Pub Date : 2025-11-04DOI: 10.1038/s41569-025-01230-2
Valtteri J. M. Muroke
Valtteri Muroke discusses the LoDoCo trial, in which treatment with low-dose colchicine was shown to reduce cardiovascular end points in patients with stable coronary artery disease, identifying anti-inflammatory therapy as an effective strategy for the secondary prevention of cardiovascular events.
{"title":"Colchicine in patients with cardiovascular disease","authors":"Valtteri J. M. Muroke","doi":"10.1038/s41569-025-01230-2","DOIUrl":"10.1038/s41569-025-01230-2","url":null,"abstract":"Valtteri Muroke discusses the LoDoCo trial, in which treatment with low-dose colchicine was shown to reduce cardiovascular end points in patients with stable coronary artery disease, identifying anti-inflammatory therapy as an effective strategy for the secondary prevention of cardiovascular events.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"23 1","pages":"7-7"},"PeriodicalIF":44.2,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145434395","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 : 2025-10-22DOI: 10.1038/s41569-025-01228-w
John G. F. Cleland
New evidence from five randomized trials suggests that withholding β-blockers after myocardial infarction (MI) is safe for carefully selected, low-risk patients. However, even if β-blockers are not required to treat ventricular dysfunction, hypertension or arrhythmias, it might still be wiser to continue treatment during the vulnerable period immediately after MI and withdraw treatment several months later.
{"title":"Safely implementing new knowledge from trials of withholding β-blockers after myocardial infarction","authors":"John G. F. Cleland","doi":"10.1038/s41569-025-01228-w","DOIUrl":"10.1038/s41569-025-01228-w","url":null,"abstract":"New evidence from five randomized trials suggests that withholding β-blockers after myocardial infarction (MI) is safe for carefully selected, low-risk patients. However, even if β-blockers are not required to treat ventricular dysfunction, hypertension or arrhythmias, it might still be wiser to continue treatment during the vulnerable period immediately after MI and withdraw treatment several months later.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 12","pages":"915-916"},"PeriodicalIF":44.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339414","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 : 2025-10-16DOI: 10.1038/s41569-025-01222-2
Dong Zhao,Yun Zhang,Jiguang Wang,Liu He,Yihua He,Changsheng Ma
Over the past decade, substantial progress has been made in China in improving health-care infrastructure and enacting national policies focused on the prevention of cardiovascular disease (CVD) and other non-communicable chronic diseases. Nevertheless, a considerable gap remains between the national goals for cardiovascular health and the burden of CVD in the Chinese population. The rapid advances in digital health-care platforms and the increasing adoption of artificial intelligence (AI) technologies across various health-care sectors underscore the potential for these innovative approaches to address existing challenges in CVD prevention. In this Review, we summarize the major challenges in implementing preventative strategies and highlight the core obstacles to achieving the national goals for cardiovascular health in China. Furthermore, we discuss the potential value of, and the challenges associated with, digital health-care and AI technology in the implementation of preventative strategies in China and other countries with similar needs.
{"title":"Cardiovascular disease prevention in China: challenges and opportunities in the artificial intelligence-enabled digital health era.","authors":"Dong Zhao,Yun Zhang,Jiguang Wang,Liu He,Yihua He,Changsheng Ma","doi":"10.1038/s41569-025-01222-2","DOIUrl":"https://doi.org/10.1038/s41569-025-01222-2","url":null,"abstract":"Over the past decade, substantial progress has been made in China in improving health-care infrastructure and enacting national policies focused on the prevention of cardiovascular disease (CVD) and other non-communicable chronic diseases. Nevertheless, a considerable gap remains between the national goals for cardiovascular health and the burden of CVD in the Chinese population. The rapid advances in digital health-care platforms and the increasing adoption of artificial intelligence (AI) technologies across various health-care sectors underscore the potential for these innovative approaches to address existing challenges in CVD prevention. In this Review, we summarize the major challenges in implementing preventative strategies and highlight the core obstacles to achieving the national goals for cardiovascular health in China. Furthermore, we discuss the potential value of, and the challenges associated with, digital health-care and AI technology in the implementation of preventative strategies in China and other countries with similar needs.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"11 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296170","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}
Women in cardiology have long faced barriers, but their leadership is redefining the field. By turning bias into opportunity and exclusion into inclusion, initiatives such as Women As One are opening doors, advancing equity and shaping a more innovative, representative future for cardiovascular care.
{"title":"Resolutions from the Women As One RISE 2025 conference for women in cardiology","authors":"Roxana Mehran, Karoline Bowman, Valeria Raona, Maria Rubini Giménez, Liesl Zühlke","doi":"10.1038/s41569-025-01225-z","DOIUrl":"10.1038/s41569-025-01225-z","url":null,"abstract":"Women in cardiology have long faced barriers, but their leadership is redefining the field. By turning bias into opportunity and exclusion into inclusion, initiatives such as Women As One are opening doors, advancing equity and shaping a more innovative, representative future for cardiovascular care.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 12","pages":"913-914"},"PeriodicalIF":44.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288387","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 : 2025-10-13DOI: 10.1038/s41569-025-01224-0
William A. E. Parker, Robert F. Storey
In patients with chronic coronary syndrome and an indication for oral anticoagulation, whether continuation of antiplatelet therapy in the initial phase after percutaneous coronary intervention is appropriate in Western populations with high atherothrombotic risk was previously unclear. The AQUATIC trial now shows that continuation of antiplatelet therapy increases the risk of both bleeding and ischaemic events in these patients.
{"title":"AQUATIC findings sink antiplatelet therapy for patients with chronic coronary syndrome requiring oral anticoagulants","authors":"William A. E. Parker, Robert F. Storey","doi":"10.1038/s41569-025-01224-0","DOIUrl":"10.1038/s41569-025-01224-0","url":null,"abstract":"In patients with chronic coronary syndrome and an indication for oral anticoagulation, whether continuation of antiplatelet therapy in the initial phase after percutaneous coronary intervention is appropriate in Western populations with high atherothrombotic risk was previously unclear. The AQUATIC trial now shows that continuation of antiplatelet therapy increases the risk of both bleeding and ischaemic events in these patients.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 12","pages":"921-922"},"PeriodicalIF":44.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145283447","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 : 2025-10-10DOI: 10.1038/s41569-025-01226-y
Irene Fernández-Ruiz
In patients with residual inflammation after acute myocardial infarction, antibody-mediated antagonism of the oxidized LDL receptor LOX1 does not induce significant regression of noncalcified atherosclerotic plaque volume over the course of 9 months compared with placebo, according to the GOLDILOX-TIMI 69 trial.
{"title":"LOX1 blockade does not modify atherosclerosis progression in patients with MI","authors":"Irene Fernández-Ruiz","doi":"10.1038/s41569-025-01226-y","DOIUrl":"10.1038/s41569-025-01226-y","url":null,"abstract":"In patients with residual inflammation after acute myocardial infarction, antibody-mediated antagonism of the oxidized LDL receptor LOX1 does not induce significant regression of noncalcified atherosclerotic plaque volume over the course of 9 months compared with placebo, according to the GOLDILOX-TIMI 69 trial.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 12","pages":"917-917"},"PeriodicalIF":44.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261395","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 : 2025-10-06DOI: 10.1038/s41569-025-01220-4
Nicholas W S Chew,Anurag Mehta,Rachel Goh,Jaycie Koh,Yiming Chen,Bryan Chong,Mark Y Chan,Muhammad Shahzeb Khan,Mark D Muthiah,Javed Butler,Arun J Sanyal,Laurence S Sperling
The growing epidemics of metabolic-dysfunction-associated steatotic liver disease, type 2 diabetes mellitus, obesity and cardiovascular disease are inextricably linked. Cardiovascular-liver-metabolic (CLM) diseases coexist and interact to constitute a synergy of epidemics (a syndemic), with shared mechanisms and socioeconomic influences. The goal of this Review is to construct this complex public-health issue into a unified framework, using epidemiological data to illustrate the current burden of disease and the trends in the CLM syndemic and to make projections for the future. We also discuss the challenges of promoting CLM health and the need for shared solutions. The proposed micro-meso-macro framework integrates strategies to improve risk prediction and precision prevention and to disentangle the competing risks within the CLM construct (micro), while keeping communities at the heart of CLM health promotion by ensuring access to healthy foods, healthy environments and metabolic interventions (meso). In addition, we propose interventions to eliminate inequities in the social and commercial determinants of health, from communities to healthcare systems (macro). Thus, multisystem interventions could address the trajectories of the CLM disease epidemics simultaneously.
{"title":"The global cardiovascular-liver-metabolic syndemic: epidemiology, trends and challenges.","authors":"Nicholas W S Chew,Anurag Mehta,Rachel Goh,Jaycie Koh,Yiming Chen,Bryan Chong,Mark Y Chan,Muhammad Shahzeb Khan,Mark D Muthiah,Javed Butler,Arun J Sanyal,Laurence S Sperling","doi":"10.1038/s41569-025-01220-4","DOIUrl":"https://doi.org/10.1038/s41569-025-01220-4","url":null,"abstract":"The growing epidemics of metabolic-dysfunction-associated steatotic liver disease, type 2 diabetes mellitus, obesity and cardiovascular disease are inextricably linked. Cardiovascular-liver-metabolic (CLM) diseases coexist and interact to constitute a synergy of epidemics (a syndemic), with shared mechanisms and socioeconomic influences. The goal of this Review is to construct this complex public-health issue into a unified framework, using epidemiological data to illustrate the current burden of disease and the trends in the CLM syndemic and to make projections for the future. We also discuss the challenges of promoting CLM health and the need for shared solutions. The proposed micro-meso-macro framework integrates strategies to improve risk prediction and precision prevention and to disentangle the competing risks within the CLM construct (micro), while keeping communities at the heart of CLM health promotion by ensuring access to healthy foods, healthy environments and metabolic interventions (meso). In addition, we propose interventions to eliminate inequities in the social and commercial determinants of health, from communities to healthcare systems (macro). Thus, multisystem interventions could address the trajectories of the CLM disease epidemics simultaneously.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"33 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235756","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 : 2025-10-02DOI: 10.1038/s41569-025-01211-5
Elmir Omerovic,Björn Redfors
Takotsubo syndrome, also known as broken heart syndrome, was first described in Japan in the 1990s and presents as acute heart failure caused by transient contractile dysfunction that mimics acute coronary syndrome but is not caused by acute coronary obstruction. Takotsubo syndrome accounts for as much as 2-3% of suspected coronary syndromes and is considerably more common in women than in men. In this Review, we discuss the historical background and clinical features of Takotsubo syndrome and our evolving understanding of its pathophysiology. The hallmark feature of Takotsubo syndrome is transient left ventricular dysfunction linked to emotional or physical stressors. Despite advances in our understanding of the clinical presentation and possible pathophysiological mechanisms of Takotsubo syndrome, this condition continues to challenge our fundamental understanding of human anatomy and physiology, particularly regarding how acute emotional and physical stressors can trigger such profound cardiovascular dysfunction. Although the definitive mechanisms remain elusive, current hypotheses largely centre on catecholamine surges and sympathetic nervous system hyperactivation. Diagnostic criteria have been developed by the Mayo Clinic and European Society of Cardiology working groups but, in the absence of randomized controlled clinical trials, no specific treatments for Takotsubo syndrome are available. In this Review, we highlight the complex pathophysiology of Takotsubo syndrome, with an emphasis on the interplay between emotional stress and cardiac health, and call for the development of evidence-based management protocols.
{"title":"Takotsubo syndrome: pathophysiological insights and innovations in patient care.","authors":"Elmir Omerovic,Björn Redfors","doi":"10.1038/s41569-025-01211-5","DOIUrl":"https://doi.org/10.1038/s41569-025-01211-5","url":null,"abstract":"Takotsubo syndrome, also known as broken heart syndrome, was first described in Japan in the 1990s and presents as acute heart failure caused by transient contractile dysfunction that mimics acute coronary syndrome but is not caused by acute coronary obstruction. Takotsubo syndrome accounts for as much as 2-3% of suspected coronary syndromes and is considerably more common in women than in men. In this Review, we discuss the historical background and clinical features of Takotsubo syndrome and our evolving understanding of its pathophysiology. The hallmark feature of Takotsubo syndrome is transient left ventricular dysfunction linked to emotional or physical stressors. Despite advances in our understanding of the clinical presentation and possible pathophysiological mechanisms of Takotsubo syndrome, this condition continues to challenge our fundamental understanding of human anatomy and physiology, particularly regarding how acute emotional and physical stressors can trigger such profound cardiovascular dysfunction. Although the definitive mechanisms remain elusive, current hypotheses largely centre on catecholamine surges and sympathetic nervous system hyperactivation. Diagnostic criteria have been developed by the Mayo Clinic and European Society of Cardiology working groups but, in the absence of randomized controlled clinical trials, no specific treatments for Takotsubo syndrome are available. In this Review, we highlight the complex pathophysiology of Takotsubo syndrome, with an emphasis on the interplay between emotional stress and cardiac health, and call for the development of evidence-based management protocols.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"1 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209087","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 : 2025-10-01DOI: 10.1038/s41569-025-01212-4
Julian F R Paton,Tymoteusz Żera,Rajanikanth Vadigepalli,Neil Herring,David J Paterson
The miniaturization of implantable sensors and actuators, combined with advances in interactive modelling and high-resolution imaging, is propelling the use of medical devices for counteracting impaired neural control of the cardiovascular system. In this Review, we discuss the current effectiveness of this technology for modulating autonomic activity in numerous cardiovascular conditions, including high blood pressure, heart failure and cardiac arrhythmias. We advocate for smarter closed-loop bionic devices fitted with feedback from multiple sensors to allow adaptive, state-dependent control, and discuss how the adoption of artificial intelligence technology would facilitate auto-personalization to meet the needs of patients. We also describe how transcriptomics of autonomic circuits can guide device-based approaches. Finally, the use of stem cell therapies to target sympathetic circuits more precisely will help to optimize the therapeutic effects of autonomic modulation for the treatment of arrhythmia. For bioelectronic medicine to achieve clinical utility in neurocardiology, these innovations must demonstrate improved efficacy beyond that offered by contemporary interventions.
{"title":"Multimodal, device-based therapeutic targeting of the cardiovascular autonomic nervous system.","authors":"Julian F R Paton,Tymoteusz Żera,Rajanikanth Vadigepalli,Neil Herring,David J Paterson","doi":"10.1038/s41569-025-01212-4","DOIUrl":"https://doi.org/10.1038/s41569-025-01212-4","url":null,"abstract":"The miniaturization of implantable sensors and actuators, combined with advances in interactive modelling and high-resolution imaging, is propelling the use of medical devices for counteracting impaired neural control of the cardiovascular system. In this Review, we discuss the current effectiveness of this technology for modulating autonomic activity in numerous cardiovascular conditions, including high blood pressure, heart failure and cardiac arrhythmias. We advocate for smarter closed-loop bionic devices fitted with feedback from multiple sensors to allow adaptive, state-dependent control, and discuss how the adoption of artificial intelligence technology would facilitate auto-personalization to meet the needs of patients. We also describe how transcriptomics of autonomic circuits can guide device-based approaches. Finally, the use of stem cell therapies to target sympathetic circuits more precisely will help to optimize the therapeutic effects of autonomic modulation for the treatment of arrhythmia. For bioelectronic medicine to achieve clinical utility in neurocardiology, these innovations must demonstrate improved efficacy beyond that offered by contemporary interventions.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"76 1","pages":""},"PeriodicalIF":49.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203620","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 : 2025-09-23DOI: 10.1038/s41569-025-01221-3
Karina Huynh
In the mouse ischaemic myocardium, neutrophils promote ventricular tachycardia via the secretion of resistin-like molecule-γ, according to a new study published in Science.
{"title":"Resistin-like molecule-γ promotes arrhythmia and cell death after MI","authors":"Karina Huynh","doi":"10.1038/s41569-025-01221-3","DOIUrl":"10.1038/s41569-025-01221-3","url":null,"abstract":"In the mouse ischaemic myocardium, neutrophils promote ventricular tachycardia via the secretion of resistin-like molecule-γ, according to a new study published in Science.","PeriodicalId":18976,"journal":{"name":"Nature Reviews Cardiology","volume":"22 12","pages":"917-917"},"PeriodicalIF":44.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127173","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}
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