% increase in large HDL-P. IR index was significantly reduced by -9%.</div></div><div><h3>Conclusion</h3><div>Plozasiran induced APOC3 decreases and quantitative and qualitative changes in LP evaluated by NMR in HTG patients. Plozasiran reduces TRL-P by ≈ 50%, shifts LDL to larger particles, and increases HDL-P concentration. Small dense LDL (sdLDL) are associated with IR and increased ASCVD risk. While high-potency TRL-lowering therapies can sometimes lead to an overall LDL-C increase, LDL-P is not increased and plozasiran shifts the LDL particle size distribution from sdLDL towards larger sizes. The 50% reduction in TRL-P coupled with potential benefits of qualitative changes in LDL without any increase in LDL-P, suggests a promising potential to lower ASCVD risk, which will be evaluated in a prospective outcomes trial.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101138"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104505","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 THE FIND-FH MACHINE LEARNING ALGORITHM FOR THE IDENTIFICATION OF INDIVIDUALS WITH SUSPECTED FAMILIAL HYPERCHOLESTEROLEMIA","authors":"Spencer Carter MD,&nbsp;Taylor Triana MD,&nbsp;Mujeeb Basit MD, MMSc,&nbsp;Ruth Schneider MSN, APRN, ANP-BC,&nbsp;Colby R. Ayers MS,&nbsp;Jessica Moon,&nbsp;Tanvi Ingle BS,&nbsp;Lakeisha Cade,&nbsp;Diane E. MacDougall MS,&nbsp;George Blike MD MHCDS,&nbsp;Zahid Ahmad MD,&nbsp;Amit Khera MD, MSc","doi":"10.1016/j.ajpc.2025.101095","DOIUrl":"10.1016/j.ajpc.2025.101095","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>CVD Prevention – Primary and Secondary</div></div><div><h3>Background</h3><div>Familial Hypercholesterolemia (FH) is an inherited disorder of cholesterol metabolism that is markedly underdiagnosed. This study evaluated the real-world performance of the FIND-FH score, a novel machine learning algorithm, in the identification of individuals with high likelihood of FH.</div></div><div><h3>Methods</h3><div>The FIND-FH model was applied to electronic health record (EHR) data from a large academic medical center. Manual chart review was performed to determine the diagnosis of FH by Simon Broome and Dutch Lipid Clinic Network (DCLN) criteria. Individual characteristics were compared across quintiles of the FIND-FH score. Individuals deemed suitable for clinical outreach for FH were identified using predetermined criteria.</div></div><div><h3>Results</h3><div>Of the 93,418 individuals with adequate EHR data, the FIND-FH algorithm identified 340 with high probability of FH, after appropriate exclusions. These individuals were mean age 49.8 years, 59% male, and mean highest LDL-C of 168.4 mg/dL (±51.9). A total of 20-32% met diagnostic criteria for at least possible FH based on available EHR data. When stratifying by FIND-FH score, several variables differed significantly by quintile, including Simon-Broome and DLCN probability. In the entire cohort, 191 (56%) had enough clinical suspicion for FH to warrant outreach. Among these, 101 (53%) had highest LDL-C &lt;190 mg/dL and would be missed by traditional LDL-C based FH screening strategies.</div></div><div><h3>Conclusions</h3><div>In a large academic healthcare system EHR cohort, most individuals identified as higher risk for FH by the FIND-FH algorithm were deemed appropriate for further evaluation, even when EHR data alone could not confirm the clinical diagnosis of FH. This algorithm can be used as an adjunct to traditional LDL-C screening strategies to identify individuals with FH.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101095"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104606","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":"EXPLORING PRESCRIPTION PATTERNS OF SGLT2 INHIBITORS IN CKD PATIENTS WITHOUT DIABETES MELLITUS OR HEART FAILURE: MITIGATING CARDIOVASCULAR HEALTH EVENTS","authors":"Erasmus Mutabi MD,&nbsp;Ashni Dharia MD,&nbsp;Yue Yin Ph.D,&nbsp;Mrudula Gadani MD","doi":"10.1016/j.ajpc.2025.101098","DOIUrl":"10.1016/j.ajpc.2025.101098","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Kidney Disease</div></div><div><h3>Background</h3><div>Kidney Disease: Improving Global Outcomes (KDIGO) chronic kidney disease (CKD) management guidelines have a level 1A recommendation for initiating sodium-glucose cotransporter-2 inhibitors (SGLT2i) in CKD patients without diabetes mellitus (DM) or heart failure (HF) as it has demonstrated benefits in reducing risks of heart failure hospitalizations and cardiovascular death. However, real-world prescription patterns remain unclear, particularly on the influence of social determinants of health (SDOH).</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on CKD patients without DM or HF at two outpatient academic medical centers in the Midwest between 2023 and 2024. SDOH was performed during the visits. Multivariate logistic regression adjusted for baseline characteristics, comorbidities, and SDOH. Outcomes were analyzed using descriptive statistics, t-tests, and chisquare tests. Statistical significance was set at a p &lt; 0.05.</div></div><div><h3>Results</h3><div>Out of 378 CKD patients without DM or HF, only 5.82% were prescribed SGLT2i. Their mean age was 68 years. SGLT2i were less likely to be prescribed to males (27.27%), Asians (4.55%), and Hispanics (4.55%). While statistical significance was not achieved, a high prevalence of housing instability, food insecurity, lack of transportation, health illiteracy, and depression was observed among patients not receiving SGLT2i.</div></div><div><h3>Conclusions</h3><div>Despite strong guideline recommendations, our study reveals a significant gap in SGLT2i utilization in CKD patients without DM or HF. Lower prescription rates among men, Asians, and Hispanics, suggest potential cultural barriers, socioeconomic constraints, and implicit biases. Overall, low prescription rates suggest broader systemic issues, including slow adoption of evidence-based practices and poor SDOH integration into clinical workflow. Addressing these disparities requires improved healthcare access and promoting equity. Future research should explore larger, more diverse cohorts to better understand prescribing patterns, assess the impact of SDOH, and develop targeted strategies to improve cardiovascular and kidney health outcomes in this population.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101098"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104620","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":"BEMPEDOIC ACID AND MAJOR ADVERSE CARDIOVASCULAR EVENTS ACROSS THE SPECTRUM OF KIDNEY FUNCTION: A SECONDARY ANALYSIS OF THE CLEAR OUTCOMES TRIAL","authors":"Carolina P. Zingano MD ,&nbsp;Danielle Brennan MS ,&nbsp;Steven E. Nissen MD ,&nbsp;Luke J. Laffin MD","doi":"10.1016/j.ajpc.2025.101126","DOIUrl":"10.1016/j.ajpc.2025.101126","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>CVD Prevention – Primary and Secondary</div></div><div><h3>Background</h3><div>Decreased kidney function is an independent risk marker for increased cardiovascular morbidity and mortality. Statins are a cornerstone of cardiovascular disease prevention, however statins are frequently not tolerated. Bempedoic acid prevents major adverse cardiovascular events (MACE) among statin-intolerant patients. However, the effect of bempedoic acid in preventing MACE at different levels of kidney function is unknown.</div></div><div><h3>Methods</h3><div>The CLEAR Outcomes trial randomized statin-intolerant adults at high risk of, or with established cardiovascular disease, to bempedoic acid 180 mg or placebo. We analyzed MACE-4 and MACE-3 outcomes in subgroups by estimated glomerular filtration rate (eGFR), ≥90; ≥60 to &lt;90; ≥45 to &lt;60; and &lt;45mL/min/1.73m2. We also analyzed the interaction between treatment effects and eGFR in a continuous manner.</div></div><div><h3>Results</h3><div>13970 adults were randomized to bempedoic acid or placebo, 2449 of them had eGFR ≥90 ml/min/1.73m2, 8604 had eGFR of 60-90 ml/min/1.73m2, 2342 had eGFR of 45-60 ml/min/1.73m2 and 574 had eGFR below 45 ml/min/1.73m2. The effect of bempedoic acid on prevention of MACE did not differ by eGFR groups for both MACE-4 (pinteraction = 0.93) and MACE-3 (pinteraction = 0.51). No interaction was detected by examining eGFR as a continuous measurement. The proportion of patients experiencing any adverse event in both groups increased with decreasing baseline eGFR but was similar between the bempedoic acid and placebo groups.</div></div><div><h3>Conclusions</h3><div>Compared with placebo, bempedoic acid reduced MACE among statin-intolerant patients irrespective of baseline eGFR.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101126"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104628","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":"SAFETY AND EFFICACY OF OBICETRAPIB IN PATIENTS WITH HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA","authors":"Andy Hsieh PharmD ,&nbsp;Stephen Nicholls MBBS PhD ,&nbsp;Adam J Nelson MBBS PhD ,&nbsp;Marc Ditmarsch MD ,&nbsp;John J.P. Kastelein MD, PhD ,&nbsp;Christie M. Ballantyne MD ,&nbsp;Kausik K. Ray MD, MPHil, FMedSc ,&nbsp;Ann Marie Navar MD, PhD ,&nbsp;Steven E. Nissen MD ,&nbsp;Anne C. Goldberg MD ,&nbsp;Liam R. Brunham MD, PhD ,&nbsp;Erin Wuerdeman ,&nbsp;Annie Neild ,&nbsp;Douglas Kling ,&nbsp;Brian A. Ference MD, MPHIL, MSC ,&nbsp;Ulrich Laufs MD ,&nbsp;Maciej Banach MD ,&nbsp;Roxana Mehran MD ,&nbsp;Alberico L. Catapano ,&nbsp;Michael H. Davidson MD","doi":"10.1016/j.ajpc.2025.101131","DOIUrl":"10.1016/j.ajpc.2025.101131","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Pharmacologic Therapy</div></div><div><h3>Background</h3><div>BROOKLYN examined the efficacy, safety, and tolerability of obicetrapib 10 mg, as an adjunct to maximally tolerated lipid-modifying therapies, in patients with heterozygous familial hypercholesterolemia (HeFH) and suboptimal LDL-C control.</div></div><div><h3>Methods</h3><div>This was a phase 3, randomized, double-blind, placebo-controlled trial NCT05425745 with 1 year follow up in 354 patients across 70 sites. Participants (n=354) with HeFH and fasting LDL-C ³70 mg/dL taking maximally tolerated lipid-modifying therapies were randomly assigned to receive obicetrapib 10 mg or matching placebo orally daily for 52 weeks in a 2:1 ratio. Study primary endpoint assessed obicetrapib compared with placebo in LS mean percent change from baseline to week 12 in LDL-C. Secondary endpoints included obicetrapib compared with placebo in percent changes from baseline in Apo B, nonHDL-C, HDL-C, total-C, Lp(a), and TG, and safety measures; Apo A1 was an exploratory endpoint.</div></div><div><h3>Results</h3><div>Mean baseline lipoprotein lipid levels for obicetrapib and placebo, respectively, were LDL-C: 123.4 and 119.9 mg/dL; ApoB: 107.2 and 105.3 mg/dL; non-HDL-C: 148.4 and 146.7 mg/dL; and HDL-C: 53.2 and 50.2 mg/dL. Obicetrapib, compared with placebo, significantly reduced mean LDL-C -36.3% at day 84 (P&lt;0.0001) and -41.5% at day 365 (P&lt;0.0001). On day 84 and day 365, obicetrapib, compared with placebo, significantly reduced mean ApoB -24.4%, -25.8%; non-HDL-C -34.5%, -37.5%; Lp(a) -45.9%, -54.3%; and increased HDL-C 138.7%,121.4%, respectively. Obicetrapib was well tolerated with no serious adverse events or clinically significant changes in vital signs, electrocardiograms, or other clinical laboratory values.</div></div><div><h3>Conclusions</h3><div>Obicetrapib, as an adjunct to maximally tolerated lipid-modifying therapies, produced significant LDL-C lowering at day 84 with sustained effect through day 365 in patients with HeFH. Obicetrapib holds promise for patients with HeFH who are unable to attain their LDL-C treatment targets with available lipid-lowering agents.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101131"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104633","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":"US POPULATION ELIGIBILITY AND ESTIMATED PREVENTABLE CARDIOVASCULAR DISEASE EVENTS FROM INCLISIRAN TREATMENT","authors":"Nathan Wong PhD, FACC, FAHA, FNLA, MAPSC ,&nbsp;Hridhay Karthikeyan MS ,&nbsp;Wenjun Fan MD, PhD ,&nbsp;Batul Electricwala PhD","doi":"10.1016/j.ajpc.2025.101125","DOIUrl":"10.1016/j.ajpc.2025.101125","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Pharmacologic Therapy</div></div><div><h3>Background</h3><div>Many patients do not reach recommended low-density lipoproteincholesterol (LDL-C) levels on statin therapy alone. Inclisiran is a first-in-class siRNA therapy approved for lowering LDL-C, providing approximately 50% further LDL-C reduction. We estimated the number of US adults meeting inclisiran eligibility criteria and the number of potentially preventable atherosclerotic cardiovascular disease (ASCVD) events.</div></div><div><h3>Methods</h3><div>From the 2011-2020 National Health and Nutrition Examination Surveys (NHANES) we identified 3 potential patient cohorts: 1. high-risk primary prevention (&gt;20% 10-year ASCVD risk or 7.5 - &lt;20% plus two risk enhancing factors), 2. diabetes, and 3. secondary prevention with ASCVD aged &gt;18 years with LDL-C&gt;70 mg/dL (&gt;55 mg/dL if very high risk ASCVD) despite statin therapy. NHANES sample weighting was used to project inclisiran eligibility for the US population. For estimated number of ASCVD events in 10 years “without inclisiran” the ASCVD Pooled Cohort Equation was applied to the high-risk primary prevention and diabetes cohorts and the SMART2 Risk Score was applied to the secondary prevention cohort. Relative risk reductions for ASCVD events were estimated by extrapolating the risk reductions observed in the Cholesterol Treatment Trialists (CCT) Collaboration with the achieved LDL-C metaanalysis reduction results from inclisiran Phase III trials. These risk reductions were then applied to our estimated eligible sample for inclisiran as identified above to estimate the preventable ASCVD events “with inclisiran”. Analysis for eligibility and preventable events was stratified by age, sex, and ethnicity.</div></div><div><h3>Results</h3><div>Among high-risk primary prevention, diabetes, and secondary prevention cohorts we estimated 9.05 million (M), 6.47M, and 7.98M US adults, respectively to be eligible for inclisiran. Based on 34.5% (primary prevention), 29% (diabetes) and 29% (secondary prevention) estimated respective risk reductions from inclisiran, we estimated 860,585, 459,809, and 710,990 ASCVD events could be preventable over 10 years of inclisiran treatment (Figure). Most preventable ASCVD events occurred among high-risk primary prevention, males and white persons.</div></div><div><h3>Conclusions</h3><div>We estimate over 23M US adults with inadequately controlled LDL-C despite statin therapy may be eligible for inclisiran treatment, with the potential to prevent 2.0M ASCVD events over 10 years. Earlier inclisiran initiation has the potential to significantly reduce adverse ASCVD outcomes.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101125"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104755","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 CARDIOVASCULAR RISK ASSESSMENT AND PREVENTION: IMPACT OF A CME PROGRAM ON CLINICIAN KNOWLEDGE AND COMPETENCE","authors":"Margaret Harris PhD, CHCP,&nbsp;Ann Carothers,&nbsp;Fred Stange DO","doi":"10.1016/j.ajpc.2025.101105","DOIUrl":"10.1016/j.ajpc.2025.101105","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Assessment</div></div><div><h3>Background</h3><div>Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. A growing body of evidence supports the importance of proactive risk assessment along the cardiac continuum to optimize prevention strategies. Image-guided cardiovascular risk assessment techniques have emerged as valuable tools in detecting and stratifying risk in primary prevention settings. However, gaps remain in the knowledge and competence of healthcare providers regarding the effective integration of these approaches into clinical practice. This educational initiative aimed to enhance the knowledge and competence of cardiologists and primary care physicians (PCPs) in understanding the cardiac risk continuum and utilizing image-guided cardiovascular risk assessment techniques to improve patient outcomes.</div></div><div><h3>Methods</h3><div>based program with 3 expert faculty, originally broadcast live in-person and online at the 2024 American Heart Association (AHA) annual scientific session. The program included pre- and post- activity assessments to evaluate improvements in knowledge, competence, and confidence. Data were collected on participant performance across key learning objectives, including knowledge of the cardiac risk continuum, the role of image-guided risk assessment, and clinical application of these strategies in primary cardiovascular prevention. Four multiple-choice questions were used: 3 assessed knowledge and 1 determined confidence using a Likert-type scale. Endpoints were assessed using a repeated-pair design with pre-/post-assessment. A paired t-test was conducted on the overall average number of correct responses for physician knowledge, and a McNemar’s test was conducted at the question level (significance level, P&lt; .05) for confidence rating. The program launched on 12/5/2024 and data were collected on 2/4/2025.</div></div><div><h3>Results</h3><div>The program demonstrated significant improvements in participant knowledge, competence, and confidence. Cardiologists and PCPs showed a 34% and 42% improvement, respectively, in understanding the cardiac risk continuum and role of image-guided risk assessment techniques for cardiovascular prevention (P &lt; .001). Confidence in tailoring primary prevention strategies increased among 30% of cardiologists and 41% of PCPs.</div></div><div><h3>Conclusions</h3><div>This CME initiative successfully addressed key gaps in cardiovascular risk assessment knowledge and practice, leading to measurable improvements in clinician competence and confidence. The findings highlight the value of structured educational interventions in promoting evidence-based strategies for cardiovascular disease prevention.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101105"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104743","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":"CATCHING CHOLESTEROL CULPRITS: MACHINE-LEARNING ALGORITHM (MLA)-BASED APPROACH TO DETECTION OF UNDIAGNOSED FAMILIAL HYPERCHOLESTEROLEMIA (FH)","authors":"David Kulp MSc ,&nbsp;Benjamin Furman MPH (co-first author) ,&nbsp;Kain Kim BA ,&nbsp;Shivani Lam BS ,&nbsp;Shoshana Bardach PhD ,&nbsp;Laurence Sperling MD ,&nbsp;Danny Eapen MD","doi":"10.1016/j.ajpc.2025.101180","DOIUrl":"10.1016/j.ajpc.2025.101180","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD /CVD Risk Reduction</div></div><div><h3>Background</h3><div>FH is a genetic disorder marked by elevated LDL-C and risk for premature ASCVD. Most patients remain undiagnosed. MLAs offer scalable approaches for identifying high-risk individuals using electronic health record data. The Flag-Identify-Network-Deliver™ Initiative (FIND-FH®) uses an MLA from the Family Heart Foundation to flag potential cases, followed by chart review and patient outreach. This study evaluates the impact of MLA-driven identification on FH diagnosis and management.</div></div><div><h3>Methods</h3><div>Patients flagged by the FIND-FH® MLA from January 2017-June 2022 at a single academic medical center (n=471) were reviewed. After excluding individuals with known FH, those with LDL-C &gt;190mg/dL and family history of ASCVD were deemed “likely FH” (n=115). In August 2024, patients were contacted via MyChart messages and phone calls recommending FH evaluation; primary care physicians (PCP) were also notified. The primary outcome was new documentation of FH post-contact; secondary outcomes included response rates, changes in lipid-lowering therapy, and specialty of managing clinician, tracked via chart review.</div></div><div><h3>Results</h3><div>Of 115 identified patients, 113 were contacted; 2 had died. Forty-one (36.3%) patients responded; 43 (38.1%) viewed messages. PCP response rate was 53.2%. Seventeen (15%) patients received a new diagnosis of FH post-contact; 2 (1.8%) had a family history of FH. Post-outreach, 16 (14.2%) had new notes discussing FH, and 22 (19.5%) had changes (escalation or reduction) to lipid-lowering therapy, 6 were newly diagnosed with FH. Twenty-two (19.5%) remained untreated, 74 (65.5%) on 1 therapy, 14 (12.4%) on 2, and 3 (2.7%) on 3; most (78.8%) were on statins. Lipids were managed by PCPs (48.7%), university-based cardiologists (38.1%), outside/community cardiologists (6.2%), or others (7.1%). Patients with a new diagnosis of FH, clinical notes discussing FH, or changes to lipid-lowering therapy were deemed as having “action taken.” Mean LDL-C among patients with action taken (n=39) was 130.5mg/dL compared to 108.1mg/dL for patients without (n=69, p=0.047). Lp(a) testing occurred in 11.5%; CAC scoring in 17.7%.</div></div><div><h3>Conclusions</h3><div>MLA-driven outreach led to new FH documentation and enhanced care coordination for previously undiagnosed individuals. Results suggest that MLA-enhanced case finding may help address gaps in FH diagnosis and management. Future efforts include optimizing outreach and embedding realtime MLA tools into clinical workflows.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101180"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104866","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}