European heart journal open最新文献

{"title":"Intervention, improved prevention, imaging, inflammation, and innovation: the five I's cardiovascular highlights in <i>EHJ Open</i> 2024.","authors":"Magnus Bäck, Maciej Banach, Frieder Braunschweig, Salvatore De Rosa, Frank A Flachskampf, Thomas Kahan, Daniel F J Ketelhuth, Patrizio Lancellotti, Susanna C Larsson, Linda Mellbin, Gianluigi Savarese, Annette Schophuus Jensen, Karolina Szummer, Denis Wahl","doi":"10.1093/ehjopen/oeaf015","DOIUrl":"10.1093/ehjopen/oeaf015","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeaf015"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: A multi-component intervention increased access to smoking cessation treatment after hospitalization for atherosclerotic cardiovascular disease: a randomized trial.","authors":"","doi":"10.1093/ehjopen/oeaf010","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf010","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ehjopen/oeae028.].</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeaf010"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of atrial fibrillation on oxygen uptake and haemodynamics in patients with heart failure: a systematic review and meta-analysis.","authors":"Veronika Schmid, Stephen J Foulkes, Jenelle K Dziano, Jing Wang, Jan Verwerft, Adrian D Elliott, Mark J Haykowsky","doi":"10.1093/ehjopen/oeaf003","DOIUrl":"10.1093/ehjopen/oeaf003","url":null,"abstract":"<p><strong>Aims: </strong>Atrial fibrillation (AF) may exacerbate exercise intolerance and haemodynamic limitations in individuals with heart failure (HF). Therefore, we performed a systematic search and meta-analysis to quantify the impact of AF on exercise tolerance (peak oxygen uptake, VO₂peak; primary outcome) and exercise haemodynamics (secondary outcomes) in patients with HF.</p><p><strong>Methods and results: </strong>PubMed, Scopus, and Web of Science databases were systematically searched for articles from inception to June 2024. Studies were included if they: (i) examined participants with HF; (ii) compared participants with AF to those not in AF (i.e. sinus rhythm); (iii) measured VO₂peak from expired gas analysis. A fixed effects meta-analysis was performed, with groups compared using the weighted average effect size, represented as the weighted mean difference (WMD) with 95% confidence intervals (95% CI). Of 573 identified studies, 16 met the full inclusion comparing VO₂peak in HF-patients in AF [HF-AF; <i>n</i> = 1,271, 68% male, 67 years, left ventricular ejection fraction (LVEF): 41%], and HF in sinus rhythm (HF-SR; <i>n</i> = 4910; 62% male, 62 years, LVEF: 41%). VO₂peak was significantly lower in HF-AF (WMD: -1.55mL/kg/min, 95%-CI: -1.81 to -1.28, <i>n</i> = 6471). This coincided with a slightly lower peak heart rate (WMD: -2.94 b/min, 95%-CI: -4.76 to -1.13 b/min, <i>n</i> = 5115), decreased O₂pulse (WMD: -1.58 mL/beat, 95% CI: -1.90 to -1.26, <i>n</i> = 3049), and lower systolic blood pressure (WMD: -11.11 mmHg, 95% CI: -14.01 to -8.21, <i>n</i> = 2409).</p><p><strong>Conclusion: </strong>In patients with HF, AF is associated with greater VO₂peak impairment, potentially due to reduced stroke volume and/or arterio-venous oxygen difference. This highlights the importance of combined strategies to identify and manage AF in individuals with HF.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeaf003"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low LDL cholesterol and risk of bacterial and viral infections: observational and Mendelian randomization studies.","authors":"Marianne Benn, Frida Emanuelsson, Anne Tybjærg-Hansen, Børge G Nordestgaard","doi":"10.1093/ehjopen/oeaf009","DOIUrl":"10.1093/ehjopen/oeaf009","url":null,"abstract":"<p><strong>Aims: </strong>Low levels of LDL cholesterol may be associated with risk of infectious disease. We tested the hypothesis that low LDL cholesterol due to genetic variation in the <i>LDLR</i>, <i>PCSK9</i>, and <i>HMGCR</i> genes and a polygenic LDL cholesterol score is associated with risk of infectious diseases in the general population.</p><p><strong>Methods and results: </strong>Using observational and Mendelian randomization designs, we examined associations of low plasma LDL cholesterol with risk of bacterial and viral infections in 119 805 individuals from the Copenhagen General Population Study/Copenhagen City Heart Study, 468 701 from the UK Biobank, and up to 376 773 from the FinnGen Research Project. Observationally, low LDL cholesterol concentrations were associated with risk of hospitalization for both bacterial and viral infections. In genetic analyses, a 1 mmol/L lower LDL cholesterol was associated with lower plasma PCSK9 {-0.55 nmol/L [95% confidence interval (CI): -1.06 to -0.05]; <i>P</i> = 0.03}, leucocyte count [-0.42 × 10⁹/L (-0.61 to -0.24); <i>P</i> < 0.001], and high-sensitivity C-reactive protein [-0.44 mg/L (-0.79 to -0.09); <i>P</i> = 0.014]. Using an <i>LDLR</i>, <i>HMGCR</i>, and <i>PCSK9</i> score, a 1 mmol/L lower LDL cholesterol was associated with risk ratios of 0.91 (95% CI: 0.86-0.97; <i>P</i> = 0.002) for unspecified bacterial infection, of 0.92 (0.87-0.97; <i>P</i> = 0.004) for diarrhoeal disease, and of 1.15 (1.03-1.29; <i>P</i> = 0.012) for unspecified viral infections and 1.64 (1.13-2.39; <i>P</i> = 0.009) for HIV/AIDS. Using a polygenic LDL cholesterol score largely showed similar results and in addition a lower risk of 0.85 (0.76-0.96; <i>P</i> = 0.006) for bacterial pneumonia and 0.91 (0.82-0.99; <i>P</i> = 0.035) for sepsis.</p><p><strong>Conclusion: </strong>Genetically low LDL cholesterol concentrations were associated with lower concentration of markers of inflammation; lower risk of hospitalization for unspecified bacterial infections, infectious diarrhoeal diseases, bacterial pneumonia, and sepsis; and higher risk of viral infections and HIV/AIDS.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeaf009"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex and age-specific 10-year mortality after coronary stenting: an analysis of two randomized trials.","authors":"Tineke H Pinxterhuis, Eline H Ploumen, Carine J M Doggen, Daphne van Vliet, Marlies M Kok, Paolo Zocca, Marc Hartmann, K Gert van Houwelingen, Martin G Stoel, Frits H A F de Man, Gerard C M Linssen, Clemens von Birgelen","doi":"10.1093/ehjopen/oeaf006","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf006","url":null,"abstract":"<p><strong>Aims: </strong>Over time, clinical outcome after percutaneous coronary intervention (PCI) with contemporary drug-eluting stents (DES) has improved. While most patients survive for many years after PCI, data on potential sex differences in age-specific 10-year mortality risk in all-comer patients are scarce. This study aimed to examine the sex- and age-specific 10-year mortality risk after PCI with new-generation DES.</p><p><strong>Methods and results: </strong>This investigator-driven study assessed women and men, enrolled in our centre in two large-scale all-comer PCI trials (TWENTE and DUTCH PEERS; <i>ClinicalTrials.gov NCT01066650</i> and <i>NCT01331707</i>, respectively), and compared their long-term mortality risk with that of the general population. The life status was checked in a national database of personal records. Information about the causes of death was obtained from medical records. Of all 2743 patients, 220/748 women and 461/1995 men died (29.4 vs. 23.1%, respectively, <i>P</i> < 0.001). Deceased patients had higher cardiovascular risk profiles and were older than patients who survived. Compared to the general population of a similar age, women and men who underwent PCI showed significantly increased 10-year all-cause mortality risks with a standardized mortality ratio of 2.13 [95% confidence interval (CI): 1.85-2.41] and 1.63 (95% CI: 1.48-1.78), respectively. No sex difference in causes of death was observed (cardiac, 28.2% women vs. 30.8% men, <i>P</i> = 0.46; vascular, 4.1 vs. 5.4%, <i>P</i> = 0.45; non-cardiovascular, 38.2 vs. 44.5%, <i>P</i> = 0.11).</p><p><strong>Conclusion: </strong>PCI patients of both sexes showed higher 10-year age-specific mortality risks than the general population with a more pronounced difference observed in women. There was no sex difference in underlying causes of death. Furthermore, both women and men who died had higher cardiovascular risk profiles than those who survived.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeaf006"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Triglycerides, total Cholesterol, and Body weight Index associating with frailty and predicting poor outcome after transcatheter aortic valve implantation: insights from LAPLACE-TAVI registry.","authors":"Shinichiro Doi, Takehiro Funamizu, Hiroshi Iwata, Ryo Naito, Soshi Moriya, Takuma Koike, Ryota Nishio, Norihito Takahashi, Yuichi Chikata, Seiji Koga, Shinya Okazaki, Ryosuke Higuchi, Itaru Takamisawa, Mike Saji, Kei Sato, Harutoshi Tamura, Hiroaki Yokoyama, Takayuki Onishi, Tetsuya Tobaru, Shuichiro Takanashi, Minoru Tabata, Tohru Minamino","doi":"10.1093/ehjopen/oeaf008","DOIUrl":"10.1093/ehjopen/oeaf008","url":null,"abstract":"<p><strong>Aims: </strong>The nutritional status and frailty are crucial in patients with aortic stenosis undergoing transcatheter aortic valve implantation (TAVI), as they significantly impact outcomes. We have previously developed an easily calculable nutritional index, TCBI (Triglycerides, total Cholesterol, and Body weight Index), which has been validated as a prognostic indicator in various cardiovascular disease contexts. This study aimed to evaluate the impact of a low TCBI on the frailty and outcomes of patients undergoing TAVI.</p><p><strong>Methods and results: </strong>This study is a part of a Japanese multi-centre prospective registry database of TAVI cases (<i>n</i> = 824). Participants were categorized into three groups based on TCBI tertiles before TAVI. The primary endpoint was all-cause mortality with a follow-up duration of up to 3 years. In the lowest TCBI tertile group, motor functions reflecting frailty were substantially impaired, and cumulative incidences of primary endpoint was significantly higher compared to other groups. Multivariate Cox proportional hazard analyses adjusted by risk factors for poor outcomes following TAVI identified low TCBI significantly associated with an increased risk of the primary endpoint [hazard ratio (HR) and 95% confidence interval (95% CI) of 1 SD lower TCBI for all-cause mortality: 1.52, 1.08-2.13, <i>P</i> = 0.015]. Moreover, in individuals who experienced serious preprocedural complications, the negative prognostic impact of low TCBI was significantly amplified (HR and 95% CI: 4.9, 1.9-12.5, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The present findings underscore the importance of nutritional assessment in patients undergoing TAVI. TCBI proved useful for accurate risk stratification and determining TAVI procedural strategies.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeaf008"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health improvements by understanding residual risk in coronary artery disease and new targets for prevention/treatment: rationale and research protocol of the HURRICANE project.","authors":"Chiara Caselli, Mariaelena Occhipinti, Katia Pane, Carmelo De Gori, Silvia Rocchiccioli, Nicoletta Botto, Concetta Prontera, Carlo Cavaliere, Rosetta Ragusa, Cecilia Vecoli, Francesco Sansone, Emanuela Passaro, Elisa Ceccherini, Antonio Morlando, Alberto Clemente, Monica Franzese, Erica Maffei, Bruna Punzo, Alessia Gimelli, Filippo Cademartiri, Danilo Neglia","doi":"10.1093/ehjopen/oeaf005","DOIUrl":"10.1093/ehjopen/oeaf005","url":null,"abstract":"<p><p>Optimal medical treatment in patients with stable coronary artery disease (CAD) reduced morbidity and mortality but left a substantial residual risk (RR) of disease progression and events. According to recent evidence, insulin resistance or pre-diabetes together with elevated levels of triglycerides, low levels, and functionality of HDL-cholesterol, often associated with a chronic inflammatory state, are deemed to be relevant components of cardiometabolic and vascular RR. In the present project, we aim at discovering specific individual genetic/molecular profiles subtending emerging cardiometabolic and vascular risk patterns and associated with more severe stable CAD phenotypes. To this end, we will analyse clinical data, blood samples, and imaging data already gathered in a retrospective population of 561 patients with suspected stable coronary disease and will develop integrated predictive models of severity and extent of disease defined by qualitative and quantitative analysis of coronary plaques by cardiac computed tomography. The new predictive models, which will incorporate relevant clinical and genetic/molecular variables associated with more severe coronary atherosclerosis, will be validated in a similar prospective population of patients and extended to the prediction of progression (at 1 year follow-up) of coronary disease phenotypes, occurring despite optimal medical treatment. <b>Registration</b>  ClinicalTrials.gov ID: NCT06601153.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeaf005"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of computed tomography-derived myocardial extracellular volume in aortic stenosis: a meta-analysis of all-cause mortality and heart failure hospitalization.","authors":"Jin Kirigaya, Shingo Kato, Kensuke Matsushita, Nobuyuki Horita, Daisuke Utsunomiya, Kiyoshi Hibi","doi":"10.1093/ehjopen/oeaf007","DOIUrl":"10.1093/ehjopen/oeaf007","url":null,"abstract":"<p><strong>Aims: </strong>Pre-existing myocardial fibrosis before aortic valve replacement (AVR) is a major cause of postoperative heart failure (HF). Evaluation of fibrosis by computed tomography extracellular volume (CT-ECV) may allow risk stratification for patients with severe aortic stenosis (AS) scheduled for transaortic AVR (TAVR) or surgical AVR (SAVR). We performed a meta-analysis to determine the prognostic value of CT-ECV for the prediction of adverse events in patients with severe AS scheduled for AVR.</p><p><strong>Methods and results: </strong>Electronic database searches of PubMed, Web of Science Core Collection, Cochrane advanced search, and EMBASE were performed. A comprehensive literature review was conducted to examine the association between CT-ECV and prognosis in patients with severe AS who underwent AVR. The diagnostic performance of CT-ECV for predicting composite adverse events (all-cause death and hospitalization for HF) was assessed using a pooled odds ratio (OR). Data from 902 patients with severe AS were extracted from six studies, including 881 TAVR and 21 SAVR cases. The pooled OR of abnormal CT-ECV for predicting adverse events was 4.53 [95% confidence interval (CI): 3.13-6.57 (<i>I</i> ² = 10%, <i>P</i> for heterogeneity = 0.50)]. We performed an OR meta-analysis on five studies with only TAVR cases (<i>n</i> = 807). The pooled OR of abnormal CT-ECV for predicting adverse events in TAVR patients was 4.85 [95% CI: 3.26-7.21 (<i>I</i>² = 0%, <i>P</i> < 0.001)].</p><p><strong>Conclusion: </strong>Considering the high prognostic ability and versatility of CT-ECV, it may be used to predict postoperative adverse events in patients with severe AS who underwent AVR.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeaf007"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes of long-term mortality in patients with ST-segment elevation myocardial infarction is dictated by the presence of microvascular obstruction.","authors":"Giselle Fisher, Brynn Okeson, Evan Walser-Kuntz, Joao L Cavalcante, Jay H Traverse","doi":"10.1093/ehjopen/oeaf002","DOIUrl":"10.1093/ehjopen/oeaf002","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeaf002"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of children with heterozygous familial hypercholesterolaemia worldwide: a meta-analysis.","authors":"Ibadete Bytyçi, Sefer Bytyqi, Joanna Lewek, Stanislaw Surma, Gani Bajraktari, Michael Henein, Amirhossein Sahebkar, Mutaz Al-Khnifsawi, Ioanna Gouni-Berthold, Ivan Pećin, Peter P Toth, Francesco Paneni, Niki Katsiki, Carlos Escobar, Carl J Lavie, Dan Gaita, Raul D Santos, Arrigo F G Cicero, Agata Bielecka-Dabrowa, Ali Ahmed, Maciej Banach","doi":"10.1093/ehjopen/oeaf001","DOIUrl":"10.1093/ehjopen/oeaf001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;Heterozygous familial hypercholesterolaemia (HeFH) is one of the most frequent monogenic disorders in the world, leading to premature atherosclerotic cardiovascular diseases. The aim of this meta-analysis was to evaluate the efficacy and safety of lipid-lowering therapy (LLT) and achievement of low density lipoprotein cholesterol (LDL-C) goal in children with HeFH.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and results: &lt;/strong&gt;The main endpoint was efficacy of goal achievement for LDL-C and other lipid parameters: total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), apolipoprotein B, and lipoprotein(a), and the LLT safety [adverse events (AEs), including endocrine function, and growth indices]. The secondary endpoint was an effect of LLT on attainment of LDL-C goal treatment (&lt;3.5 mmol/L/130 mg/dL). A total of 41 studies with 4667 paediatric patients at mean age 12.08 ± 2.4 years were included. Seventeen reported the efficacy and safety of LLT therapy compared to control, while the remaining assessed LLT through pre- and post-treatment. At median follow-up of 18.8 months, the group on LLT had significantly higher mean reductions of TC, LDL-C, TG, and increased HDL-C compared to control [-1.75 mmol/L (-67.7 mg/dL), -1.84 mmol/L (-71.2 mg/dL), -0.11 mmol/L (-9.74 mg/dL), 0.08 mmol/L (3.1 mg/dL), respectively, &lt;i&gt;P&lt;/i&gt; &lt; 0.001 for all]. In the subgroup analysis according to different types of LLT, we observed a significantly higher mean reduction of LDL-C by statin combined with ezetimibe treatment, followed by statins in monotherapy, PCSK9 inhibitors, and monotherapy with ezetimibe [-2.48 mmol/L (-95.9 mg/dL), -2.16 mmol/L (-83.5 mg/dL), -2.03 mmol/L (-78.5 mg/dL), and -1.50 mmol/L (-58 mg/dL), respectively, test for overall effect: &lt;i&gt;P&lt;/i&gt; &lt; 0.001]. The pooled LDL-C was reduced by 33.44% [-2.14 mmol/L (-82.8 mg/dL), &lt;i&gt;P&lt;/i&gt; &lt; 0.001] and failed to reach the goal treatment (&lt;3.5 mmol/L) by 12.6% (95% CI, 12.4-12.9%). A total of 38.7% of children achieved the LDL-C goal, 23.9% fell short by up to 10%, 10.7% experienced moderate failure (were over the LDL-C target between &gt;10% and 20%), and 26.7% failed by more than 20% to reach the LDL-C target. When comparing different regions, only Sweden and Greece achieved the LDL-C goal &lt; 3.5 mmol/L in the follow-up. Netherlands, Norway, Poland, USA, UK, France, Spain, Belgium, and Austria required 2.2%, 3.4%, 3.5%, 8.9%, 10.2%, 11.2%, 11.2%, 15%, and 19.4% additional reduction in LDL-C respectively to achieve the LDL-C goal of &lt; 3.5 mmol/L. All other countries required over 20% additional reduction in LDL-C to achieve the LDL-C goal. For other investigated countries, over 20% mean LDL-C reduction was required. All parameters related to endocrine function and demographic indices were unaffected by LLT therapy (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). The AEs were not reported significantly higher when compared to the control, and the prevalence of therapy discontinuation was only 0.8%.&lt;/p&gt;","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 1","pages":"oeaf001"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}