Pub Date : 2025-08-28DOI: 10.1016/j.ijcrp.2025.200504
Brijesh Sathian, Abdalla Fadul, Yasir Alabbas, Hanadi Al Hamad
This correspondence critiques a 2025 study by Tsenov et al. on hypertrophic cardiomyopathy, highlighting discrepancies in reported symptom burden, psychological support, employment impact, diagnostic delays, activity restrictions, and medication tolerability. Recent evidence suggests improved outcomes with novel therapies and integrated care, challenging the study's conclusions. We advocate for reconciled analyses and future longitudinal studies to enhance patient-centered hypertrophic cardiomyopathy management.
{"title":"Addressing discrepancies in symptom and psychosocial assessments in hypertrophic cardiomyopathy","authors":"Brijesh Sathian, Abdalla Fadul, Yasir Alabbas, Hanadi Al Hamad","doi":"10.1016/j.ijcrp.2025.200504","DOIUrl":"10.1016/j.ijcrp.2025.200504","url":null,"abstract":"<div><div>This correspondence critiques a 2025 study by Tsenov et al. on hypertrophic cardiomyopathy, highlighting discrepancies in reported symptom burden, psychological support, employment impact, diagnostic delays, activity restrictions, and medication tolerability. Recent evidence suggests improved outcomes with novel therapies and integrated care, challenging the study's conclusions. We advocate for reconciled analyses and future longitudinal studies to enhance patient-centered hypertrophic cardiomyopathy management.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200504"},"PeriodicalIF":2.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925232","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}
Pub Date : 2025-08-26DOI: 10.1016/j.ijcrp.2025.200502
Gianluca Pagnoni , Dilia Giuggioli , Marco de Pinto , Arianna Maini , Elisa Battigaglia , Pierluca Macripò , Amelia Spinella , Giulia Olivetti , Antonio Manenti , Marcello Pinti , Giuseppe Boriani , Daniela Aschieri , Anna Vittoria Mattioli , Francesco Fedele , Francesca Coppi
Background
Vitamin D plays several roles beyond bone metabolism, potentially protecting the cardiovascular system. Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis and vascular dysfunction, carrying a high cardiovascular risk. However, the relationship between vitamin D insufficiency and cardiovascular involvement in SSc patients remains unclear. This study aims to assess the association between low vitamin D levels, echocardiographic parameters indicative of ventricular dysfunction, and cardiovascular risk factors in SSc patients.
Methods
A retrospective observational study involved 160 SSc patients undergoing echocardiography and serum 25-hydroxyvitamin D measurement. Patients were categorized into two groups: vitamin D insufficiency (<30 ng/mL) and normal levels (≥30 ng/mL). Echocardiographic parameters and cardiovascular risk factors were evaluated.
Results
Vitamin D insufficiency was detected in 68.9 % of patients. Patients with insufficient vitamin D had higher systolic pulmonary arterial pressure (PAPs; 37.68 ± 7.56 mmHg vs. 33.12 ± 6.17 mmHg; p = 0.004), reduced TAPSE/PAPs ratio (0.65 ± 0.13 vs. 0.72 ± 0.14; p = 0.021), increased interventricular septal thickness (8.17 ± 1.28 mm vs. 7.69 ± 1.18 mm; p = 0.028), and greater left ventricular end-diastolic diameter (44.06 ± 4.28 mm vs. 42.67 ± 3.44 mm; p = 0.037), indicating ventricular dysfunction. Vitamin D insufficiency significantly correlated with hypertension (OR = 2.31; p = 0.032), dyslipidemia (OR = 2.45; p = 0.015), and overweight/obesity (OR = 4.73; p = 0.002), but not with diabetes or smoking.
Conclusions
Vitamin D insufficiency may contribute to cardiovascular dysfunction in SSc patients. Monitoring vitamin D levels might improve cardiovascular risk stratification. Further studies are necessary to determine if supplementation could enhance cardiac outcomes.
除了骨骼代谢，维生素D还具有多种作用，可能保护心血管系统。系统性硬化症（SSc）是一种以纤维化和血管功能障碍为特征的自身免疫性疾病，具有较高的心血管风险。然而，SSc患者维生素D不足与心血管疾病之间的关系尚不清楚。本研究旨在评估SSc患者低维生素D水平、指示心室功能障碍的超声心动图参数和心血管危险因素之间的关系。方法对160例SSc患者进行超声心动图和血清25-羟基维生素D测定。患者分为两组：维生素D不足（≤30 ng/mL）和正常（≥30 ng/mL）。评价超声心动图参数及心血管危险因素。结果68.9%的患者存在维生素D不足。维生素D不足患者肺动脉收缩压升高（PAPs; 37.68±7.56 mmHg vs. 33.12±6.17 mmHg; p = 0.004）， TAPSE/PAPs比值降低（0.65±0.13 vs. 0.72±0.14;p = 0.021），室间隔厚度增加（8.17±1.28 mm vs. 7.69±1.18 mm; p = 0.028），左室舒张末期内径增大（44.06±4.28 mm vs. 42.67±3.44 mm; p = 0.037），提示心室功能障碍。维生素D不足与高血压（OR = 2.31; p = 0.032）、血脂异常（OR = 2.45; p = 0.015）和超重/肥胖（OR = 4.73; p = 0.002）显著相关，但与糖尿病或吸烟无关。结论维生素D不足可能导致SSc患者心血管功能障碍。监测维生素D水平可能改善心血管风险分层。需要进一步的研究来确定补充剂是否可以改善心脏预后。
{"title":"Vitamin D insufficiency and cardiovascular involvement in systemic sclerosis: Association with echocardiographic parameters and risk factors","authors":"Gianluca Pagnoni , Dilia Giuggioli , Marco de Pinto , Arianna Maini , Elisa Battigaglia , Pierluca Macripò , Amelia Spinella , Giulia Olivetti , Antonio Manenti , Marcello Pinti , Giuseppe Boriani , Daniela Aschieri , Anna Vittoria Mattioli , Francesco Fedele , Francesca Coppi","doi":"10.1016/j.ijcrp.2025.200502","DOIUrl":"10.1016/j.ijcrp.2025.200502","url":null,"abstract":"<div><h3>Background</h3><div>Vitamin D plays several roles beyond bone metabolism, potentially protecting the cardiovascular system. Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis and vascular dysfunction, carrying a high cardiovascular risk. However, the relationship between vitamin D insufficiency and cardiovascular involvement in SSc patients remains unclear. This study aims to assess the association between low vitamin D levels, echocardiographic parameters indicative of ventricular dysfunction, and cardiovascular risk factors in SSc patients.</div></div><div><h3>Methods</h3><div>A retrospective observational study involved 160 SSc patients undergoing echocardiography and serum 25-hydroxyvitamin D measurement. Patients were categorized into two groups: vitamin D insufficiency (<30 ng/mL) and normal levels (≥30 ng/mL). Echocardiographic parameters and cardiovascular risk factors were evaluated.</div></div><div><h3>Results</h3><div>Vitamin D insufficiency was detected in 68.9 % of patients. Patients with insufficient vitamin D had higher systolic pulmonary arterial pressure (PAPs; 37.68 ± 7.56 mmHg vs. 33.12 ± 6.17 mmHg; p = 0.004), reduced TAPSE/PAPs ratio (0.65 ± 0.13 vs. 0.72 ± 0.14; p = 0.021), increased interventricular septal thickness (8.17 ± 1.28 mm vs. 7.69 ± 1.18 mm; p = 0.028), and greater left ventricular end-diastolic diameter (44.06 ± 4.28 mm vs. 42.67 ± 3.44 mm; p = 0.037), indicating ventricular dysfunction. Vitamin D insufficiency significantly correlated with hypertension (OR = 2.31; p = 0.032), dyslipidemia (OR = 2.45; p = 0.015), and overweight/obesity (OR = 4.73; p = 0.002), but not with diabetes or smoking.</div></div><div><h3>Conclusions</h3><div>Vitamin D insufficiency may contribute to cardiovascular dysfunction in SSc patients. Monitoring vitamin D levels might improve cardiovascular risk stratification. Further studies are necessary to determine if supplementation could enhance cardiac outcomes.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200502"},"PeriodicalIF":2.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932068","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}
Pub Date : 2025-08-26DOI: 10.1016/j.ijcrp.2025.200501
Renzo Melchiori , Sara Diaz Saravia , Pablo M. Rubio , Lucas Szlaien , Romina Mouriño , Martin O'Flaherty , Manglio Rizzo , Alejandro Hita
Introduction
The inflammatory mechanisms of cancer can be associated with atherosclerosis development and progression. Although the incidence of events in secondary prevention following a first acute coronary syndrome is poorly documented.
Methods
A retrospective cohort study including patients who underwent a coronary angiography for first Acute Coronary Syndrome (ACS), and without prior history of Major Cardiovascular Events (MACE) from 2008 to 2023 was analyzed. Included patients were grouped according to the absence or presence of cancer: G1 non-oncologic, and G2 oncologic (either prior or current history). We compared the incidence rate ratio of MACE within 3 years after ACS between groups Time-to-event analysis was conducted through proportional Cox regression analysis, estimating hazard ratio, and corresponding 95 % confidence intervals (95 % CI)
Results
Of 937 patients who underwent a coronary angiography, 787 patients were included, of which 88.7 % (n = 698) presented without cancer. Over a median follow-up time of 48 months [IQR = 14–72], the incidence rate of MACE was 4.4 cases per 1000 patients/months of follow-up (n = 173 MACE events). When comparing both groups, the incidence rate ratio of MACE was 1.9 (95 % CI 1.24–2.99), significantly increased in the cancer group (P = 0.0032). Cancer was an independent predictor of MACE after adjustment for traditional cardiovascular risk factors (HR 1.84, 95 % CI 1.19–2.85; P = 0.006).
Conclusions
Patients with cancer represent a novel independent risk factor for MACE, even following secondary preventive therapies. These results highlight future endpoints for cardiovascular prevention and further public health interventions in this population.
癌症的炎症机制可能与动脉粥样硬化的发展和进展有关。尽管首次急性冠状动脉综合征后二级预防事件的发生率文献很少。方法回顾性分析2008 - 2023年首次急性冠脉综合征（ACS）行冠状动脉造影且无重大心血管事件（MACE）病史的患者。纳入的患者根据有无癌症分组：G1非肿瘤性和G2肿瘤性（既往或当前病史）。我们比较各组间ACS后3年内MACE的发生率比，通过比例Cox回归分析进行时间-事件分析，估计风险比和相应的95%可信区间（95% CI）。结果在937例接受冠状动脉造影的患者中，纳入787例患者，其中89.7% （n = 698）未出现癌症。中位随访时间为48个月[IQR = 14-72]， MACE发生率为每1000例患者/月4.4例（n = 173例MACE事件）。两组比较，MACE的发生率比为1.9 (95% CI 1.24-2.99)，肿瘤组明显升高（P = 0.0032）。校正传统心血管危险因素后，癌症是MACE的独立预测因子（HR 1.84, 95% CI 1.19-2.85; P = 0.006）。结论癌症患者是MACE的一个新的独立危险因素，即使在二级预防治疗后也是如此。这些结果强调了心血管预防和进一步公共卫生干预在这一人群中的未来终点。
{"title":"Cancer as a novel risk factor for major cardiovascular adverse events in secondary prevention","authors":"Renzo Melchiori , Sara Diaz Saravia , Pablo M. Rubio , Lucas Szlaien , Romina Mouriño , Martin O'Flaherty , Manglio Rizzo , Alejandro Hita","doi":"10.1016/j.ijcrp.2025.200501","DOIUrl":"10.1016/j.ijcrp.2025.200501","url":null,"abstract":"<div><h3>Introduction</h3><div>The inflammatory mechanisms of cancer can be associated with atherosclerosis development and progression. Although the incidence of events in secondary prevention following a first acute coronary syndrome is poorly documented.</div></div><div><h3>Methods</h3><div>A retrospective cohort study including patients who underwent a coronary angiography for first Acute Coronary Syndrome (ACS), and without prior history of Major Cardiovascular Events (MACE) from 2008 to 2023 was analyzed. Included patients were grouped according to the absence or presence of cancer: G1 non-oncologic, and G2 oncologic (either prior or current history). We compared the incidence rate ratio of MACE within 3 years after ACS between groups Time-to-event analysis was conducted through proportional Cox regression analysis, estimating hazard ratio, and corresponding 95 % confidence intervals (95 % CI)</div></div><div><h3>Results</h3><div>Of 937 patients who underwent a coronary angiography, 787 patients were included, of which 88.7 % (n = 698) presented without cancer. Over a median follow-up time of 48 months [IQR = 14–72], the incidence rate of MACE was 4.4 cases per 1000 patients/months of follow-up (n = 173 MACE events). When comparing both groups, the incidence rate ratio of MACE was 1.9 (95 % CI 1.24–2.99), significantly increased in the cancer group (P = 0.0032). Cancer was an independent predictor of MACE after adjustment for traditional cardiovascular risk factors (HR 1.84, 95 % CI 1.19–2.85; P = 0.006).</div></div><div><h3>Conclusions</h3><div>Patients with cancer represent a novel independent risk factor for MACE, even following secondary preventive therapies. These results highlight future endpoints for cardiovascular prevention and further public health interventions in this population.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200501"},"PeriodicalIF":2.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988271","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}
Pub Date : 2025-08-22DOI: 10.1016/j.ijcrp.2025.200500
Matilda Hurskainen , Juho Tynkkynen , Leo-Pekka Lyytikäinen , Terho Lehtimäki , Kjell Nikus , Jussi Hernesniemi
Background
Patients with coronary artery disease (CAD) have increased risk of ischemic stroke (IS). Our aim was to screen for significant electrocardiogram (ECG) features for IS risk in patients treated for acute coronary syndrome (ACS).
Methods
This retrospective registry study is based on 7760 ACS patients treated in Tays Heart Hospital (2007–2018) with follow-up for incident IS until December 31st, 2020. ECGs recorded during ACSs were analysed by the Marquette™ 12SL™ ECG Analysis Program version 24. Preliminary screening for ECG features was conducted using age- and sex adjusted Cox regression analysis and corrected by multiple testing (Bonferroni method). Highly correlated variables were excluded from the final age-, sex- and atrial fibrillation (AF)/atrial flutter (AFL) adjusted Cox regression and subdistribution hazard (SDH) multivariable analyses.
Results
From 7760 patients, 489 (6.3 %) suffered IS during a median follow-up of 5.7 years (IQR 3.1–8.8). In the final multivariable model, the main risk factors were premature ventricular complexes (PVCs) or aberrantly conducted complexes in AF/AFL (SDH, 2.01 [1.22–3.31]), left ventricular (LV) hypertrophy (LVH) by Sokolow-Lyon criteria (SDH, 1.52 [1.12–2.06]), S wave amplitude in lead V4 (SDH, 1.13 [1.05–1.21]) and negative P wave peak time in lead V2 (SDH, 1.12 [1.02–1.23]). T wave amplitude in lead V6 (SDH, 0.78 [0.69–0.88]) and T wave duration in lead aVL (SDH, 0.85 [0.78–0.92]) showed an inverse association with IS risk. The continuous variables correspond to 1 SD.
Conclusions
ECG markers demonstrating LV dysfunction, LVH and atriopathy associate with IS risk after ACS, although external validation is still required.
{"title":"Electrocardiogram markers predicting ischemic stroke after acute coronary syndrome","authors":"Matilda Hurskainen , Juho Tynkkynen , Leo-Pekka Lyytikäinen , Terho Lehtimäki , Kjell Nikus , Jussi Hernesniemi","doi":"10.1016/j.ijcrp.2025.200500","DOIUrl":"10.1016/j.ijcrp.2025.200500","url":null,"abstract":"<div><h3>Background</h3><div>Patients with coronary artery disease (CAD) have increased risk of ischemic stroke (IS). Our aim was to screen for significant electrocardiogram (ECG) features for IS risk in patients treated for acute coronary syndrome (ACS).</div></div><div><h3>Methods</h3><div>This retrospective registry study is based on 7760 ACS patients treated in Tays Heart Hospital (2007–2018) with follow-up for incident IS until December 31st<sup>,</sup> 2020. ECGs recorded during ACSs were analysed by the Marquette™ 12SL™ ECG Analysis Program version 24. Preliminary screening for ECG features was conducted using age- and sex adjusted Cox regression analysis and corrected by multiple testing (Bonferroni method). Highly correlated variables were excluded from the final age-, sex- and atrial fibrillation (AF)/atrial flutter (AFL) adjusted Cox regression and subdistribution hazard (SDH) multivariable analyses.</div></div><div><h3>Results</h3><div>From 7760 patients, 489 (6.3 %) suffered IS during a median follow-up of 5.7 years (IQR 3.1–8.8). In the final multivariable model, the main risk factors were premature ventricular complexes (PVCs) or aberrantly conducted complexes in AF/AFL (SDH, 2.01 [1.22–3.31]), left ventricular (LV) hypertrophy (LVH) by Sokolow-Lyon criteria (SDH, 1.52 [1.12–2.06]), S wave amplitude in lead V4 (SDH, 1.13 [1.05–1.21]) and negative P wave peak time in lead V2 (SDH, 1.12 [1.02–1.23]). T wave amplitude in lead V6 (SDH, 0.78 [0.69–0.88]) and T wave duration in lead aVL (SDH, 0.85 [0.78–0.92]) showed an inverse association with IS risk. The continuous variables correspond to 1 SD.</div></div><div><h3>Conclusions</h3><div>ECG markers demonstrating LV dysfunction, LVH and atriopathy associate with IS risk after ACS, although external validation is still required.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200500"},"PeriodicalIF":2.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913540","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}
Heart failure (HF) represents a major global public health challenge. This study aims to report the HF prevalence and disability in mainland China from 1990 to 2021, as well as the underlying etiology.
Methods
Data on HF-related prevalence and years lived with disability (YLDs) were obtained from Global Burden of Disease 2021 study for mainland China. Analyses were conducted by age and sex, with the burden rates expressed per 100,000 population. Age-period-cohort models were used to describe the trajectory of HF during 1990–2021. We analyzed the potential etiologies of HF, and performed decomposition analysis to quantify the main drivers of changes in the burden.
Results
In 2021, the prevalence and YLDs rates of HF in mainland China were 920.7 per 100,000 population (95 % uncertainty interval [UI]: 795.7–1080.8) and 90.7 per 100,000 population (95 % UI: 60.9–124.8), respectively. Both the prevalence and YLDs rates were higher in males than in females. From 1990 to 2021, the crude prevalence rate and crude YLDs rate of HF consistently increased, while the age-standardized prevalence rate and age-standardized rate of YLDs exhibited an double-peak trend. By 2021, ischemic heart disease had surpassed hypertensive heart disease as the leading cause of HF prevalence. Population aging was the largest contributor to changes in HF burden.
Conclusion
Our analysis of the GBD 2021 study indicated that the burden of HF is projected to increase substantially with an aging population. Strengthened societal efforts are urgently needed to prevent and manage HF from its causes, with particular attention to older adults.
{"title":"Burden and etiology of heart failure in mainland China from 1990 to 2021: Results from the GBD 2021 study","authors":"Zhang Fang , Xiaofang Luo , Yuhui Zhang , Jian Zhang","doi":"10.1016/j.ijcrp.2025.200497","DOIUrl":"10.1016/j.ijcrp.2025.200497","url":null,"abstract":"<div><h3>Background and aims</h3><div>Heart failure (HF) represents a major global public health challenge. This study aims to report the HF prevalence and disability in mainland China from 1990 to 2021, as well as the underlying etiology.</div></div><div><h3>Methods</h3><div>Data on HF-related prevalence and years lived with disability (YLDs) were obtained from Global Burden of Disease 2021 study for mainland China. Analyses were conducted by age and sex, with the burden rates expressed per 100,000 population. Age-period-cohort models were used to describe the trajectory of HF during 1990–2021. We analyzed the potential etiologies of HF, and performed decomposition analysis to quantify the main drivers of changes in the burden.</div></div><div><h3>Results</h3><div>In 2021, the prevalence and YLDs rates of HF in mainland China were 920.7 per 100,000 population (95 % uncertainty interval [UI]: 795.7–1080.8) and 90.7 per 100,000 population (95 % UI: 60.9–124.8), respectively. Both the prevalence and YLDs rates were higher in males than in females. From 1990 to 2021, the crude prevalence rate and crude YLDs rate of HF consistently increased, while the age-standardized prevalence rate and age-standardized rate of YLDs exhibited an double-peak trend. By 2021, ischemic heart disease had surpassed hypertensive heart disease as the leading cause of HF prevalence. Population aging was the largest contributor to changes in HF burden.</div></div><div><h3>Conclusion</h3><div>Our analysis of the GBD 2021 study indicated that the burden of HF is projected to increase substantially with an aging population. Strengthened societal efforts are urgently needed to prevent and manage HF from its causes, with particular attention to older adults.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200497"},"PeriodicalIF":2.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916332","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}
Pub Date : 2025-08-19DOI: 10.1016/j.ijcrp.2025.200496
Esteban Ortiz-Prado , Vladimir Ullauri Solorzano , Diana Moreira-Vera , Jorge Vasconez-Gonzalez , Juan S. Izquierdo-Condoy
Background
Misinformation linking COVID-19 vaccines to myocardial infarction (MI) has fueled vaccine hesitancy, particularly in high-mortality settings like Ecuador. This study examines the association between COVID-19 infections, vaccinations, and MI mortality to address these concerns.
Objective
To investigate whether COVID-19 vaccinations or infections are associated with increased MI mortality in Ecuador.
Methods
This descriptive observational ecological time-series study analyzed 710 days of national health registry data from January 2021 to December 2022. The dataset included daily counts of myocardial infarction (MI) deaths, COVID-19 deaths, and COVID-19 vaccinations. Time-series regression models were used to assess the association between MI mortality (outcome) and both COVID-19 deaths and vaccination rates (predictors), with analyses stratified by sex.
Results
We recorded a total of 26,637 myocardial infarction (MI) deaths and 24,066 COVID-19 deaths during the study period. Daily COVID-19 deaths were significantly associated with an increase in MI mortality (β = 0.08667, p < 0.0001, R2 = 0.2048), with a stronger effect observed in women (β = 0.1103, p < 0.0001) compared to men (β = 0.07343, p < 0.0001). Additionally, new COVID-19 cases were positively correlated with daily MI deaths (β = 0.002725, p < 0.0001, R2 = 0.2543). In contrast, COVID-19 vaccination rates were associated with a small but statistically significant protective effect against MI mortality (β = −1.188e–5, p = 0.0218, R2 = 0.0074).
Conclusion
COVID-19 infection, rather than vaccination, is strongly associated with increased myocardial infarction (MI) mortality in Ecuador. In contrast, the small but statistically significant protective effect observed for vaccination reinforces its cardiovascular safety and public health value. These findings directly counter prevailing misinformation linking vaccines to MI and provide evidence to support vaccination campaigns, particularly in high-risk and high-mortality settings.
将COVID-19疫苗与心肌梗死（MI）联系起来的错误信息加剧了对疫苗的犹豫，特别是在厄瓜多尔等死亡率高的国家。本研究探讨了COVID-19感染、疫苗接种和心肌梗死死亡率之间的关系，以解决这些问题。目的调查厄瓜多尔COVID-19疫苗接种或感染是否与心肌梗死死亡率增加有关。方法采用描述性观察生态时序研究，分析了2021年1月至2022年12月710天的国家健康登记数据。该数据集包括心肌梗死（MI）死亡、COVID-19死亡和COVID-19疫苗接种的每日计数。使用时间序列回归模型评估心肌梗死死亡率（结果）与COVID-19死亡率和疫苗接种率（预测因子）之间的关系，并按性别分层分析。结果在研究期间，共记录了26,637例心肌梗死（MI）死亡和24,066例COVID-19死亡。每日COVID-19死亡与心肌梗死死亡率增加显著相关（β = 0.08667, p < 0.0001, R2 = 0.2048），与男性（β = 0.07343, p < 0.0001）相比，女性（β = 0.1103, p < 0.0001）的影响更大。此外，新发COVID-19病例与每日心肌梗死死亡呈正相关（β = 0.002725, p < 0.0001, R2 = 0.2543）。相比之下，COVID-19疫苗接种率对心肌梗死死亡率的保护作用虽小，但具有统计学意义（β = - 1.188e-5, p = 0.0218, R2 = 0.0074）。结论与厄瓜多尔心肌梗死（MI）死亡率增加密切相关的是covid -19感染，而不是疫苗接种。相比之下，疫苗接种所观察到的虽小但统计上显著的保护作用强化了其心血管安全性和公共卫生价值。这些发现直接反驳了将疫苗与心肌梗死联系起来的普遍错误信息，并为支持疫苗接种运动提供了证据，特别是在高风险和高死亡率环境中。
{"title":"SARS-CoV-2 infection, not vaccination, the true association between COVID-19 and myocardial infarction mortality: A nationwide study in Ecuador","authors":"Esteban Ortiz-Prado , Vladimir Ullauri Solorzano , Diana Moreira-Vera , Jorge Vasconez-Gonzalez , Juan S. Izquierdo-Condoy","doi":"10.1016/j.ijcrp.2025.200496","DOIUrl":"10.1016/j.ijcrp.2025.200496","url":null,"abstract":"<div><h3>Background</h3><div>Misinformation linking COVID-19 vaccines to myocardial infarction (MI) has fueled vaccine hesitancy, particularly in high-mortality settings like Ecuador. This study examines the association between COVID-19 infections, vaccinations, and MI mortality to address these concerns.</div></div><div><h3>Objective</h3><div>To investigate whether COVID-19 vaccinations or infections are associated with increased MI mortality in Ecuador.</div></div><div><h3>Methods</h3><div>This descriptive observational ecological time-series study analyzed 710 days of national health registry data from January 2021 to December 2022. The dataset included daily counts of myocardial infarction (MI) deaths, COVID-19 deaths, and COVID-19 vaccinations. Time-series regression models were used to assess the association between MI mortality (outcome) and both COVID-19 deaths and vaccination rates (predictors), with analyses stratified by sex.</div></div><div><h3>Results</h3><div>We recorded a total of 26,637 myocardial infarction (MI) deaths and 24,066 COVID-19 deaths during the study period. Daily COVID-19 deaths were significantly associated with an increase in MI mortality (β = 0.08667, p < 0.0001, R<sup>2</sup> = 0.2048), with a stronger effect observed in women (β = 0.1103, p < 0.0001) compared to men (β = 0.07343, p < 0.0001). Additionally, new COVID-19 cases were positively correlated with daily MI deaths (β = 0.002725, p < 0.0001, R<sup>2</sup> = 0.2543). In contrast, COVID-19 vaccination rates were associated with a small but statistically significant protective effect against MI mortality (β = −1.188e–5, p = 0.0218, R<sup>2</sup> = 0.0074).</div></div><div><h3>Conclusion</h3><div>COVID-19 infection, rather than vaccination, is strongly associated with increased myocardial infarction (MI) mortality in Ecuador. In contrast, the small but statistically significant protective effect observed for vaccination reinforces its cardiovascular safety and public health value. These findings directly counter prevailing misinformation linking vaccines to MI and provide evidence to support vaccination campaigns, particularly in high-risk and high-mortality settings.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200496"},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890776","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}
Pub Date : 2025-08-19DOI: 10.1016/j.ijcrp.2025.200493
Frédéric Dutheil , Naira El Gritli , Valentin Magnon , Marek Zak , Reza Bagheri , Julien Steven Baker , Ukadike Chris Ugbolue , Jean-Baptiste Bouillon-Minois , Igor Tauveron , Luc Vialatte
Introduction
Pheochromocytoma is a catecholamine-producing tumor, that may alter cardiovascular activity. Conveniently, sympathovagal activity can be measured non-intrusively and pain-free through heart rate variability (HRV).
Objective
To conduct a systematic review and meta-analysis on the impact of pheochromocytoma on HRV parameters.
Methods
PubMed, Cochrane, Embase and Google Scholar were searched until October 10, 2024 for articles reporting HRV parameters in pheochromocytoma patients. Random-effects meta-analysis were conducted on each HRV parameters stratified on pheochromocytoma patients and controls and then comparing these two groups: RR intervals (or Normal-to-Normal intervals-NN), SDNN (Standard Deviation of RR intervals), RMSSD (square root of the mean difference of successive RR intervals), pNN50 (percentage of RR intervals with >50 ms of variation), LF (low-frequency) and HF (high-frequency), and LF/HF.
Results
We included six studies for a total of 178 patients: 94 with pheochromocytoma and 84 controls. Compared to controls, pheochromocytoma patients had higher vagal activity with higher HF (ES = 0.50, 95CI 0.04 to 0.96) and rMSSD (1.22, 0.09 to 2.35), and a tendency for higher pNN50 (1.14, −0.14 to 2.41). The sympathovagal balance tended to be higher in pheochromocytoma patients compared to controls with a tendency for a decreased LF/HF (−0.97, −2.03 to 0.09). Pheochromocytoma patients also tended to have lower RR-intervals than controls (−0.39, −0.86 to 0.07). Sympathetic activity (LF and SDNN) did not differ between pheochromocytoma and controls.
Conclusion
Paradoxically, pheochromocytoma patients have higher HRV. The sympathovagal balance may be explained by a desensitization of beta-adrenergic receptors consecutive to chronic high levels of catecholamine.
{"title":"Pheochromocytoma and heart rate variability: a systematic review and meta-analysis","authors":"Frédéric Dutheil , Naira El Gritli , Valentin Magnon , Marek Zak , Reza Bagheri , Julien Steven Baker , Ukadike Chris Ugbolue , Jean-Baptiste Bouillon-Minois , Igor Tauveron , Luc Vialatte","doi":"10.1016/j.ijcrp.2025.200493","DOIUrl":"10.1016/j.ijcrp.2025.200493","url":null,"abstract":"<div><h3>Introduction</h3><div>Pheochromocytoma is a catecholamine-producing tumor, that may alter cardiovascular activity. Conveniently, sympathovagal activity can be measured non-intrusively and pain-free through heart rate variability (HRV).</div></div><div><h3>Objective</h3><div>To conduct a systematic review and meta-analysis on the impact of pheochromocytoma on HRV parameters.</div></div><div><h3>Methods</h3><div>PubMed, Cochrane, Embase and Google Scholar were searched until October 10, 2024 for articles reporting HRV parameters in pheochromocytoma patients. Random-effects meta-analysis were conducted on each HRV parameters stratified on pheochromocytoma patients and controls and then comparing these two groups: RR intervals (or Normal-to-Normal intervals-NN), SDNN (Standard Deviation of RR intervals), RMSSD (square root of the mean difference of successive RR intervals), pNN50 (percentage of RR intervals with >50 ms of variation), LF (low-frequency) and HF (high-frequency), and LF/HF.</div></div><div><h3>Results</h3><div>We included six studies for a total of 178 patients: 94 with pheochromocytoma and 84 controls. Compared to controls, pheochromocytoma patients had higher vagal activity with higher HF (ES = 0.50, 95CI 0.04 to 0.96) and rMSSD (1.22, 0.09 to 2.35), and a tendency for higher pNN50 (1.14, −0.14 to 2.41). The sympathovagal balance tended to be higher in pheochromocytoma patients compared to controls with a tendency for a decreased LF/HF (−0.97, −2.03 to 0.09). Pheochromocytoma patients also tended to have lower RR-intervals than controls (−0.39, −0.86 to 0.07). Sympathetic activity (LF and SDNN) did not differ between pheochromocytoma and controls.</div></div><div><h3>Conclusion</h3><div>Paradoxically, pheochromocytoma patients have higher HRV. The sympathovagal balance may be explained by a desensitization of beta-adrenergic receptors consecutive to chronic high levels of catecholamine.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200493"},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864260","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}
This study investigated the impact of the diurnal temperature range (DTR) on hospitalizations related to cardiovascular disease (CVD). Following the PRISMA protocol, a systematic review and meta-analysis searched various databases for English studies using keywords related to DTR and CVD up to June 1, 2023. A random-effects meta-analysis model was utilized to aggregate previous estimates of DTR effects on CVD admissions. The findings revealed that a 1 °C increase in DTR is associated with a 1.5 % increase in all CVD hospitalizations (95 % CI: 0.2 %, 3 %). Additionally, for each 1 °C increase in DTR, admissions due to acute myocardial infarction (AMI) and heart failure increased by relative risks (RR) of 1.02 (95 % CI: 1.01, 1.03) and 1.04 (95 % CI: 1.03, 1.04), respectively. Our analysis showed that a 1 °C increase in DTR was associated with a 0.9 % increase in all CVD hospital admissions among those aged ≥65 years (95 % CI: 0.3 %, 1.6 %). The overall estimates indicated that DTR (per 1 °C increment) was associated with a 0.6 % (95 % CI: 0.2 %, 1.1 %) increase in females and a 1.7 % (95 % CI: 1.3 %, 2.2 %) increase in males. It was statistically significant for elderly individuals, corresponding to a 4.5 % increase in stroke risk (RR: 1.045 [95 % CI: 1.01, 1.07]). Overall, this study emphasizes that daily fluctuations in DTR increase the hospitalization risk in cardiovascular patients, highlighting the need to consider the effects of DTR on cardiovascular health, especially among vulnerable age and sex groups.
{"title":"Diurnal temperature range and hospital admission due to cardiovascular diseases: A systematic review and meta-analysis study","authors":"Hamidreza Aghababaeian , Mostafa Hadei , Mahsa Sepasian , Masoumeh Gharaee , Ladan Araghi Ahvazi , Rahim Sharafkhani , Mohammad Zarei","doi":"10.1016/j.ijcrp.2025.200487","DOIUrl":"10.1016/j.ijcrp.2025.200487","url":null,"abstract":"<div><div>This study investigated the impact of the diurnal temperature range (DTR) on hospitalizations related to cardiovascular disease (CVD). Following the PRISMA protocol, a systematic review and meta-analysis searched various databases for English studies using keywords related to DTR and CVD up to June 1, 2023. A random-effects meta-analysis model was utilized to aggregate previous estimates of DTR effects on CVD admissions. The findings revealed that a 1 °C increase in DTR is associated with a 1.5 % increase in all CVD hospitalizations (95 % CI: 0.2 %, 3 %). Additionally, for each 1 °C increase in DTR, admissions due to acute myocardial infarction (AMI) and heart failure increased by relative risks (RR) of 1.02 (95 % CI: 1.01, 1.03) and 1.04 (95 % CI: 1.03, 1.04), respectively. Our analysis showed that a 1 °C increase in DTR was associated with a 0.9 % increase in all CVD hospital admissions among those aged ≥65 years (95 % CI: 0.3 %, 1.6 %). The overall estimates indicated that DTR (per 1 °C increment) was associated with a 0.6 % (95 % CI: 0.2 %, 1.1 %) increase in females and a 1.7 % (95 % CI: 1.3 %, 2.2 %) increase in males. It was statistically significant for elderly individuals, corresponding to a 4.5 % increase in stroke risk (RR: 1.045 [95 % CI: 1.01, 1.07]). Overall, this study emphasizes that daily fluctuations in DTR increase the hospitalization risk in cardiovascular patients, highlighting the need to consider the effects of DTR on cardiovascular health, especially among vulnerable age and sex groups.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200487"},"PeriodicalIF":2.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878403","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}
Pub Date : 2025-08-14DOI: 10.1016/j.ijcrp.2025.200495
Guangbin Sun , Zeyu Chen , Hongyue Sun , Ze Yang , Dongfang Zhang , Liwen Zhang , Miao Liu , Xueli Yang
Research has indicated that PM2.5 exposure and low muscle strength may increase the risk of cardiovascular diseases (CVDs). However, inconsistent findings existed on PM2.5 constituents and CVDs, and little is known about the interplay between PM2.5 constituents and muscle strength. This study aimed to examine the associations of PM2.5 and its components with the incidence of CVDs and to further investigate the joint effects of pollutants and muscle strength on CVDs in a nationwide cohort from 2011–2018. PM2.5 and five constituents, including black carbon (BC), organic matter (OM), sulfate (SO42−), nitrate (NO3−), and ammonium (NH4+), were obtained from established spatiotemporal models and evaluated annually within the follow-up period. A time-varying Cox model was employed to investigate the impact of long-term exposure to PM2.5 and its components on CVDs. The joint effects on CVDs were examined under exposure to both pollutants (high vs. low) and muscle strength (normal vs. low). During the 7-year follow-up, 1971 cases of CVD occurred among the 10,413 participants. Significant associations of CVDs with a one standard deviation increase in each pollutant were observed, with HRs (95 % CIs) of 1.15 (1.09, 1.21) for PM2.5, 1.17 (1.11, 1.24) for OM, 1.16 (1.09, 1.22) for BC, 1.13 (1.07, 1.19) for NH4+, 1.14 (1.08, 1.19) for NO3− and 1.13 (1.07, 1.19) for SO42−. Higher risks of CVDs were obtained in participants exposed to high levels of PM2.5 constituents and low muscle strength. These findings suggest that reduced muscle strength may enhance the effects of PM2.5 constituents on cardiovascular damage.
{"title":"Joint associations of long-term exposure to fine particulate constituents and muscle strength with cardiovascular diseases: a nationwide cohort study in China","authors":"Guangbin Sun , Zeyu Chen , Hongyue Sun , Ze Yang , Dongfang Zhang , Liwen Zhang , Miao Liu , Xueli Yang","doi":"10.1016/j.ijcrp.2025.200495","DOIUrl":"10.1016/j.ijcrp.2025.200495","url":null,"abstract":"<div><div>Research has indicated that PM<sub>2.5</sub> exposure and low muscle strength may increase the risk of cardiovascular diseases (CVDs). However, inconsistent findings existed on PM<sub>2.5</sub> constituents and CVDs, and little is known about the interplay between PM<sub>2.5</sub> constituents and muscle strength. This study aimed to examine the associations of PM<sub>2.5</sub> and its components with the incidence of CVDs and to further investigate the joint effects of pollutants and muscle strength on CVDs in a nationwide cohort from 2011–2018. PM<sub>2.5</sub> and five constituents, including black carbon (BC), organic matter (OM), sulfate (SO<sub>4</sub><sup>2−</sup>), nitrate (NO<sub>3</sub><sup>−</sup>), and ammonium (NH<sub>4</sub><sup>+</sup>), were obtained from established spatiotemporal models and evaluated annually within the follow-up period. A time-varying Cox model was employed to investigate the impact of long-term exposure to PM<sub>2.5</sub> and its components on CVDs. The joint effects on CVDs were examined under exposure to both pollutants (high vs. low) and muscle strength (normal vs. low). During the 7-year follow-up, 1971 cases of CVD occurred among the 10,413 participants. Significant associations of CVDs with a one standard deviation increase in each pollutant were observed, with HRs (95 % CIs) of 1.15 (1.09, 1.21) for PM<sub>2.5</sub>, 1.17 (1.11, 1.24) for OM, 1.16 (1.09, 1.22) for BC, 1.13 (1.07, 1.19) for NH<sub>4</sub><sup>+</sup>, 1.14 (1.08, 1.19) for NO<sub>3</sub><sup>−</sup> and 1.13 (1.07, 1.19) for SO<sub>4</sub><sup>2−</sup>. Higher risks of CVDs were obtained in participants exposed to high levels of PM<sub>2.5</sub> constituents and low muscle strength. These findings suggest that reduced muscle strength may enhance the effects of PM<sub>2.5</sub> constituents on cardiovascular damage.</div></div>","PeriodicalId":29726,"journal":{"name":"International Journal of Cardiology Cardiovascular Risk and Prevention","volume":"27 ","pages":"Article 200495"},"PeriodicalIF":2.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890775","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号