Dyslipidemia is a major metabolic disorder and a key risk factor for atherosclerotic cardiovascular disease (ASCVD), particularly in the geriatric population. Elderly patients frequently present with multiple comorbidities, such as hypertension and hyperuricemia, which complicate clinical management and substantially increase cardiovascular risk. Moreover, acute conditions, including trauma-related injuries, may further disrupt metabolic control, functional capacity, and adherence to long-term therapy. This case report describes a 70-year-old male patient (RE) who presented to a primary healthcare center with swelling and intermittent pain in the right lower extremity following a fall. The patient had a known history of dyslipidemia, hypertension, and hyperuricemia. Laboratory investigations revealed elevated total cholesterol (242 mg/dL), borderline fasting plasma glucose (102 mg/dL), and uric acid level of 6.6 mg/dL. Physical examination was unremarkable except for edema and localized tenderness in the affected limb, consistent with a soft tissue injury. A holistic management approach was implemented, integrating pharmacological and non-pharmacological interventions. Statin therapy was initiated to address dyslipidemia, antihypertensive treatment was optimized, and analgesic therapy combined with limb elevation was provided to manage acute pain and edema. Non-pharmacological strategies included comprehensive lifestyle modification, encompassing dietary counseling (low saturated fat, low salt, and low purine diet), gradual resumption of physical activity following injury recovery, and structured patient–family education to improve adherence and prevent recurrent falls. Follow-up evaluation demonstrated clinical improvement, including resolution of edema, improved functional mobility, and better metabolic control. The novelty of this case lies in demonstrating how acute trauma in geriatric patients can act as a critical entry point for integrated chronic disease management within primary care settings. This case emphasizes that holistic, biopsychosocial–spiritual management not only improves lipid and blood pressure control but also enhances functional outcomes and quality of life in elderly patients with complex comorbidities.

Preoperative anxiety is associated with postoperative cardiovascular events, extubation delay, and pain in patients undergoing cardiac surgery: A prospective observational study in Taiwan.

Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide, and excess adiposity is a major contributor to cardiovascular (CV) risk. However, obesity is a heterogeneous condition, and body mass index (BMI) alone fails to capture important differences in fat distribution and lean mass that substantially influence CV outcomes. Growing clinical and epidemiological evidence indicates that body composition, rather than body weight per se, provides a more accurate and biologically meaningful framework for CV risk assessment. This narrative review summarizes clinical evidence linking key components of body composition, including total and regional adiposity, skeletal muscle mass, and ectopic fat depots, to CV risk and prognosis. Central and visceral adiposity are consistently shown to be more strongly associated with cardiometabolic dysfunction, atherosclerosis, and CV events than generalized obesity. In parallel, reduced lean mass and sarcopenia emerge as independent predictors of adverse CV outcomes, particularly in older adults and patients with established CVD. Ectopic fat depots, such as epicardial and hepatic fat, further contribute to CV pathology through local and systemic mechanisms. Collectively, these findings highlight the limitations of BMI-centered approaches and support the integration of body composition measures into CV risk stratification. Emphasizing body recomposition, with reduction of harmful fat depots and preservation of skeletal muscle, may enable more precise, individualized strategies for CV prevention and management.

The cardiovascular evaluation of candidates for living kidney donation.

Sex-based differences in cardiovascular risk management and abdominal aortic aneurysm growth: Insights from a contemporary cohort study.

Risk-associated and clinically informative biomarkers for cardiovascular risk stratification in metabolic dysfunction-Associated steatotic liver disease.

Dual trajectories of nighttime sleep duration and frailty in relation to cardiovascular disease risk in middle-aged and older Chinese adults: a longitudinal study.

Triglyceride-derived metabolic parameters have been proposed as indirect measures of insulin resistance and also as predictors of worse prognosis, mainly in Asian populations. However, their value as risk predictors of micro- and macrovascular complications in non-Asian individuals with type 2 diabetes is uncertain. Triglyceride-derived parameters, the atherogenic index of plasma (AIP, the triglyceride/HDL-cholesterol ratio), the triglyceride-glucose index (TyG, the triglyceride-fasting glucose product) and the TyG*BMI were calculated at baseline and during the 1st year of follow-up in a prospective cohort of 667 individuals with type 2 diabetes. Multivariable Cox analyses assessed the associations between triglyceride-derived parameters (as continuous and categorical tertile variables) and cardiovascular (total and major cardiovascular events) and microvascular (renal, retinopathy and peripheral neuropathy events) outcomes and mortality. Over a median 10.6 years of follow-up, there were 212 total cardiovascular events (172 major ones), 263 all-cause deaths and 124 new microalbuminuria developments, 98 advanced renal function deteriorations, 154 retinopathy and 173 peripheral neuropathy development/progression events. None of the triglyceride-derived metabolic parameters, either analysed as continuous or categorical variables, were associated with significantly higher risks for any of the adverse outcomes. The best predictive performance was the 1st year TyG for retinopathy development/progression (HR: 1.24; 95%CI: 1.01-1.53, for increments of 1-SD), which attenuated to non-significant (HR: 1.16; 95%CI: 0.92-1.45) after further adjustment for serum LDL-cholesterol levels. No triglyceride-derived metabolic parameter was predictive of any adverse outcome, either micro- or macrovascular events or mortality, suggesting that they should not be used for risk stratification in individuals with type 2 diabetes.

Influenza infection is a well-established trigger of severe respiratory and cardiovascular complications, particularly in older adults, frail individuals, and patients with underlying cardiovascular disease. Seasonal peaks are consistently associated with excess hospitalizations and mortality. Epidemiological studies have shown sharp increases in acute cardiac events during and immediately after influenza infection, including a high-rate of acute coronary syndromes and heart failure. The cardiovascular impact of influenza is mediated by multiple mechanisms. Systemic inflammation, plaque destabilization, metabolic imbalance, endothelial dysfunction, and pro-thrombotic activation collectively contribute to acute coronary syndromes, myocarditis, arrhythmias, and acute or worsening heart failure. These complications generate a substantial clinical and socioeconomic burden, particularly in elderly and high-risk individuals. Despite the availability of effective and inexpensive vaccines, influenza vaccination remains underused in high-risk cardiovascular populations. Randomized trials and meta-analyses consistently support vaccination as a powerful preventive tool, associated with a 25-37% reduction in major adverse cardiovascular events and mortality, with benefits comparable to established cardioprotective therapies. Evidence is strongest in patients with coronary artery disease, ACS, diabetes, and in older adults, although results in heart failure populations remain more heterogeneous. Enhanced vaccines including adjuvanted, high-dose, and cell-based formulations offer superior protection in elderly and immunocompromised individuals and are increasingly recommended by national and international health authorities. Given the robust evidence linking influenza to cardiovascular events and the proven protective role of vaccination, systematic implementation of tailored influenza immunization strategies in patients with CVD is essential to optimize preventive care.

Differences between cystatin C- and creatinine-based estimated glomerular filtration rate (eGFR) have been associated with adverse outcomes in both chronic disease and general population cohorts, but their significance in surgical patients is unknown. The hypothesis of this study was that lower cystatin C-based relative to creatinine-based eGFR would be associated with higher risks of postoperative complications. This was a retrospective cohort study of patients who had major noncardiac surgery at two large hospitals in China, located in geographically distant regions and with differing ethnic compositions. The exposure was different in preoperative eGFR based on cystatin C and creatinine (eGFRdiff = eGFRcys - eGFRcr). The primary outcome was a composite of postoperative complications and death. Associations were assessed using logistic regression models adjusting for demographics, comorbidities, surgery characteristics, and laboratory results. A total of 35,488 patients from the Nanfang cohort and 23,417 from the Xinjiang cohort were included. The primary outcome occurred in 8.4 and 14.4% of patients, respectively. More negative eGFRdiff values were consistently associated with higher risk of the primary outcome (adjusted odds ratio per 10 ml · min -1 · 1.73 m -2 decrease was 1.12 [95% confidence interval, 1.09 to 1.15] in the Nanfang cohort and 1.11 [95% confidence interval, 1.09 to 1.14] in the Xinjiang cohort; both P < 0.001). Associations were also observed across categories of component outcomes (cardiovascular events, acute kidney injury, infections, pulmonary complications, and death). More negative preoperative eGFRdiff was independently associated with higher risk of postoperative complications in Asian patients undergoing noncardiac surgery. eGFRdiff may represent a novel risk marker with potential utility for perioperative risk stratification.

Cardiovascular disease (CVD) remains the leading cause of mortality and is often underestimated in women, particularly in those with a history of preeclampsia (PE). Obesity has increased every year, with countries being unsuccessful in reducing its prevalence. This study aimed to evaluate cardiovascular outcomes in women aged less than 40 years old, considering both PE history and central adiposity (CA). We conducted a retrospective case-control study using data from a Brazilian cohort initiated in 1978/1979, with follow-up in 2016/2017. Of the 1775 individuals evaluated, 929 were women, and 188 reported their PE history. Women were categorized as having PE history or no PE history (CTL) and further classified by the presence of CA (waist circumference ≥88 cm). Cardiovascular events, blood pressure, and arterial stiffness were also recorded. Hypertension was present in 66.7 and 69.7% of women with PE_CA and PE_noCA, respectively. The risk was 19-fold higher in PE_CA and 24-fold higher in PE_noCA than in CTL_noCA. Conditional inference tree (CTree) analysis confirmed that PE preeclampsia (P < 0.0001) was the strongest determinant of hypertension, followed by CA (P < 0.0001) and dyslipidemia (P = 0.019). CA significantly worsened SBP [24-h ambulatory blood pressure monitoring (ABPM) +15.6 mmHg; daytime ABPM +15.9 mmHg; office + 15.3 mmHg] and increased pulse wave velocity (PWV) by 1.14 m/s among women with history of PE. PE significantly increased the cardiovascular risk, with CA further exacerbating vascular impairment. Early cardiovascular risk assessment and prevention strategies are essential for young women with a history of PE to prevent future cardiovascular events.

Despite intensive lipid-lowering therapy, individuals with atherosclerotic cardiovascular disease (ASCVD) exhibit residual inflammatory risk, which drives recurrent cardiovascular events. This risk is amplified in type 2 diabetes mellitus (T2DM), where a pro-inflammatory milieu accelerates atherogenesis. Monocyte-derived macrophages (MDMs), key mediators of vascular inflammation, contribute significantly to this process. Icosapent ethyl (IPE), a highly purified ethyl ester of eicosapentaenoic acid (EPA), reduces major adverse cardiovascular events (MACE) beyond triglyceride lowering, yet its cellular mechanisms remain unclear. This study aims to determine whether IPE modulates inflammatory pathways in patient-derived MDMs and to distinguish direct EPA effects from therapy-mediated changes. This single-centre, open-label, randomised observational cohort study will recruit ASCVD patients, stratified by T2DM status, who are prescribed IPE (Vazkepa®). MDMs and plasma/serum samples will be collected from patients, either IPE-naïve or following 6 months of therapy. In parallel, direct EPA effects will be assessed by treating MDMs from healthy donors and ASCVD patients with physiologically relevant concentrations of EPA. We will evaluate NOD-like receptor protein 3 (NLRP3) inflammasome priming and activation, inflammatory cytokine profiles, and markers of cellular senescence. The study will investigate mechanisms that potentially underlie the cardiovascular benefits of IPE, focusing on the modulation of inflammatory pathways. We hypothesise that IPE attenuates priming and activation of the NLRP3 inflammasome in monocyte-derived macrophages, thereby reducing cellular inflammation and senescence. This study will provide mechanistic insight into how IPE influences macrophage-driven inflammation in ASCVD and T2DM, informing strategies to target residual inflammatory risk in high-risk cardiometabolic populations.

Immune checkpoint inhibitors (ICIs) have transformed cancer treatment, yet their use carries the risk of ICI-related myocarditis (ICIrM), a rare but potentially fatal adverse event. Although the overall incidence of ICIrM has been described, recent trends and diagnostic shifts remain poorly characterized. We retrospectively reviewed 11,602 patients treated with ICIs at a multi-center institution from 2011 to 2024. ICIrM cases were identified through manual chart review, and baseline characteristics, cardiovascular events, and outcomes were assessed. The study was designed as a descriptive analysis of temporal trends in ICI therapy use and ICIrM. ICIrM occurred in 127 patients (1.1%), with a mean age of 66.7±12.7years and 56.5% male. Median time to onset was 45days (IQR 106). ICI use increased steadily over the past decade, with a marked rise in ICIrM diagnoses in 2023-2024, accounting for 47.2% of all cases. Diagnostic prevalence rose from 0.5% before 2020 to 1.3% after 2020, likely reflecting enhanced recognition due to the implementation of guideline-based diagnostic criteria (Bonaca et al. and ESC-ICOS). Seasonal variation in ICIrM incidence was not observed. The increasing incidence of ICIrM likely reflects improved clinical awareness and diagnostic practices. Continued efforts to optimize surveillance, early detection, and mitigation strategies are essential as ICI use expands globally.

Xanthine oxidase inhibitors for gout: Applications and novel drug development.

Unraveling the significance of carotid siphon calcifications: Mechanisms and clinical implications in vascular aging - A narrative review.

Introduction: Hypothyroidism is linked to adverse changes in lipid metabolism and cardiac function, increasing cardiovascular risk. The major cardiovascular changes that occur in hypothyroidism include a decrease in cardiac output and cardiac contractility, a reduction in heart rate, and an increase in peripheral vascular resistance. Carotid intima-media Thickness (CIMT) is an established marker of subclinical atherosclerosis. Aim: To evaluate the correlation between CIMT and cardiovascular parameters in patients with hypothyroidism. Materials and Methods: The present cross-sectional observational study was conducted at the Medical College and Hospital, Kolkata, West Bengal, India (General Medicine Department, Inpatients and Outpatients) between December 2022 and May 2024. A total of 100 patients with established primary hypothyroidism were enrolled. Data collected included demographics (age, sex), Body Mass Index (BMI) and Blood Pressure (BP), thyroid function tests {Thyroid-Stimulating Hormone (TSH), Free Thyroxine (FT4), anti-Thyroid Peroxidase (anti-TPO) antibody}, lipid profile, liver and renal function tests, fasting glucose and HbA1c, Complete Blood Count (CBC), 12- lead ECG, Two-dimensional Echocardiography (2D ECHO), and carotid Doppler ultrasound to measure CIMT and carotid artery flow velocities. Statistical analyses (Pearson’s correlation, Chi-square test and Student’s t-test) were performed using appropriate software, with p&lt;0.05 considered significant. Results: Of the 100 patients, 54% were female. Most (82%) had overt hypothyroidism and 18% had subclinical hypothyroidism. Mean±SD body mass index was 26.2±2.8 kg/m², and mean diastolic blood pressure was 89.4±3.0 mmHg. Mean±SD total cholesterol was 197±33 mg/dL, triglycerides 188±71 mg/dL, low-density lipoprotein cholesterol 116±95 mg/dL, and highdensity lipoprotein cholesterol 46.93±4.9365 mg/dL. Sinus bradycardia was present in 43%, and diastolic dysfunction (grade I–II) on echocardiography was observed in 42% of patients. The mean common carotid artery intima-media thickness (CCA-CIMT) was 0.62±0.13 mm (right) and 0.60±0.14 mm (left). The corresponding mean internal carotid artery CIMT (ICA-CIMT) values were 0.60±0.14 mm (right) and 0.62±0.14 mm (left). Crucially, CIMT showed significant positive correlations with total cholesterol (r=0.72, p&lt;0.001), triglycerides (r=0.69, p&lt;0.001), LDL-cholesterol (r=0.20, p=0.05), peak systolic velocities in the right and left common carotid arteries (p&lt;0.001 for both), and TSH (r=0.25, p=0.01), and a significant negative correlation with HDL-cholesterol (r=-0.26, p=0.008). Conclusion: In patients with hypothyroidism, CIMT is positively correlated with atherogenic lipid parameters and TSH. These findings suggest that increased CIMT reflects subclinical atherosclerotic and cardiovascular risk in hypothyroid patients and underlines the importance of early cardiovascular evaluation in this population.

Association of life's essential 8 with cardiovascular outcomes and mortality in adults with prediabetes: mediating role of inflammatory biomarkers.

Rehabilitation before (prehabilitation) and after solid organ transplantation is gaining increasing interest as an important aspect of holistic treatment. Despite guidelines recommending clinical implementation, there are very few established prehabilitation or rehabilitation programmes routinely delivered within transplant centres. This review provides insight into the current landscape within this area. Prehabilitation and rehabilitation has demonstrated potential to improve clinical outcomes for individuals preparing and living with solid organ transplantation, particularly with regards to aerobic capacity, muscle strength and quality of life. These programmes can address important components of pre/posttransplant clinical outcomes, particularly frailty, length of hospital stay, cardiovascular risk and metabolic health. Research has to date been limited by small sample sizes and heterogeneous interventions. Further high-quality research is needed alongside clinical implementation. Research to date has demonstrated the potential of prehabilitation and rehabilitation across the solid organ transplantation pathway to improve clinical outcomes, as well as to support individuals to live well. Further research with large randomised controlled trials is warranted, with the aim to support the implementation of pre/rehabilitation as part of routine care in multiprofessional clinics.

Asciminib represents a significant advancement in the treatment of chronic myeloid leukemia, establishing a novel therapeutic paradigm by specifically targeting the ABL1 myristoyl pocket, a mechanism distinct from that of conventional adenosine triphosphate-competitive inhibitors. Such a selective inhibitor offers an alternative treatment strategy for patients with chronic myeloid leukemia who have developed resistance to previous tyrosine kinase inhibitor therapies. Although asciminib demonstrates a superior safety profile, primarily characterized by a reduction in cardiovascular adverse events associated with prior tyrosine kinase inhibitors, its clinical significance extends further. The effectiveness of asciminib, combined with its capacity to overcome resistance through combination strategies with adenosine triphosphate-binding site tyrosine kinase inhibitors, establishes it as a focal point in emerging chronic myeloid leukemia treatment approaches. It remains essential to continue research and clinical trials to enhance the therapeutic efficacy of asciminib and manage its associated side effects.

Urinary chlorine at hospital admission as a predictor of diuretic resistance and clinical evolution in acute heart failure.