International Journal of Cardiology Cardiovascular Risk and Prevention最新文献

{"title":"Efficacy and safety of proprotein convertase subtilisin/kexin type 9 inhibitors for adults with familial hypercholesterolemia: A network meta-analysis","authors":"Weiwei Ding ,&nbsp;Lingyao Sun ,&nbsp;Yun Shi,&nbsp;Lei Tian","doi":"10.1016/j.ijcrp.2025.200568","DOIUrl":"10.1016/j.ijcrp.2025.200568","url":null,"abstract":"<div><h3>Purpose</h3><div>The comparative efficacy and safety profiles of PCSK9 inhibitors in familial hypercholesterolemia (FH), including genotype-dependent treatment responses, remain unclear.</div></div><div><h3>Methods</h3><div>This systematic review was conducted in accordance with the Preferred Reporting Items for Meta-Analyses guidelines. A network meta-analysis of randomized clinical trials evaluating the use of PCSK9 inhibitors for the treatment of FH patients, including subgroup analyses of efficacy, was performed.</div></div><div><h3>Results</h3><div>Fifteen randomized clinical trials (n = 2954 patients) were included. All PCSK9 inhibitors significantly improved lipid parameters compared to control. In heterozygous FH (HeFH) populations, ongericimab showed the greatest reductions in LDL-C (mean difference [MD]: −74.98 %), ApoB (MD: −64.64 %), and Lp(a) (MD: −59.66 %), with SUCRA rankings of 68.7 %, 63.6 %, and 95.0 %, respectively. However, these results are based on a single trial and require further validation. No significant lipid-lowering effects were observed in HoFH patients. In terms of safety, lerodalcibep showed the most favorable profile for injection-site reactions and ALT &gt;3 × ULN, with SUCRA values of 98.5 % and 96.7 %, respectively. Inclisiran was associated with a significantly higher risk of injection-site reactions.</div></div><div><h3>Conclusion</h3><div>PCSK9 inhibitors generally show favorable efficacy and safety in FH patients. However, comparative rankings and point estimates should be interpreted with caution due to funnel plot asymmetry for LDL-C and imbalances in trial data. Ongericimab demonstrated promising results in HeFH, but further validation is required. Inclisiran's efficacy may be underestimated due to short-term follow-up. Monotherapy with PCSK9 inhibitors has limited efficacy in HoFH patients, highlighting the need for combination therapies.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"28 ","pages":"Article 200568"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of jugular, pulmonary and inferior vena cava ultrasound in decompensated heart failure in primary care","authors":"Victoria Cendrós ,&nbsp;Elena Navas ,&nbsp;Esther Miranzo ,&nbsp;Miguel Ángel Muñoz ,&nbsp;Laura Pirretas ,&nbsp;Leila Pifarrè ,&nbsp;Marco Inzoli ,&nbsp;Cristina Enjuanes ,&nbsp;Verónica Sierra ,&nbsp;Ana Roger ,&nbsp;Rosa Caballol-Angelats ,&nbsp;José María Verdú-Rotellar","doi":"10.1016/j.ijcrp.2026.200571","DOIUrl":"10.1016/j.ijcrp.2026.200571","url":null,"abstract":"<div><h3>Background</h3><div>Multiparametric ultrasound combining pulmonary and venous assessment (inferior vena cava [IVC] and internal jugular vein) is a feasible tool for characterizing hemodynamic congestion in patients with heart failure (HF) managed in Primary Care.</div></div><div><h3>Objective</h3><div>To evaluate the short-term prognostic value of pulmonary and venous ultrasound in patients with decompensated HF treated with intravenous diuretics in community settings.</div></div><div><h3>Methods</h3><div>Prospective cohort study including patients with decompensated HF attended between April 2024 and September 2025 across seven Primary Care teams of the Catalan Health Institute. Clinical, analytical, and ultrasound variables (IVC, jugular vein, and 8-zone lung ultrasound) were recorded. The primary outcome was a composite of death, HF hospitalisation, or new intravenous treatment within seven days.</div></div><div><h3>Results</h3><div>A total of 197 patients were included (56.4 % women; mean age 84.7 ± 7.5 years). Signs of venous and pulmonary congestion were frequent at inclusion. Within seven days, 14.8 % of patients experienced the composite outcome. In multivariate analysis, IVC collapsibility &lt;25 % (OR 3.70; 95 % CI 1.13–14.53; p = 0.039) and prior heart failure hospitalisation (OR 4.47; 95 % CI 1.48–14.10; p = 0.008) were independently associated with events, whereas lung and jugular ultrasound parameters were not.</div></div><div><h3>Conclusions</h3><div>Multiparametric ultrasound performed in Primary Care allows identification and quantification of hemodynamic congestion in decompensated HF. Among evaluated parameters, only IVC collapsibility showed independent short-term prognostic value, supporting its integration into community-based risk stratification models.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"28 ","pages":"Article 200571"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of antihypertensive drugs deprescribing in older adults: A systematic review and meta-analysis of randomized controlled trials","authors":"Amal A. Alsubaiei ,&nbsp;Saud A. Alyahya ,&nbsp;Ahmed Emara ,&nbsp;Shaikha J. Aldeyain ,&nbsp;Mohammad F. Alenezi ,&nbsp;Rawan A. Almutairi ,&nbsp;Batoul H. Aljaber ,&nbsp;Izuddin A. Rawashdeh ,&nbsp;Abdel-Rahman Qamar ,&nbsp;Abdullah M. Alharran","doi":"10.1016/j.ijcrp.2025.200570","DOIUrl":"10.1016/j.ijcrp.2025.200570","url":null,"abstract":"<div><h3>Background</h3><div>Although antihypertensive therapy is beneficial, aggressive treatment in frail, multimorbid older adults may increase adverse outcomes such as falls and hypotension. Deprescribing has emerged as a potential strategy to reduce these risks, but evidence regarding its safety remains limited. This systematic review and meta-analysis assessed the clinical outcomes of antihypertensive deprescribing in older adults.</div></div><div><h3>Methods</h3><div>PubMed, Scopus, CENTRAL, and Web of Science were searched for randomized controlled trials (RCTs) published up to October 2025 comparing antihypertensive deprescribing with usual care. Primary outcomes were all-cause mortality, cardiovascular mortality, and all-cause hospitalizations. Secondary outcomes included major adverse cardiovascular events (MACE), serious adverse events (SAEs), and falls. Pooled risk ratios (RRs) were calculated using a random-effects model.</div></div><div><h3>Results</h3><div>Four RCTs involving 2173 participants were included. Deprescribing showed no significant difference versus usual care in all-cause mortality (RR 1.02, 95 % CI 0.93–1.12), cardiovascular mortality (RR 1.11, 95 % CI 0.80–1.55), or all-cause hospitalizations (RR 0.95, 95 % CI 0.85–1.05). No significant differences were observed for MACE (RR 1.09, 95 % CI 0.90–1.33), MI (RR 0.76, 95 % CI 0.42–1.38), stroke (RR 1.12, 95 % CI 0.66–1.89), SAEs (RR 1.08, 95 % CI 0.90–1.30), or falls (RR 1.00, 95 % CI 0.89–1.13).</div></div><div><h3>Conclusion</h3><div>In older adults, a strategy of deprescribing antihypertensive drugs was not associated with an increased risk of mortality, MACE, or other SAEs. Despite that these findings provide reassuring evidence for deprescribing strategies, the current evidence base remains limited and uncertain, warranting caution and strict clinical monitoring.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"28 ","pages":"Article 200570"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of an assessment form on promoting in-hospital initiation of sodium–glucose cotransporter-2 inhibitors in hospitalized patients with heart failure","authors":"Takuya Okamoto ,&nbsp;Koichiro Matsumura ,&nbsp;Hiroyo Miyata ,&nbsp;Yuta Kimoto ,&nbsp;Kazue Hamamura ,&nbsp;Keiko Kato ,&nbsp;Shohei Hakozaki ,&nbsp;Eijiro Yagi ,&nbsp;Masafumi Ueno ,&nbsp;Kimiko Fujiwara ,&nbsp;Manabu Takegami ,&nbsp;Gaku Nakazawa","doi":"10.1016/j.ijcrp.2026.200577","DOIUrl":"10.1016/j.ijcrp.2026.200577","url":null,"abstract":"<div><h3>Background</h3><div>Despite the established benefits of in-hospital administration of sodium–glucose cotransporter-2 inhibitors (SGLT2i) in patients with heart failure (HF), their implementation remains insufficient. To investigate whether the use of an Assessment Form influences SGLT2i prescriptions at discharge among hospitalized patients with HF.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed consecutive patients with HF from a prospective registry between September 2024 and August 2025 after the implementation of an Assessment Form. Patients who died during hospitalization were excluded. The Assessment Form was completed collaboratively by physicians and nurses. Physicians checked whether guideline-directed medical therapy (including SGLT2i) had been prescribed, and documented the reasons if not initiated, while nurses evaluated the patients’ pre-hospital living conditions and self-care abilities. The primary endpoint was the prescription rate of SGLT2i at discharge according to the Assessment Form.</div></div><div><h3>Results</h3><div>Among the 208 analyzed patients (median age, 81 years [range, 75–87] years, 59 % male], the Assessment Form was used by 61.1 % (127/208). The prescription rate of SGLT2i at discharge was significantly higher in patients who completed the Assessment Form than in those who did not (65.4 % vs. 45.7 %, <em>p</em> &lt; 0.01). Multivariable logistic regression identified use of the Assessment Form as an independent factor associated with SGLT2i prescription at discharge (odds ratio 2.12, 95 % confidence interval 1.04–4.32, <em>p</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Implementation of an Assessment Form was associated with increased initiation of in-hospital SGLT2i therapy. The active use of such structured forms may help promote adherence to guideline-directed therapies during hospitalization for HF.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"28 ","pages":"Article 200577"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The sphingolipid metabolite sphingosine protects against hypertension by targeting metabolic-inflammatory crosstalk via the NLRP3 inflammasome","authors":"Wenjun Li ,&nbsp;Dan Zhou ,&nbsp;Yanmei Ji ,&nbsp;Meirong Yang ,&nbsp;Yunhong Yang ,&nbsp;Mengyao Dao ,&nbsp;Xianyu He ,&nbsp;Xingfang Jin","doi":"10.1016/j.ijcrp.2025.200562","DOIUrl":"10.1016/j.ijcrp.2025.200562","url":null,"abstract":"<div><h3>Background</h3><div>Hypertension is the most common chronic non-communicable disease and one of the most significant risk factors for cardiovascular and cerebrovascular diseases. Sphingosine (SPH) is a central bioactive lipid metabolite positioned at the crucial intersection of ceramide and sphingosine-1-phosphate (S1P) synthesis is increasingly implicated in cardiometabolic health. However, its precise role in the pathophysiology of hypertension and its interplay with inflammatory pathways remain largely unknown. This study aimed to research the therapeutic effects of SPH in hypertension and to explore its underlying mechanisms, focus on a key driver of sterile inflammation that the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome pathway.</div></div><div><h3>Methods</h3><div>An Angiotensin II (Ang II)-induced hypertensive mouse model and an in vitro model using human umbilical vein endothelial cells (HUVECs) were established. The effects of SPH administration on Ang II-induced hypertension, end-organ damage, and the activation status of the NLRP3 inflammasome were systematically evaluated.</div></div><div><h3>Results</h3><div>In vivo, Ang II infusion triggered significant hypertension, cardiac hypertrophy, and aortic fibrosis, which was accompanied by activation of the NLRP3 inflammasome in cardiovascular tissues. Therapeutic administration of SPH, in a manner comparable to the specific NLRP3 antagonist MCC950, markedly lowered blood pressure and attenuated these pathological changes. In vitro, SPH treatment effectively suppressed Ang II-induced NLRP3 inflammasome activation.</div><div>and released of pro-inflammatory cytokines in HUVECs. Furthermore, SPH exhibited direct protective effects on the endothelium by promoting HUVEC proliferation and against Ang II-induced injury. Mechanistically, SPH suppressed the expression and activation of key inflammasome components, including NLRP3, cleaved Caspase-1, and mature IL-1β and IL-18.</div></div><div><h3>Conclusions</h3><div>This study reveals a novel protective role for Sphingosine in hypertension, acting via the suppression of the NLRP3 inflammasome pathway to decrease inflammation and oxidative stress. These findings explore a new mechanistic link between sphingolipid metabolism and blood pressure regulation and highlight SPH as a potential therapeutic agent for targeting the critical series of metabolic dysregulation and inflammation in hypertensive cardiovascular disease.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"28 ","pages":"Article 200562"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk for coronary artery disease among individuals with normal low-density lipoprotein cholesterol (LDL-C) levels","authors":"Zhuqing Shi ,&nbsp;Ashley J. Mulford ,&nbsp;Jun Wei ,&nbsp;Huy Tran ,&nbsp;Annabelle Ashworth ,&nbsp;S. Lilly Zheng ,&nbsp;Brian T. Helfand ,&nbsp;David Duggan ,&nbsp;Henry M. Dunnenberger ,&nbsp;Peter J. Hulick ,&nbsp;David J. Davidson ,&nbsp;Arman Qamar ,&nbsp;Alan R. Sanders ,&nbsp;Jianfeng Xu","doi":"10.1016/j.ijcrp.2026.200572","DOIUrl":"10.1016/j.ijcrp.2026.200572","url":null,"abstract":"<div><h3>Background</h3><div>Low-density lipoprotein cholesterol (LDL-C) levels &lt;100 mg/dL are generally considered normal. We tested the controversial hypothesis that a subset of individuals with ‘normal’ LDL-C levels may have a non-negligible risk of coronary artery disease (CAD) due to inherited factors, including monogenic variants and polygenic risk scores (PGS).</div></div><div><h3>Methods</h3><div>A retrospective analysis of a prospective cohort from the Genomic Health Initiative at Endeavor Health, including 7880 participants without a prior diagnosis of CAD and not on statins at recruitment. Participants were stratified by baseline LDL-C levels and followed for incident CAD. The association of CAD risk with carrier status for pathogenic/likely pathogenic (P/LP) variants in <em>LDLR</em>, <em>APOB</em>, and <em>PCSK9</em>, as well as with PGS, was tested using Cox regression models adjusted for relevant covariates at baseline.</div></div><div><h3>Results</h3><div>Among participants, 31.2 % had LDL-C &lt;100 mg/dL (normal), 39.5 % had LDL-C 100–129 mg/dL, and 29.3 % had LDL-C ≥130 mg/dL. Over a median follow-up of 8 years, CAD was diagnosed in 5.3 %, 6.9 %, and 7.6 % of participants in these LDL-C groups, respectively. Among those with normal LDL-C, CAD incidence rose to 9.5 % in individuals with high genetic risk (P/LP variants and/or high PGS). Genetic risk was significantly associated with CAD in multivariable models (<em>P</em> &lt; 0.001). These findings were consistent in subjects of European and non-European ancestry.</div></div><div><h3>Conclusion</h3><div>Individuals with ‘normal’ LDL-C levels can have substantial CAD risk if they carry high genetic risk. These findings underscore the importance of incorporating genetic information into CAD risk assessment, even among those with traditionally normal lipid profiles.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"28 ","pages":"Article 200572"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extent and predictors of guideline-directed medical therapy optimization during cardiac rehabilitation in patients with heart failure","authors":"Corentin Nicolas ,&nbsp;Nicolas Girerd ,&nbsp;Kevin Duarte ,&nbsp;Olivier Huttin ,&nbsp;Karim Djaballah ,&nbsp;Jerome Felloni ,&nbsp;Guillaume Baudry ,&nbsp;Luca Monzo","doi":"10.1016/j.ijcrp.2026.200579","DOIUrl":"10.1016/j.ijcrp.2026.200579","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac rehabilitation (CR) may offer a structured framework for guideline-directed medical therapy (GDMT) optimization, but its real-world impact is uncertain. We aimed to quantify GDMT optimization and identify its clinical predictors during CR.</div></div><div><h3>Methods</h3><div>This retrospective single-centre study included patients hospitalized for acute HF with reduced (HFrEF) or mildly reduced (HFmrEF) ejection fraction who subsequently underwent first inpatient or ambulatory CR at Nancy University Hospital (2021–2024). Changes in GDMT optimization were evaluated using the HF prescription and the KCMO scores and expressed as adjusted standardized differences (ASD). Multivariable linear regression identified independent predictors of optimization.</div></div><div><h3>Results</h3><div>Among the 106 patients included (84 % HFrEF, mean age 59 years; 75 % male), baseline GDMT use was high, but doses were suboptimal. During CR, significant uptitration occurred across all major drug classes, including angiotensin receptor–neprilysin inhibitors (ASD: +22 %), beta-blockers (ASD: +21 %), mineralocorticoid receptor antagonists (ASD: +43 %), and sodium–glucose cotransporter 2 inhibitors (ASD: +45 %) (all p &lt; 0.001). Overall GDMT optimization improved significantly, as evidenced by increases in both the KCMO (ASD: +39.9) and HF prescription (ASD: +1.27) scores (both p &lt; 0.001), with consistent effects across inpatient and ambulatory settings. In multivariable analysis, higher loop-diuretic dose and prior treatment by HF specialists were associated with less optimization, whereas hypertension predicted greater intensification.</div></div><div><h3>Conclusions</h3><div>Cardiac rehabilitation after HF hospitalization promoted substantial GDMT optimization, especially in hypertensive patients. Higher loop-diuretic dose at admission predicted less optimization, suggesting that minimizing diuretic doses may ease GDMT titration.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"28 ","pages":"Article 200579"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of prescriber adherence to guideline-directed medical therapy for heart failure at Jimma Medical Center, Ethiopia","authors":"Getachew Yitayew Tarekegn ,&nbsp;Legese Chelkeba ,&nbsp;Mariam Dubale Deko ,&nbsp;Fisseha Nigussie Dagnew ,&nbsp;Samuel Berihun Dagnew ,&nbsp;Tilaye Arega Moges ,&nbsp;Sisay Sitotaw Anberbr ,&nbsp;Taklo Simeneh Yazie ,&nbsp;Addisu Assfaw Ayen ,&nbsp;Behailu Terefe Tesfaye","doi":"10.1016/j.ijcrp.2025.200555","DOIUrl":"10.1016/j.ijcrp.2025.200555","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure with reduced ejection fraction (HFrEF) requires guideline-directed medical therapy (GDMT) to reduce morbidity and mortality. However, adherence to GDMT is often suboptimal in resource-limited settings, such as the Jimma Medical Center, Ethiopia.</div></div><div><h3>Objectives</h3><div>To assess prescriber adherence to guideline-based medical therapy in heart failure at Jimma Medical Center, Ethiopia.</div></div><div><h3>Methods</h3><div>A convergent mixed-methods study was conducted from December 2023 to April 2024, enrolling 215 adult HFrEF patients. Prescriber adherence was measured using the Guideline Adherence Index (GAI) and QUALIFY scores. Semi-structured interviews with physicians explored the qualitative factors that affect adherence. Multinomial logistic regression identified the factors associated with adherence.</div></div><div><h3>Results</h3><div>Only 13.5 % of patients were discharged on all four recommended GDMT classes (ACEI/ARB, beta-blockers, MRAs, and SGLT2 inhibitors). Moderate and poor prescriber adherence occurred in 70.1 % and 16.3 % of the cases, respectively. Patient adherence was higher (74.9 % by MARS-5), yet 94 % were physically inactive, and 54.4 % regularly consumed salt. Insurance coverage (AOR: 4.81; p = 0.001), salt restriction (AOR: 6.62; p = 0.003), and shorter hospital stays (AOR: 0.90; p = 0.005) were linked to better adherence, whereas higher ejection fraction (AOR: 1.07; p = 0.005) and more comorbidities (AOR: 2.36; p = 0.037) predicted poorer adherence. The qualitative findings highlighted medication stock-outs, financial barriers, and clinical complexities as key challenges, with institutional support and multidisciplinary care as facilitators.</div></div><div><h3>Conclusions</h3><div>Prescriber and patient adherence to GDMT for HFrEF at Jimma Medical Center was suboptimal. Interventions targeting prescriber training, expansion of insurance coverage, patient education, and multidisciplinary care are needed to improve outcomes.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"28 ","pages":"Article 200555"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of COVID-19 pandemic on admission, management and mortality of pulmonary embolism in cancer patients","authors":"Dror Magen ,&nbsp;Adam Folman ,&nbsp;Marlon V. Gatuz ,&nbsp;Rami Abu Fanne ,&nbsp;Ariel Roguin ,&nbsp;Ofer Kobo","doi":"10.1016/j.ijcrp.2026.200580","DOIUrl":"10.1016/j.ijcrp.2026.200580","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary embolism (PE) is a leading cause of morbidity among cancer patients. The COVID-19 pandemic introduced new challenges to healthcare delivery. This study aimed to evaluate the impact of the COVID-19 pandemic on PE-related hospitalizations, treatment, and in-hospital outcomes in patients with active cancer.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis using the National Inpatient Sample database from 2016 to 2021. Patients with active cancer and a primary diagnosis of acute PE were categorized into three groups: pre-COVID-19 (2016–2019), peak COVID-19 (2020), and ongoing COVID-19 (2021). We compared baseline characteristics, in-hospital procedures, and clinical outcomes among these groups. Multivariable logistic regression was employed to assess associations between COVID-19 periods and outcomes.</div></div><div><h3>Results</h3><div>Among 170,630 patients with PE and cancer, admission rates decreased during the pandemic. Patients hospitalized during the COVID-19 pandemic more frequently presented with severe PE phenotypes, including saddle PE (9.7 % and 9.4 % vs. 7.5 %, p &lt; 0.001) and acute cor pulmonale (8.4 % and 8.9 % vs. 5.9 %, p &lt; 0.001). Thrombolysis-based therapies increased during the pandemic, whereas adjusted odds of catheter-directed embolectomy were lower. Despite more severe presentations, in-hospital mortality remained relatively stable (6.0 % pre-COVID-19, 6.0 % peak, 5.5 % ongoing; p = 0.004).</div></div><div><h3>Conclusion</h3><div>The COVID-19 pandemic led to decreased PE-related hospitalizations among cancer patients but was associated with more severe presentations and shifts in therapeutic strategies. Notably, in-hospital mortality remained stable, which may be consistent with maintained PE care pathways during the pandemic. These findings highlight the need for robust, adaptable healthcare systems to ensure continuity of care for high-risk populations during global health crises.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"28 ","pages":"Article 200580"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Bridging the clinical, molecular and genetic perspectives on myocarditis in post-COVID-19 era”","authors":"Siddharth Birla ,&nbsp;Arshia Angural ,&nbsp;Arya Madathumchalil ,&nbsp;Ritika V. Shende ,&nbsp;Sharvani V. Shastry ,&nbsp;Pallavi Kanyappa Shekar ,&nbsp;Manjappa Mahadevappa ,&nbsp;Prashant Vishwanath ,&nbsp;Akila Prashant","doi":"10.1016/j.ijcrp.2026.200576","DOIUrl":"10.1016/j.ijcrp.2026.200576","url":null,"abstract":"<div><div>Myocarditis is a non-familial inflammatory manifestation of the myocardium, primarily induced by viral infections, but it may also stem from bacterial pathogens, autoimmune disorders, or adverse drug reactions. Its diagnosis remains challenging due to heterogeneous and often non-specific clinical presentations. Recent epidemiological studies have indicated a markedly increased incidence of myocarditis following SARS-CoV-2 infection and mRNA COVID-19 vaccinations (to a lesser extent) compared to pre-pandemic statistics. While a significant number of cases follow a mild and self-limiting disease course, severe manifestations can lead to arrhythmias, heart failure, or even sudden cardiac death. Importantly, accumulating evidence indicates that even mild myocarditis confers an elevated long-term risk of adverse cardiovascular outcomes. Beyond clinical and imaging-based observations, recent advances highlight a critical role for host genetic susceptibility in modulating immune responses, myocardial injury, and disease severity. This review provides a comprehensive synthesis of the etiology, pathophysiological mechanisms, clinical spectrum, diagnostic approaches, and evidence-based management of COVID-19-associated myocarditis, while critically integrating emerging genetic and transcriptomic insights that may explain disease heterogeneity, variable inter-individual susceptibility, and long-term prognosis. By bridging clinical aspects with molecular and genetic frameworks, this review underscores the importance of personalized risk stratification, vigilant post-recovery surveillance, and targeted preventive strategies in the post-pandemic era.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"28 ","pages":"Article 200576"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}