American journal of preventive cardiology最新文献

{"title":"TARGETED METABOLOMIC PROFILING REVEALS DISTINCT PATHWAY ALTERATIONS IN FAMILIAL HYPERCHOLESTEROLEMIA","authors":"Sergey Solomevich PhD ,&nbsp;Kejun Shao ,&nbsp;Karthik Dhanabalan PhD ,&nbsp;Daria Salamevich MD ,&nbsp;Wenliang Song MD","doi":"10.1016/j.ajpc.2025.101136","DOIUrl":"10.1016/j.ajpc.2025.101136","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Novel Biomarkers</div></div><div><h3>Background</h3><div>Familial hypercholesterolemia (FH) is a monogenic lipid disorder characterized by markedly elevated low-density lipoprotein cholesterol and a high risk of premature atherosclerosis. However, LDLC alone does not fully account for the metabolic complexity and residual cardiovascular risk observed in FH. In this study, we performed targeted metabolomic profiling to uncover systemic metabolic alterations and identify pathways that may contribute to disease pathogenesis and cardiovascular outcomes.</div></div><div><h3>Methods</h3><div>Plasma samples from 16 FH patients and 15 non-FH controls were analyzed using a SCIEX Triple Quad™ 7500 LC-MS/MS-QTRAP with an ExionLC system. Chromatographic separation was performed on a Kinetex F5 column using a water/acetonitrile gradient with 0.1% formic acid. A Scheduled MRM™ method in positive and negative ion modes targeted over 800 metabolites. Instrument settings included a 350°C ion source temperature and optimized gas flows. Peaks were quantified using Analyst 3.1 software and normalized to internal standards. Data processing and pathway analysis were conducted using MetaboAnalyst 6.0 and GraphPad Prism 10.</div></div><div><h3>Results</h3><div>Targeted metabolomic profiling detected 248 plasma metabolites, of which 72 were significantly downregulated and 9 upregulated in FH patients compared to healthy controls. PCA and PLS-DA demonstrated clear group separation, and volcano plot and heatmap analyses confirmed distinct differences in metabolite abundance. Pathway enrichment analysis revealed 16 significantly disrupted metabolic pathways in FH (Figure 1), including primary bile acid biosynthesis (p = 0.0005), beta-alanine metabolism (p = 0.0013), arginine and proline metabolism (p = 0.0013), glutathione metabolism (p = 0.0087), and pyrimidine metabolism (p = 0.0097). Several of the altered pathways were linked to amino acid metabolism, oxidative stress, and nucleotide synthesis, indicating broad systemic metabolic disturbances in FH beyond lipid dysregulation.</div></div><div><h3>Conclusions</h3><div>Our targeted metabolomic analysis revealed broad metabolic dysregulation in FH patients, including significant alterations in bile acid biosynthesis, amino acid metabolism, nucleotide pathways, and oxidative stress processes. This work lays the groundwork for future studies to identify novel biomarkers and therapeutic targets for cardiovascular risk reduction in FH.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101136"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104870","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":"WHAT WOMEN WANT: EMPOWERING WOMEN TO IMPROVE THEIR CARDIOVASCULAR HEALTH AND LIFE EXPECTANCY THROUGH COMMUNITY EDUCATION","authors":"Caitlin Walker NP-C,&nbsp;Kristin Alvstad PharmD,&nbsp;Kathleen Johnson PA,&nbsp;Chris Paver PharmD,&nbsp;Kardie Tobb DO, MS, FASPC, FACC","doi":"10.1016/j.ajpc.2025.101176","DOIUrl":"10.1016/j.ajpc.2025.101176","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCD/CVD in Women</div></div><div><h3>Background</h3><div>Disparities in awareness of and mortality from cardiovascular disease exist by age, education level, gender and race/ethnicity. Disparities are exacerbated by systemic gaps in communities with less access to care and mistrust of health systems. We report on a community intervention that (1) promoted education on cardiovascular disease prevention; (2) was tailored to address women’s health and wellness needs; and (3) addressed systemic gaps in a community with a life expectancy 15 years lower than neighboring zip codes.</div></div><div><h3>Methods</h3><div>The intervention was a Women’s Heart Wellness Event that included workshops on cardiometabolic health, well woman visits, stress, hypertension, nutrition, and movement. The event featured a “Choose Your Own Heart Health Adventure” including mobile health units providing health screenings; community-based organizations providing resources to meet health and social needs; and hands-on activities related to cardiovascular disease prevention. We administered a survey to evaluate the intervention (N=87). Most respondents were Black or African American women.</div></div><div><h3>Results</h3><div>Survey respondents had a statistically significant increase in their knowledge of cardiometabolic health, well woman visits, stress, hypertension, nutrition, and physical activity after the event compared to before the event (p&lt;0.05 for all measures). Women were least knowledgeable about cardiometabolic health before the event, and there was room for improvement in understanding about cardiometabolic health after the event. Most women reported that they plan to apply the information presented during the event to their health including eating healthy (94%), getting regularly physical activity (93%), and maintaining a healthy weight (92%). After the event, only about twenty percent of women did not plan to attend their annual well woman’s visit with the remaining 80% planning to attend</div></div><div><h3>Conclusions</h3><div>Community interventions providing educational workshops, screenings, resources, and hands-on activities can increase women’s knowledge about cardiovascular disease prevention and intention to apply knowledge to their health. Yet, additional work remains to address systemic gaps in communities. Future events tailored to meet women’s health and social needs can expand education regarding cardiometabolic health and well woman’s visits.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101176"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104852","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":"SUBCLINICAL CARDIOVASCULAR DISEASE IN PEOPLE LIVING WITH HIV","authors":"MaryElizabeth Simkevich BA ,&nbsp;Syed Hashim Bokhari MD ,&nbsp;Yash Patel MD, MPH ,&nbsp;Melanie Parent BA ,&nbsp;Gerald Bloomfield MD, MPH ,&nbsp;Michelle Richard MD ,&nbsp;Tasnim F. Imran MD, MPH ,&nbsp;John McGeary PhD ,&nbsp;James Rudolph MD ,&nbsp;Gaurav Choudhary MD ,&nbsp;Wen-Chih Wu MD, MPH ,&nbsp;Sebhat Erqou MD, PhD","doi":"10.1016/j.ajpc.2025.101087","DOIUrl":"10.1016/j.ajpc.2025.101087","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Factors</div></div><div><h3>Background</h3><div>People living with HIV (PLHIV) experience chronic inflammation, which may contribute to tissue fibrosis, premature vascular aging (PVA), and cardiac dysfunction. This cross-sectional pilot study aimed to determine the association of HIV status with cardiorespiratory fitness, inflammation, fibrosis, PVA, and cardiac dysfunction.</div></div><div><h3>Methods</h3><div>Male veterans, 21 HIV+ and 20 HIV-, were recruited from the Providence VA Medical Center and matched on age (within 5 years), sex, race, and other factors. Participants completed questionnaires, blood tests, a treadmill stress test, echocardiogram, coronary CT scan, and an optional cardiac MRI (CMR). Multivariable linear regressions adjusted for age and smoking status were performed on these data to determine their associations with HIV status.</div></div><div><h3>Results</h3><div>HIV+ participant age (54.2 ± 11.6 years) was comparable to controls (56.2 ± 11.3 years, p = 0.6), with a similar racial distribution in both groups. HIV status was associated with GDF15, a marker of fibrosis (beta = 109.9, 95% CI [10.6, 209.2], p = 0.031), but not with LogST2, Galectin3 (other markers of fibrosis), Log IL6, or Log CRP (markers of inflammation). HIV+ participants had a higher mean extracellular volume (ECV; a measure of fibrosis on CMR) compared to controls (21.6% vs. 17.9%) and a higher predicted vascular age based on coronary calcium score than controls (55.5 vs. 52.6 years) though neither was statistically significant (p = 0.071, p = 0.645). There was a trend toward a positive association between HIV status and mean ECV (beta = 3.83, 95% CI [-0.30, 8.0], p = 0.067). HIV+ participants had comparable exercise tolerance to controls (11.7 Mets vs 10.4 Mets, p = 0.215). HIV status was negatively associated with right ventricular ejection fraction on CMR (51.8% HIV+ vs. 57.5% Controls, beta= -5.78, 95% CI [-10.8, -0.7], p = 0.027), but not with left ventricular ejection fraction.</div></div><div><h3>Conclusions</h3><div>Data from this pilot study suggest that HIV+ status is associated with increased myocardial fibrosis and decreased right ventricular function. Further studies are needed to elucidate these findings.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101087"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104943","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 CONTINUING MEDICAL EDUCATION ON CLINICIAN KNOWLEDGE AND CONFIDENCE IN CETP INHIBITION FOR LDL-C REDUCTION IN HEFH","authors":"Margaret Harris PhD, CHCP,&nbsp;Alison O'Connor,&nbsp;George Boutsalis PhD","doi":"10.1016/j.ajpc.2025.101103","DOIUrl":"10.1016/j.ajpc.2025.101103","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD /CVD Risk Reduction</div></div><div><h3>Background</h3><div>Heterozygous familial hypercholesterolemia (HeFH) remains a high-risk condition for atherosclerotic cardiovascular disease (ASCVD), necessitating effective LDL-C reduction strategies beyond statins. Cholesteryl ester transfer protein (CETP) inhibition has emerged as a promising adjunct therapy. This study evaluates the impact of an accredited continuing medical education (CME) program on clinician knowledge and confidence in CETP inhibition for LDL-C management in HeFH.</div></div><div><h3>Methods</h3><div>A CME program titled Latest Developments in LDL-C Reduction with CETP Inhibition in HeFH: Unpacking New Evidence was launched on December 20, 2024, and evaluated through January 31, 2025. Participants included cardiologists (n=112) and primary care physicians (PCPs) (n=156). Knowledge and competence were assessed through pre- and post-education assessments, with statistical significance measured via paired t-tests and Cohen’s d effect sizes. Confidence shifts were also analyzed.</div></div><div><h3>Results</h3><div><strong>Knowledge Gains</strong>:<ul><li><span>○</span><span><div>Rationale for non-statin LDL-C lowering in HeFH: 10% of cardiologists and 14% of PCPs improved their knowledge (P &lt; .05).</div></span></li><li><span>○</span><span><div>Clinical safety and efficacy of CETP inhibitors: 33% of cardiologists and 34% of PCPs improved (P &lt; .01).</div></span></li></ul></div><div><strong>Confidence Gains:</strong><ul><li><span>○</span><span><div>Confidence in implementing team-based LDL-C management strategies increased from 16% to 27% among cardiologists (P &lt; .001) and from 9% to 17% among PCPs (P &lt; .001).</div></span></li></ul></div></div><div><h3>Conclusions</h3><div>This CME program significantly enhanced clinician knowledge and confidence in CETP inhibition for LDL-C reduction in HeFH. The findings highlight the need for continued education to support optimal integration of emerging lipid-lowering strategies into clinical practice.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101103"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104951","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":"A META-ANALYSIS ON RENAL DENERVATION IN RESISTANT HYPERTENSION: UNVEILING THE PROMISE AND PERSISTENCE OF BLOOD PRESSURE CONTROL","authors":"Lakshmi Sai Niharika Janga MD ,&nbsp;Preethi meher Nadimpalli MBBS ,&nbsp;Carlos Patiño Rivas MD ,&nbsp;Akshat Banga MD","doi":"10.1016/j.ajpc.2025.101174","DOIUrl":"10.1016/j.ajpc.2025.101174","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD /CVD Risk Reduction</div></div><div><h3>Background</h3><div>The prevalence of resistant hypertension (RH) among treated hypertensive patients is estimated to be around 10-20%, it is expected to rise due to increasing rates of obesity, chronic kidney disease, and an aging global population. Prior studies have shown variable effects of renal denervation (RDN) on blood pressure (BP) reduction in this population, with uncertainty regarding the durability of these effects over time. This meta-analysis aims to evaluate the efficacy of RDN on BP in RH patients and compare short-term (≤6 months) and long-term (&gt;6 months) outcomes.</div></div><div><h3>Methods</h3><div>We conducted a meta-analysis using the REML random-effects model. Studies reporting 24-hr ambulatory BP changes in RH patients, with intervention population undergoing RDN at beginning of study and control population not undergoing RDN at beginning of study were included. These are categorized as short-term (≤6 months) or long-term (&gt;6 months) based on follow-up periods. Data were extracted for mean BP differences, standard deviations, and sample sizes. Forest plots were generated to visualize mean differences with 95% confidence intervals (CI), and heterogeneity was evaluated using τ2, I2, and H2 statistics, and overall effect sizes were tested using z-scores.</div></div><div><h3>Results</h3><div>For short-term outcomes (≤6 months), nine studies (n=771) showed a mean BP reduction of - 4.59 mmHg (95% CI: -8.60, -0.58). The overall effect was statistically significant (z=-2.24, p=0.02). For long-term outcomes (&gt;6 months), seven studies (n=1355) demonstrated a mean BP reduction of -7.25 mmHg (95% CI: -17.50, 3.01), with no statistically significant overall effect (z=-1.39, p=0.17).</div></div><div><h3>Conclusions</h3><div>While the short-term outcomes revealed a statistically significant decline in 24-hr ambulatory BP (mean difference: -4.51 mmHg), the long-term efficacy revealed a sustained trend but did not reach statistical significance. These findings highlight the need for larger, standardized trials incorporating diverse populations and standardized protocols to better understand RDN’s role in RHTN management and its sustained impact on BP control.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101174"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104996","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":"Novel strategies to FIND people living with genetic dyslipidemias: The family heart foundation flag, identify, network, and deliver (FIND) familial hypercholesterolemia collaborative learning network","authors":"Shoshana H. Bardach ,&nbsp;George Blike ,&nbsp;Laurence Sperling ,&nbsp;Kain Kim ,&nbsp;Benjamin W. Furman ,&nbsp;David R.G. Kulp ,&nbsp;Shivani Lam ,&nbsp;Danny Eapen ,&nbsp;Jennifer A. Orr ,&nbsp;Kerrilynn C. Hennessey ,&nbsp;Mary P. McGowan ,&nbsp;Amit Khera ,&nbsp;Martha Gulati ,&nbsp;Zahid Ahmad ,&nbsp;Taylor Triana ,&nbsp;Brian S. Mittman ,&nbsp;Katherine Wilemon","doi":"10.1016/j.ajpc.2025.101275","DOIUrl":"10.1016/j.ajpc.2025.101275","url":null,"abstract":"<div><h3>Background</h3><div>Familial Hypercholesterolemia (FH) is among the most common genetic disorders. However, most people with FH are undiagnosed and many experience preventable premature cardiovascular disease. To improve identification of FH, the Family Heart Foundation established the Flag Identify Network Deliver™ Collaborative Learning Network (FIND FH™ CLN). This multi-year quality improvement initiative involves five healthcare systems, individuals with FH, and quality improvement/implementation scientists. This manuscript describes the methods and results of the FIND FH CLN.</div></div><div><h3>Methods</h3><div>The FIND FH CLN leveraged a machine learning model (MLM) run on de-identified data from each healthcare system, coupled with implementation/quality improvement methods to enhance FH diagnosis. Healthcare systems were supported in identifying care gaps, engaging patients in diagnostic assessment, locating improvement opportunities, and implementing feasible interventions. Tracked outcomes included outreach volume, completed appointments, and new diagnoses of FH. Improvement approaches, care process changes, and challenges/lessons learned were recorded.</div></div><div><h3>Results</h3><div>Across sites, 4476 individuals were flagged by the MLM; 847 patients were contacted following output review, 209 appointments were completed, and 175 diagnoses of definite, probable, or possible FH resulted. Two sites completed outreach to all patients deemed appropriate; three sites are still engaged in outreach. FH identification was facilitated by educational activities delivered to clinical teams, development of electronic health system-based features, and availability of web-based information targeting clinicians and patients.</div></div><div><h3>Conclusion</h3><div>This multifaceted initiative provides insights and methods that can inform efforts to accelerate identification and improve care of individuals with FH at other institutions as well as other under-diagnosed conditions.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101275"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in depression related cardiovascular mortality among adults from 1999 to 2020: a retrospective study in the United States","authors":"Shahzaib Ahmed ,&nbsp;Eeman Ahmad ,&nbsp;Ayesha Ali ,&nbsp;Hamza Ashraf ,&nbsp;Hoor Ul Ain ,&nbsp;Mahrosh Kasbati ,&nbsp;Ibrahim Nagmeldin Hassan ,&nbsp;Hana J. Abukhadijah ,&nbsp;Shoaib Ahmad ,&nbsp;Irfan Ullah ,&nbsp;Chadi Alraies ,&nbsp;Gregg C. Fonarow","doi":"10.1016/j.ajpc.2025.101076","DOIUrl":"10.1016/j.ajpc.2025.101076","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) and depression frequently coexist, leading to worse outcomes and higher mortality than CVD alone. Despite this impact, long-term trends in cardiovascular mortality among adults with depression remain underexplored.</div></div><div><h3>Methods</h3><div>We used the CDC WONDER database to obtain death certificate data from 1999 to 2020 for adults aged ≥25 years. Age-adjusted mortality rates (AAMRs) and crude mortality rates (CMRs) per 100,000 population were extracted. Annual percent change (APC) and average APC (AAPC) were estimated using Joinpoint regression and compared to the general population using pairwise comparison.</div></div><div><h3>Results</h3><div>A total of 79,813 CVD deaths occurred in adults with depression. Mortality trends were stable until 2002 (APC: 0.14), declined significantly through 2010 (APC: -6.87), remained relatively stable from 2010 to 2018 (APC: -0.80), then rose significantly until 2020 (APC: 8.52). AAPCs differed significantly from the general population. AAMRs were consistently higher in females than males and highest among NH Whites, followed by NH Black or African Americans, Hispanics/Latinos, and NH Asian or Pacific Islanders. Regional variation in AAMRs was noted (Midwest: 2.2; West: 1.7; Northeast: 1.5; South: 1.4), with AAPCs differing from the general population in the Midwest and Northeast. AAMRs were higher in non-metropolitan (2.2) than metropolitan areas (1.6). APCs for CMRs in all analysed age groups (45–54 to 85+) differed significantly from the general population.</div></div><div><h3>Conclusion</h3><div>CVD mortality rates among adults with depression have risen since 2018, with disparities by sex, race, and geography. These findings underscore the need for targeted interventions to reduce mortality in this high-risk population.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101076"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019077","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":"EFFECTS OF CARDIOPULMONARY STRESS FROM CANCER AND ASSOCIATED TREATMENT ON CARDIOVASCULAR RISK SCORE IN CARDIAC PATIENTS: A PILOT STUDY","authors":"Bilal Niazi BS ,&nbsp;Matthew Vetrano BS ,&nbsp;Ermin Tale BS ,&nbsp;Jared Wilber BS ,&nbsp;Samantha Sanger BS ,&nbsp;Todd J Cohen MD","doi":"10.1016/j.ajpc.2025.101163","DOIUrl":"10.1016/j.ajpc.2025.101163","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD in Special Populations</div></div><div><h3>Background</h3><div>The predicting risk of cardiovascular disease EVENTs (PREVENT) score has become a widely used tool to assess cardiovascular disease (CVD) risk. The improved calibration and inclusion of additional clinical and social variables make for comprehensive cardiac risk assessments compared to the atherosclerotic cardiovascular disease 2013 risk estimator (ASCVD). Studies have shown an increased incidence of atherosclerotic cardiovascular disease and heart failure in patients who are cancer survivors. However, no comparative studies have evaluated PREVENT and ASCVD risk scores in patients with a history of cancer.</div></div><div><h3>Methods</h3><div>A six-year retrospective analysis (2019-2025) was performed using the Long Island Heart Rhythm Center electronic medical records. Patients were selected by keyword search including “malignancy,” “cancer,” and “neoplasm.” Patients with a history of cancer were then age and sex-matched to controls. PREVENT and ASCVD scores were calculated based on American Heart Association criteria. Statistical comparison was performed utilizing a paired t-test; p0.05 was statistically significant.</div></div><div><h3>Results</h3><div>21 patients with oncologic diagnoses were identified, of which 5 were included (23.8%) based on data availability in their medical charts, along with age and sex-matched controls (n=5). Patient characteristics included a mean age of 63.85.9 years; M/F 0 [0%]/5 [100%]. Neoplasias identified included breast (1), lung (1), colon (1), pituitary (1), and thyroid (1). PREVENT scores for 10-year total CVD risk were 8.41% and 4.52% for cancer patients and controls, respectively (p=0.19). PREVENT scores for 30-year total CVD risk were 29.79% and 18.77% for cancer patients and controls, respectively (p=0.28). The 10-year ASCVD scores were 7.94% and 9.94% for patients with a history of cancer and controls, respectively (p=0.039).</div></div><div><h3>Conclusions</h3><div>This study demonstrated a dichotomy in results when comparing the PREVENT risk assessment to the ASCVD risk assessment in the same-aged population. Specifically, the PREVENT score was higher in patients with oncologic disorders as compared to controls. However, the ASCVD scores were lowered in those with a history of cancer. This study is limited due to its small sample size and retrospective design. A larger multicenter prospective study is needed in the future.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101163"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSOCIATION OF CARDIOMETABOLIC DISEASE WITH SUBCLINICAL CARDIAC REMODELING IN MEN VS WOMEN IN THE FRAMINGHAM HEART STUDY","authors":"Rachel L. Goldberg MD, MBA ,&nbsp;Yunong Zhao MS ,&nbsp;Joanne M. Murabito MD, ScM ,&nbsp;Susan Cheng MD, MMSc, MPH ,&nbsp;Ramachandran S. Vasan MD ,&nbsp;Daniel Levy MD ,&nbsp;Jennifer E. Ho MD ,&nbsp;Emily S. Lau MD, MPH","doi":"10.1016/j.ajpc.2025.101160","DOIUrl":"10.1016/j.ajpc.2025.101160","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCD/CVD in Women</div></div><div><h3>Background</h3><div>Although the prevalence of cardiometabolic disease is greater in men vs women, the relative risk of cardiovascular disease (CVD) conferred by cardiometabolic conditions is higher in women than in men. Mechanisms underlying these apparent sex differences are not well understood. In this context, we examined the sex-specific association of cardiometabolic risk factor burden with subclinical echocardiographic cardiac remodeling.</div></div><div><h3>Methods</h3><div>In a cross-sectional observational study, we examined whether sex modifies the association between cardiometabolic disease burden (measured as metabolic syndrome severity [MetSS] score) with echocardiographic markers of subclinical cardiac remodeling (including cardiac strain and diastolic function) using multiplicative interaction terms in multivariable linear regression models.</div></div><div><h3>Results</h3><div>Among 6182 Framingham Heart Study participants (54% women; mean age 51 ± 15 years), we found that sex modifies the association between MetSS score (mean 2.1 ± 1.7, range 0-5) with subclinical markers of systolic and diastolic function. Specifically, higher MetSS score was associated with worse global longitudinal strain (GLS) and E/e’ ratio in women vs men. For example, every 1-point increase in MetSS score was associated with 1.66% higher (worse) GLS in women compared with 1.18% greater GLS in men (ß 1.66, SE 0.21 in women vs ß 1.18, SE 0.22, pint 0.01). Similarly, the MetS score was more strongly associated with a higher (worse) E/e’ ratio in women vs men (ß 1.55, SE, 0.13 in women vs ß, 0.96, SE, 0.13, pint &lt;0.001 in men).</div></div><div><h3>Conclusions</h3><div>We found that sex modifies the association of cardiometabolic disease burden with subclinical markers of systolic and diastolic dysfunction. Specifically, higher cardiometabolic disease burden was associated with worse GLS and E/e’ ratio in women vs men. These findings suggest that women may experience more adverse cardiac remodeling in response to risk exposures compared with men, which may explain why cardiometabolic traits confer a greater relative risk of CVD in women.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101160"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104176","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":"NORMAL EPICARDIAL FAT VOLUME IS A EXCELLENT PREDICTOR FOR LESS CARDIOVASCULAR STRUCTURAL AND FUNCTIONAL ABNORMALITIES INCLUDING CORONARY CALCIUM SCORE","authors":"Mahfouz El Shahawy MD ,&nbsp;Matea Spahiu Medical student ,&nbsp;Eisha Mohmed MD ,&nbsp;Antontella Sabatini MD","doi":"10.1016/j.ajpc.2025.101161","DOIUrl":"10.1016/j.ajpc.2025.101161","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Assessment</div></div><div><h3>Background</h3><div>Epicardial fat volume measurement has emerged as a significant marker in the early detection and prevention of cardiovascular diseases. Excess epicardial fat volume is strongly linked to endothelial dysfunction, which can ultimately lead to the development of coronary calcification. The purpose of this study was to assess whether normal epicardial fat volume is associated with lower structural and functional abnormalities including coronary calcification than have been reported with excess EFV.</div></div><div><h3>Methods</h3><div>389 asymptomatic subjects were screened for cardiovascular risk assessment. Out of 389 subjects, 286 had normal EFV. A total of 286 subjects were then screened for cardiovascular risk using the Early Cardiovascular Disease Risk Scoring System (ECVDRS). The ECVDRS incorporates 7 vascular tests and 3 cardiac tests, with an additional inclusion of C-reactive protein (CRP) and pro-BNP measurements. The coronary artery calcium (CAC) score and epicardial fat volume (EFV) were assessed using a Siemens SOMATOM Definition Dual Source 64 × 2 CT scanner values less then 125mL were considered normal.</div><div>Out of the 286 participants, 244(86%) subjects under the age of 80 were found to have low or normal EFV. These 244 individuals were further divided into age groups for analysis.</div><div>Group 1: &lt; 40 years</div><div>Group 2: 40–49 years</div><div>Group 3: 50–64 years</div><div>Group 4: 65–79 years</div><div>See Table</div></div><div><h3>Results</h3><div><ul><li><span>-</span><span><div>Majority of the patients have normal epicardial fat volume.</div></span></li><li><span>-</span><span><div>In the asymptomatic subjects with normal epicardial fat volume was associated with lower coronary calcium scores regardless of age category.</div></span></li><li><span>-</span><span><div>Normal EFV is assuring for decades to come with less cardiovascular structural and functional abnormalities as noted in the table.</div></span></li></ul></div></div><div><h3>Conclusions</h3><div>In conclusion, normal epicardial fat volume (EFV) is associated with less structural and functional abnormalities including coronary calcium score than have been reported with excess EFV. Hence, we recommend future guidelines to mandate assessing and recording every EFV in all imaging of coronary calcium score in cardiovascular risk assessment.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101161"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104180","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}