Current Problems In Cardiology[JOURNAL]
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200 papers
A race against time: The impact of timing of first post-implantation LVAD infection and patient outcomes.
Takla A, Babayale O, Verghese B … +2 more , Khodjaev S, Laguio-Vila M
Curr Probl Cardiol · 2025 Dec · PMID 41077104 · Publisher ↗
BACKGROUND: Left ventricular assist devices (LVADs) serve as lifesaving support for patients with advanced heart failure but are prone to infectious complications. The timing of these infections may play a crucial role i...
BACKGROUND: Left ventricular assist devices (LVADs) serve as lifesaving support for patients with advanced heart failure but are prone to infectious complications. The timing of these infections may play a crucial role in determining clinical outcomes. This study examines the differences between early (≤18 months) and late (>18 months) LVAD infections. METHODS: In this retrospective cohort study, 105 LVAD patient charts were reviewed, and 50 patients identified to have LVAD-related infections. These patients were categorized based on the timing of infection: early (≤18 months post-implantation) and late (>18 months). Variables analyzed included patient demographics, infection type, microbial etiology, post-implantation complications, treatment course, relapse rates, and survival outcomes. RESULTS: Early infections were associated with more severe LVAD infections, including higher rates of bacteremia and candidemia. It was also linked to infection with more aggressive pathogens, higher prevalence of Staphylococcus aureus in early infections (45 % vs. 26 %), a higher relapse rate (80 % vs. 63 %) (p = 0.029), and a shorter time to relapse. Among those with relapses, bacteremia was predominantly associated with the recurrence. Furthermore, early infections resulted in higher mortality (25.8 % vs. 15.7 %) and a shorter mean survival time (2.3 vs. 4 years). CONCLUSIONS: Early LVAD infections are associated with higher relapse rates and worse clinical outcomes compared to late infections. These findings suggest that closer monitoring, more aggressive early interventions, and tailored antimicrobial strategies may improve patient outcomes in the early post-implantation period. Prospective studies are needed to validate these observations and guide infection prevention strategies in LVAD patients.
Interleukin-36: a novel therapeutic target for atherosclerosis.
Tan S, Li Y, Yao Z … +4 more , Xu X, Wang J, Zhu X, He P
Curr Probl Cardiol · 2025 Dec · PMID 41027491 · Publisher ↗
Cardiovascular diseases remain the foremost cause of global morbidity and mortality, with atherosclerosis serving as the pathological basis for most related disorders. Despite the clinical benefits of statin therapy, a s...
Cardiovascular diseases remain the foremost cause of global morbidity and mortality, with atherosclerosis serving as the pathological basis for most related disorders. Despite the clinical benefits of statin therapy, a substantial residual risk persists, underscoring the need to explore novel therapeutic targets. Interleukin-36 (IL-36), a member of the interleukin-1 family, has emerged as a key regulator of immune and inflammatory responses. Beyond its established roles in tissue repair, host defense, and inflammatory signaling, IL-36 has been increasingly implicated in cardiovascular pathology, including myocardial infarction, ischemic injury, and myocarditis. Recent evidence highlights its pro-atherogenic functions mediated through sustained vascular inflammation, abnormal angiogenesis, impaired cholesterol metabolism, excessive neutrophil extracellular trap formation, and disrupted autophagy. These findings collectively suggest that IL-36 not only contributes to the initiation and progression of atherosclerosis but also holds promise as a potential therapeutic target. This review summarizes recent progress on the regulatory roles and signaling mechanisms of IL-36, emphasizing its contribution to atherogenesis.
Nocturnal hypertension and cardiovascular events: risk analysis using propensity score matching.
Perea J, Martin D, Holguín MR … +5 more , Arluna D, Gomez O, Simone S, Liprandi AS, Sosa Liprandi MI
Curr Probl Cardiol · 2025 Dec · PMID 41015137 · Publisher ↗
BACKGROUND: Nocturnal hypertension (NHT) is associated with major adverse cardiovascular events (MACE) and heart failure (HF), and remains an area of growing interest, with evidence suggesting a differential impact compa...
BACKGROUND: Nocturnal hypertension (NHT) is associated with major adverse cardiovascular events (MACE) and heart failure (HF), and remains an area of growing interest, with evidence suggesting a differential impact compared to daytime hypertension (DTH). OBJECTIVES: To evaluate the relationship between NHT and the risk of cardiovascular events, independently of daytime blood pressure. METHODS: We conducted an observational study based on a continuous registry of patients who underwent ambulatory blood pressure monitoring at a tertiary care center. Propensity score matching (1:1) was applied using relevant clinical factors to ensure comparability between groups. The primary outcome was the composite of MACE and HF. Cox regression and cubic spline models were used to explore non-linear associations and identify critical thresholds. RESULTS: After matching, 1,392 patients were analyzed (691 per group). In adjusted models, nocturnal systolic blood pressure was significantly associated with increased risk of MACE/HF (HR 1.04; 95 % CI: 1.01-1.07), whereas daytime systolic pressure showed no association (HR 0.98; 95 % CI: 0.95-1.01). In the multivariable model, NHT maintained its adverse effect (HR 1.03; 95 % CI: 1.01-1.04), together with other established clinical predictors. Risk curves demonstrated a non-linear association, with a significant increase in risk above 148 mmHg of nocturnal systolic blood pressure. CONCLUSIONS: NHT independently increases the risk of cardiovascular events and provides prognostic thresholds that may improve risk stratification.
Design and methods of the AUTOMATED-WCT trial: evaluating machine learning-based ECG support for WCT interpretation.
May AM, LoCoco S, Mikhova KM … +11 more , Ghadban R, Cuculich PS, Cooper DH, Maddox TM, Thakkar P, Deych E, Rowlandson I, Siotis A, Anavaker N, Noseworthy PA, Kashou A
Curr Probl Cardiol · 2025 Dec · PMID 41015136 · Publisher ↗
BACKGROUND: Distinguishing wide complex tachycardia (WCT) as ventricular tachycardia (VT) or supraventricular WCT (SWCT) is critical yet challenging. Manual ECG algorithms require substantial expertise and are inconsiste...
BACKGROUND: Distinguishing wide complex tachycardia (WCT) as ventricular tachycardia (VT) or supraventricular WCT (SWCT) is critical yet challenging. Manual ECG algorithms require substantial expertise and are inconsistently applied, and contemporary computerized ECG interpretation (CEI) systems often return only a generic "wide complex tachycardia" label. Novel machine learning-based ECG models (Solo Model, Paired Model) can provide a VT probability or a direct VT/SWCT classification, but they have not yet been evaluated in a prospective, randomized, workflow-integrated trial. DESIGN: We will conduct a prospective, multicenter, investigator-initiated, open-label, four-arm randomized reader trial. Physicians (attendings and fellows in cardiology, emergency medicine, critical care) will be randomized 1:1:1:1 to: (1) Control #1-WCT ECG only; (2) Control #2-WCT ECG + baseline ECG; (3) Solo Model-WCT ECG + model output (no baseline ECG); (4) Paired Model-WCT ECG + baseline ECG + model output. Each participant will interpret 20 adjudicated WCT ECGs on a secure virtual platform, classify rhythm, rate confidence and percieved usefulness, and indicate likely next steps in clinical management. PRIMARY ENDPOINT: WCT classification accuracy. Secondary endpoints: sensitivity, specificity, PPV, NPV, F1 score, time to diagnosis, interpreation confidence, perceived usefulness, and intended management after diagnosis. CONCLUSION: The AUTOMATED-WCT Trial will be the first randomized, multicenter evidence on machine learning-based ECG decision support for WCT differentiation.
Knowledge mapping of SGLT2-inhibitors and cardiovascular outcomes: A bibliometric analysis.
Rezabakhsh A, Iraji H, Avagimyan A … +8 more , Aghajanova E, Jndoyan Z, Mirzoyan L, Hassan W, Habtemariam S, Meddahi-Pellé A, Pavon-Djavid G, Barzegri A
Curr Probl Cardiol · 2025 Dec · PMID 40939781 · Publisher ↗
INTRODUCTION: Initially developed for the treatment of type 2 diabetes mellitus (T2DM), SGLT2 inhibitors have increasingly been recognized for their substantial cardiovascular, renal, and metabolic benefits. This study u...
INTRODUCTION: Initially developed for the treatment of type 2 diabetes mellitus (T2DM), SGLT2 inhibitors have increasingly been recognized for their substantial cardiovascular, renal, and metabolic benefits. This study undertakes a systematic bibliometric analysis to delineate research trends, quantify advancements, and identify influential studies on SGLT2 inhibitors and cardiovascular outcomes. METHODS: A comprehensive literature search was performed using the Scopus database, resulting in 10,211 documents up to the search date. Both original research articles and reviews (narrative and systematic) were included. Quantitative metrics such as publication count, citation analysis, and authorship were employed. Network visualization tools (e.g., VOSviewer) and bibliometric software (R Studio with bibliometrix packages) were used to analyze collaboration networks, keyword co-occurrence, and thematic clustering. RESULTS: The analysis revealed a significant upward trend in publication volume, with a notable peak in recent years, indicating a heightened interest in the topic among scientists. The United States and selected European institutions emerged as major contributors, with prominent authors and funding sources influencing the research output. Thematic analysis highlighted a focus on cardiovascular diseases, heart failure, renal outcomes, and mechanistic studies of SGLT2 inhibitor action. Notably, landmark randomized controlled trials have reported significant reductions in cardiovascular mortality, heart failure hospitalizations, and progression of kidney disease. CONCLUSION: This study underscores the transformative impact of SGLT2 inhibitors on cardiovascular therapy. The analytical framework highlights the expansion of the field, and the integration of translational research.
Value of extreme left axis deviation in patients with complete left bundle branch block.
Vannoni G, Labadet CD, Caminotti G … +7 more , Zambudio B, Fiamengo JM, Campana LN, Vannoni MV, Marambio GM, Lax JA, Gagliardi JA
Curr Probl Cardiol · 2025 Nov · PMID 40939780 · Publisher ↗
INTRODUCTION: Complete left bundle branch block (LBBB) is associated with increased risk of cardiovascular events. The value of extreme deviation of the QRS axis to the left (LAD) in the context of LBBB is controversial....
INTRODUCTION: Complete left bundle branch block (LBBB) is associated with increased risk of cardiovascular events. The value of extreme deviation of the QRS axis to the left (LAD) in the context of LBBB is controversial. OBJECTIVE: To evaluate whether LAD (-45°) in patients with LBBB is a marker of systolic dysfunction and ventricular remodeling. MATERIAL AND METHODS: Cross-sectional cohort study including 102 patients with LBBB who underwent echocardiography to assess left ventricular (LV) diameters, wall thickness and ejection fraction (EF). RESULTS: Mean age was 67.9 ± 13 years. 48 % were women. 80.4 % met Strauss criteria for LBBB and 28.4 % had LAD. The LAD group showed lower EF (32.2 ± 12 % vs. 46.7 ± 17 %, p = 0.00009) and higher LV end-diastolic diameter index (34.8 ± 9 vs. 30.9 ± 6, p = 0.011). LAD had 45 % sensitivity, 88 % specificity, positive predictive value of 0.79 and negative predictive value of 0.62 for identifying reduced EF. Cardiomyopathy diagnosis was more frequent in the LAD group (93.1 % vs. 61.6 %; p = 0.0016). LV hypertrophy prevalence was similar between groups, but LAD patients had higher prevalence of eccentric LV hypertrophy. CONCLUSION: In LBBB, LAD (-45°) identifies patients with worse systolic function, greater degree of LV dilatation, and more eccentric hypertrophy. Additionally, cardiomyopathy prevalence was higher in this population.
Sex differences in in-hospital outcomes in hypertrophic cardiomyopathy: A nationwide analysis.
Saad AM, Abozenah M, Salerno C … +1 more , Goldsweig AM
Curr Probl Cardiol · 2025 Nov · PMID 40939779 · Publisher ↗
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiomyopathy. HCM is associated with heart failure (HF), arrhythmia, and acute coronary syndrome (ACS). The influence of sex on in-hospital out...
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiomyopathy. HCM is associated with heart failure (HF), arrhythmia, and acute coronary syndrome (ACS). The influence of sex on in-hospital outcomes in HCM is unknown. We conducted a nationwide analysis to compare outcomes between women and men with HCM hospitalized for HF, arrhythmias, or ACS. METHODS: This retrospective cohort analysis of the 2022 National Inpatient Sample (NIS) identified adults hospitalized with acute HF, arrhythmia, or ACS plus a secondary diagnosis of HCM. The primary outcome was in-hospital mortality. Secondary outcomes included length of stay (LOS) and total hospital charges. Multivariable logistic and linear regression models were used to adjust for demographics and comorbidities. RESULTS: Among 5,089 HCM admissions (51.1 % female; mean age 65.9 years), women were older (68.9 vs. 62.1 years) and more often admitted for acute HF. Arrhythmia presentations were similarly common in both sexes, and men more frequently had ACS. In-hospital mortality was 1.7 % and did not differ by sex after adjustment (adjusted odds ratio 1.3, p = 0.63). Mean LOS was 4.3 days and was similar between sexes. Total hospitalization charges showed no significant sex difference for HF or ACS, but men incurred higher charges for arrhythmias. CONCLUSIONS: In this nationwide analysis, sex was not an independent predictor of in-hospital mortality or LOS among admissions with HCM and acute cardiovascular events. Resource utilization was broadly comparable except for arrhythmia admissions, where charges were substantially higher in men. Differences in hospital charges suggest that differences in management may exist.
The triadic relationship between nonalcoholic fatty liver disease, type 2 diabetes, and cardiovascular disease: From molecular mechanisms to clinical management.
Jin Y, Alissa M, Ahmed AE … +6 more , Al-Doaiss AA, Asiri N, Assiri Y, Khan SU, Khan MU, Joseph S
Curr Probl Cardiol · 2025 Nov · PMID 40912345 · Publisher ↗
Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) represent interconnected metabolic disorders with multifaceted etiology, demonstrating bidirectional relationships and pronounced associations...
Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) represent interconnected metabolic disorders with multifaceted etiology, demonstrating bidirectional relationships and pronounced associations with cardiovascular diseases (CVDs). Despite extensive research, significant knowledge gaps persist regarding the temporal progression of these comorbidities, optimal screening strategies for high-risk populations, and personalized therapeutic approaches targeting the hepatic-cardiac-metabolic axis simultaneously. Current literature lacks a comprehensive analysis of phenotypic heterogeneity within NAFLD-T2DM-CVD clusters and fails to address sex-specific and ethnic variations in disease progression patterns adequately. A systematic literature search was conducted across PubMed, Medline, Embase, Web of Science, and Google Scholar databases from inception to June 2024, employing various combinations of terms including NAFLD, NASH, T2DM, and CVDs, with emphasis on identifying mechanistic pathways, epidemiological trends, and therapeutic innovations. This review identifies novel pathophysiological mechanisms linking hepatic steatosis, insulin resistance, and cardiovascular dysfunction, including previously underexplored roles of gut microbiome dysbiosis, advanced glycation end products, and epigenetic modifications. Emerging evidence suggests distinct molecular signatures that could facilitate precision medicine approaches. The intricate interplay between diabetes, hepatic dysfunction, and cardiovascular complications represents a global health challenge requiring integrated management strategies. Future research should prioritize developing biomarker-guided therapeutic algorithms, investigating sex-specific treatment responses, and establishing standardized protocols for concurrent NAFLD-T2DM-CVD management to optimize clinical outcomes and reduce healthcare burden.
HER2-targeted therapies and cardiotoxicity: From major concern to manageable risk.
Pamungkas RP, Pratiwi L, Sutanto H
Curr Probl Cardiol · 2025 Nov · PMID 40912344 · Publisher ↗
HER2-targeted therapies have dramatically improved outcomes for patients with HER2-positive breast cancer, but their potential for cardiotoxicity remains a critical clinical concern. Early trials reported high rates of c...
HER2-targeted therapies have dramatically improved outcomes for patients with HER2-positive breast cancer, but their potential for cardiotoxicity remains a critical clinical concern. Early trials reported high rates of cardiac dysfunction, particularly with concomitant anthracycline use, prompting the development of intensive cardiac monitoring strategies. However, emerging evidence suggests that most cardiotoxic events are asymptomatic, reversible, and rarely require permanent treatment discontinuation, particularly with newer agents such as antibody-drug conjugates. Clinical determinants include baseline left ventricular dysfunction, age, comorbidities, and combination chemotherapy, while biomarkers and advanced imaging are promising tools for early detection. Mechanistically, HER2 inhibition disrupts cardiomyocyte survival pathways and mitochondrial function, but the relationship between these changes and clinically meaningful heart failure remains incompletely defined. Recent studies, including SAFE-HEaRt, demonstrate that HER2 therapy can often be safely continued under cardio-oncology supervision with appropriate cardioprotective interventions. Nevertheless, gaps persist in risk stratification, long-term surveillance, and the integration of biomarkers and imaging into routine practice. This article critically examines the pathophysiology, clinical risk factors, and management of HER2 therapy-induced cardiotoxicity, ultimately arguing that with proper monitoring and multidisciplinary care, cardiotoxicity should not preclude optimal oncologic treatment.
The effect of 0.5 mg dose of colchicine on clinical outcomes in patients with acute myocardial infarction: An updated meta-analysis of randomized controlled trials.
Nazmy A, Sobhy A, Elshahat A … +10 more , Atta K, Murad MR, Ibrahim M, El-Shirbiny H, Ibrahim RA, Sayed MS, Gomaa M, Shaban AY, Naeem M, Abdelaziz A
Curr Probl Cardiol · 2025 Nov · PMID 40912343 · Publisher ↗
BACKGROUND: Inflammation plays a critical role in the progression of atherosclerosis, and the anti-inflammatory effects on clinical outcomes of patients with acute myocardial infarction (AMI) are still uncertain. OBJECTI...
BACKGROUND: Inflammation plays a critical role in the progression of atherosclerosis, and the anti-inflammatory effects on clinical outcomes of patients with acute myocardial infarction (AMI) are still uncertain. OBJECTIVES: We aimed to study the effects of a 0.5 mg dose of colchicine on clinical outcomes following AMI. METHODS: We systematically searched PubMed, Scopus, Web of Science, and Cochrane Central from inception to January 2025 for randomized controlled trials (RCTs) assessing 0.5 mg colchicine in AMI patients. The primary outcome was the incidence of major adverse cardiovascular events (MACE). Secondary outcomes included individual MACE components, cardiovascular (CV) and non-CV mortality, atrial fibrillation (AF), hospital readmission, and gastrointestinal (GIT) adverse events, including diarrhea. RESULTS: Ten RCTs involving 13,623 patients with a median follow-up of 6 months (range 5 days-36 months) were included. Low-dose colchicine showed a non-significant trend toward reducing MACE versus placebo (RR = 0.90, 95% CI: 0.80-1.01, p = 0.07; I² = 0%). Hospital readmission was significantly reduced by 49% (OR = 0.51, 95% CI: 0.26-0.98, p = 0.04; number needed to treat [NNT] = 25). Colchicine increased the risk of diarrhea (RR = 1.58, 95% CI: 1.06-2.36, p = 0.03; I² = 71%; number needed to harm [NNH] = 50) but showed no significant differences in all-cause mortality, CV mortality, myocardial infarction, stroke, or other GIT events. CONCLUSION: Low-dose colchicine had a lower hospital readmission rate, but with higher rates of diarrhea compared to placebo. Long-term assessment is indeed to validate the current findings.
The top 100 most cited articles in cardiovascular research: A bibliometric perspective.
Abdelwahab SI, Taha MME, Farasani A … +6 more , Moshi JM, Assiri A, Alshahrani S, Sahli KA, Shubaily HM, Hassan W
Curr Probl Cardiol · 2025 Nov · PMID 40865747 · Publisher ↗
OBJECTIVE: The aim is to analyze the citation dynamics, and research focus of the top 100 most cited cardiovascular research. METHODS: Data were retrieved from the Scopus database in January 2025, focusing on journals co...
OBJECTIVE: The aim is to analyze the citation dynamics, and research focus of the top 100 most cited cardiovascular research. METHODS: Data were retrieved from the Scopus database in January 2025, focusing on journals containing the term "cardio" in their title. Only original research articles and reviews were included. The data were analyzed using VOSviewer and R Studio to assess co-authorship networks, keyword co-occurrence, citation mapping, and citation impact indicators. RESULTS: A total of 100 articles, published between 1967 and 2020, were included in the analysis. These articles had an average of 2,285 citations each. The growth rate of publications was 3.74 %, with an average document age of 20.8 years. Collaboration was extensive, with 1,653 authors contributing to these papers, and 25 % of publications involved international collaboration. Citation analysis showed increasing citation rates over time, with recent papers achieving significant impact in a short period. The top authors, universities, countries, and sources of publication were identified, revealing the global nature of cardiovascular research and its collaborative nature. The title co-words analysis was also performed to understand the main focus of the most cited papers. CONCLUSIONS: This study offers a deeper understanding of the most cited cardiovascular research papers, addressing gaps in previous bibliometric studies by providing insights into citation dynamics, author collaborations, and thematic shifts. Future studies should explore the quality of research and expand the scope of bibliometric analyses.
Peripartum hypertension and neonatal outcomes across races: 2016-2022.
Usman MS, Salman A, Aisha E … +11 more , Khan U, Naz S, Faisal S, Khan IY, Arif MH, Mohiuddin N, Khan AA, Afzal A, Janjua H, Ali F, Siddiqi TJ
Curr Probl Cardiol · 2025 Oct · PMID 40846220 · Publisher ↗
BACKGROUND: Maternal hypertension, a major pregnancy complication, can adversely affect newborn health. Our study investigated racial/ethnic disparities in neonatal outcomes among hypertensive pregnant women in the US. M...
BACKGROUND: Maternal hypertension, a major pregnancy complication, can adversely affect newborn health. Our study investigated racial/ethnic disparities in neonatal outcomes among hypertensive pregnant women in the US. METHODS: Using data from the CDC WONDER Natality database, we conducted a retrospective cohort study focusing on live births to hypertensive mothers from 2016 to 2022. We calculated rates [95% CI] per 1000 live births for NICU admissions, neonatal assisted ventilation, low birth weight, and in-hospital mortality across racial/ethnic groups and regions. RESULTS: We analyzed 2,392,664 live births to hypertensive women. In-hospital neonatal mortality rates were highest in Black American women (BA) (3.6 [3.5, 3.8]). Neonatal assisted ventilation rates were highest in Native Hawaiian/Pacific Islander women (NH/PI) (131.8 [123.4, 140.7]) and low birth weight rates were highest in BA (235.1 [233.9, 236.3]). Across all races, female neonates had a higher rate of low birth weight compared to male neonates, while male neonates had higher incidences of NICU admissions, neonatal assisted ventilation, and in-hospital mortality. The Midwest had the highest rates for NICU admissions in NH/PI (254.2 [217.2, 295.2]), neonatal assisted ventilation in American Indian/Alaska Native women (143.8 [133.2, 155.1]), and in-hospital mortality in BA (4.1 [3.7, 4.5]). The South had the highest rate of low birth weight for BA (244.4 [242.9, 246.0]). CONCLUSIONS: Significant racial and regional disparities exist in neonatal outcomes among hypertensive women in the US, with BA mothers experiencing the poorest outcomes. Further research is necessary to develop targeted interventions for high-risk populations.
Trends in cardiovascular risk in Peru: A 10-year population-based analysis (2015-2024).
Diaz-Arocutipa C, Nombera-Aznaran N, Benites-Zapata V … +2 more , Kikushima-Alcantara P, Herrera-Añazco P
Curr Probl Cardiol · 2025 Oct · PMID 40846219 · Publisher ↗
BACKGROUND: Data on national trends in cardiovascular risk in Latin America are limited. We aimed to evaluate changes in estimated 10-year cardiovascular risk in Peru between 2015 and 2024, and assess disparities by sex,...
BACKGROUND: Data on national trends in cardiovascular risk in Latin America are limited. We aimed to evaluate changes in estimated 10-year cardiovascular risk in Peru between 2015 and 2024, and assess disparities by sex, age, residence, and region. METHODS: We conducted a cross-sectional analysis using nationally representative data from the Peruvian Demographic and Health Survey. Adults aged 40-74 years with complete risk factor data were included. Ten-year cardiovascular risk was estimated using the 2019 WHO non-laboratory prediction charts for Andean Latin America. Trends in mean absolute risk and the proportion of individuals at ≥high risk were assessed using joinpoint regression models, overall and by sex, age group, area of residence, and region. RESULTS: Among 104,617 participants, mean estimated 10-year cardiovascular risk declined from 5% in 2015 to 4.4% in 2024 (average annual percent change [AAPC] -2.3%; 95% C: -3.2 to -1.5). The prevalence of ≥high cardiovascular risk decreased from 10.3% to 8.5% (AAPC -3.2%; 95% CI -5.0 to -1.6). Risk declined significantly among women, younger adults, and both urban and rural populations, but remained unchanged in men and older adults. Regional trends were heterogeneous, with the steepest reductions observed in Amazonas, Ica, and Ayacucho. CONCLUSIONS: Although a slight decline in estimated cardiovascular risk was observed in Peru over the past decade, the change may have limited clinical relevance. These trends emphasize the need for stronger, equity-focused efforts to reduce the burden of cardiovascular disease at the national level.
Interatrial shunt devices in heart failure with preserved ejection fraction: A meta-analysis of randomized trials.
Prata AA, Coan ACC, Coylewright M … +6 more , Fernandes JM, Katsuyama ES, Fukunaga CK, Barbosa GS, Scardini PG, Luciana GP
Curr Probl Cardiol · 2025 Nov · PMID 40846218 · Publisher ↗
BACKGROUND: The clinical effect of an iatrogenic interatrial shunt in heart failure with preserved ejection fraction (HFpEF) was based on observational data, wherein decompression of the pressure-overloaded left atrium i...
BACKGROUND: The clinical effect of an iatrogenic interatrial shunt in heart failure with preserved ejection fraction (HFpEF) was based on observational data, wherein decompression of the pressure-overloaded left atrium improved symptoms and hemodynamics. However, the identification of a specific patient population that may benefit remains unclear. METHODS: We searched for randomized controlled trials (RCTs) that compared the creation of interatrial shunts versus a sham procedure in patients with HFpEF. The primary outcomes of interest were HF events and Cardiovascular (CV) mortality. RESULTS: Three RCTs were included, encompassing 966 patients, of which 479 (49.5%) were in the interatrial shunt group. The mean age of the participants was 73.2 years, with an average LVEF of 58.7%. Of the 479 patients undergoing interatrial shunt placement, 69% had exercise hemodynamics to assist in selection for therapy. Interatrial shunt therapy in the selected patients showed a trend towards an increased risk of HF events (RR:1.29;95%CI:0.98-1.70;p=0.069) and CV death (RR:2.30;95%CI:0.94-5.59;p=0.067), compared with the sham procedure. CONCLUSION: In this meta-analysis of patients with HFpEF, interatrial shunt therapy showed a trend towards an increased risk of HF events and CV mortality compared with the sham procedure, with no significant improvement in MACE, quality of life, or rates of MI and stroke/TIA. These findings raise concerns about interatrial shunt therapy for the broader HFpEF population and highlight the need for better patient selection.
Revisiting type 2 myocardial infarction: Unmet clinical needs.
Palermi A, Saraullo S, Giordano MB … +3 more , Ricci F, Gallina S, Renda G
Curr Probl Cardiol · 2025 Oct · PMID 40783170 · Publisher ↗
Cardiovascular disease is the most common cause of mortality and morbidity worldwide and acute coronary syndrome (ACS) is often the first clinical manifestation. Currently, the diagnosis of acute myocardial infarction (A...
Cardiovascular disease is the most common cause of mortality and morbidity worldwide and acute coronary syndrome (ACS) is often the first clinical manifestation. Currently, the diagnosis of acute myocardial infarction (AMI) is based on the fourth universal definition of myocardial infarction (MI), with different subtypes based on their pathophysiological background. While type 1 myocardial infarction (T1MI) is defined by an acute coronary event with plaque disruption and consequent athero-thrombosis, type 2 myocardial infarction (T2MI) is defined as an event due to oxygen demand and supply imbalance, unrelated to acute coronary athero-thrombosis. The differentiation between these two entities is crucial since T1MI benefits from an early invasive approach aimed at myocardial reperfusion, while in T2MI it is critical to focus on the cause of the ischemia mismatch. Furthermore, T2MI is often associated with a poorer prognosis. The presence and severity of coronary artery disease (CAD) may significantly influence the ischemic threshold and the risk of T2MI, as it has been identified as an independent predictor of cardiovascular death and recurrent MI. The key point of contention is determining the presence of CAD in T2MI to identify patients eligible for a reperfusion strategy and to tailor therapy as well as secondary prevention strategies. In this narrative review, we aim to highlight the differences in clinical features, imaging, and biomarkers between T1MI and T2MI, emphasizing the role of CAD, in refining the diagnostic-therapeutic algorithm in T2MI.
Electrodes and leads in electrocardiography: a conceptual review.
Mc Loughlin MJ, Brugada P
Curr Probl Cardiol · 2025 Oct · PMID 40780631 · Publisher ↗
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Metabolic syndrome, ischemic heart disease, and heart failure: insights from the Colombian Heart Failure Registry (RECOLFACA).
Mejía MÁ, Cárdenas SL, Echeverría LE … +8 more , Rivera-Toquica A, Gómez-Mesa JE, Gutiérrez CIS, Estupiñán JFC, Santos CVA, Herazo JB, Luna P, Peña ÁAG
Curr Probl Cardiol · 2025 Oct · PMID 40769236 · Publisher ↗
BACKGROUND: Ischemic heart disease (IHD) is still a leading cause of morbidity and mortality worldwide, with major implications for healthcare systems, especially in low- and middle-income countries. Effective metabolic...
BACKGROUND: Ischemic heart disease (IHD) is still a leading cause of morbidity and mortality worldwide, with major implications for healthcare systems, especially in low- and middle-income countries. Effective metabolic control and risk factor management, including evidence-based pharmacological therapies such as statins, ACE inhibitors (ACEIs), and angiotensin receptor-neprilysin inhibitors (ARNIs), are essential for reducing adverse outcomes. However, gaps persist in the implementation of these therapies, particularly in resource-limited regions. OBJECTIVE: To evaluate metabolic control and the use of evidence-based therapies in patients with IHD enrolled in the Colombian Heart Failure Registry (RECOLFACA), and to identify barriers to optimal treatment implementation. METHODS: This cross-sectional study analyzed demographic, clinical, and biochemical data, as well as medication usage, from patients with confirmed IHD. Descriptive and inferential statistical analyses were performed to identify treatment patterns and associated factors. RESULTS: Among 2,528 patients with heart failure (HF), 1,123 had IHD. Statins were prescribed to 73.6% (827), antiplatelets to 66.3% (745), and ARNIs to only 10.1% (114), despite guideline recommendations. Statin use was notably low among patients with chronic kidney disease (CKD) (18.1%), diabetes mellitus type 2 (15.8%), and both conditions combined (3.2%). CONCLUSIONS: Despite robust evidence supporting their efficacy, the use of statins, ACEIs, and ARNIs remains suboptimal in Colombia. Addressing barriers to access, adherence, and healthcare delivery is crucial to improve outcomes and align clinical practices with international standards. These findings highlight the need for targeted interventions and future studies to evaluate strategies that enhance access to and adherence with guideline-directed therapies.
Developing a tool to predict the likelihood of undergoing orthotopic cardiac transplant from the urgent waitlist - a single centre UK experience.
Dulay MS, Patel R, Banya W … +6 more , Yogasivam D, Assaf R, Raza N, Morley-Smith A, Riesgo-Gil F, Dar O
Curr Probl Cardiol · 2025 Oct · PMID 40769235 · Publisher ↗
BACKGROUND: Orthotopic Cardiac Transplantation (OCTx) improves survival in advanced heart failure. Currently, a tool in United Kingdom from NHS Blood and Transplant (NHSBT) helps predict likelihood of OCTx from waitlist....
BACKGROUND: Orthotopic Cardiac Transplantation (OCTx) improves survival in advanced heart failure. Currently, a tool in United Kingdom from NHS Blood and Transplant (NHSBT) helps predict likelihood of OCTx from waitlist. However, it does not use predictive variables such as age, or Human Leukocyte Antibody (HLA%). We aimed to develop OCTx predictive models incorporating known prognostic variables at 3-, 6-, 9- and 12-months. METHODS: All patients who were urgent-listed for OCTx at Harefield Hospital between 2014 and 2018 (n = 125) were analysed. Variables included age, gender, blood group (BG), midline sternotomy, ventricular assist device (VAD), body mass index (BMI) and HLA%. Multivariable logistic regression models were constructed following internal validation per timepoint. A separate validation dataset was collected using 52 patients transplanted between 2019 and 2023, to compare model effectiveness against the current NHSBT tool. RESULTS: At 3-months, variables included were age, gender, sternotomy, BG O and HLA%=0, with model area under curve (AUC) of 0.74 (0.66-0.83 95 % confidence interval [CI]). 6-month model included variables age, gender, BG O, sternotomy, BMI and HLA%=0, model AUC of 0.80 (0.72-0.89 95 % CI). 9-month model used age, BG O, VAD, BMI and HLA%=0, giving an AUC of 0.80 (0.71-0.89 95 % CI). The final 12-month model included midline sternotomy, BMI and HLA%=0 and HLA%=1-24, with AUC 0.78 (0.68-0.88 95 % CI). Our predictive models recorded an 85 % win-ratio compared to the NHSBT tool. CONCLUSION: We were able to develop models to predict urgent OCTx, with greater accuracy than the currently available tool. Multicentre external validation would help enable its wider implementation.
Inflammation, abdominal aortic aneurysm enlargement and rupture. Lessons learned from the Covid19 pandemic.
Sterpetti AV, Miceli F, Di Girolamo A … +4 more , Bozzani A, Arici V, Ascione M, Marzo LD
Curr Probl Cardiol · 2025 Oct · PMID 40769234 · Publisher ↗
Patients with moderate-severe COVID19 infection suffer from several cardiovascular diseases: heart failure (3 %-33 %), myocardial ischemia (0.9 %-11 %), ventricular dysfunction (10 %-47 %), arrhythmias (9 %-17 %), venous...
Patients with moderate-severe COVID19 infection suffer from several cardiovascular diseases: heart failure (3 %-33 %), myocardial ischemia (0.9 %-11 %), ventricular dysfunction (10 %-47 %), arrhythmias (9 %-17 %), venous thrombo-embolism (25 %) and arterial thrombosis (1 %-3 %). Although intracranial and coronary arterial aneurysms have been described in adults and children with COVID19, few reports have correlated COVID19 infection and sudden degeneration of aortic aneurysms and dissections. We analyzed the risk factor for enlargement and rupture of aortic aneurysms in patrients with moderate-severe COVID19 infection. Several COVID19 related mechanisms may impact aortic aneurysm progression: increased elastin and collagen digestion by enzymes triggered by viral spike proteins in ACE2-negative myeloid cells and/or by inflammatory cytokines; hypoxemia related to thrombosis of micro vessels of the aneurismal wall; dysregulation of the immune system. Patients with known arterial aneurysm may be at risk for sudden increase of dimensions and rupture during moderate-severe COVID19 infection.
SGLT2 inhibitors and cardiac fibrosis: A comprehensive review.
Karakasis P, Theofilis P, Vlachakis PK … +10 more , Apostolos A, Milaras N, Ktenopoulos N, Grigoriou K, Klisic A, Karagiannidis E, Fyntanidou B, Patoulias D, Antoniadis AP, Fragakis N
Curr Probl Cardiol · 2025 Oct · PMID 40769233 · Publisher ↗
Cardiac fibrosis is a key pathological substrate that drives diastolic dysfunction, arrhythmogenesis, and heart failure progression across a spectrum of cardiometabolic disorders. Sodium-glucose cotransporter 2 (SGLT2) i...
Cardiac fibrosis is a key pathological substrate that drives diastolic dysfunction, arrhythmogenesis, and heart failure progression across a spectrum of cardiometabolic disorders. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for glucose lowering, have demonstrated pleiotropic effects on myocardial structure, notably attenuating fibrotic remodeling. Experimental models of diabetes, hypertension, ischemia, and cardiotoxicity consistently show that SGLT2 inhibitors mitigate interstitial and perivascular fibrosis through modulation of oxidative stress, mitochondrial function, autophagy, and canonical profibrotic signaling cascades, including TGF-β/Smad, STAT3, and mTOR. These actions are largely preserved in non-diabetic settings and appear to extend beyond hemodynamic or glycemic benefits. Clinical data, including cardiac magnetic resonance-based assessments, support the notion of diffuse fibrosis regression, particularly in heart failure with preserved ejection fraction and diabetic cardiomyopathy. Moreover, reductions in serum collagen biomarkers and improvements in myocardial energetics further substantiate their antifibrotic capacity. Nonetheless, fibrosis-specific endpoints remain underrepresented in major cardiovascular outcome trials, and histological validation in human tissue is lacking. Integrating artificial intelligence-driven fibrosis quantification, spatial transcriptomics, and high-resolution imaging may refine phenotyping and enable precision antifibrotic therapy. Whether fibrosis regression translates into durable clinical benefit remains an open question. This review comprehensively synthesizes the mechanistic, translational, and clinical evidence supporting the role of SGLT2 inhibitors as modulators of cardiac fibrosis across diverse cardiovascular disease states.
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