Long-term outcomes of abnormal global longitudinal left ventricular strain during sepsis: A retrospective cohort study.

Prognostic significance of provocative spasm tests in patients with myocardial infarction with and without obstructive coronary arteries.

Percutaneous Coronary Intervention or Optimal Medical Therapy for Woven Coronary Anomaly (The Multicenter EVOLUTE-WOVEN Study).

Obstructive sleep apnea increases recurrent cardiovascular event risk in younger but not older patients with acute coronary syndrome: a prospective cohort study.

To evaluate 24-h ambulatory systolic blood pressure (BP), diastolic BP, and pulse rate patterns in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI), and their association with major adverse cardiac events (MACE). We conducted a prospective cohort study in ACS patients in who ambulatory BP monitoring was recorded during 2 weeks post-PCI. Clinical and laboratory factors correlated with dipping BP and pulse rate were analyzed by multivariable logistic regression analysis. A Cox proportional hazard model was applied to find the associated factor(s) with their MACE. We included 141 patients with ST-elevation myocardial infarction (STEMI) ( n = 47) and non-STEMI ( n = 94). The average age was 61.7 ± 11.1 years. Most of them are men (63.8%), had non-STEMI (66.7%), and triple vessel disease (51.1%). Upon assessment of nocturnal dipping BP, 22% were dippers, while the others were nondippers and reverse dippers (39.7 and 38.3%, respectively). Nocturnal hypertension, neutrophil-to-lymphocyte, and mean platelet volume were significantly associated with nondippers [adjusted odds ratio: 5.71, 95% confidence interval (CI): 2.51-12.99; 1.29, 95% CI: 1.01-1.63; 1.84, 95% CI: 1.16-2.93, respectively]. Nondipping pulse rate was found in 66.0% with a mean pulse rate of 75.4 ± 10.9 beats per minute (bpm) (awake) and 70.0 ± 11.2 bpm (sleep). Nondipping pulse rate was only found as an independent factor associated with MACE (hazard ratio: 2.69, 95% CI: 1.06-6.86, P = 0.04). This study demonstrated a significant association of MACE with nondipping pulse rate in patients with ACS who underwent PCI.

GLP-1-based therapies and limb outcomes in PAD: a systematic review and meta-analysis of real-world studies.

Impact of sodium-glucose cotransporter-2 inhibitors on clinical outcomes in patients with type 1 diabetes after dialysis-requiring acute kidney injury: a real-world cohort study.

Type 2 diabetes (T2D) management has shifted towards integrated cardiometabolic and renal risk reduction. Although glucagon-like peptide-1 receptor agonists (GLP-1RAs) and newer dual agonists show promising benefits, comparative evidence across agents and outcomes remains limited. To compare the cardiovascular and renal effects of modern GLP-1RAs (dulaglutide, semaglutide, lixisenatide), tirzepatide and cotadutide in high-risk T2D populations, and to explore multivariate relationships among clinical outcomes. A systematic review and network meta-analysis was conducted following PRISMA and Cochrane guidance (PROSPERO: CRD42024592825). Randomised controlled trials published between 2014 and 2025 with ≥ 6 months follow-up were included. Outcomes were cardiovascular death, myocardial infarction (MI), stroke, total major adverse cardiovascular events (MACE), eGFR and UACR. Random- and common-effects models were applied using netmeta (R). Treatment rankings were estimated using p-scores. Inconsistency, heterogeneity and small-study effects were evaluated. Correlation networks and principal component analysis (PCA) were performed to characterise interrelationships among clinical variables. Thirty-four trials were included, predominantly multinational CVOTs and CKD-focused studies. Semaglutide regimens showed the most consistent reduction in MACE and MI versus placebo, with the strongest effect observed for semaglutide combined with SGLT2 inhibition. Dulaglutide 1.5 mg and tirzepatide 15 mg significantly reduced stroke risk. Cardiovascular death estimates were largely imprecise with evidence of small-study effects. Renal effects differed by endpoint: eGFR changes were generally modest, whereas UACR showed marked reductions, particularly with dulaglutide plus dapagliflozin, DPP-4 inhibitors and semaglutide 1 mg. PCA confirmed strong cardiometabolic-renal interdependence. Cardiovascular and renal benefits of GLP-1-based therapies are outcome-specific. Semaglutide favoured MACE/MI reduction, dulaglutide and tirzepatide supported stroke prevention, and albuminuria outcomes were more responsive than eGFR. Further long-term head-to-head trials are needed.

Oral P2Y12 inhibitors only versus cangrelor in critically ill patients requiring percutaneous coronary interventions supported by microaxial flow pumps.

Evaluating Long-Term Outcomes Across eGFR Equations in Older Adults.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used in patients with type 2 diabetes mellitus and chronic kidney disease. However, their safety and efficacy in kidney transplant recipients remain uncertain. This study aims to evaluate the impact of GLP-1 RAs on all-cause mortality, major adverse cardiovascular events (MACE), and major adverse kidney events (MAKE) in adult kidney transplant recipients. We conducted a systematic review and meta-analysis of retrospective cohort studies reporting outcomes in adult kidney transplant recipients treated with GLP-1 RAs. A comprehensive search of PubMed, Embase and Cochrane Library was performed up to July 2025. Studies were included if they reported on at least one of the following outcomes: all-cause mortality, MACE, or MAKE. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. A total of four retrospective cohort studies involving 27,153 were included. A total of 5,479 (20.2%) patients received GLP-1 RAs. The median follow-up period across studies ranged from 1.38 to 3.1 years. GLP-1 RAs treatment was associated with a significant reduction in all-cause mortality, with an aHR of 0.52 (95% CI: 0.32-0.85, I² = 86%; p = 0.009). Similarly, a significant reduction in MAKEs was observed, with a pooled aHR of 0.62 (95% CI, 0.53-0.73; I² = 15%; p < 0.00001). In kidney transplant recipients with type 2 DM, GLP-1 RAs appear to be associated with reduced risks of all-cause mortality and MAKEs. However, given the high heterogeneity across studies and the influence of a single large cohort, these findings should be interpreted with caution and considered exploratory. Prospective studies are needed to confirm the long-term safety and efficacy of GLP-1 RAs in this population. The online version contains supplementary material available at 10.1007/s40200-025-01801-7.

Prognostic value of cardiac magnetic resonance pulmonary transit time and myocardial strain across different stages of ST-elevation myocardial infarction.

Mental disorders, psychotropic drug dispensation and unfavourable sociodemographic factors in patients with myocardial infarction with and without obstructive coronary arteries.

Drug-Coated Balloon Versus Drug-Eluting Stent for Coronary Revascularization in Patients With Chronic Kidney Disease: A Real-World Propensity-Matched Study.

This review addresses an increasingly recognized but still underdiagnosed group of patients presenting for noncardiac surgery with angina with nonobstructive coronary arteries (ANOCA) driven by coronary vasomotor dysfunction (CVDys). It synthesizes current knowledge on the pathophysiology, clinical presentation, diagnosis, and treatment of CVDys - encompassing endothelial dysfunction, epicardial and microvascular spasm, and structural and functional coronary microvascular dysfunction - and provides anesthesiologists with phenotype‑guided recommendations for preoperative assessment, intraoperative management, and postoperative care. Large angiographic cohorts indicate that up to 40% of patients with angina have ANOCA, with CVDys identifiable in most patients and associated with increased mortality and major adverse cardiovascular events. Contemporary guidelines acknowledge ANOCA, advocate noninvasive perfusion imaging and invasive coronary function testing for endotype definition, and recommend endotype‑tailored therapies such as statins, angiotensin-converting enzyme inhibitors, beta‑blockers, and calcium channel blockers, alongside with perioperative strategies emphasizing symptom stability, functional capacity, meticulous hemodynamic control, stress reduction, and continuation of disease‑modifying and antianginal therapy. CVDys is particularly prevalent in females and often associated with atypical symptoms, diagnostic delay, psychological burden, and impaired quality of life. A structured, phenotype‑driven anesthetic approach - prioritizing stable hemodynamics, avoidance of vascular spasm triggers, preservation of euvolemia and oxygen delivery, multimodal analgesia, perioperative stress reduction, early recognition of ischemic symptoms, and close collaboration with cardiology - may reduce ischemic events and improve outcomes in this high risk but frequently overlooked population.

This study aims to use routinely collected health data and trial emulation methodology to inform the design of a pragmatic randomized controlled trial (RCT) in people requiring multivessel coronary revascularization with severe symptomatic multivessel disease and high-risk characteristics, typically underrepresented in previous RCTs. Hospital episode statistics (HES) linked to Office for National Statistics will be the main data source. The study population is patients who require multivessel myocardial revascularization with at least one of the following high-risk characteristics: age >75 years, female, diagnosed with acute coronary syndrome, heart failure, chronic kidney disease, peripheral vascular disease, or intermediate frailty risk. The intervention procedure is coronary artery bypass grafting (CABG) and the control (reference) is percutaneous coronary intervention (PCI). Outcomes include all-cause and cardiovascular (CV) death, CV hospitalization, major adverse cardiovascular events, and major vascular complications or bleeding within 5 years of the index procedure. This study includes 3 stages of statistical analyses: (1) latent class analysis (LCA) to identify mutually exclusive patient clusters (latent classes) representing different clinical phenotypes, (2) instrumental variable analysis (IVA) to estimate the average treatment effect (ATE) in the whole population and each patient cluster; and (3) repeating stage 2 in an emulated trial population obtained by matching the HES population with individual participant data from an RCT. We will then co-design the protocol for a definitive clinical trial in partnership with patients, public, and stakeholders. This study introduces a novel, stepwise data science framework that integrates machine learning (unsupervised learning through LCA), causal inference, and trial emulation methods applied in big data, to design a future stratified and adaptive RCT of CABG versus PCI in high-risk patients. Our proposed approach fosters new collaborations among data scientists, trial methodologists, clinicians, and patient and public representatives in complex trial designs for diverse, high-risk populations. This study represents a new framework for co-production in trials of cardiovascular interventions, which offers a scalable model and has the potential to transfer to other disease areas. URL: https://www. gov/study/NCT05853536. Unique identifier: NCT05853536.

Effects of PCSK9 inhibitors on vascular function, lipid profile, and cardiovascular outcomes in patients with peripheral artery disease: A systematic review and meta-analysis.

Artificial Intelligence-Based ABI Dynamic Fluctuation Patterns Predict Adverse Vascular Events in PAD: A Multicenter Prospective Study.

Impact of Adherence to the Global Algorithm for Initial Crossing Strategy Selection in Chronic Total Occlusion Percutaneous Coronary Intervention.

Impact of Prophylactic Postoperative Vasopressors on Outcomes of Patients Undergoing Thoracic Endovascular Aortic Repair.