Reviews In Cardiovascular Medicine[JOURNAL]
Sun
200 papers
Development of a Clinical Prediction Model for Acute Kidney Injury Among In-Hospital Cardiac Arrest Patients During Intensive Care Unit Hospitalization.
Abudu H, Liu Z, Niu Y … +7 more , Xu G, He K, Dong J, Tuerxun T, Hua G, Yan X, Fan H
Rev Cardiovasc Med · 2026 Apr · PMID 42110188 · Full text
BACKGROUND: Acute kidney injury (AKI) is a significant cause of mortality among post-cardiac arrest patients. However, clinical prediction models for assessing AKI risk for in-hospital cardiac arrest (IHCA) patients rema...
BACKGROUND: Acute kidney injury (AKI) is a significant cause of mortality among post-cardiac arrest patients. However, clinical prediction models for assessing AKI risk for in-hospital cardiac arrest (IHCA) patients remain limited. Thus, this retrospective study aimed to develop a nomogram that uses readily available clinical characteristics to predict the likelihood of AKI in this group of patients during intensive care unit (ICU) hospitalization. METHODS: This study constructed a nomogram based on the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and conducted variable selection through Least Absolute Shrinkage and Selection Operator (LASSO) regression, followed by univariate and multivariate logistic regression analyses on the selected variables. Model performance was evaluated by calculating sensitivity, specificity, and the Youden index, and by performing decision curve analysis (DCA), clinical impact curve (CIC), and receiver operating characteristic (ROC) curve analysis. RESULTS: This study included 1427 cardiac arrest (CA) patients, who were randomly allocated into a training cohort (n = 999) and a validation cohort (n = 428). We identified five independent predictors for post-cardiac arrest AKI: weight (adjusted odds ratio (aOR): 1.016, 95% confidence interval (CI): 1.009-1.024), peripheral capillary oxygen saturation (SpO) (aOR: 1.044, 95% CI: 1.026-1.063), sodium (aOR: 0.947, 95% CI: 0.919-0.975), Sequential Organ Failure Assessment (SOFA) score (aOR: 1.134, 95% CI: 1.083-1.190), and Oxford Acute Severity of Illness Score (OASIS) score (aOR: 1.080, 95% CI: 1.059-1.103). The model demonstrated strong performance, with area under the curve (AUC) values of 0.920 and 0.875 in the training and validation cohorts, respectively. Upon validation, the specificity, sensitivity, and Youden index for the model were 0.837, 0.781, and 0.618, respectively. The calibration curve indicated good agreement between predictions and observations. The DCA and CIC confirmed the clinical utility of the model. CONCLUSION: The developed prediction model exhibits high predictive performance for predicting AKI in IHCA patients.
Astrocyte-Neuron Crosstalk in Hypertension: Mechanisms and Therapeutic Significance.
Zhao M, Jia H, Li N
Rev Cardiovasc Med · 2026 Apr · PMID 42110187 · Full text
Hypertension is a major global health challenge that poses a serious threat to cardiovascular function. Crosstalk between astrocytes and neurons plays a central role in blood pressure regulation within the central nervou...
Hypertension is a major global health challenge that poses a serious threat to cardiovascular function. Crosstalk between astrocytes and neurons plays a central role in blood pressure regulation within the central nervous system. As the prevalence of hypertension continues to increase, significant progress has been made in understanding the associated pathological mechanisms involving astrocytes and neurons. Accumulating evidence indicates that astrocytes engage in complex metabolic-immune networks to communicate with neurons, thereby contributing critically to the development and progression of hypertension. This review highlights recent advances in our understanding of the bidirectional regulatory mechanisms between astrocytes and neurons in the context of hypertension.
A New and Robust Prognostic Biomarker for Mortality Risk Prediction in Dialysis Patients With Coronary Artery Disease: Red Cell Distribution Width-to-Albumin Ratio.
Zhao X, Xie E, Zhai Z … +7 more , Sun D, Shen S, He H, Liu W, Cai L, Zeng H, Zheng J
Rev Cardiovasc Med · 2026 Apr · PMID 42110186 · Full text
BACKGROUND: Coronary artery disease (CAD) remains a fundamental etiology of morbidity and mortality among patients receiving dialysis, a cohort known to have a particularly poor prognosis. While traditional CAD risk fact...
BACKGROUND: Coronary artery disease (CAD) remains a fundamental etiology of morbidity and mortality among patients receiving dialysis, a cohort known to have a particularly poor prognosis. While traditional CAD risk factors, such as hyperlipidemia, hypertension, and diabetes, remain noteworthy, these factors do not fully capture the complexity of the disease in dialysis patients. Therefore, innovative and robust biomarkers that can refine risk stratification and enhance prognostic precision in this vulnerable population are imperative. Hence, this study aimed to evaluate the use of the red cell distribution width-to-albumin ratio (RAR) to predict clinical outcomes, particularly in dialysis patients with CAD. METHODS: We analyzed data from a multicenter cohort of 1128 CAD patients on dialysis who were enrolled between January 2015 and June 2021. Patient stratification into tertiles was performed based on RARs. The primary endpoints were all-cause mortality and cardiovascular mortality. The secondary endpoint was the occurrence of major adverse cardiovascular events (MACEs), comprising non-fatal myocardial infarction, non-fatal stroke, and other cardiovascular events. RESULTS: The median follow-up duration was 20.9 months 378 (33.5%) patients experienced all-cause mortality, 261 (19.1%) cardiovascular mortality, and 485 (43.0%) MACEs. In multivariable Cox proportional hazards regression, patients in the highest RAR tertile demonstrated remarkably escalated risks of all-cause mortality (hazard ratio (HR): 1.592, 95% confidence interval (CI): 1.212-2.092), cardiovascular mortality (HR: 1.503, 95% CI: 1.086-2.080), and MACEs (HR: 1.452, 95% CI: 1.141-1.846) compared with those in the lowest tertile. Moreover, restricted cubic spline analysis revealed a linear, dose-dependent association between elevated RAR and an increased risk of these adverse outcomes. The integration of the RAR into existing risk models, specifically the Global Registry of Acute Coronary Events and Gensini scores, noticeably amplified the predictive performance, as demonstrated by notable enhancements in both net reclassification improvement and integrated discrimination improvement. CONCLUSIONS: An elevated RAR serves as an independent predictor of poor outcomes in patients with CAD undergoing dialysis. CLINICAL TRIAL REGISTRATION: This study was registered at ClinicalTrials.gov (Identifier: NCT05841082; https://clinicaltrials.gov/study/NCT05841082).
Cardiovascular Outcomes in Patients With Diabetes and Chronic Liver Disease.
Caturano A
Rev Cardiovasc Med · 2026 Apr · PMID 42110185 · Full text
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DNA Methylation: A Key Epigenetic Regulator of Cardiovascular Diseases.
Chen W, Li X, Zhu L
Rev Cardiovasc Med · 2026 Apr · PMID 42110184 · Full text
CVDs arise from the interplay of multiple factors, with genetics and environmental exposures representing key drivers. Accumulating evidence over recent decades has unequivocally established that epigenetic modifications...
CVDs arise from the interplay of multiple factors, with genetics and environmental exposures representing key drivers. Accumulating evidence over recent decades has unequivocally established that epigenetic modifications, most prominently DNA methylation, play a pivotal, non-redundant role in the initiation, development, and progression of CVDs. As a critical molecular bridge linking genetic predisposition, environmental insults, and the pathogenesis of CVDs, DNA methylation dynamically mediates crosstalk among these three components, thereby emerging as a core focus for dissecting the underlying pathological mechanisms of CVDs. Thus, this review summarizes the functional roles of DNA methylation in common CVDs, including coronary heart disease (CHD), hypertension, and heart failure (HF). Special emphasis is placed on the regulatory mechanisms of DNA methylation in driving disease pathogenesis, as well as the associated translational potential for preventing CVDs and for clinical management. Moreover, this review delineates the specific pathways through which DNA methylation modulates CVDs onset and progression-providing a novel perspective for in-depth investigation of disease etiologies-and offers a robust theoretical basis for identifying novel therapeutic targets for CVDs. Ultimately, these insights aim to lay a foundation for the optimization and innovation of clinical diagnostic and therapeutic strategies for CVDs.
Recent Advances in Understanding the Mechanisms of Therapy-Related Cardiovascular Events in Pediatric Hematologic Malignancies.
He W, Feng J, Luo R … +3 more , Jiang F, Sui X, Hong X
Rev Cardiovasc Med · 2026 Apr · PMID 42110183 · Full text
This narrative review synthesizes the most recent advances in elucidating the mechanisms underlying cardiovascular events associated with the treatment of pediatric hematologic malignancies. First, this review delineates...
This narrative review synthesizes the most recent advances in elucidating the mechanisms underlying cardiovascular events associated with the treatment of pediatric hematologic malignancies. First, this review delineates the principal therapeutic modalities currently employed, including chemotherapy, radiotherapy, cellular immunotherapy, and small-molecule targeted therapy. Subsequently, this review offers a systematic and nuanced appraisal of the mechanisms through which these treatments precipitate cardiovascular injury, encompassing direct cardiotoxic effects, inflammatory activation, and immune-mediated tissue damage. Finally, this review examines emerging therapeutic targets with potential relevance for intervention, to refine treatment strategies, mitigate cardiovascular adverse effects, and enhance both quality of life and long-term outcomes in affected children. This review integrates these mechanisms within a cohesive, pediatric-specific conceptual framework and highlights actionable cardioprotective targets across therapeutic modalities.
Predictors of In-Hospital Mortality From Infective Endocarditis in a Resource-Limited, War-Affected Tertiary Center.
Ghalib MA, Al-Kebsi M, Al-Maimoony T … +1 more , Al-Habeet A
Rev Cardiovasc Med · 2026 Apr · PMID 42110182 · Full text
BACKGROUND: Infective endocarditis (IE) carries a high in-hospital mortality, particularly in resource-limited and war-affected settings. However, data on short-term mortality predictors in such environments remain limit...
BACKGROUND: Infective endocarditis (IE) carries a high in-hospital mortality, particularly in resource-limited and war-affected settings. However, data on short-term mortality predictors in such environments remain limited. Therefore, this study aimed to identify independent predictors of in-hospital mortality among patients with IE treated at a tertiary referral center in Yemen. METHODS: A prospective cohort study was conducted between October 2023 and August 2025 at the largest tertiary referral center in Yemen. A total of 60 consecutive patients with IE (46 with definite IE and 14 with possible IE) were included, diagnosed according to the modified Duke criteria. Candidate predictors were screened using univariable analyses. Given the limited number of outcome events, the least absolute shrinkage and selection operator (LASSO) regression was applied for variable selection, followed by Firth's penalized logistic regression to obtain bias-reduced estimates. RESULTS: A total of 17 patients died during hospitalization, yielding an in-hospital mortality rate of 28.3%. Baseline demographic characteristics, microbiological findings, and most echocardiographic parameters were not independently associated with mortality. However, in-hospital complications showed strong associations with death. In the final penalized multivariable model, septic shock (adjusted odds ratio (AOR) 14.441; 95% confidence interval (CI): 2.242-176.650; = 0.004) and acute kidney injury (AKI) (AOR 5.286; 95% CI: 1.226-26.440; = 0.0264) emerged as the most robust independent predictors of in-hospital mortality, whereas uncontrolled infection did not retain statistical significance. CONCLUSIONS: In this war-affected and resource-limited setting, in-hospital mortality from IE was substantial and driven primarily by severe systemic complications. Early recognition and aggressive management of septic shock and AKI may improve short-term outcomes in similar low-resource environments.
Early In-Hospital Initiation of Sodium-Glucose Cotransporter-2 Inhibitors After ST-Elevation Myocardial Infarction: A Clinical Review of Hemodynamic and Renal Safety.
Farhan M, Patel T, Almarouj D … +9 more , Seyfi A, Abdi SIA, Abufanas A, Rimawi A, Al-Zuhairi I, Al-Zuhairi A, Al Azzawi A, Patel BD, Awosika A
Rev Cardiovasc Med · 2026 Apr · PMID 42110181 · Full text
Survivors of ST-elevation myocardial infarction (STEMI) continue to face appreciable risks of hospitalization for heart failure and acute kidney injury (AKI), even in the era of prompt primary percutaneous coronary inter...
Survivors of ST-elevation myocardial infarction (STEMI) continue to face appreciable risks of hospitalization for heart failure and acute kidney injury (AKI), even in the era of prompt primary percutaneous coronary intervention (PCI). Sodium-glucose cotransporter-2 inhibitors (SGLT2i) deliver proven cardio-renal benefits in chronic heart failure and chronic kidney disease (CKD); however, the safety profile of these agents when initiating administration during the index STEMI admission remains poorly characterized. This clinical review summarizes contemporary evidence on the hemodynamic and renal safety of initiating SGLT2i therapy 24-72 h after PCI in patients with STEMI and provides a pragmatic, evidence-informed bedside framework, supported by randomized controlled trials (RCTs) and mechanistic and observational data from January 2018 to July 2025. Trial eligibility criteria and safety endpoints were extracted qualitatively; no formal meta-analysis was performed. Among at least 11,221 participants, early SGLT2i initiation was well tolerated: rates of hypotension, volume depletion, AKI, and diabetic ketoacidosis (DKA) were comparable to placebo. The characteristic 3-6 mL/min/1.73 m decline in estimated glomerular filtration rate (eGFR) represented a reversible tubuloglomerular feedback (TGF) adjustment rather than nephrotoxicity. Mechanistic studies attribute these findings to mild natriuresis without sympathetic activation and to afferent arteriolar vasoconstriction, which lowers intraglomerular pressure. Synthesizing trial exclusion criteria with clinical judgement, we propose the START checklist (stable hemodynamics, tubular reserve, acid-base stability, risk factors, timing (24-72 h)) as provisional guidance to support bedside decision-making while large outcome studies, such as the empagliflozin after acute myocardial infarction (EMPACT-MI) trial and the extended empagliflozin to prevent worsening of left ventricular volumes and systolic function after myocardial infarction (EMPRESS-MI) trial read-outs, are awaited. Current evidence supports the hemodynamic and renal safety of commencing SGLT2i soon after PCI in hemodynamically stable STEMI patients with preserved tubular reserve. In the absence of ongoing trials, cautious adoption guided by the START framework can help clinicians capture potential cardio-renal benefits without compromising acute care.
Vericiguat: A New Horizon for Heart Failure Treatment.
Carbonaro C, Bocchino PP, Bertello E … +7 more , Griffith Brookles C, Angelini F, Gallone G, Pidello S, Feneziani A, Raineri C, De Ferrari GM
Rev Cardiovasc Med · 2026 Apr · PMID 42110180 · Full text
Despite advances in guideline-directed medical therapy (GDMT), heart failure with reduced ejection fraction (HFrEF) remains a progressive condition with high morbidity and mortality. Vericiguat, a soluble guanylate cycla...
Despite advances in guideline-directed medical therapy (GDMT), heart failure with reduced ejection fraction (HFrEF) remains a progressive condition with high morbidity and mortality. Vericiguat, a soluble guanylate cyclase (sGC) stimulator, represents a novel therapeutic class that augments the nitric oxide-sGC-cyclic guanosine monophosphate (cGMP) pathway, which is impaired in HFrEF. The VICTORIA trial demonstrated that vericiguat significantly reduced the composite endpoint of cardiovascular death or heart failure hospitalization (HFH) in high-risk patients following a worsening event. Recent data from the VICTOR trial and subsequent pooled analyses suggest broader applicability, indicating that vericiguat may signal a potential mortality benefit in selected stable, ambulatory HFrEF patients with elevated natriuretic peptides but without recent hospitalization. The safety profile is favorable, with hypotension being the most common adverse event. Overall, vericiguat offers a valuable therapeutic option for a wide spectrum of HFrEF patients. Moreover, the ability of vericiguat to improve outcomes in both post-worsening and selected high-risk stable populations suggests this sGC stimulator may serve as a critical fifth component of GDMT, offering a new avenue for a personalized approach to HFrEF treatment. This review synthesizes key clinical evidence to elucidate the role of vericiguat in modern HFrEF management.
Reply to Comment on "Combination of the Fibrosis-4 Index and Carbohydrate Antigen 125 to Predict Morbidity and Mortality in Acute Heart Failure".
Appiani F, López-Vilella R, Almenar-Bonet L
Rev Cardiovasc Med · 2026 Apr · PMID 42110179 · Full text
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Mechanisms and Therapeutic Potential of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure.
Huang Z, Ling G, Fang C … +5 more , Wu Z, Ye S, Zhang C, Luo C, Zheng B
Rev Cardiovasc Med · 2026 Apr · PMID 42110178 · Full text
Heart failure (HF) is a major global cause of hospitalization and mortality, representing a complex clinical syndrome with significant unmet therapeutic needs. Sodium-glucose cotransporter 2 inhibitors (SGLT2is), origina...
Heart failure (HF) is a major global cause of hospitalization and mortality, representing a complex clinical syndrome with significant unmet therapeutic needs. Sodium-glucose cotransporter 2 inhibitors (SGLT2is), originally developed for glycemic control, have recently demonstrated remarkable efficacy in the management of HF. This review comprehensively examines the mechanisms of action and therapeutic potential of SGLT2is in HF, with a focus on their multifaceted effects on hemodynamics, cardiac metabolism, inflammatory responses, oxidative stress, and neuroendocrine activation. In addition, clinical trial outcomes and safety profiles of SGLT2is in HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and HF with mid-range ejection fraction (HFmrEF) are thoroughly evaluated. Finally, this article discusses future research directions and clinical application prospects, aiming to provide novel insights and strategies for treating HF.
Plaque Progression and Rupture in Obstructive Coronary Artery Disease: A Review of Current Imaging Modalities.
Veneziano FA, Cocco N, Gentile F … +2 more , Chietera F, De Luca L
Rev Cardiovasc Med · 2026 Apr · PMID 42110177 · Full text
Atherosclerotic plaque progression and rupture are the chief determinants of acute coronary syndromes and long-term outcomes in obstructive coronary artery disease (CAD). Residual risk persists despite intensive low-dens...
Atherosclerotic plaque progression and rupture are the chief determinants of acute coronary syndromes and long-term outcomes in obstructive coronary artery disease (CAD). Residual risk persists despite intensive low-density lipoprotein-lowering and contemporary secondary prevention, because vascular inflammation and microstructural frailty often remain unresolved. At the bedside, the lesion that precipitates infarction is seldom the tightest but rather the most unstable. This review integrates the mechanistic chain, from endothelial dysfunction and retention/oxidation of apolipoprotein B lipoproteins to maladaptive innate and adaptive immunity, failed efferocytosis with necrotic core expansion, and biomechanical forces that thin and fatigue the fibrous cap, with their corresponding imaging phenotypes. Thus, this study aimed to examine how intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near-infrared spectroscopy (NIRS), alongside coronary computed tomography angiography (CCTA), cardiac magnetic resonance (CMR), and positron emission tomography (PET), characterize these processes and enable longitudinal tracking of disease activity. Moreover, we briefly discuss emerging therapeutic implications of plaque imaging, focusing on how improved identification of vulnerable plaque features may inform risk stratification. Finally, we evaluate therapies that extend beyond lipid-lowering to modulate inflammatory and immune pathways, reinforce cap stability, and support a risk-adapted, trajectory-based pathway in which serial imaging and biomarkers guide treatment intensity. Together, these advances support a shift in clinical practice from stenosis-centered revascularization to imaging-guided, vulnerability-centered prevention.
The Association Between Lipoprotein(a) and Atherosclerotic Cardiovascular Disease Severity.
Zha L, Wang D, Li F … +10 more , Wang Y, Wang Z, Zeng K, Yan S, Liu D, Pei D, Cao Y, Yu Y, Weng L, Jin E
Rev Cardiovasc Med · 2026 Apr · PMID 42110176 · Full text
BACKGROUND: Lipoprotein(a) (Lp(a)) has emerged as an independent determinant of risk among the multiple factors associated with atherosclerotic cardiovascular disease. This study, which utilized data from the northern Ch...
BACKGROUND: Lipoprotein(a) (Lp(a)) has emerged as an independent determinant of risk among the multiple factors associated with atherosclerotic cardiovascular disease. This study, which utilized data from the northern Chinese population, aimed to investigate the association between Lp(a) and conventional coronary heart disease risk factors. Furthermore, the Lp(a) level may reflect the severity of vascular stenosis in individuals affected by coronary heart disease, offering valuable insights for future clinical interventions. METHODS: A total of 778 individuals who underwent coronary angiography and were later confirmed to have coronary artery disease from September 2022 to December 2024 participated in this study. Baseline clinical information collected for each participant included sex, age, height, weight, smoking and drinking habits, history of hypertension, diabetes status, lipid parameters, and other pertinent medical characteristics. RESULT: The analysis demonstrated that progressive increases in circulating Lp(a) levels were associated with a pronounced escalation in vascular stenosis, a pattern reaching statistical significance ( < 0.05). An evaluation of the receiver operating characteristic (ROC) curve indicated that Lp(a) yielded an area under the curve (AUC) value of 0.673 (95% confidence interval (CI): 0.630-0.716; < 0.001) for identifying severe coronary artery stenosis. A significant correlation (r = 0.306; < 0.0001) was revealed in the assessment of the correlation between Lp(a) and the Gensini score. An independent association was observed between Lp(a) levels and the number of diseased coronary arteries (odds ratio (OR) = 1.029, 95% CI: 1.017-1.041; < 0.001). Furthermore, individuals with higher Gensini scores exhibited significantly increased Lp(a) levels. Notably, patients with chronic total occlusion (CTO) lesions or multi-vessel disease also demonstrated markedly higher Lp(a) levels (all values < 0.001). CONCLUSION: Elevated Lp(a) concentrations are linked to increased severity of coronary heart disease, as evidenced by higher Gensini scores. Elevated Lp(a) concentrations are also associated with an increased occurrence of multi-vessel coronary artery stenosis or total occlusions.
Advances in Diagnosis and Therapeutic Guidance for Acute Coronary Syndrome: A Narrative of A Precision Medicine Approach.
Koike T, Niida T, Koga S … +3 more , Yaginuma K, Isoda K, Inoue K
Rev Cardiovasc Med · 2026 Apr · PMID 42110175 · Full text
Acute coronary syndrome (ACS) remains one of the leading causes of cardiovascular morbidity and mortality. Recent advances in high-sensitivity cardiac troponin assays, multimodal imaging, and antithrombotic therapies hav...
Acute coronary syndrome (ACS) remains one of the leading causes of cardiovascular morbidity and mortality. Recent advances in high-sensitivity cardiac troponin assays, multimodal imaging, and antithrombotic therapies have introduced more individualized risk assessment and management. This review highlights a precision-oriented diagnostic pathway, which integrates the 0/1-hour algorithm with imaging modalities for the comprehensive evaluation of culprit and non-culprit lesions. Revascularization strategies are advancing, with imaging-guided percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), enabling more tailored approaches for complex diseases. Meanwhile, mechanical circulatory support offers potential benefits for cardiogenic shock; nevertheless, there are uncertainties regarding optimal timing and patient selection. Long-term antithrombotic therapy is becoming increasingly optimized. Recent strategies have focused on reducing the duration of dual antiplatelet therapy (DAPT) and exploring de-escalation approaches such as P2Y inhibitor monotherapy. Secondary prevention extends beyond lipid-lowering therapies and includes metabolic and anti-inflammatory interventions. Collectively, these advancements indicate a shift toward truly personalized care for ACS, aiming to improve outcomes by transitioning away from a one-size-fits-all approach.
Nursing Care of Heart Failure With Preserved Ejection Fraction: Review.
Feng X, Liu H, Wang X … +4 more , Xu M, Ma L, Zhu L, Wang X
Rev Cardiovasc Med · 2026 Apr · PMID 42110174 · Full text
The incidence of heart failure with preserved ejection fraction (HFpEF) has been steadily increasing in recent years, which poses significant challenges to clinical management. Indeed, these rises are attributable to the...
The incidence of heart failure with preserved ejection fraction (HFpEF) has been steadily increasing in recent years, which poses significant challenges to clinical management. Indeed, these rises are attributable to the incompletely understood pathophysiology of the condition, limited treatment options, a prolonged clinical course, a substantial economic burden, and frequent, complex comorbidities. Thus, to address these challenges, this review synthesizes current research on the pathophysiological mechanisms, epidemiological characteristics, and clinical management of HFpEF. Meanwhile, this review further examines the existing gaps and challenges in nursing practices, aiming to inform and optimize clinical nursing care for this patient population. A systematic literature search was performed across four databases (PubMed, Cochrane Library, Web of Science, and Embase) from inception to April 2024, using the keywords "heart failure with preserved ejection fraction", "HFpEF", and "nurs*". Ultimately, after duplicates and irrelevant records were removed, 72 articles were included in this review. Nursing care plays a pivotal role in enhancing the quality of life and improving clinical outcomes for patients with heart failure with preserved ejection fraction. Future efforts should prioritize optimizing treatment plans, reinforcing patient education, developing robust risk prediction models, and exploring innovative nursing care frameworks. Additionally, attention must be paid to the rational allocation and efficient use of nursing resources to deliver more effective, individualized patient care. Current clinical practice lacks standardized nursing protocols for the diagnosis, treatment, and long-term management of HFpEF. Therefore, conducting comprehensive patient assessments, implementing evidence-based nursing interventions tailored to individual diagnoses, and integrating advanced nursing models into routine practice are essential to enhance the quality of care.
Long-Term Outcomes After Percutaneous Coronary Intervention According to the High-Sensitivity C-Reactive Protein-to-Albumin Ratio in Patients With Chronic Obstructive Pulmonary Disease in China.
Cao Y, Tong Y, Wang Z … +5 more , Qi Y, Gao J, Wang W, Tang YD, Zheng Y
Rev Cardiovasc Med · 2026 Apr · PMID 42110173 · Full text
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) frequently occur together, with systemic inflammation linking these two conditions. Recently, the high-sensitivity C-reactive pro...
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) frequently occur together, with systemic inflammation linking these two conditions. Recently, the high-sensitivity C-reactive protein to albumin ratio (hsCAR) has been identified as a composite biomarker of inflammation and nutrition. Thus, this study aimed to examine the prognostic value of hsCAR in patients with COPD-CAD undergoing percutaneous coronary intervention (PCI). METHODS: In this cohort study, consecutive patients with COPD-CAD who underwent PCI between 2014 and 2019 were enrolled and categorized into tertiles by hsCAR values. The primary endpoint was major adverse cardiac events (MACEs), including cardiac death, target vessel revascularization (TVR), and nonfatal myocardial infarction (MI). Patients underwent a follow-up for up to 4 years, and the incidence of MACEs was compared between the hsCAR groups using Kaplan-Meier curves and Cox regression analyses. RESULTS: A total of 262 patients were enrolled. Over a median follow-up of approximately 4 years, higher hsCAR levels were associated with an increased incidence of MACEs. The cumulative incidence of MACEs was highest in Group C (hsCAR ≥0.079). The incidence of MACEs was significantly higher in Group C than in Group A (19.5% vs. 5.7%; hazard ratio (HR) = 3.27, 95% confidence interval (CI): 1.08-9.86; = 0.035). Receiver operating characteristic (ROC) curve analysis confirmed the associated discriminatory ability (area under the curve (AUC) = 0.651; = 0.004). Restricted cubic spline (RCS) analysis showed a linear increase in the risk of MACEs as the absolute value of hsCAR exceeded 0.0446. Subgroup analyses revealed consistent associations across strata, with no significant interactions. CONCLUSION: Elevated baseline hsCAR is an independent predictor of long-term MACEs in patients with COPD-CAD undergoing PCI. As an inexpensive and readily available biomarker, hsCAR could be used for post-PCI risk stratification to guide targeted secondary prevention in this high-risk population.
Influence of Plasma Atherogenic Index on Coronary Artery Disease Severity: Insights From a Large-Scale Cohort Study in China.
Wang X, Xu W, Song Q … +9 more , Zhao Z, Xia C, Li Y, Xie Y, Wang J, Yang C, Zhao Z, Meng X, Wang F
Rev Cardiovasc Med · 2026 Apr · PMID 42110172 · Full text
BACKGROUND: The atherogenic index of plasma (AIP), calculated from triglyceride and high-density lipoprotein cholesterol levels, is associated with atherosclerosis and coronary artery disease (CAD). However, evidence con...
BACKGROUND: The atherogenic index of plasma (AIP), calculated from triglyceride and high-density lipoprotein cholesterol levels, is associated with atherosclerosis and coronary artery disease (CAD). However, evidence concerning the impact of the AIP on CAD severity remains limited. This study aims to assess the correlation between AIP and the severity of CAD. METHODS: This study included 19,929 hospitalized participants diagnosed with CAD. After excluding participants with missing data, aged >75 years, or diagnosed with chronic kidney disease or cancer, a total of 2561 individuals were included. The 2561 participants were divided into three AIP tertile groups: AIP1 (AIP <0.016, n = 854), AIP2 (0.016 ≤ AIP < 0.216, n = 853), and AIP3 (AIP ≥0.216, n = 854). In this study, CAD severity was determined by the count of coronary arteries exhibiting stenosis of 50% or greater. Multivessel CAD was defined as ≥50% stenosis in two or more major coronary arteries. The relationship between AIP and CAD severity was assessed using logistic regression models. RESULTS: Results indicate that the AIP independently predicts CAD severity, with an odds ratio of 1.700 (95% confidence interval (CI): 1.160-2.491; = 0.007). The AIP3 group demonstrated a significantly higher risk of multivessel CAD compared to the AIP1 group (odds ratio (OR), 1.441; 95% CI: 1.124-1.848; = 0.004), particularly in patients without diabetes mellitus (OR, 1.421; 95% CI: 1.030-1.962; = 0.033). CONCLUSIONS: The AIP was significantly associated with CAD severity, suggesting that it could be a convenient and valuable marker for severity stratification in patients with CAD in clinical practice.
Glucose and Lipid Metabolic Mechanisms in Vascular Aging and Related Therapeutic Strategies.
Han F, Wen Z, Li C … +1 more , Chen T
Rev Cardiovasc Med · 2026 Apr · PMID 42110171 · Full text
Vascular aging represents an independent risk factor for vascular disorders, with underlying cellular and molecular mechanisms closely associated with metabolic dysfunction, particularly disturbances in glucose and lipid...
Vascular aging represents an independent risk factor for vascular disorders, with underlying cellular and molecular mechanisms closely associated with metabolic dysfunction, particularly disturbances in glucose and lipid metabolism. Therefore, understanding the interplay between disorders in glucose and lipid metabolism, as well as vascular aging, is crucial for preventing vascular disease. Early clinical recognition and targeted intervention are essential for the diagnosis and management of vascular senescence-related conditions. This review evaluates the metabolic mechanism underlying vascular aging, highlights clinical biomarkers and assessment strategies, and summarizes timely therapeutic approaches aimed at improving metabolic function.
Analysis of Morphological High-Risk Factors for Retrograde Type A Aortic Dissection.
Long C, Xia J, Luo C … +4 more , Cai J, Khan A, Feng Y, Lei Z
Rev Cardiovasc Med · 2026 Apr · PMID 42110170 · Full text
BACKGROUND: The mechanism involved in retrograde type A aortic dissection (RTAD) remains unclear, while research through morphological studies is limited. Therefore, this study aimed to compare the aortic geometric featu...
BACKGROUND: The mechanism involved in retrograde type A aortic dissection (RTAD) remains unclear, while research through morphological studies is limited. Therefore, this study aimed to compare the aortic geometric features between RTAD and type B aortic dissection (TBAD) and to identify specific anatomical predictors of RTAD. METHODS: A total of 60 patients diagnosed with acute aortic dissection, with the primary entry tear located in the descending aorta, were included based on aortic computed tomography angiography (CTA) performed at our center between November 2019 and November 2023. Among them, 21 were RTAD cases, and 39 were TBAD cases. Aortic CTA morphological data were collected using Carestream Image Suite V4 and EndoSize software. Retrospective statistical analysis was performed using SPSS 26 and RStudio to explore relationships among aortic and aortic arch morphologies, angles, primary tear location, tear size, and dissection type. RESULTS: (1) No significant differences were observed between the two groups in gender, age, height, weight, body mass index (BMI), hyperlipidemia, hypertension, diabetes, coronary artery disease, or smoking history (all > 0.05). (2) Multivariate logistic analysis revealed that reduced minimum diameter of the ascending aorta (odds ratio (OR) 0.488, 95% confidence interval (CI) 0.245-0.974; = 0.042), increased maximum diameter of the ascending aorta (OR 2.318, 95% CI 1.107-4.857; = 0.026), and reduced minimum diameter of the distal aortic arch (OR 0.594, 95% CI 0.362-0.974; = 0.039) were significant predictors of RTAD. (3) The RTAD risk prediction model demonstrated excellent predictive performance and robustness across datasets and experimental conditions, effectively identifying high-risk patients and providing reliable support for clinical decision-making (C-index = 0.952; area under the curve (AUC) = 0.952). Calibration curves showed high consistency between predicted probabilities and observed outcomes, and decision curve analysis (DCA) indicated significant clinical net benefits across a wide range of threshold probabilities. CONCLUSIONS: (1) Reduced minimum diameter of the ascending aorta, increased maximum diameter of the ascending aorta, and reduced minimum diameter of the distal aortic arch are specific predictors of TBAD progressing to RTAD. (2) The RTAD risk prediction model, incorporating these high-risk factors, offers clinical guidance for the prevention and early intervention of RTAD.
Barriers to the Implementation of Acute Coronary Syndrome Guidelines in Healthcare: A Systematic Review.
Stolic S, George S, Mbuzi V … +2 more , Terry D, Hou XY
Rev Cardiovasc Med · 2026 Apr · PMID 42110169 · Full text
BACKGROUND: Clinical guidelines, pathways, and protocols assist in coordinating care for individuals with suspected or confirmed acute coronary syndrome (ACS). The recently updated 2025 ACS guidelines in Australia and in...
BACKGROUND: Clinical guidelines, pathways, and protocols assist in coordinating care for individuals with suspected or confirmed acute coronary syndrome (ACS). The recently updated 2025 ACS guidelines in Australia and internationally introduced significant changes to improve outcomes compared with the 2016 versions. However, barriers to implementing these ACS clinical guidelines in healthcare settings can lead to significant delays in the management of ACS patients, poor patient outcomes, and increased healthcare costs. This systematic review aims to identify the barriers that healthcare professionals face in implementing ACS clinical guidelines in primary and tertiary healthcare settings. METHODS: Articles were identified through six databases encompassing EBSCO/Cumulative Index to Nursing and Allied Health literature, Cochrane's library, ProQuest, PubMed/Medline, ScienceDirect, and Web of Science, as well as hand searching. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework. Search terms included "barriers" OR "obstacles" and "Acute Coronary Syndrome" and "guidelines". A total of 1625 scientific papers discussing barriers to implementing ACS care guidelines were identified. Following the EndNote automated duplicate process, 67 duplicates were removed. A total of 1558 titles and abstracts were screened using the Joanna Briggs Institute System for Unified Management, Assessment and Review of Information (JBI Sumari). Of the records screened, 1482 were excluded; 76 full papers were retrieved and reviewed. Of these, 68 full-text articles were excluded; 8 studies were included in the final analysis. RESULTS: The eight included studies were conducted in high-income countries (the USA, Australia, Norway) and low- and middle-income countries (Kenya, Egypt, Indonesia, Sub-Saharan Africa, Tanzania). Sample sizes ranged from 9 to 156,328 participants. Barriers to implementation were grouped into patient-, provider/staff-, and system-level factors. Patient factors included age, gender, race, lack of ACS knowledge, inappropriate healthcare-seeking behavior, delays in treatment, nonadherence to ACS management and lifestyle recommendations, nonattendance at diagnostic tests, language barriers, and geographical distance to the nearest healthcare setting. Provider/staff barriers included deficits in staff knowledge of patient triage, lack of confidence in managing patients with ACS, and deficits in diagnosis and in the provision of recommended management. System factors included inadequate training, the availability of guidelines/protocols, the condition/lack of equipment, and the absence of interventional cardiology units. In addition, factors included reduced available beds, high staff-to-patient ratios, shortages of qualified staff, delays in referral systems, delays in transport and treatment, and openness to adopting new guidelines. CONCLUSION: Accurate triage and risk stratification are essential to reduce ACS-related mortality. Health systems should prioritize timely electrocardiogram (ECG) interpretation, transport to percutaneous coronary intervention (PCI)-capable centers, and workforce training. Policy actions must address resource gaps, standardize chest pain pathways, and invest in infrastructure to ensure equitable implementation of the updated 2025 ACS guidelines. THE PROSPERO REGISTRATION: CRD42023409325, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023409325.
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