Cardiology in Review最新文献

{"title":"A Review of Serum Biomarkers for Neurologic Prognostication After Cardiac Arrest.","authors":"Andrew Bauerschmidt, Christopher Fredricks, Stephan A Mayer, Jon B Rosenberg, Fawaz Al-Mufti","doi":"10.1097/CRD.0000000000001055","DOIUrl":"10.1097/CRD.0000000000001055","url":null,"abstract":"<p><p>Neurologic prognostication for comatose survivors of cardiac arrest is a complex task with a profound impact on clinical outcomes. Laboratory biomarkers provide objective data with regard to the degree of cerebral injury and can contribute to establishing the overall prognosis. This review provides a comprehensive overview of all laboratory markers currently utilized both in the clinical and research settings. Biomarkers currently under investigation have a wide range of features, which make for a challenging integration into prognostication protocols and models; these include different half-lives, presence in nonneuronal tissues, metabolic characteristics, and detection characteristics. Ultimately, each of these properties results in variable sensitivity and specificity with regard to predicting neurologic outcome. Neuron-specific enolase is the only biomarker widely used in clinical practice at this time. Tau, glial fibrillary acidic protein, and neurofilament light chain are promising investigational markers that have been studied in large clinical trials, with neurofilament light chain having the strongest characteristics in discriminating between good and poor neurologic outcomes. The characteristics and potential role as biomarkers are also reviewed for ubiquitin C-terminal hydrolase L1 protein, S100B protein, interleukins, and microRNAs.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving Burden of Cardiac Arrest Mortality in Sleep Apnea: A Nationwide Study From 1999 to 2024.","authors":"Muhammad Abdullah Naveed, Tahreem Mari, Bazil Azeem, Saifullah Khan, Faiqa Iqbal, Shireen Asifa, Hamza Naveed, Ahila Ali, Hamza Ali, Muhammad Omer Rehan, Rabia Iqbal Mansoor, Mushood Ahmed, Rahul Chikatimalla, Himaja Dutt Chigurupati, Raheel Ahmed, Sivaram Neppala","doi":"10.1097/CRD.0000000000001069","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001069","url":null,"abstract":"<p><p>Sleep apnea is recognized as a major contributor to cardiovascular morbidity and mortality, including sudden cardiac arrest. This study examines trends in cardiac arrest mortality among US adults with sleep apnea and evaluates disparities across demographic and geographic groups. A retrospective analysis was conducted utilizing the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research data from 1999 to 2024. This study included adults aged ≥25 years who were diagnosed with sleep apnea and cardiac arrest. Age-adjusted mortality rates (AAMRs) and annual percentage changes (APCs) were computed employing Joinpoint regression, stratified by sex, race/ethnicity, region, and urbanization. A total of 57,186 deaths related to cardiac arrest occurred within this population. AAMRs increased from 0.3 to 1.5 per 100,000 [APC, 6.08% (95% confidence interval, 5.60-6.86); P < 0.001], exhibiting a pronounced increase through 2021 (APC, 7.45%) followed by a plateau thereafter. A sex-stratified analysis indicated that mortality rates were higher in males (overall AAMR, 1.3) compared with females (0.6). Non-Hispanic (NH) Black individuals exhibited the highest overall AAMR (1.4), followed by NH White (0.9), Hispanic (0.7), and NH other (0.5). Regionally, the Western United States recorded the highest AAMR (1.2), with rural areas witnessing a more pronounced increase. Cardiac arrest mortality in patients with sleep apnea has escalated over 2 decades, particularly among men, racial minorities, and those in the Western United States. These findings underscore the need for targeted screening, equitable access to care, and public health strategies to mitigate cardiovascular risks in high-burden populations.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatty Kidney Disease: Current Understanding in 2025.","authors":"Htun Min Aung, Navida Wazeed, Abhishesh Wagle, Kaedi Burke, Belinda Jim","doi":"10.1097/CRD.0000000000001060","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001060","url":null,"abstract":"<p><p>The term \"fatty transformation of the kidney\" first appeared in the literature in 1883. As the global epidemic of overweight and obesity continues to escalate, the biopsy incidence of obesity-related glomerulopathy has risen correspondingly, establishing fatty kidney disease as an increasingly recognized clinical entity within chronic kidney disease. Our understanding of how increased fat accumulation in and around the kidney contributes to the complex pathogenesis of fatty kidney disease has substantially improved. In this review article, we summarize the current literature on fatty kidney disease. We also present recent advances in treatment strategies such as glucagon-like peptide-1 receptor agonists and highlight the importance of a multidisciplinary team approach for the early detection and effective management of patients with chronic kidney disease with overweight and obesity.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are We Monitoring Too Much? A Critical Review of Telemetry Overuse in Inpatient Medicine.","authors":"Hadrian Hoang-Vu Tran, Audrey Thu, Anu Radha Twayana, Axel Fuertes, Marco Gonzalez, Krutagni Adwait Mehta, Marina Basta, Maggie James, Daniel Elias, Yghor Myrtho Figaro, Damien Islek, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001067","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001067","url":null,"abstract":"<p><p>Continuous cardiac telemetry is a critical tool for detecting arrhythmias and guiding management in high-risk inpatients, but its diffusion into low-acuity settings has outpaced evidence of benefit. This review synthesizes contemporary evidence on the scope, consequences, and drivers of telemetry overuse, as well as strategies for aligning practice with guideline-based indications. Current data demonstrate that clinically significant arrhythmias are rarely detected in low-risk populations and that monitoring seldom alters management or improves outcomes. Instead, inappropriate use contributes to alarm fatigue, workflow interruptions, unnecessary diagnostic cascades, prolonged hospitalizations, and substantial health system costs. Overuse is driven by cultural norms of defensive medicine, educational gaps across provider groups, and systemic factors such as default order configurations, absent autoexpiration policies, and poor handoff communication. Quality improvement initiatives-including indication-based order entry, daily reassessment, nursing empowerment, and autodiscontinue timers-consistently reduce inappropriate telemetry without compromising patient safety. Emerging innovations, such as wearable monitors and artificial intelligence-enhanced alert algorithms, offer promising alternatives to improve monitoring precision and reduce alarm burden. Taken together, the evidence underscores the need for multifaceted interventions that integrate education, workflow redesign, and institutional leadership to ensure that telemetry use is both evidence-based and resource-conscious.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality Trends in Atrial Fibrillation and Renal Failure Among Older US Adults: A 25-Year Retrospective Analysis (1999-2024).","authors":"Muhammad Hasan, Muhammad Hammad Chola, Talha Ali, Bazil Azeem, Muhammad Shuraim Chola, Muhammad Abdullah Naveed, Ahila Ali, Kriti Soni, Hritvik Jain, Himaja Dutt Chigurupati, Raheel Ahmed, Sivaram Neppala","doi":"10.1097/CRD.0000000000001058","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001058","url":null,"abstract":"<p><p>A well-established relationship exists between renal failure (RF), particularly chronic kidney disease, and atrial fibrillation (AF), as each condition can exacerbate the other. AF is observed with greater frequency in individuals with chronic kidney disease in the United States. This study investigates mortality trends associated with AF and RF from 1999 to 2024, concentrating on gender, racial, and regional disparities. We analyzed mortality data from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research database, focusing on deaths where AF and RF contributed. Age-adjusted mortality rates (AAMRs) were calculated and stratified by sex, race/ethnicity, state, and region. The annual percentage change (APC) and average APC were estimated using the Joinpoint regression method. A total of 394,882 deaths related to AF and RF have been recorded, with the overall AAMR increasing from 16.6 in 1999 to 52.8 in 2023. Mortality rates experienced a significant increase from 1999 to 2012 (APC, 6.1%; P = 0.003), followed by a decrease from 2012 to 2015 (APC, -8.04%; P = 0.003), and then a resurgence from 2015 to 2024 (APC, 7.89%; P < 0.001). Males consistently exhibited higher AAMR than females (43.43 vs 27.01), as did non-Hispanic White individuals in comparison to other racial groups. Geographic disparities indicated higher mortality rates in urban areas and the Midwest. There has been a significant increase in mortalities associated with AF and RF among older adults (aged ≥65 years). Notably, recent surges have been observed in Colorado, Minnesota, and South Dakota, underscoring the necessity for targeted public health interventions.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Venous Thromboembolism Risk, Assessment, and Prophylaxis in Aesthetic Plastic Surgery.","authors":"Tobias Whitford, William H Frishman","doi":"10.1097/CRD.0000000000001063","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001063","url":null,"abstract":"<p><p>Venous thromboembolism (VTE), encompassing deep venous thrombosis and pulmonary embolism, poses a significant and potentially fatal risk in surgical patients, including those undergoing aesthetic plastic surgery procedures. Despite its severity, there remains a notable lack of consensus and high-quality evidence regarding optimal VTE risk assessment and prophylaxis strategies. This review synthesizes current evidence on VTE incidence, identifies key patient and procedural risk factors, evaluates various risk assessment models employed in aesthetic plastic surgery, and discusses mechanical and pharmacological prophylaxis methods. It highlights the complexities and often contradictory findings in the literature, particularly concerning the balance between VTE prevention and the risk of bleeding complications. Recommendations are provided for clinicians to enhance patient safety in the absence of definitive, all-inclusive guidelines, emphasizing the critical need for further rigorous research to standardize VTE prevention in aesthetic plastic surgery.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Semaglutide on Cardiovascular Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Zaryab Bacha, Javeria Javed, Maheen Sheraz, Munazza Sikandar, Mishal Zakir, Muhammad Abdullah Ali, Mamur Khan, Asad Iqbal, Ammara Rehman, Umama Alam, Raheel Ahmed","doi":"10.1097/CRD.0000000000001057","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001057","url":null,"abstract":"<p><p>Cardiovascular complications remain the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM), despite substantial advances in pharmacologic management. Semaglutide, a glucagon-like peptide-1 receptor agonist, has shown potential in reducing cardiovascular events through its multifaceted metabolic and anti-inflammatory effects. This systematic review and meta-analysis aimed to assess the efficacy and safety of semaglutide in improving cardiovascular outcomes among patients with T2DM. A comprehensive literature search was conducted across multiple databases up to March 30, 2025. Randomized controlled trials comparing semaglutide with placebo in adults with T2DM were included. Five randomized controlled trials with a total of 19,717 participants were included. Semaglutide was associated with a significant reduction in major adverse cardiovascular events [risk ratios (RR), 0.82; P < 0.00001], cardiovascular death (RR, 0.81; P = 0.05), and need for coronary revascularization (RR, 0.74; P < 0.0001). A significant reduction in cardiac disorder-related adverse events was also observed (RR = 0.80; P = 0.03). No significant difference was noted in all-cause mortality (RR = 0.83; P = 0.16), hospitalization for heart failure (RR = 0.86; P = 0.10) or unstable angina (RR = 0.94; P = 0.63), nonfatal myocardial infarction (RR = 0.82; P = 0.10) or stroke (RR = 0.83; P = 0.06), and vascular disorders (RR = 1.03; P = 0.73). These findings highlight semaglutide's role as a cardioprotective agent, supporting its integration into standard care for high-risk T2DM patients.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polycystic Ovary Syndrome and Cardiovascular Disease: Pathophysiology, Clinical Evidence, and Preventive Strategies.","authors":"Rimsha Ahmad, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001054","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001054","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting reproductive-aged women and is increasingly recognized as a condition with significant cardiometabolic implications. Women with PCOS frequently exhibit insulin resistance, dyslipidemia, hypertension, obesity, and chronic low-grade inflammation, all of which contribute to an elevated risk of cardiovascular disease. Subclinical vascular abnormalities, including increased carotid intima-media thickness, coronary artery calcium, and impaired endothelial function, are evident early and may persist into later life. While epidemiologic data suggest an association between PCOS and adverse cardiovascular outcomes, the independent causal relationship remains incompletely defined due to confounding by obesity and metabolic syndrome. Aging and menopause further modify risk, highlighting the need for longitudinal, phenotype-specific research. Current clinical guidelines emphasize early recognition of cardiovascular risk in women with PCOS, advocating for comprehensive screening and preventive strategies, including lifestyle modification and targeted pharmacotherapy. Future studies should clarify long-term outcomes and determine whether early intervention can reduce lifetime cardiovascular burden in this population.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy and Safety of Transcatheter Aortic Valve Replacement Versus Surgical Aortic Valve Replacement in Patients With End-Stage Renal Disease: A Systematic Review and Meta-Analysis.","authors":"Zaryab Bacha, Javeria Javed, Fazia Khattak, Izhar Muhammad Shah, Muhammad Abdullah Ali, Maheen Sheraz, Ehtisham Wali, Iqra Shahid, Ayesha Farooq, Zainab Obaid Ullah, Zmarak Khan, Sajjad Ghanim Al-Badri, Fatima Sajjad, Fathimathul Henna, Sidra Irfan","doi":"10.1097/CRD.0000000000001064","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001064","url":null,"abstract":"<p><p>End-stage renal disease (ESRD) severely elevates the risks of aortic stenosis interventions. While surgical aortic valve replacement (SAVR) has traditionally been the gold standard treatment, transcatheter aortic valve replacement (TAVR) has been introduced as a minimally invasive alternative. This systematic review and meta-analysis aimed to evaluate the safety and efficacy of TAVR compared with SAVR in patients with ESRD. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive literature search of databases PubMed, Embase, and Web of Science up to March 2025 found 7 cohort studies comprising 15,462 patients. Primary outcomes consisted of 30-day and in-hospital mortality, while secondary outcomes evaluated pacemaker implantation, complications, length of stay, costs, and discharge report. TAVR was related to considerably lower in-hospital mortality (risk ratio, 0.52) and a pattern toward decreased 30-day mortality. It also decreased the risks of cardiac tamponade, respiratory issues, blood transfusions, and transfers to other facilities. No TAVR was associated with increased rates of pacemaker implantation and vascular complications. It notably shortened hospital stay and enhanced home discharge rates, while healthcare costs were lower compared with SAVR. Sensitivity analyses validated the reliability of most findings. Regardless of high heterogeneity and limitations consisting of geographic restriction to the United States and limited long-term outcomes, this study contributes to evidence that TAVR may offer superior short-term outcomes for patients with ESRD, especially those at high surgical risk. Clinical decisions should be personalized, weighing procedural risks against impactful benefits.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-Driven Multimodality Fusion in Cardiac Imaging: Integrating CT, MRI, and Echocardiography for Precision.","authors":"Hadrian Hoang-Vu Tran, Audrey Thu, Anu Radha Twayana, Axel Fuertes, Marco Gonzalez, Marina Basta, Maggie James, Krutagni Adwait Mehta, Daniel Elias, Yghor Myrtho Figaro, Damien Islek, Wililam H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001052","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001052","url":null,"abstract":"<p><p>Artificial intelligence (AI)-enabled multimodal cardiovascular imaging holds significant promise for improving diagnostic accuracy, enhancing risk stratification, and supporting clinical decision-making. However, its translation into routine practice remains limited by multiple technical, infrastructural, and clinical barriers. This review synthesizes current challenges, including variability in image quality, alignment, and acquisition protocols; scarcity of large, annotated multimodality datasets; interoperability limitations across vendors and institutions; clinical skepticism due to limited prospective validation; and substantial development and implementation costs. Drawing from recent advances, we outline future research priorities to bridge the gap between technical feasibility and clinical utility. Key strategies include developing unified, vendor-agnostic AI models resilient to inter-institutional variability; integrating diverse data types such as genomics, wearable biosensors, and longitudinal clinical records; leveraging reinforcement learning for adaptive decision-support systems; and employing longitudinal imaging fusion for disease tracking and predictive analytics. We emphasize the need for rigorous prospective clinical trials, harmonized imaging standards, and collaborative data-sharing frameworks to ensure robust, equitable, and scalable deployment. Addressing these challenges through coordinated multidisciplinary efforts will be essential to realize the full potential of AI-driven multimodal cardiovascular imaging in advancing precision cardiovascular care.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}