2024 ESC Guidelines for the management of chronic coronary syndromes

European Heart Journal, Journal Year: 2024, Volume and Issue: 45(36), P. 3415 - 3537

Published: Aug. 30, 2024

Language: Английский

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Global burden and national health inequity of ischemic heart disease attributed to kidney dysfunction from 1990 to 2021: findings from the Global Burden of Disease Study 2021

Atherosclerosis, Journal Year: 2025, Volume and Issue: unknown, P. 119140 - 119140

Published: Feb. 1, 2025

Language: Английский

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Ischaemic heart disease in patients with cancer

European Heart Journal, Journal Year: 2024, Volume and Issue: 45(14), P. 1209 - 1223

Published: Feb. 7, 2024

Cardiologists are encountering a growing number of cancer patients with ischaemic heart disease (IHD). Several factors account for the interrelationship between these two conditions, in addition to improving survival rates population. Established cardiovascular (CV) risk factors, such as hypercholesterolaemia and obesity, predispose both IHD cancer, through specific mechanisms via low-grade, systemic inflammation. This latter is also fuelled by clonal haematopoiesis indeterminate potential. Furthermore, experimental work indicates that can promote one another, CV or metabolic toxicity anticancer therapies lead IHD. The connections reinforced social determinants health, non-medical modify health outcomes comprise individual societal domains, including economic stability, educational healthcare access quality, neighbourhood built environment, community context. Management often challenging, due atypical presentation, increased bleeding risk, worse compared without cancer. decision proceed coronary revascularization choice antithrombotic therapy be difficult, particularly chronic syndromes, necessitating multidisciplinary discussion considers general guidelines features on case basis. Randomized controlled trial evidence very limited there urgent need more data inform clinical practice. Therefore, coexistence raises important scientific practical questions call collaborative efforts from cardio-oncology, cardiology, oncology communities.

Language: Английский

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Polygenic Risk Is Associated With Long-Term Coronary Plaque Progression and High-Risk Plaque

JACC. Cardiovascular imaging, Journal Year: 2024, Volume and Issue: 17(12), P. 1445 - 1459

Published: Aug. 14, 2024

The longitudinal relation between coronary artery disease (CAD) polygenic risk score (PRS) and long-term plaque progression high-risk (HRP) features is unknown. goal of this study was to investigate the impact CAD PRS on HRP. Patients underwent measurement prospective serial computed tomography angiography (CTA) imaging. Coronary CTA scans were analyzed with a previously validated artificial intelligence–based algorithm (atherosclerosis imaging–quantitative imaging). relationship change in percent atheroma volume (PAV), noncalcified progression, HRP prevalence investigated linear mixed-effect models adjusted for baseline conventional factors. A total 288 subjects (mean age 58 ± 7 years; 60% male) included median scan interval 10.2 years. At baseline, patients high had more than 5-fold higher PAV those low (10.4% vs 1.9%; P < 0.001). Per 10 years follow-up, 1 SD increase associated 0.69% multivariable model. provided additional discriminatory benefit above-median during follow-up when added model factors (AUC: 0.73 0.69; = 0.039). an OR 2.85 (95% CI: 1.14-7.14; 0.026) 6.16 2.55-14.91; 0.001) having at compared PRS. Polygenic strongly future suspected CAD.

Language: Английский

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Focus on trials and prevention: suspected angina, atrial fibrillation, COVID, wine consumption, and physical activity

European Heart Journal, Journal Year: 2025, Volume and Issue: 46(2), P. 105 - 109

Published: Jan. 7, 2025

Language: Английский

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Breaking binary in cardiovascular disease risk prediction

Deleted Journal, Journal Year: 2025, Volume and Issue: 2(1)

Published: Jan. 13, 2025

Abstract Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death in world. However, advances genetics, omics research, machine learning (ML), and precision medicine have inspired revolutionary new tools ASCVD risk stratification. Together, polygenic scores (PRS) composite ML-based algorithms help shift paradigm away from binary predictions towards more comprehensive continuum models. Continued efforts are needed to address socioeconomic racial disparities PRS space.

Language: Английский

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Genomic Drivers of Coronary Artery Disease and Risk of Future Outcomes After Coronary Angiography

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(1), P. e2455368 - e2455368

Published: Jan. 21, 2025

Importance Disease characteristics of genetically mediated coronary artery disease (CAD) on angiography and the association genomic risk with outcomes after are not well understood. Objective To assess angiographic post–coronary patients drivers CAD: familial hypercholesterolemia (FH), high polygenic score (PRS), clonal hematopoiesis indeterminate potential (CHIP). Design, Setting, Participants A retrospective cohort study 3518 Mass General Brigham Biobank participants information who underwent was conducted between July 18, 2000, August 1, 2023. Exposures The presence a factor CAD, defined as FH variant, CAD PRS, or CHIP driver variation. Main Outcomes Measures Coronary presentation (stable acute), (severity burden), (repeat angiogram, revascularization, in-stent restenosis), clinical (heart failure all-cause mortality). Results Among (2467 [70.1%] male; median age, 64.0 [IQR, 55.0-72.0] years), 1509 (42.9%) had at least 1 (26 FH, 1191 466 CHIP) that associated acute syndromes (adjusted odds ratio, 2.67; 95% CI, 2.19-3.26) presence, burden, severity CAD. This driven by PRS. One SD PRS 12.51-point higher Gensini score. During 9 years follow-up, there an increased among carriers for repeat angiogram hazard ratio [AHR], 1.70; 1.02-2.83), revascularization (AHR, 1.97; 1.02-3.80), people angiogram: AHR, 1.79; 1.45-2.22; revascularization: 1.85; 1.37-2.50; restenosis: 3.89; 2.16-7.01). no significant increase in but were heart 1.58; 1.04-2.40) mortality 1.78; 1.47-2.16). Conclusions Relevance findings this suggest germline monogenic presentation, burden atherosclerosis, restenosis. variant status is incident angiography.

Language: Английский

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Development and Validation of a Predictive Model Based on Serum Silent Information Regulator 6 Levels in Chinese Older Adult Patients: Cross-Sectional Descriptive Study

JMIR Aging, Journal Year: 2025, Volume and Issue: 8, P. e64374 - e64374

Published: Jan. 15, 2025

Abstract Background Serum levels of silent information regulator 6 (SIRT6), a key biomarker aging, were identified as predictor coronary artery disease (CAD), but whether SIRT6 can distinguish severity lesions in older adult patients is unknown. Objectives This study developed nomogram to demonstrate the functionality assessing atherosclerosis. Methods Patients aged 60 years and with angina pectoris screened for this single-center clinical between October 1, 2022, March 31, 2023. specimens eligible collected detection by enzyme-linked immunosorbent assay. Clinical data putative predictors, including 29 physiological characteristics, biochemical parameters, carotid ultrasonographic results, complete angiography findings, evaluated, CAD diagnosis primary outcome. The was derived from Extreme Gradient Boosting (XGBoost) model, logistic regression variable selection. Model performance assessed examining discrimination, calibration, use separately. A 10-fold cross-validation technique used compare all models. models’ further evaluated on internal validation set ensure that obtained results not due overoptimization. Results Eligible (n=222) divided into 2 cohorts: development cohort (n=178) (n=44). both an independent risk factor adults. area under receiver operating characteristic curve (AUROC) 0.725 (95% CI 0.653‐0.797). optimal cutoff value predicting 546.384 pg/mL. Predictors included serum levels, triglyceride glucose (TyG) index, apolipoprotein B. model achieved AUROC 0.956 0.928‐0.983) cohort. Similarly, cohort, 0.913 0.828‐0.999). All models demonstrated satisfactory predicted outcomes closely aligning actual results. Conclusions shows promise CAD, enhanced predictive abilities when combined TyG index. In settings, monitoring fluctuations may offer valuable insights early detection. outcome prediction aid trial design personalized decision-making, particularly institutions where being explored aging or cardiovascular health.

Language: Английский

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Hemoglobin-to-red blood cell distribution width ratio as a protective factor against coronary artery disease: a cross-sectional analysis of NHANES (2011-2018)

Frontiers in Pharmacology, Journal Year: 2025, Volume and Issue: 16

Published: Jan. 29, 2025

Background Coronary artery disease (CAD) is the leading cause of death worldwide, and inflammation a significant factor in its development. While hemoglobin-to-red blood cell distribution width ratio (HRR), an indicator inflammation, has been linked to various diseases, association with CAD not well established. Methods We conducted analysis using data from National Health Nutrition Examination Survey (NHANES) spanning 2011 2018. After excluding participants due age, missing data, potential confounding factors, 6,881 individuals were included our study. was identified through self-reported questionnaires, HRR determined laboratory measurements. controlled for factors such as hypertension, waist circumference, systolic pressure, fasting plasma glucose, others logistic regression explore relationship between CAD. Results found that higher levels associated lower risk In fully adjusted model, odds ratios second, third, fourth quartiles 0.38, 0.42, 0.51, respectively, compared first quartile (P &lt; 0.001). An increase by one unit 49% decrease likelihood Furthermore, linear models indicated 74% reduction each one-unit = 0.0002). There notable threshold at 1.02; beyond this point, 91% odds. This suggests above 1.02, strategies body water content reduce viscosity could potentially their developing Conclusion Our study revealed inverse risk, indicating may serve protective against

Language: Английский

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Psychiatric disorders and following risk of chronic kidney disease: a prospective cohort study from UK Biobank

BMC Psychiatry, Journal Year: 2025, Volume and Issue: 25(1)

Published: Feb. 11, 2025

Psychiatric disorders have been reported to influence many health outcomes, but evidence about their impact on chronic kidney disease (CKD) has not fully explored, as well possible mechanisms implicated are still unclear. Four hundred forty-one thousand eight ninety-three participants from UK Biobank were included in this study. To assess the association between psychiatric mainly including depression, anxiety, stress-related disorders, substance misuse psychotic disorder, and CKD, a Cox regression model using age underlying time scale was employed. This approach considers progression of beginning end study elapsed time. Flexible nonparametric smoothing conducted illustrate temporal patterns. Subgroup analyses performed by stratification gender, genetic susceptibility at entry or exit cohort, follow-up duration, number baseline. Mediation analysis implemented evaluate roles body mass index (BMI), hypertension, diabetes. Compared with individuals without an increased risk CKD observed patients (hazard ratios (HR) = 1.52, 95% confidence intervals (CI): 1.40–1.65, p-value < 0.001). The hazard ratio among gradually increased, became significant after 10 years follow-ups. HR for followed up 10–12 1.60 (95% CI: 1.34–1.91, 0.001), 1.66 1.29–2.13, 0.001) 12–13 years. Five distinct found be significantly associated developing CKD. highest disorder (HR 1.95, 95%CI: 1.28–2.97, 0.002). When adjusting 1.86 (95%CI: 1.14–3.04, 0.013). Although these associations nominally significant, they did reach statistical significance applying Bonferroni multiple corrections, potentially due limited sample size. revealed that who under 60, morbidities having diagnosed over may high-risk populations. Hypertension, BMI diabetes mediated 49.13% 37.60%-67.08%), 12.11% 8.49%-17.24%) 3.78% 1.58%-6.52%) total effect, respectively. delayed onset elevated only more than Our highlights lifestyle interventions, routine monitoring function, early screening personalized management strategies potential approaches precise prevention

Language: Английский

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