Coronary artery disease (CAD) is common in liver transplant (LT) recipients, but post-LT rates compared to the general population are unknown in Sweden. We identified all LT recipients in the Swedish National Patient Registry (1987-2020). Each patient was matched with up to 10 population controls for age, sex, municipality, and transplantation year. International Classification of Diseases (ICD) codes defined liver disease aetiology and cardiovascular risk factors. New CAD events were a composite of myocardial infarction, coronary revascularisation, angina, or CAD-related death. Cox regression compared CAD risk in LT recipients and controls across subgroups. We identified 2925 LT recipients and 27,589 controls. Mean age was 54 years; 63% were men. Cardiovascular risk factors were more common in LT recipients. During a median follow-up of 8.0 years, LT recipients had over twice the CAD risk compared with controls (adjusted hazard ratio [aHR]=2.02; 95% confidence interval [CI]=1.80-2.30). Among LT recipients, chronic kidney disease (CKD) (aHR=2.64; 95%CI=1.94-3.60) and previous CAD (aHR=7.85; 95%CI=6.10-10.11) predicted incident CAD. In controls, several factors-including previous CAD, hypertension, diabetes, hypercholesterolemia, CKD, and lung disease-were predictive. The CAD rate was twofold higher in LT recipients than controls. In recipients, only CKD and prior CAD predicted post-transplant CAD, whereas traditional risk factors predicted CAD in controls.

Individuals with normal coronary arteries may develop coronary artery disease (CAD). Coronary computed tomography (CT) angiography (CCTA) offers a non-invasive method to assess the development of CAD. In a post-hoc observational study of the Scottish Computed Tomography of the HEART (SCOT-HEART) trial, we identified patients with normal coronary arteries on initial CCTA who subsequently underwent clinically indicated CT. Images were visually assessed for the presence, severity, and type of CAD. Normal coronary arteries on baseline CCTA were present in 524 patients (mean age 53 ± 10 years, 38% male). After a median of 9.3 (Interquartile range, IQR: 9.3-10.8) years, 31 (6%) underwent repeat CCTA and 162 (31%) underwent chest CT. There were no differences in baseline clinical characteristics amongst those who did or did not have repeat CCTA, but those with subsequent chest CT were older and had higher cardiovascular risk scores. CAD was identified on 48% (n = 15) of CCTA and 25% (n = 41) of chest CT. Median time to CT scan on which CAD was identified was 8.1 (IQR: 6.9-9.7) years. There was no difference in all-cause mortality or combined CAD death or non-fatal myocardial infarction in patients who had CAD identified on subsequent CT. However, they were more likely to undergo invasive coronary angiography (adjusted hazard ratio [aHR] 4.94, 95% confidence interval [CI]: 1.95, 12.51; p < 0.001) and revascularization (aHR 19.99, 95% CI: 1.69, 237.1; p = 0.018), adjusted for age and sex. One third of patients with previously normal CCTA will develop CAD on clinically indicated CT imaging over a 10-year period. Question In patients with normal coronary arteries on coronary computed tomography angiography (CCTA), the risk of developing CAD in the future is uncertain. Findings Among 524 patients with normal coronaries, CAD was identified on 48% of CCTA and 25% of chest CT during 10 years of follow-up. Clinical relevance A substantial proportion of patients with initially normal coronary arteries on CCTA later develop CAD, highlighting the need for clinicians to be alert for the development of new CAD in patients with initially normal coronary arteries.

Gaps in Incidence and Design of Peripheral Versus Coronary Artery Disease Clinical Trials.

The hypertensive disorders of pregnancy (HDPs), that is, preeclampsia and gestational hypertension, are characterized by endothelial dysfunction in pregnancy and are epidemiologically and genetically associated with risk for coronary artery disease (CAD). A recent study suggested that endothelial cell (EC)-acting CAD risk variants may identify individuals who benefit from more intensive lipid-lowering treatment. The present study evaluated whether the same EC CAD genetic risk score is also associated with HDPs using comprehensive statistical genetic approaches. We examined 35 previously identified EC-acting and 205 non-EC-acting risk variants associated with CAD. First, using the nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be), a prospective, multicenter US pregnancy cohort, we calculated polygenic risk scores (PRS) comprised of either EC-acting or non-EC-acting CAD risk variants in genotyped, unrelated participants across multiple ancestry groups. Scores were adjusted for population genetic structure using 10 principal components, then tested for associations with HDPs using logistic regression models adjusted for age. Second, we tested the genetic association of EC-acting and non-EC-acting CAD variants with preeclampsia and gestational hypertension using 2-sample Mendelian randomization. Among 6782 unrelated nuMoM2b participants (mean [SD] age, 27.0 [5.5] years, 1040 [15.3%] with HDPs in the index pregnancy), participants with higher EC-acting PRS had a higher incidence of HDPs. Each SD of higher EC-acting PRS was associated with 1.09-fold increased odds of HDP (95% CI, 1.02-1.17; P=0.008); by contrast, the non-EC-acting PRS was not significantly associated with HDP risk (odds ratio, 1.05 [95% CI, 0.98-1.12]; P=0.14). In 2-sample Mendelian randomization, EC-acting CAD variants were strongly associated with both preeclampsia (odds ratio, 1.55 [95% CI, 1.30-1.86]; P<0.001) and gestational hypertension (odds ratio, 1.54 [95% CI, 1.29-1.85]; P<0.001). PRS and 2-sample Mendelian randomization approaches suggest enrichment for EC-acting CAD genetic risk variants in women with HDPs. These findings support a shared genetic architecture between HDPs and CAD through endothelial dysfunction.

Generational changes in cardiometabolic disease incidence by risk factor strata in the UK Biobank.

Stress echocardiography (SE) detects myocardial ischemia while coronary computed tomography angiography (CCTA) detects structural abnormalities associated with coronary artery disease (CAD). A pilot retrospective study of 270 consecutive patients who underwent both SE and CCTA to explore which test is more accurate in patients with CAD. Health records and risk factors, SE, and CCTA outcomes were reviewed. SE outcomes were positive (n = 36) and negative (n = 234); CCTA outcomes were based on CAD severity (absent, mild, moderate, and severe). 219 (81.1%) patients had a positive CCTA, indicating the presence of CAD with mild, moderate, or severe stenosis. Despite a positive CCTA (n = 191), 70.7% had a negative SE. This discrepancy was most prevalent in the moderate CCTA category, where 110 patients had a negative SE but positive CCTA. Additionally, 9 patients demonstrated a positive SE despite no significant CCTA findings, indicating that functional abnormalities could have remained undetected by anatomical imaging. It is suggested that significant CAD detected by CCTA does not necessarily suggest myocardial ischemia, while the presence of myocardial ischemia is not necessarily associated with significant CAD, suggesting other causes (e.g., microvascular angina). A positive CCTA but negative SE findings may suggest the presence of coronary collaterals.

Pericardial fluid extracellular vesicles enhance angiogenesis and blunt cardiac fibrosis in coronary disease.

PPG-CAGAN: A PPG signal with coronary artery disease synthesis method based on generative adversarial learning

Synergy effects between cholesterol efflux capacity and CPAP on atherosclerotic coronary plaques in patients with sleep-disordered breathing; the ENTERPRISE-CEC trial.

Persistent gaps in management and risk factor control among patients with atherosclerotic cardiovascular disease: All of us research program.

Coronary artery disease (CAD) progression is directly associated with major adverse cardiovascular events and death. This study aimed to construct a pericoronary adipose tissue (PCAT) radiomics model to predict subsequent progression in patients with CAD. Data from 116 patients who had at least 2 coronary computed tomography angiography (CCTA) exams between March 1, 2020, and August 30, 2022, were collected at our institution. Obstructive stenosis, CAD-RADS classification, segment involvement score (SIS), and segment stenosis score (SSS) were noted. The radiomics features of the proximal to the left anterior descending artery, left circumflex artery, and right coronary artery were extracted on CCTA images using fully automated software. According to CAD-RADS, SIS, and SSS, non-progression was identified in 96, 80, and 72 patients and progression was identified in 20, 36, and 44 patients, respectively. All patients were randomly divided into the training and testing cohorts in a 7:3 ratio. Cox regression models were constructed based on PCAT radiomics signatures, and their predictive abilities were measured using receiver operating characteristic curves. We included 116 patients (age 58.00 [53.25, 64.00] years; 78 [67.20%] were male). After screening, 16 PCAT radiomics features were identified as being significantly related to CAD progression. The Cox regression models had area under the curve values of 0.841, 0.838, and 0.725 in the training cohort and 0.818, 0.817, and 0.851 in the testing cohort, respectively, to predict 2-year CAD-RADS, SIS, and SSS progression. PCAT-based radiomics models demonstrated promising performance in predicting subsequent CAD progression. PCAT-based radiomics signatures derived from coronary CT angiography provided incremental predictive value for CAD progression beyond conventional imaging markers (CAD-RADS, SIS, SSS), and may serve as noninvasive imaging biomarkers for individualized risk stratification.

Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by sustained proliferation of megakaryocytes leading to high platelet counts. ET confers risk of thrombosis and vascular complications, which are the main causes of morbidity and mortality. This study aimed to describe disease features, identify thrombosis predictors, and determine prognostic factors for overall survival (OS) in ET patients. This retrospective study analyzed 156 patients with ET diagnosis based on WHO criteria between 2016 and 2021 at Hacettepe University Hospitals. Demographic, clinical, laboratory data, and outcomes including thrombosis events and survival status were extracted from medical records. Factors associated with thrombosis and OS were analyzed. The primary objectives were to [1] define thrombotic risk factors and [2] identify predictors of survival in ET. Median age was 58 years, 66.7% were female, and 46.4% were JAK2-mutated. History of coronary artery disease (CAD) was significantly associated with thrombosis (31.6% vs. 8.8%, p = 0.011). JAK2-mutated patients showed higher prevalence of pro-atherosclerotic comorbidities like diabetes, hypertension and CAD (43.7% vs. 28%, p = 0.044). Lower platelet count (< 728.5 × 109/L), bilirubin and GGT levels correlated with increased thrombotic events. Independent adverse prognostic factors for 5-year OS were bone marrow fibrosis at diagnosis (97.7% vs. 87.5%, p = 0.040), progression to myelofibrosis (97.8% vs. 80.0%, p = 0.039), hypoalbuminemia ≤ 4.34 g/dL (97.7% vs. 94.9%, p = 0.001), and LDL cholesterol ≤ 98.5 mg/dL (100% vs. 91.1%, p = 0.015). JAK2 mutation was associated with inferior OS (p = 0.026). Median follow-up duration was 49.3 months (range: 5.8-83.0 months). Follow-up was longer in mutation-positive patients compared to mutation-negative (52.5 vs. 45.5 months, p = 0.018). According to IPSET scoring, 40.4% were low-risk, 25.6% intermediate, and 34% high-risk. R-IPSET classification yielded 26.9% very low, 13.5% low, 28.2% intermediate, and 31.4% high-risk. Kaplan-Meier survival analysis revealed statistically significant survival differences between R-IPSET groups (p = 0.027), but not among classic IPSET (p = 0.156). Readily assessable clinical and laboratory parameters can refine risk prediction for thrombosis and survival outcomes in ET. Further research is warranted to validate findings and inform individualized management approaches.

Predicting major adverse cardiac events using radiomics models on coronary computed tomography angiography: A systematic review and meta-analysis.

Characterization of biomarker profiles in patients with coronary artery disease: A prospective coronary computed tomography angiography study.

Continuous positive airway pressure as an alternative to deep-inspiration breath holding for mediastinal lymphoma radiotherapy.

Assessment of fatal cardiovascular disease risk using data-driven diabetes subgroups and SCORE2-Diabetes: a prospective, observational, population-based analysis of adults with diabetes in Mexico City.

Adolescent blood pressure guidelines rely on expert consensus because evidence on cardiovascular outcomes is limited. This study aimed to examine the link between adolescent blood pressure indices and early cardiovascular events. We conducted a cohort study among 902 741 adolescents aged 16 to 19 years who were evaluated for mandatory service from 1979 to 2019, excluding those with preexisting cardiometabolic conditions. Individuals were followed until 50 or death or insurance loss or December 31, 2021, whichever occurred first. Exposures included baseline blood pressure and American Academy of Pediatrics categories: normal (<120/<80 mm Hg), elevated (120/<80-129/<80 mm Hg), stage 1 (130/80-139/89 mm Hg), stage 2 (≥140/90 mm Hg), and hypertension (clinical diagnosis). The primary outcome was incident cardiovascular events (ischemic heart disease or cerebrovascular disease). Hazard ratios were estimated using Cox models adjusted for demographic, socioeconomic, and clinical confounders. During over 18 million person-years of follow-up, 6305 cardiovascular disease events were recorded, yielding an incidence rate of 0.35 per 1000 person-years. Increased diastolic, systolic, and mean arterial blood pressure were significantly associated with increased risk. Compared with the Normal group, adjusted hazard ratios for cardiovascular disease were 1.14 (95% CI, 1.08-1.22) for stage 1, 1.31 (1.20-1.44) for stage 2, and 2.42 (1.87-3.12) for hypertension. Risk in the stage 1 category was particularly sensitive to diastolic blood pressure. Higher blood pressure indices during adolescence were strongly associated with an elevated risk of early cardiovascular disease, highlighting the potential need to refine current guidelines to better reflect cardiovascular risk.

Cardiovascular magnetic resonance (CMR) is the gold standard imaging modality for evaluating cardiac structure, function, and myocardial tissue characteristics, yet its widespread adoption remains limited by cost, technological complexity, and infrastructure barriers-especially in low- and middle-income countries (LMICs). Recent advances in low-field (LF) CMR, particularly around 0.55 Tesla, demonstrate that strong diagnostic performance can be achieved despite reduced signal-to-noise ratios. Optimized hardware, including advanced gradient coils and radiofrequency systems, as well as AI-driven image reconstruction techniques, has greatly enhanced image quality. LF magnets offer notable advantages that reduce infrastructure demands and simplify protocols-both critical for lower resource settings. Clinical applications in cardiac function, tissue characterization, flow quantification, and even interventional procedures have expanded through sequences adapted to LFs, including novel approaches to myocardial mapping and real-time imaging. Concurrently, cryogen-free magnet designs and smaller system footprints have simplified installation and lowered operational costs. These developments bolster the feasibility of scaling CMR in environments where high-field scanners are prohibitively expensive or challenging to maintain. Moreover, greater accessibility to LF CMR could help bridge global disparities in cardiovascular diagnostics, enabling earlier detection of cardiomyopathies and ischemic heart disease in underserved regions. Although challenges remain-such as reduced signal-to-noise ratio, slower acquisition times, and limited availability of cardiac-specific hardware-ongoing innovations and collaborative global initiatives position LF CMR as a transformative, sustainable solution for modern cardiovascular care worldwide.

Ranolazine, approved for the symptomatic treatment of chronic stable angina, is currently indicated as an additional treatment when angina symptoms are not controlled with traditional drugs such as beta-blockers and calcium channel blockers. This review summarizes clinical studies that support current established recommendations for its use and discusses emerging evidence in clinical settings other than ischemic heart disease. A growing number of studies have shown a significant antiarrhythmic effect of this molecule, at both atrial and ventricular levels. Treatment with ranolazine has been associated with a reduced risk of atrial fibrillation and a greater likelihood of restoring sinus rhythm. Additionally, ranolazine is associated with a reduced risk of ventricular arrhythmias in various clinical settings. Ranolazine also plays a modest but clinically significant role in controlling glucose metabolism and is mentioned in the 2023 European Society of Cardiology guidelines on diabetes as a treatment capable of reducing glycated hemoglobin, especially in diabetic patients with poor metabolic control. In cardio-oncology, preclinical and clinical studies have shown a potential cardioprotective effect of ranolazine during certain chemotherapy treatments. In vitro and in vivo studies also suggest a favorable impact of ranolazine on the nervous system, with potential therapeutic effects, for example, in the treatment of neuropathic pain. Although the aforementioned contexts require further evaluation in targeted clinical trials, in all these areas ranolazine's pharmacodynamic profile suggests clinical benefits. Overall, a review that integrates current recommendations with a critical analysis of emerging therapeutic frontiers lays the foundation for an increasingly personalized therapeutic approach.

The Influence of Gender on the Outcomes of Revascularization for Aortoiliac Occlusive Disease.