{"title":"Letter by Pyrpyris et al Regarding Article, \"Nonculprit Vulnerable Plaques and Prognosis in Myocardial Infarction With Versus Without ST-Segment Elevation: A PROSPECT II Substudy\".","authors":"Nikolaos Pyrpyris,Kyriakos Dimitriadis,Konstantinos Tsioufis","doi":"10.1161/circulationaha.125.076284","DOIUrl":"https://doi.org/10.1161/circulationaha.125.076284","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"142 1","pages":"e14-e15"},"PeriodicalIF":37.8,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1161/circulationaha.125.077511
Michael Maeng,Pernille G Thrane,David Erlinge,Akiko Maehara,Gregg W Stone
{"title":"Response by Maeng et al to Letters Regarding Article, \"Nonculprit Vulnerable Plaques and Prognosis in Myocardial Infarction With Versus Without ST-Segment Elevation: A PROSPECT II Substudy\".","authors":"Michael Maeng,Pernille G Thrane,David Erlinge,Akiko Maehara,Gregg W Stone","doi":"10.1161/circulationaha.125.077511","DOIUrl":"https://doi.org/10.1161/circulationaha.125.077511","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"38 1","pages":"e17-e18"},"PeriodicalIF":37.8,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1161/circulationaha.125.079034
Thomas Münzel,Thomas Lüscher,Christopher M Kramer,Keith Churchwell,Amam Mbakwem,Sanjay Rajagopalan
Non-communicable diseases (NCDs) account for 70% of global mortality and are responsible for over 38 million deaths annually, with cardiovascular disease (CVD) constituting most of these fatalities. While traditional risk factors for CVD have long been recognized, there is growing evidence that a rising prevalence of ubiquitous environmental risk factors (ERFs) may play an increasingly significant role in the genesis and rising prevalence of NCDs. ERFs include many interconnected anthropogenic exposures with cumulative compound health impacts, including air pollution, noise exposure, artificial light at night, plastic pollution, chemical pollution and the various effects of climate change, such as heat extremes, desert storms, floods and wildfires. Urbanization has intensified the impact of many ERFs and created intense exposure environments, highlighting the urgency and the opportunity to address these for maximum public health benefit. Impactful intervention often requires regulatory and policy-driven efforts addressing the genesis of exposures and minimizes their health impact, particularly in vulnerable populations who may contribute the least but may be impacted the most. Solutions must involve the development of resiliency and adaptation measures to a changing world, where the probability of sudden catastrophic and cascading events is much more likely. Political will and international cooperation are essential in establishing and enforcing regulations that promote cleaner air and water, quieter and natural biodiverse environments, and sustainable infrastructure in urban, and rural medical facilities. Integration of planetary and environmental health into cardiovascular care will be vital in reducing the burden of NCDs globally. By addressing the root causes of environmental stressors, it is possible to reduce the incidence of CVDs and promote healthier, just and sustainable societies.
{"title":"Environmental Stressors and Cardiovascular Health: Acting Locally for Global Impact in a Changing World: A Statement of the European Society of Cardiology, the American College of Cardiology, the American Heart Association, and the World Heart Federation.","authors":"Thomas Münzel,Thomas Lüscher,Christopher M Kramer,Keith Churchwell,Amam Mbakwem,Sanjay Rajagopalan","doi":"10.1161/circulationaha.125.079034","DOIUrl":"https://doi.org/10.1161/circulationaha.125.079034","url":null,"abstract":"Non-communicable diseases (NCDs) account for 70% of global mortality and are responsible for over 38 million deaths annually, with cardiovascular disease (CVD) constituting most of these fatalities. While traditional risk factors for CVD have long been recognized, there is growing evidence that a rising prevalence of ubiquitous environmental risk factors (ERFs) may play an increasingly significant role in the genesis and rising prevalence of NCDs. ERFs include many interconnected anthropogenic exposures with cumulative compound health impacts, including air pollution, noise exposure, artificial light at night, plastic pollution, chemical pollution and the various effects of climate change, such as heat extremes, desert storms, floods and wildfires. Urbanization has intensified the impact of many ERFs and created intense exposure environments, highlighting the urgency and the opportunity to address these for maximum public health benefit. Impactful intervention often requires regulatory and policy-driven efforts addressing the genesis of exposures and minimizes their health impact, particularly in vulnerable populations who may contribute the least but may be impacted the most. Solutions must involve the development of resiliency and adaptation measures to a changing world, where the probability of sudden catastrophic and cascading events is much more likely. Political will and international cooperation are essential in establishing and enforcing regulations that promote cleaner air and water, quieter and natural biodiverse environments, and sustainable infrastructure in urban, and rural medical facilities. Integration of planetary and environmental health into cardiovascular care will be vital in reducing the burden of NCDs globally. By addressing the root causes of environmental stressors, it is possible to reduce the incidence of CVDs and promote healthier, just and sustainable societies.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"92 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1161/CIRCULATIONAHA.125.076450
Peng Sun
{"title":"Letter by Sun Regarding Article, \"Nonculprit Vulnerable Plaques and Prognosis in Myocardial Infarction With Versus Without ST-Segment Elevation: A PROSPECT II Substudy\".","authors":"Peng Sun","doi":"10.1161/CIRCULATIONAHA.125.076450","DOIUrl":"https://doi.org/10.1161/CIRCULATIONAHA.125.076450","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"153 3","pages":"e16"},"PeriodicalIF":38.6,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1161/CIR.0000000000001413
Anping Cai, Antoni Bayes-Genis, Joanne Ryan, Yingqing Feng, James L Januzzi, Andrew M Tonkin, Jiazhen Zheng, Mark R Nelson, Johannes T Neumann, Robyn L Woods, Cammie Tran, Aletta E Schutte, Ambarish Pandey, Lin Yee Chen, Lin Liu, Junguo Zhang, John J McNeil, Lawrence Beilin, Hung-Fat Tse, Gianfranco Parati, Zhen Zhou
{"title":"Correction to: Heart Stress and Blood Pressure Management in Older Adults: Post Hoc Analysis of the ASPREE Trial.","authors":"Anping Cai, Antoni Bayes-Genis, Joanne Ryan, Yingqing Feng, James L Januzzi, Andrew M Tonkin, Jiazhen Zheng, Mark R Nelson, Johannes T Neumann, Robyn L Woods, Cammie Tran, Aletta E Schutte, Ambarish Pandey, Lin Yee Chen, Lin Liu, Junguo Zhang, John J McNeil, Lawrence Beilin, Hung-Fat Tse, Gianfranco Parati, Zhen Zhou","doi":"10.1161/CIR.0000000000001413","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001413","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"153 3","pages":"e20"},"PeriodicalIF":38.6,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20Epub Date: 2025-11-07DOI: 10.1161/CIRCULATIONAHA.125.075388
Sergio Raposeiras-Roubín, Emad Abu Assi, César Jiménez Méndez, Ester Mínguez de la Guía, José Ángel Pérez Rivera, Marta Marcos Mangas, Ana Ayesta, Aitor Uribarri, Pablo Jorge Pérez, Pablo José Antúnez Muinos, Clara Bonanad Lozano, Anna Carrasquer, Ana Viana-Tejedor, Pablo Domínguez Erquicia, Alberto Villar Ruiz, Macarena López Vázquez, Lara Aguilar Iglesias, Alberto Alén Andrémar, Maria Vidal Burdeus, Marta Maria Martin Cabeza, María Cristina González Cambeiro, Daznia Bompart, Juan Carlos Gómez Polo, Marina Teresa García García, Ana Merino Merino, José Rozado, José Antonio Panera de la Mano, Francisco Salmerón Martínez, Ester Sánchez Corral, Isabel Santos Sánchez, Ángel Víctor Hernández-Martos, Andrés Antelo Abejón, Andrés Iñiguez Romo, Miguel Corbi-Pascual, Albert Ariza-Solé
Background: Current guidelines recommend a stepwise strategy to achieve low-density lipoprotein cholesterol (LDL-C) goals after acute coronary syndrome (ACS). Earlier intensive strategies based on a combination of lipid-lowering therapies (LLTs) could be useful from the onset of ACS. However, the role of bempedoic acid in ACS, particularly when combined with high-intensity statins and ezetimibe, remains uncertain. The aim of ES-BempedACS (Efficacy and Security of Bempedoic Acid in Acute Coronary Syndrome) was to compare the efficacy and safety of triple LLT (high-dose, high-intensity statin+ezetimibe+bempedoic acid) versus standard of care (high-dose, high-intensity statin+ezetimibe) after ACS.
Methods: ES-BempedACS is a multicenter, independent, pragmatic, prospective, randomized, open, blinded end point controlled trial conducted in 12 Spanish hospitals between November 2023 and October 2024. The primary end point was the proportion of patients achieving LDL-C <55 mg/dL (<1.4 mmol/L) at 8 weeks after ACS, comparing triple LLT with standard of care.
Results: A total of 206 patients (59.5±10.9 years of age [mean±SD]; 21.4% women) were randomized within the first 72 hours of ACS to triple LLT or standard therapy of high-intensity statin+ezetimibe (ie, dual LLT). The baseline LDL-C level was 133.6±28.8 mg/dL. After 8 weeks, the LDL-C level was reduced to <55 mg/dL in 59.4% of patients in the triple LLT group compared with 53.1% in the control group (dual LLT; P=0.376). The percentage change in LDL-C level was 57.5±17.8% and 56.9±18.5% in the triple and dual LLT groups, respectively (P=0.823). Triple versus dual LLT showed similar results in reduction of non-high-density lipoprotein cholesterol levels (49.0±25.4 in triple LLT versus 49.1±31.2 in dual LLT; P=0.970) and triglyceride levels (14.9±36.9 in triple LLT versus 16.8±36.0 in dual LLT;) P=0.718), without differences in adverse events.
Conclusions: Both dual and triple LLT after ACS allow for high rates (>50%) of adequate LDL-C control (<55 mg/dL) at 8 weeks. Adding bempedoic acid to statin-ezetimibe therapy in the setting of ACS is safe but failed to improve the percentage of patients achieving the LDL-C goal (<55 mg/dL) at 8 weeks. Larger, randomized studies are needed to confirm our findings.
{"title":"Triple Versus Dual Lipid-Lowering Therapy in Acute Coronary Syndrome: The ES-BempedACS Randomized Clinical Trial.","authors":"Sergio Raposeiras-Roubín, Emad Abu Assi, César Jiménez Méndez, Ester Mínguez de la Guía, José Ángel Pérez Rivera, Marta Marcos Mangas, Ana Ayesta, Aitor Uribarri, Pablo Jorge Pérez, Pablo José Antúnez Muinos, Clara Bonanad Lozano, Anna Carrasquer, Ana Viana-Tejedor, Pablo Domínguez Erquicia, Alberto Villar Ruiz, Macarena López Vázquez, Lara Aguilar Iglesias, Alberto Alén Andrémar, Maria Vidal Burdeus, Marta Maria Martin Cabeza, María Cristina González Cambeiro, Daznia Bompart, Juan Carlos Gómez Polo, Marina Teresa García García, Ana Merino Merino, José Rozado, José Antonio Panera de la Mano, Francisco Salmerón Martínez, Ester Sánchez Corral, Isabel Santos Sánchez, Ángel Víctor Hernández-Martos, Andrés Antelo Abejón, Andrés Iñiguez Romo, Miguel Corbi-Pascual, Albert Ariza-Solé","doi":"10.1161/CIRCULATIONAHA.125.075388","DOIUrl":"10.1161/CIRCULATIONAHA.125.075388","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend a stepwise strategy to achieve low-density lipoprotein cholesterol (LDL-C) goals after acute coronary syndrome (ACS). Earlier intensive strategies based on a combination of lipid-lowering therapies (LLTs) could be useful from the onset of ACS. However, the role of bempedoic acid in ACS, particularly when combined with high-intensity statins and ezetimibe, remains uncertain. The aim of ES-BempedACS (Efficacy and Security of Bempedoic Acid in Acute Coronary Syndrome) was to compare the efficacy and safety of triple LLT (high-dose, high-intensity statin+ezetimibe+bempedoic acid) versus standard of care (high-dose, high-intensity statin+ezetimibe) after ACS.</p><p><strong>Methods: </strong>ES-BempedACS is a multicenter, independent, pragmatic, prospective, randomized, open, blinded end point controlled trial conducted in 12 Spanish hospitals between November 2023 and October 2024. The primary end point was the proportion of patients achieving LDL-C <55 mg/dL (<1.4 mmol/L) at 8 weeks after ACS, comparing triple LLT with standard of care.</p><p><strong>Results: </strong>A total of 206 patients (59.5±10.9 years of age [mean±SD]; 21.4% women) were randomized within the first 72 hours of ACS to triple LLT or standard therapy of high-intensity statin+ezetimibe (ie, dual LLT). The baseline LDL-C level was 133.6±28.8 mg/dL. After 8 weeks, the LDL-C level was reduced to <55 mg/dL in 59.4% of patients in the triple LLT group compared with 53.1% in the control group (dual LLT; <i>P</i>=0.376). The percentage change in LDL-C level was 57.5±17.8% and 56.9±18.5% in the triple and dual LLT groups, respectively (<i>P</i>=0.823). Triple versus dual LLT showed similar results in reduction of non-high-density lipoprotein cholesterol levels (49.0±25.4 in triple LLT versus 49.1±31.2 in dual LLT; <i>P</i>=0.970) and triglyceride levels (14.9±36.9 in triple LLT versus 16.8±36.0 in dual LLT;) <i>P</i>=0.718), without differences in adverse events.</p><p><strong>Conclusions: </strong>Both dual and triple LLT after ACS allow for high rates (>50%) of adequate LDL-C control (<55 mg/dL) at 8 weeks. Adding bempedoic acid to statin-ezetimibe therapy in the setting of ACS is safe but failed to improve the percentage of patients achieving the LDL-C goal (<55 mg/dL) at 8 weeks. Larger, randomized studies are needed to confirm our findings.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrialsregister.eu; Unique identifier: 2021-006550-31.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":" ","pages":"140-149"},"PeriodicalIF":38.6,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1161/CIR.0000000000001414
Nancy Song, Tariku J Beyene, Daniel K Amponsah, Steven M Asch, Paul A Heidenreich, Celina M Yong
{"title":"Correction to: Novel Use of Z Codes to Identify Social Determinants of Cardiovascular Disease Outcomes.","authors":"Nancy Song, Tariku J Beyene, Daniel K Amponsah, Steven M Asch, Paul A Heidenreich, Celina M Yong","doi":"10.1161/CIR.0000000000001414","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001414","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"153 3","pages":"e19"},"PeriodicalIF":38.6,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1161/circulationaha.125.077933
Jinlong He,Yi Zhu
{"title":"Selective mRNA Translation: A New Player in Ferroptosis After Myocardial Infarction.","authors":"Jinlong He,Yi Zhu","doi":"10.1161/circulationaha.125.077933","DOIUrl":"https://doi.org/10.1161/circulationaha.125.077933","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"275 1","pages":"185-188"},"PeriodicalIF":37.8,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1161/circulationaha.125.077650
Jordana B Cohen,Daniel W Jones,John M Flack
{"title":"From Race-Based to Equity-Informed Antihypertensive Medication Selection: Rationale for the 2025 AHA/ACC Guideline Change.","authors":"Jordana B Cohen,Daniel W Jones,John M Flack","doi":"10.1161/circulationaha.125.077650","DOIUrl":"https://doi.org/10.1161/circulationaha.125.077650","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"63 1","pages":"137-139"},"PeriodicalIF":37.8,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20Epub Date: 2025-11-10DOI: 10.1161/CIRCULATIONAHA.125.078155
Ramzi Dudum, Sneha S Jain, Domenico Mastrodicasa, Adam Furst, Shiqin Xu, Summer Ngo, David Eng, Nishith Khandwala, Doug Sousa, Akshay Chaudhari, Curtis Langlotz, Alexander T Sandhu, David J Maron, Fatima Rodriguez
{"title":"Effects of Real-Time Notification of AI-Detected Incidental Coronary Artery Calcium on Statin Prescription: The NOTIFY-PICTURE Trial.","authors":"Ramzi Dudum, Sneha S Jain, Domenico Mastrodicasa, Adam Furst, Shiqin Xu, Summer Ngo, David Eng, Nishith Khandwala, Doug Sousa, Akshay Chaudhari, Curtis Langlotz, Alexander T Sandhu, David J Maron, Fatima Rodriguez","doi":"10.1161/CIRCULATIONAHA.125.078155","DOIUrl":"10.1161/CIRCULATIONAHA.125.078155","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":" ","pages":"210-212"},"PeriodicalIF":38.6,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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