American journal of preventive cardiology最新文献

{"title":"PHARMACOLOGIC SURVEILLANCE STUDY OF FDA ADVERSE EVENT REPORTING SYSTEM (FAERS) EVENTS OF EMPAGOFLOZIN AND CANAGLIFLOZIN","authors":"Ilana Logvinsky MD MPH,&nbsp;Gautam Maddineni MD,&nbsp;Eric Wu DO,&nbsp;Vivek Singh MD,&nbsp;Nabil Benhayoun MD","doi":"10.1016/j.ajpc.2025.101144","DOIUrl":"10.1016/j.ajpc.2025.101144","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Pharmacologic Therapy</div></div><div><h3>Background</h3><div>Sodium-glucose cotransporter-2 (SGLT2) inhibitors are widely used to manage type 2 diabetes, heart failure, and chronic kidney disease by preventing glucose reabsorption in the renal tubules. These medications effectively reduce the risk of major adverse cardiovascular events. However, SGLT2 inhibitors have been associated with specific adverse events, necessitating a careful evaluation of their safety profiles.</div></div><div><h3>Methods</h3><div>Adverse event data for empagliflozin and canagliflozin from January 2016 to September 2024 were extracted from the FAERS database. Reported side effects analyzed included DKA, euDKA, bacterial UTIs, fungal urogenital infections, and Fournier's gangrene. RORs and 95% confidence intervals (CIs) were calculated to compare the relative risk of these adverse events for the two medications.</div></div><div><h3>Results</h3><div>The total reported adverse events for empagliflozin and canagliflozin were 32,471 and 16,322, respectively. Empagliflozin was associated with a significantly higher risk of euDKA (ROR 2.88, CI 2.47–3.35), bacterial UTIs (ROR 1.29, CI 1.15– 1.46), fungal urogenital infections (ROR 1.66, C 1.50–1.84), and Fournier's gangrene (ROR 1.91, CI 1.65–2.23) compared to canagliflozin. In contrast, empagliflozin demonstrated a lower risk of developing DKA compared to canagliflozin (ROR 0.81, CI 0.76–0.86). All findings were statistically significant.</div></div><div><h3>Conclusions</h3><div>Empagliflozin and canagliflozin are SGLT2 inhibitors with distinct safety profiles commonly used. Empagliflozin is associated with a higher risk of euDKA, bacterial UTIs, fungal urogenital infections, and Fournier's gangrene but a lower risk of DKA compared to canagliflozin. For patients with a predisposition to urinary tract infections (bacterial or fungal), canagliflozin may be preferred. Similarly, canagliflozin may be a better option for patients with uncontrolled diabetes due to its lower risk of euDKA. Individualized therapy based on patient- specific risk factors is recommended.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101144"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104362","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 AT HIGH CARDIOVASCULAR RISK","authors":"Andrew Hsieh PharmD ,&nbsp;Stephen J Nicholls MBBS PhD ,&nbsp;Adam J Nelson MBBS, PhD ,&nbsp;Marc Ditmarsch MD ,&nbsp;John JP Kastelein MD, PhD ,&nbsp;Christie M Ballantyne MD ,&nbsp;Kausik K Ray MD MPHil FMedSci ,&nbsp;Ann Marie Navar MD, Phd ,&nbsp;Steven E Nissen MD ,&nbsp;Mariko Harada-Shiba MD, Phd ,&nbsp;Danielle L. Curcio MBA ,&nbsp;Annie Neild PhD ,&nbsp;Douglas Kling MBA ,&nbsp;Julie Butters BHSc, MBA ,&nbsp;Brian A Ference MD, MPHIL, MSC ,&nbsp;Ulrich Laufs MD ,&nbsp;Maciej Banach MD PhD ,&nbsp;Roxana Mehran MD ,&nbsp;Alberico L Catapano PhD ,&nbsp;Yong Huo MD ,&nbsp;Michael H Davidson MD","doi":"10.1016/j.ajpc.2025.101133","DOIUrl":"10.1016/j.ajpc.2025.101133","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Pharmacologic Therapy</div></div><div><h3>Background</h3><div>Obicetrapib is a highly selective cholesteryl ester transfer protein inhibitor that lowers low-density lipoprotein (LDL) cholesterol levels. The efficacy and safety of obicetrapib has not been fully characterized in patients at high risk of cardiovascular events.</div></div><div><h3>Methods</h3><div>BROADWAY enrolled 2530 patients with familial hypercholesterolemia (FH) or a history of atherosclerotic cardiovascular disease (ASCVD), treated with maximally tolerated lipid lowering therapy. Patients with either LDL cholesterol ³100 mg/deciliter and/or non-high-density lipoprotein (non-HDL) cholesterol ³130 mg/deciliter or LDL cholesterol 55-100 mg/deciliter and/or non-HDL cholesterol 85-130 mg/deciliter with at least one additional cardiovascular risk factor were randomized (2:1) to obicetrapib 10 mg or matching placebo daily for 365 days. The primary endpoint was the percent change from baseline to Day 84 in LDL cholesterol.</div></div><div><h3>Results</h3><div>Patients (mean age 65 years, female 33%, White race 74%, ASCVD 89%, FH 16%, statin use 90%) had a mean baseline LDL cholesterol level of 98 mg/deciliter. The difference between placebo and obicetrapib for the change in LDL cholesterol was -32.7% (95% confidence interval [CI] -35.8, -29.5), P&lt;0.0001. The percent change from baseline in LDL cholesterol at day 84 was +2.7% (95% CI -0.4, 5.8) with placebo and -29.9% (95% CI -32.1, -27.8) with obicetrapib. The incidence of adverse events was similar across treatment groups.</div></div><div><h3>Conclusions</h3><div>Obicetrapib was well tolerated and produced placebo-adjusted LDL cholesterol reductions of 32.7% in patients at high risk of cardiovascular events with elevated lipid levels despite treatment with maximally tolerated lipid lowering therapy.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101133"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104635","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 THE ACCURACY OF THE PREVENT CALCULATOR COMPARED TO THE PCE IN ASSESSING ATHEROSCLEROTIC CARDIOVASCULAR DISEASE RISK: THE DALLAS HEART STUDY","authors":"Gabrielle Schwab MD,&nbsp;Shanice Glasco MD,&nbsp;Colby Ayers MS,&nbsp;Parag Joshi MD,&nbsp;Ann Marie Navar MD,&nbsp;Eric Peterson MD,&nbsp;Anand Rohatgi MD,&nbsp;Amit Khera MD, MSc","doi":"10.1016/j.ajpc.2025.101152","DOIUrl":"10.1016/j.ajpc.2025.101152","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Assessment</div></div><div><h3>Background</h3><div>The predicting risk of cardiovascular disease events (PREVENT) calculator was recently (2023) developed as an updated cardiovascular disease risk calculator from the prior Pooled Cohort Equations (PCE) calculator. Few studies are available comparing the accuracy and implications on risk categorization of using the PREVENT vs. PCE calculator.</div></div><div><h3>Methods</h3><div>Participants from the Dallas Heart Study first phase (DHS1) aged 40 to 65 without known cardiovascular disease at baseline and with complete follow up data for atherosclerotic cardiovascular disease (ASCVD) events (fatal or non-fatal myocardial infarction or stroke) were included. Discrimination was assessed using the Harrell C-statistic. Calibration was assessed evaluating observed vs. predicted 10-year ASCVD risk across risk deciles using the Nam-D'Agostino χ2 test. Categorical net reclassification was performed by cross-tabulating risk estimates from PREVENT and PCE in those with and without ASCVD events. The predicted risk categories based on clinically relevant treatment thresholds were: &lt;5%, &lt;7.5% and ³7.5% 10-year ASCVD risk. Replication was performed in the Dallas Heart Study second phase (DHS2) cohort which was slightly more contemporary (enrollment 2009 vs. 2001).</div></div><div><h3>Results</h3><div>The DHS1 cohort comprised 1346 individuals, mean age 49.6 (±6.6) years, 42% male, 48% Black individuals. Applying the PREVENT and PCE calculators resulted in similar c-statistics (0.7291 vs. 0.7253). Both calculator risk estimates diverged from the observed risk deciles (p&lt;0.0001 each) with PREVENT generally underestimating risk and PCE overestimating risk, particularly in the middle and higher deciles (Fig 1,2). Among the 170 individuals who experienced an ASCVD event, PREVENT incorrectly down-classified ASCVD risk compared with PCE in 70 (41%), and only up-classified risk in 3 (Fig 3). Among the 1176 who did not experience an event, PREVENT appropriately down-classified risk in 324 (28%), and up-classified risk in 6 (Fig 4). When evaluating the DHS2 cohort (n=1742, mean age 52 years), similar results were found.</div></div><div><h3>Conclusions</h3><div>In a large, multiethnic, population-based cohort, the PREVENT calculator had comparable discrimination of ASCVD events as the PCE. Both miscalibrated observed risk, with PREVENT underestimating and PCE overestimating risk. The lower estimates by PREVENT could result in fewer individuals recommended preventive therapies, reducing therapy burden but also potentially increasing ASCVD events.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101152"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104756","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 IN-HOSPITAL IMPACT OF COMORBID CONDITIONS ON PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION (STEMI) UNDERGOING PERCUTANEOUS CORONARY INTERVENTION (PCI). A RETROSPECTIVE STUDY INVOLVING THE NATIONAL INPATIENT SAMPLE (NIS 2016-2021)","authors":"Mark Anthony Ntow MD ,&nbsp;Walter Yaw Agyeman MD ,&nbsp;Yussif Issaka MD ,&nbsp;Daniel Pinkrah MD ,&nbsp;Joshua Tetteh Narh MD","doi":"10.1016/j.ajpc.2025.101106","DOIUrl":"10.1016/j.ajpc.2025.101106","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Assessment</div></div><div><h3>Background</h3><div>ST-segment elevation myocardial infarction (STEMI) requires urgent revascularization, typically achieved through percutaneous coronary intervention (PCI). While advancements in PCI techniques and pharmacotherapy have improved outcomes, the presence of comorbidities continues to exert a significant impact on patients undergoing PCI for STEMI.</div></div><div><h3>Methods</h3><div>This study utilized the National Inpatient Sample (NIS) to identify patients who underwent PCI for STEMI between 2016 and 2021. Key comorbidities, including obesity, hypertensive heart disease, diabetes, hyperlipidemia, congestive heart failure (CHF), chronic kidney disease (CKD), peripheral arterial disease (PAD), tobacco use, previous myocardial infarction, and prior PCI, were examined. Logistic and linear regression analyses were performed to assess the impact of these comorbidities on in-hospital mortality, length of hospitalization, hospital costs, and post-procedural complications.</div></div><div><h3>Results</h3><div>A weighted national estimate of 807,780 patients underwent PCI for STEMI. Significantly higher odds of in-hospital mortality were observed in patients with CHF (aOR: 2.19, 95% CI: 2.08-2.30, p&lt;0.0001), PAD (aOR: 1.67, 95% CI: 1.50-1.87, p&lt;0.0001), CKD (aOR: 1.47, 95% CI: 1.38-1.56, p&lt;0.0001), and diabetes (aOR: 1.40, 95% CI: 1.33-1.47, p&lt;0.0001). CHF was associated with the longest hospital stay (+2.48 days, 95% CI: 2.41-2.55, p&lt;0.0001) and highest hospital costs (+$65,400, 95% CI: $62,444-$68,357, p&lt;0.0001). CHF also carried the highest odds of post-procedure cardiac arrest (aOR: 3.50, 95% CI: 1.408.74, p&lt;0.007) and cardiogenic shock (aOR: 3.60, 95% CI: 2.77-4.68, p&lt;0.0001). CKD was linked to the highest odds of post-procedure kidney failure (aOR: 2.37, 95% CI: 1.26-4.46, p&lt;0.007).</div></div><div><h3>Conclusions</h3><div>CHF, PAD, CKD, and diabetes significantly increased in-hospital mortality risk after PCI for STEMI. CHF was also associated with the longest hospital stay, highest costs, and the greatest risk of cardiac arrest and cardiogenic shock. CKD was most strongly linked to post-procedure kidney failure. These findings highlight the need for targeted management strategies to optimize outcomes in high-risk patients undergoing PCI for STEMI.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101106"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104746","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 AND PREDICTORS OF STATIN USE FOLLOWING ACUTE CORONARY SYNDROME: INSIGHTS FROM A CENTRAL MASSACHUSETTS PROSPECTIVE REGISTRY","authors":"Khanh-Van Tran MD PhD ,&nbsp;Cassie R. Shao BA ,&nbsp;Katherine A. Tak BA ,&nbsp;Elisa M. Taylor-Yeremeeva BA ,&nbsp;Carrie R. Shao BA ,&nbsp;Nouran Y. Nagy MS ,&nbsp;Asem Ali MD","doi":"10.1016/j.ajpc.2025.101177","DOIUrl":"10.1016/j.ajpc.2025.101177","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>CVD Prevention – Primary and Secondary</div></div><div><h3>Background</h3><div>Statin therapy is a cornerstone of secondary prevention in patients with acute coronary syndrome (ACS). While initiation during hospitalization is high, long-term adherence remains suboptimal. Real-world data on post-discharge statin adherence in community-based populations are limited. We aimed to characterize statin use trends and identify predictors of adherence at 6 and 12 months in a prospective cohort from Central Massachusetts.</div></div><div><h3>Methods</h3><div>We analyzed 217 patients enrolled in the Transitions, Risks, and Actions in Coronary Events – Center for Outcomes Research and Education (TRACE-CORE) prospective registry. Statin use was assessed during hospitalization and at 6- and 12-months post-discharge. Logistic regression was used to evaluate whether demographic and clinical factors (age, sex, race/ethnicity, BMI) were associated with continued statin use.</div></div><div><h3>Results</h3><div>The mean age was 63.2 ± 11.8 years, and 61% of participants were male. Statins were initiated during hospitalization in 96.6% of patients. Adherence declined to 87.1% at 6 months and 81.1% at 12 months. Logistic regression models revealed no significant associations between statin adherence and age, sex, race/ethnicity, or BMI at either time point (all p &gt; 0.05). The 6-month model had a Nagelkerke R² of 0.039 (p = 0.338), and the 12-month model had a Nagelkerke R² of 0.030 (p = 0.402), indicating limited explanatory power.</div></div><div><h3>Conclusions</h3><div>Despite high inpatient initiation, nearly one in five ACS patients discontinued statin therapy by 12 months. Traditional demographic and clinical characteristics did not explain adherence patterns. These findings, derived from a prospective, community-based registry, underscore the limitations of relying solely on demographic or clinical predictors and highlight the need for real-world behavioral and system-level interventions.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101177"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104856","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":"DAMAGED HEARTS: A GLOBAL SURVEY OF WORKPLACE VIOLENCE AMONG CARDIOLOGY PROFESSIONALS","authors":"Akshat Banga MBBS, MD ,&nbsp;Hans Mautong MD ,&nbsp;Aisha Khalid MD ,&nbsp;Gaurang Bhatt MBBS ,&nbsp;Angelo Caputi MD ,&nbsp;Salim Surani MD ,&nbsp;Faisal A. Nawaz MD ,&nbsp;Rahul Kashyap MBBS, MBA","doi":"10.1016/j.ajpc.2025.101108","DOIUrl":"10.1016/j.ajpc.2025.101108","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>Other</div></div><div><h3>Background</h3><div>Workplace Violence (WPV) against healthcare workers (HCWs) is an escalating public health issue that can negatively impact providers and patient care. Cardiology professionals (CPs) may be particularly vulnerable due to the high-stakes nature of their work; however, data regarding this issue is limited. We aim to explore the prevalence and risk factors of WPV among CPs.</div></div><div><h3>Methods</h3><div>The Violence Study of Healthcare Workers and Systems (ViSHWaS) is a global crosssectional study conducted from June to August 2022. A validated questionnaire on WPV was distributed using social media. We only retrieved data from HCWs who worked in cardiology settings. Univariate and multivariate analyses were done to determine WPV risk factors. The study was IRB-exempted.</div></div><div><h3>Results</h3><div>Responses from 126 CPs across 39 countries were included, with 51.6% male respondents and 45.2% aged 26–35. India (15.1%), the USA (14.3%), and Nepal (6.4%) were the top responders. Participants were cardiology fellows (30.9%), cardiologists (25.4%), registered nurses (14.3%), advanced practice providers (12.7%), and other types of professionals (auxiliary staff, pharmacists, researchers) (16.7%). Most participants (73.6%) worked at a public hospital. WPV prevalence was 49.2%. Verbal (47.6%) and emotional violence (30.9%) were the most common types, while the patient and/or caregiver were the most common aggressors. Among CPs who experienced WPV or witnessed it on others (n=88), 60.2% felt less motivated/ had decreased job satisfaction, and 18.19% were willing to quit their job. Univariate logistic regression did not identify female gender and working at a public hospital as significant predictors for WPV. However, after adjusting for age and type of profession in the multivariate model, the female gender was associated with a decreased risk of WPV (OR=0.40, p=0.033); while working in a public hospital was associated with an increased risk of WPV (OR=2.89, p=0.034).</div></div><div><h3>Conclusions</h3><div>WPV is prevalent among CPs. While female CPs may be protected from WPV, working in a public hospital may increase its risk. Most CPs who experienced WPV feel less motivated to work and may consider quitting, highlighting the need for effective prevention strategies.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101108"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104981","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":"DEMOGRAPHICS AND IN-HOSPITAL OUTCOMES OF PATIENTS WITH RHEUMATOID ARTHRITIS WITH CONSTRICTIVE PERICARDITIS WHO UNDERWENT PERICARDIECTOMY","authors":"Karla Inestroza","doi":"10.1016/j.ajpc.2025.101172","DOIUrl":"10.1016/j.ajpc.2025.101172","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD in Special Populations</div></div><div><h3>Background</h3><div>Pericarditis can occur as a manifestation of systemic rheumatic arthritis (RA). However, constrictive pericarditis is an unusual complication primarily considered to be related to chronic inflammation leading to thickening and scarring of the pericardium. The prognosis has been shown to be very poor unless the constriction is relieved surgically. Patients with RA have significant comorbidities that could impact prompt diagnosis and outcomes after pericardiectomy. Data related to the clinical implications of RA in patients undergoing pericardiectomy is scarce.</div></div><div><h3>Methods</h3><div>The US National Inpatient Database was queried from 2011 to 2019 for relevant ICD-9 and -10 diagnostic and procedural codes. We identified patients admitted with constrictive pericarditis who had a pericardiectomy. We compared baseline characteristics and in-hospital outcomes of patients who underwent pericardiectomy for constrictive pericarditis with vs. without rheumatoid arthritis (RA).</div></div><div><h3>Results</h3><div>We identified 5,493 patients with constrictive pericarditis who underwent pericardiectomy. Of these population, 221 (4%) had RA. There was a predominantly male affection in both groups. Patients with RA who underwent pericardiectomy were older (61.3 ± 9 years vs. 60.6 ± 13, p &lt;0.001), use tobacco more frequently (51.1% vs. 34.3%, p &lt;0.001), had more chronic obstructive pulmonary disease (33.5% vs. 18%, p &lt;0.001), pulmonary hypertension (33.5% vs. 18.1%, p &lt;0.001), and anxiety (15.8% vs. 8.6%, p &lt;0.001) compared to the group without RA.</div><div>Those with RA were less likely to be male, have hyperlipidemia, or chronic kidney disease compared to patients without RA.</div><div>There was no difference in all cause-in hospital mortality between groups, and patients with RA had shorter length of stay.</div></div><div><h3>Conclusions</h3><div>In this large retrospective US analysis, there was no difference in all-cause mortality or in-hospital complications in patients with or without RA who underwent pericardiectomy for constrictive pericarditis. It must be considered that the nature of this analysis does not account for time since diagnosis or severity of RA, and it has been reported that constriction appears during later timeframes and is more frequent with greater severity of disease in patients with RA.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101172"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104994","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":"Contribution of high BMI to the global burden of cardiovascular disease among young adults aged 20-39 from 1990 to 2021: A systematic analysis for the Global burden of disease study 2021","authors":"Jiaqi Hao ,&nbsp;Mengkai Lu ,&nbsp;Rui Sun ,&nbsp;Xiuya Guan ,&nbsp;Yuanlong Hu ,&nbsp;Muxin Zhang ,&nbsp;Zhiyuan Zhang ,&nbsp;Xinhai Cui ,&nbsp;Xin Wen ,&nbsp;Chao Li ,&nbsp;Chunxiao Zhang","doi":"10.1016/j.ajpc.2025.101283","DOIUrl":"10.1016/j.ajpc.2025.101283","url":null,"abstract":"<div><h3>Background</h3><div>Understanding temporal trends in the burden of cardiovascular disease (CVD) attributable to high body mass index (BMI) in young adults is important for effective and targeted prevention strategies and measures. We aimed to provide comprehensive estimates of CVD deaths and disability-adjusted life-years (DALYs) rate attributable to high BMI in young adults aged 20–39 years at the global, regional, and national levels, as well as temporal trends from 1990 to 2021.</div></div><div><h3>Methods</h3><div>We calculated age-standardized deaths rate and DALYs rate as well as estimated annual percentage changes (EAPC) using Global Burden of Disease (GBD) 2021 study data on deaths and DALYs for CVD attributable to high BMI among young adults aged 20–39 years.</div></div><div><h3>Results</h3><div>Among non-communicable diseases, the burden of cardiovascular disease attributed to high BMI among young adults aged 20–39 years is much higher than chronic respiratory diseases, diabetes and kidney diseases, digestive diseases, and neoplasms. Among specific types of cardiovascular disease, ischemic heart disease accounted for the highest proportion, while stroke had the largest increase in the rate of DALYs. an increase in age-standardized DALYs rate over time in low-to-middle SDI regions, a decrease in age-standardized DALYs rate over time in high SDI regions, and a decrease in health inequality in 2021 compared with 1990.</div></div><div><h3>Conclusion</h3><div>In 2021, the high burden of cardiovascular disease attributed to high BMI among young adults varied by region, country, gender, and Socio-demographic index (SDI). The greater burden of cardiovascular disease among young adults in low - and middle-income countries may be linked to unhealthy diets, health awareness, and lifestyles among young adults in low - and middle-income countries. Given the potential for improvement in high BMI, initiatives targeting this risk factor could significantly reduce the burden of CVD. Thus, prioritizing cost-effective policies and interventions is urgently needed.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101283"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931967","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":"Neutrophil-mediated effects of S100A12 on major adverse cardiovascular events: Insights from the UK biobank","authors":"Qingqing Zhang ,&nbsp;Xiangwei Ding ,&nbsp;Yanling Xu ,&nbsp;Yongping Lin ,&nbsp;Yucheng Wu","doi":"10.1016/j.ajpc.2025.101278","DOIUrl":"10.1016/j.ajpc.2025.101278","url":null,"abstract":"<div><h3>Background</h3><div>S100A12, a pro-inflammatory protein primarily secreted by neutrophils, has been implicated in vascular inflammation and atherosclerosis. However, its role in major adverse cardiovascular events (MACE) remains unclear. This study aimed to investigate the association between plasma S100A12 levels and MACE risk, and to assess the potential mediating role of neutrophil count in this relationship.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study using data from the UK Biobank (N = 47,106). Participants with prior MACE or missing S100A12 or neutrophil count data were excluded. MACE was defined as a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death. Cox proportional hazards models were used to assess the association between S100A12 and MACE risk, adjusting for demographics, lifestyle factors, metabolic parameters, and genetic predisposition. Mediation analysis was conducted to evaluate the indirect effect of neutrophil count on this association.</div></div><div><h3>Results</h3><div>During a median follow-up of 15.3 years, 2,250 (4.8 %) participants experienced MACE, with a total follow-up time of 695,581.4 patient-years. Higher S100A12 levels were significantly associated with an increased risk of MACE (HR: 1.115, 95 % CI: 1.050–1.183, <em>P</em> &lt; 0.0001), with a dose‒response relationship observed across tertiles (<em>P</em> for trend &lt; 0.0001). The association remained robust after adjusting for multiple covariates and in sensitivity analyses. Subgroup analyses showed consistent results across age, sex, and metabolic risk factors. Mediation analysis revealed that neutrophil count mediated 44.10 % of the association between S100A12 and MACE (<em>P</em> &lt; 0.0001), supporting a neutrophil-driven inflammatory mechanism.</div></div><div><h3>Conclusion</h3><div>Elevated S100A12 levels are independently associated with increased MACEs risk, with neutrophil count serving as a significant mediator.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101278"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932017","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":"CARDIOVASCULAR RISK ASSESSED VIA RETINAL IMAGING IN METABOLICALLY HEALTHY OBESITY (MHO) AND METABOLICALLY HEALTHY OVERWEIGHT (MHOW)","authors":"Yong Yu Tan MB BCh BAO ,&nbsp;Jaewon Seo MS (Data Science) ,&nbsp;A.V. Rukmini MBBS, MD, PhD ,&nbsp;Tae Hyun Park MD ,&nbsp;Simon Nusinovici PhD ,&nbsp;Sung Soo Kim MD ,&nbsp;Jungkyung Cho MD ,&nbsp;Dongjin Nam MD ,&nbsp;Junseok Joshua Park MD ,&nbsp;Sahil Thakur MBBS, MS, PhD ,&nbsp;Tyler Hyungtaek Rim MD, MBA, PhD","doi":"10.1016/j.ajpc.2025.101123","DOIUrl":"10.1016/j.ajpc.2025.101123","url":null,"abstract":"<div><h3>Therapeutic Area</h3><div>ASCVD/CVD Risk Assessment</div></div><div><h3>Background</h3><div>Metabolically healthy obesity (MHO) and metabolically healthy overweight (MHOW) represent subsets of individuals with elevated BMI but favourable metabolic profiles. Despite their classification as \"metabolically healthy,\" the cardiovascular risk in these groups remains unclear. This study examines the association between MHO, MHOW, and retinal-based cardiovascular risk scores (Dr. Noon CVD) to understand their implications for cardiovascular disease prevention better.</div></div><div><h3>Methods</h3><div>Data for this study were derived from the UK Biobank (N=59,493). Among the participants, metabolically healthy individuals (N=15,947) were categorised into groups based on BMI: metabolically healthy normal weight (MHN, N=8,410), metabolically healthy overweight (MHOW, N=5,753) and metabolically healthy obese (MHO, N=1,784). BMI was categorised as normal weight (18.5-24.9 kg/m²), overweight (25.0-29.9 kg/m²), and obese (≥30 kg/m²). Metabolic health was defined as systolic blood pressure &lt;130 mmHg without antihypertensive drugs, waist-to-hip ratio &lt;0.95 for women or &lt;1.03 for men, and absence of diabetes. Dr. Noon CVD scores were derived from retinal fundus images and validated in several populations. Linear regression models were used to examine associations between metabolic phenotypes and Dr. Noon CVD scores, adjusting for demographic, socioeconomic, and lifestyle factors.</div></div><div><h3>Results</h3><div>MHO and MHOW individuals showed 10.50% (p&lt;0.001) and 16.39% (p&lt;0.001) higher Dr. Noon CVD scores compared to metabolically healthy normal-weight (MHN) individuals, respectively. Lifestyle factors significantly influenced Dr. Noon CVD scores within both the MHO and MHOW groups, with higher physical activity levels and healthier dietary patterns correlating with reduced cardiovascular risk.</div></div><div><h3>Conclusions</h3><div>In MHO and MHOW individuals, the CVD risk remains elevated relative to metabolically healthy normal-weight individuals (MHN). This result indicates that Dr. Noon CVD biomarker may be a useful tool for early risk detection in these individuals and help implement targeted interventions to prevent future disease burden.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101123"},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104193","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}