R. Providencia, Hussam Ali, A. Creta, Sérgio Barra, P. Kanagaratnam, Richard J Schilling, M. Farkowski, R. Cappato
Catheter ablation is the most effective rhythm-control option in patients with atrial fibrillation (AF) and is currently considered and option mainly for improving symptoms. We aimed to assess the impact of catheter ablation on hard clinical outcomes. We performed a systematic review of randomized controlled trials comparing catheter ablation vs. optimized medical treatment. We searched MEDLINE, EMBASE and CENTRAL on January 8th, 2024, for trials published ≤10 years. We pooled data risk ratio (RR) & mean differences (MD), with 95% confidence interval (CI), and calculated the Number Needed to Treat (NNT). Sub-group and sensitivity analyses were performed for presence/absence of heart failure (HF), paroxysmal/persistent AF, early ablation, higher/lower quality, and published ≤5 vs >5 years. Twenty-two randomized controlled trials were identified, including 6,400 patients followed for 6 to 52 months. All primary endpoints were significantly reduced by catheter ablation vs. medical management: all-cause hospitalization (RR=0.57, 95%CI 0.39-0.85, P=0.006), AF relapse (RR=0.48, 95%CI 0.39-0.58, P<0.00001), all-cause mortality (RR=0.69, 95%CI 0.56-0.86, P=0.0007, NNT=44.7) driven trials with HF patients. A benefit was also demonstrated for all secondary endpoints: cardiovascular mortality (RR=0.55, 95%CI 0.34-0.87), cardiovascular (RR=0.83, 95%CI 0.71-0.96) and HF hospitalizations (RR=0.71, 95%CI 0.56-0.89), AF burden (MD=20.6%, 95%CI 5.6-35.5), LVEF recovery (MD=5.7%, 95%CI 3.5-7.9) and quality of life (MLHFQ, AFEQT & SF-36 scales). Catheter ablation significantly reduced hospitalizations, AF burden and relapse, and improved quality of life. An impact on hard clinical outcomes, with an important mortality reduction and improvement in LVEF, was seen for patients with AF and HF.
{"title":"Catheter ablation for atrial fibrillation and impact on clinical outcomes","authors":"R. Providencia, Hussam Ali, A. Creta, Sérgio Barra, P. Kanagaratnam, Richard J Schilling, M. Farkowski, R. Cappato","doi":"10.1093/ehjopen/oeae058","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae058","url":null,"abstract":"\u0000 \u0000 \u0000 Catheter ablation is the most effective rhythm-control option in patients with atrial fibrillation (AF) and is currently considered and option mainly for improving symptoms. We aimed to assess the impact of catheter ablation on hard clinical outcomes.\u0000 \u0000 \u0000 \u0000 We performed a systematic review of randomized controlled trials comparing catheter ablation vs. optimized medical treatment. We searched MEDLINE, EMBASE and CENTRAL on January 8th, 2024, for trials published ≤10 years. We pooled data risk ratio (RR) & mean differences (MD), with 95% confidence interval (CI), and calculated the Number Needed to Treat (NNT). Sub-group and sensitivity analyses were performed for presence/absence of heart failure (HF), paroxysmal/persistent AF, early ablation, higher/lower quality, and published ≤5 vs >5 years.\u0000 \u0000 \u0000 \u0000 Twenty-two randomized controlled trials were identified, including 6,400 patients followed for 6 to 52 months. All primary endpoints were significantly reduced by catheter ablation vs. medical management: all-cause hospitalization (RR=0.57, 95%CI 0.39-0.85, P=0.006), AF relapse (RR=0.48, 95%CI 0.39-0.58, P<0.00001), all-cause mortality (RR=0.69, 95%CI 0.56-0.86, P=0.0007, NNT=44.7) driven trials with HF patients. A benefit was also demonstrated for all secondary endpoints: cardiovascular mortality (RR=0.55, 95%CI 0.34-0.87), cardiovascular (RR=0.83, 95%CI 0.71-0.96) and HF hospitalizations (RR=0.71, 95%CI 0.56-0.89), AF burden (MD=20.6%, 95%CI 5.6-35.5), LVEF recovery (MD=5.7%, 95%CI 3.5-7.9) and quality of life (MLHFQ, AFEQT & SF-36 scales).\u0000 \u0000 \u0000 \u0000 Catheter ablation significantly reduced hospitalizations, AF burden and relapse, and improved quality of life. An impact on hard clinical outcomes, with an important mortality reduction and improvement in LVEF, was seen for patients with AF and HF.\u0000","PeriodicalId":505595,"journal":{"name":"European Heart Journal Open","volume":"51 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141644566","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}
I. Landi, L. Guerritore, A. Iannaccone, A. Ricotti, P. Rola, M. Garrone
In acute decompensated heart failure (HF), systemic venous congestion contributes to patients’ symptoms and hospital admissions. The purpose of our study is to determine if venous congestion, examined using the Venous Excess Ultrasound (VExUS) score, predicts heart failure-related hospitalisation and mortality in patients admitted to the Emergency Department (ED) with acute decompensated heart failure. 50 patients admitted for acute HF in ED underwent ultrasound assessment according to the VExUS score within the first 24 hours and 72 hours. All patients were followed-up with a telephone call at 30 and 60 days after the hospital discharge. On admission, 56% had a VEXUS score 3. After 72 hours, 32% had no more signs of congestion at the Doppler VEXUS examination (VCI < 2 cm, VEXUS score 0), a similar percentage still exhibited a VEXUS score 3 despite therapy. 80% of patients were hospitalised after the admission to the ED, whilst six (15%) died in-hospital, all exhibited a first assessment VExUS 3 score. No patient with a VExUS score below 3 died during the study. During short-term follow-up, 18 patients were re-admitted to ED for acute decompensated HF. 94% of the re-admitted patients had a VExUS score 3 at the Doppler assessment at the first ED admission. Severe venous congestion, defined as a VExUS score of 3 at the initial assessment of patients with acute decompensated HF predicts in-patient mortality, HF-related death, and early readmission.
{"title":"Assessment of Venous Congestion with Venous Excess Ultrasound (VExUS) score in the Prognosis of Acute Heart Failure in the Emergency Department: a Prospective Study","authors":"I. Landi, L. Guerritore, A. Iannaccone, A. Ricotti, P. Rola, M. Garrone","doi":"10.1093/ehjopen/oeae050","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae050","url":null,"abstract":"\u0000 \u0000 \u0000 In acute decompensated heart failure (HF), systemic venous congestion contributes to patients’ symptoms and hospital admissions. The purpose of our study is to determine if venous congestion, examined using the Venous Excess Ultrasound (VExUS) score, predicts heart failure-related hospitalisation and mortality in patients admitted to the Emergency Department (ED) with acute decompensated heart failure.\u0000 \u0000 \u0000 \u0000 50 patients admitted for acute HF in ED underwent ultrasound assessment according to the VExUS score within the first 24 hours and 72 hours. All patients were followed-up with a telephone call at 30 and 60 days after the hospital discharge.\u0000 \u0000 \u0000 \u0000 On admission, 56% had a VEXUS score 3. After 72 hours, 32% had no more signs of congestion at the Doppler VEXUS examination (VCI < 2 cm, VEXUS score 0), a similar percentage still exhibited a VEXUS score 3 despite therapy. 80% of patients were hospitalised after the admission to the ED, whilst six (15%) died in-hospital, all exhibited a first assessment VExUS 3 score. No patient with a VExUS score below 3 died during the study. During short-term follow-up, 18 patients were re-admitted to ED for acute decompensated HF. 94% of the re-admitted patients had a VExUS score 3 at the Doppler assessment at the first ED admission.\u0000 \u0000 \u0000 \u0000 Severe venous congestion, defined as a VExUS score of 3 at the initial assessment of patients with acute decompensated HF predicts in-patient mortality, HF-related death, and early readmission.\u0000","PeriodicalId":505595,"journal":{"name":"European Heart Journal Open","volume":"29 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141662289","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":"Extensive Lipid Lowering, Thickness of the Fibrous Caps, and the Plaque Stability","authors":"Shinya Goto, Shinichi Goto","doi":"10.1093/ehjopen/oeae056","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae056","url":null,"abstract":"","PeriodicalId":505595,"journal":{"name":"European Heart Journal Open","volume":"8 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141681260","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}
J. Lewek, A. Bielecka-Dabrowa, Peter P. Toth, Maciej Banach
Over several decades the approach to treating dyslipidemias during pregnancy remains essentially unchanged. The lack of advancement in this field is mostly related to the fact that we lack clinical trials of pregnant patients both with available as well as new therapies. While there are numerous novel therapies developed for nonpregnant patients, there are still many limitations in dyslipidemia treatment during pregnancy. Besides pharmacotherapy and careful clinical assessment, the initiation of behavioral modifications as well as pre-conception management are very important. Among the various lipid-lowering medications, bile acid sequestrants are the only ones officially approved for treating dyslipidemia in pregnancy. Ezetimibe and fenofibrate can be considered if their benefits outweigh potential risks. Statins are still considered contraindicated, primarily due to animal studies and human case reports. However, recent systematic reviews and meta-analyses as well as data on familial hypercholesterolemia (FH) in pregnant patients have indicated that their use may not be harmful and could even be beneficial in certain selected cases. This is especially relevant for pregnant patients at very high cardiovascular risk, such as those who have already experienced an acute cardiovascular event or have homozygous or severe forms of heterozygous FH. In these cases, the decision to continue therapy during pregnancy should weigh the potential risks of discontinuation. Bempedoic acid, olezarsen, evinacumab, evolocumab and alirocumab, and inclisiran, are options to consider just before and after pregnancy is completed. In conclusion, decisions regarding lipid-lowering therapy for pregnant patients should be personalized. Despite the challenges in designing and conducting studies in pregnant women, there is a strong need to establish the safety and efficacy of dyslipidemia treatment during pregnancy.
{"title":"Dyslipidemia management in pregnant patients: a 2024 update","authors":"J. Lewek, A. Bielecka-Dabrowa, Peter P. Toth, Maciej Banach","doi":"10.1093/ehjopen/oeae032","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae032","url":null,"abstract":"\u0000 Over several decades the approach to treating dyslipidemias during pregnancy remains essentially unchanged. The lack of advancement in this field is mostly related to the fact that we lack clinical trials of pregnant patients both with available as well as new therapies. While there are numerous novel therapies developed for nonpregnant patients, there are still many limitations in dyslipidemia treatment during pregnancy.\u0000 Besides pharmacotherapy and careful clinical assessment, the initiation of behavioral modifications as well as pre-conception management are very important. Among the various lipid-lowering medications, bile acid sequestrants are the only ones officially approved for treating dyslipidemia in pregnancy. Ezetimibe and fenofibrate can be considered if their benefits outweigh potential risks. Statins are still considered contraindicated, primarily due to animal studies and human case reports. However, recent systematic reviews and meta-analyses as well as data on familial hypercholesterolemia (FH) in pregnant patients have indicated that their use may not be harmful and could even be beneficial in certain selected cases. This is especially relevant for pregnant patients at very high cardiovascular risk, such as those who have already experienced an acute cardiovascular event or have homozygous or severe forms of heterozygous FH. In these cases, the decision to continue therapy during pregnancy should weigh the potential risks of discontinuation. Bempedoic acid, olezarsen, evinacumab, evolocumab and alirocumab, and inclisiran, are options to consider just before and after pregnancy is completed.\u0000 In conclusion, decisions regarding lipid-lowering therapy for pregnant patients should be personalized. Despite the challenges in designing and conducting studies in pregnant women, there is a strong need to establish the safety and efficacy of dyslipidemia treatment during pregnancy.","PeriodicalId":505595,"journal":{"name":"European Heart Journal Open","volume":"6 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140652877","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}
I. Turnbull, C. F. Camm, J. Halsey, H. Du, D. Bennett, Yiping Chen, Canqing Yu, D. Sun, Xiaohong Liu, Liming Li, Zhengming Chen, R. Clarke, Junshi Chen, Zhengming Chen (PI), R. Clarke, R. Collins, Liming Li (PI), Chen Wang, Jun Lv, R. Peto, R. Walters, D. Avery, D. Bennett, Ruth Boxall, Ka Hung Chan, Yiping Chen, Zhengming Chen, J. Clarke, R. Clarke, H. Du, A. Mohamed, H. Fry, S. Gilbert, P. Im, A. Iona, M. Kakkoura, C. Kartsonaki, H. Lam, Kuang Lin, James Liu, M. Mazidi, I. Millwood, S. Morris, Qunhua Nie, A. Pozarickij, Paul Ryder, S. Said, D. Schmidt, Becky Stevens, I. Turnbull, Baihan Wang, Lin Wang, N. Wright, Ling Yang, Xiaoming Yang, Pang Yao, Xiao Han, C. Hou, Q. Xia, Chao Liu, Pei Pei, Dianjanyi Sun, Canqing Yu, N. Chen, Duo Liu, Zhenzhu Tang, Ningyu Chen, Qilian Jiang, J. Lan, Mingqiang Li, Yun Liu, Fanwen Meng, Jinhuai Meng, Rong Pan, Yulu Qin, Ping Wang, Sisi Wang, L. Wei, Liyuan Zhou, C. Dong, Pengfei Ge, X. Ren, Zhongxiao Li, Enke Mao, Tao Wang, Hui Zhang, Xi Zhang, Jinyan Chen, Ximin Hu, Xi
The prevalence of atrial fibrillation (AF) is positively correlated with prior cardiovascular diseases (CVD) and CVD risk factors, but is lower in Chinese than Europeans despite their higher burden of CVD. We examined the prevalence and prognosis of AF and other ECG abnormalities in the China Kadoorie Biobank. A random sample of 25,239 adults (mean age 59.5 years, 62% women) had a 12-lead ECG recorded and interpreted using a Mortara VERITAS™ algorithm in 2013-2014. Participants were followed-up for 5 years for incident stroke, ischaemic heart disease (IHD), heart failure (HF) and all CVD, overall and by CHA2DS2-VASc scores, age, sex, and area. Overall, 1.2% had AF, 13.6% had left ventricular hypertrophy (LVH), and 28.1% had ischaemia (two-thirds of AF cases also had ischaemia or LVH). The prevalence of AF increased with age, prior CVD and levels of CHA₂DS₂-VASc scores (0.5%, 1.3%, 2.1%, 2.9%, and 4.4% for scores <2, 2, 3, 4, ≥ 5, respectively). AF was associated with 2-fold higher hazard ratios (HR) for CVD (2.15; 95% CI, 1.71–2.69) and stroke (1.88; 1.44–2.47), and a 4-fold higher HR for HF (3.79; 2.21–6.49). The 5-year cumulative incidence of CVD was comparable for AF, prior CVD and CHA₂DS₂-VASc scores ≥2 (36.7% vs 36.2% vs 37.7%, respectively), but was 2-fold greater than for ischaemia (19.4%), LVH (18.0%) or normal ECG (14.1%), respectively. The findings highlight the importance of screening for AF together with estimation of CHA₂DS₂-VASc scores for prevention of CVD in Chinese adults.
{"title":"Correlates and consequences of atrial fibrillation in a prospective study of 25,000 participants in the China Kadoorie Biobank","authors":"I. Turnbull, C. F. Camm, J. Halsey, H. Du, D. Bennett, Yiping Chen, Canqing Yu, D. Sun, Xiaohong Liu, Liming Li, Zhengming Chen, R. Clarke, Junshi Chen, Zhengming Chen (PI), R. Clarke, R. Collins, Liming Li (PI), Chen Wang, Jun Lv, R. Peto, R. Walters, D. Avery, D. Bennett, Ruth Boxall, Ka Hung Chan, Yiping Chen, Zhengming Chen, J. Clarke, R. Clarke, H. Du, A. Mohamed, H. Fry, S. Gilbert, P. Im, A. Iona, M. Kakkoura, C. Kartsonaki, H. Lam, Kuang Lin, James Liu, M. Mazidi, I. Millwood, S. Morris, Qunhua Nie, A. Pozarickij, Paul Ryder, S. Said, D. Schmidt, Becky Stevens, I. Turnbull, Baihan Wang, Lin Wang, N. Wright, Ling Yang, Xiaoming Yang, Pang Yao, Xiao Han, C. Hou, Q. Xia, Chao Liu, Pei Pei, Dianjanyi Sun, Canqing Yu, N. Chen, Duo Liu, Zhenzhu Tang, Ningyu Chen, Qilian Jiang, J. Lan, Mingqiang Li, Yun Liu, Fanwen Meng, Jinhuai Meng, Rong Pan, Yulu Qin, Ping Wang, Sisi Wang, L. Wei, Liyuan Zhou, C. Dong, Pengfei Ge, X. Ren, Zhongxiao Li, Enke Mao, Tao Wang, Hui Zhang, Xi Zhang, Jinyan Chen, Ximin Hu, Xi","doi":"10.1093/ehjopen/oeae021","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae021","url":null,"abstract":"\u0000 \u0000 \u0000 The prevalence of atrial fibrillation (AF) is positively correlated with prior cardiovascular diseases (CVD) and CVD risk factors, but is lower in Chinese than Europeans despite their higher burden of CVD. We examined the prevalence and prognosis of AF and other ECG abnormalities in the China Kadoorie Biobank.\u0000 \u0000 \u0000 \u0000 A random sample of 25,239 adults (mean age 59.5 years, 62% women) had a 12-lead ECG recorded and interpreted using a Mortara VERITAS™ algorithm in 2013-2014. Participants were followed-up for 5 years for incident stroke, ischaemic heart disease (IHD), heart failure (HF) and all CVD, overall and by CHA2DS2-VASc scores, age, sex, and area.\u0000 \u0000 \u0000 \u0000 Overall, 1.2% had AF, 13.6% had left ventricular hypertrophy (LVH), and 28.1% had ischaemia (two-thirds of AF cases also had ischaemia or LVH). The prevalence of AF increased with age, prior CVD and levels of CHA₂DS₂-VASc scores (0.5%, 1.3%, 2.1%, 2.9%, and 4.4% for scores <2, 2, 3, 4, ≥ 5, respectively). AF was associated with 2-fold higher hazard ratios (HR) for CVD (2.15; 95% CI, 1.71–2.69) and stroke (1.88; 1.44–2.47), and a 4-fold higher HR for HF (3.79; 2.21–6.49). The 5-year cumulative incidence of CVD was comparable for AF, prior CVD and CHA₂DS₂-VASc scores ≥2 (36.7% vs 36.2% vs 37.7%, respectively), but was 2-fold greater than for ischaemia (19.4%), LVH (18.0%) or normal ECG (14.1%), respectively.\u0000 \u0000 \u0000 \u0000 The findings highlight the importance of screening for AF together with estimation of CHA₂DS₂-VASc scores for prevention of CVD in Chinese adults.\u0000","PeriodicalId":505595,"journal":{"name":"European Heart Journal Open","volume":"2 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140229807","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}
R. Kirwan, M. Mazidi, Tom Butler, F. P. de Heredia, Gregory Y H Lip, Ian G Davies
Reduced muscle mass and strength is frequently associated with both alterations in blood lipids and poorer cardiometabolic outcomes in epidemiological studies; however, a causal association cannot be determined from such observations. Two-sample Mendelian randomization (MR) was applied to assess the association of genetically determined appendicular lean mass (ALM) and handgrip strength (HGS) with serum lipid particle diameter. MR was implemented using summary-level data from the largest genome-wide association studies (GWAS) on ALM (n = 450,243), HGS (n = 223,315) and lipoprotein (LDL, VLDL and HDL) particle diameters (n = 115,078). Inverse variance weighted method (IVW) was used to calc ulate the causal estimates. Weighted median (WM)-based method, and MR-Egger, leave-one-out method were applied as sensitivity analysis. Greater ALM had a statistically significant positive effect on HDL particle diameter (MR-Egger: β=0.055, SE = 0.031, p = 0.081; IVW: β=0.068, SE = 0.014, p < 0.001), and a statistically significant negative effect on VLDL particle diameter (MR-Egger: β= −0.114, SE = 0.039, p = 0.003; IVW: β= −0.081, SE = 0.017, p < 0.001). Similarly, greater HGS had a statistically significant positive effect on HDL particle diameter (MR-Egger: β=0.433, SE = 0.184, p = 0.019; IVW: β=0.121, SE = 0.052, p = 0.021), and a statistically significant negative effect on VLDL particle diameter (MR-Egger: β=−0.416, SE = 0.163, p = 0.011; IVW: β=−0.122, SE = 0.046, p = 0.009). There was no statistically significant effect of either ALM or HGS on LDL particle diameter. There were potentially causal associations between both increasing ALM and HGS, and increasing HDL particle size and decreasing VLDL particle size. These causal associations may offer possibilities for interventions aimed at improving CVD risk profile.
{"title":"The association of appendicular lean mass and grip strength with LDL, VLDL and HDL particle diameter: a Mendelian randomization study of the UK Biobank cohort","authors":"R. Kirwan, M. Mazidi, Tom Butler, F. P. de Heredia, Gregory Y H Lip, Ian G Davies","doi":"10.1093/ehjopen/oeae019","DOIUrl":"https://doi.org/10.1093/ehjopen/oeae019","url":null,"abstract":"\u0000 \u0000 \u0000 Reduced muscle mass and strength is frequently associated with both alterations in blood lipids and poorer cardiometabolic outcomes in epidemiological studies; however, a causal association cannot be determined from such observations. Two-sample Mendelian randomization (MR) was applied to assess the association of genetically determined appendicular lean mass (ALM) and handgrip strength (HGS) with serum lipid particle diameter.\u0000 \u0000 \u0000 \u0000 MR was implemented using summary-level data from the largest genome-wide association studies (GWAS) on ALM (n = 450,243), HGS (n = 223,315) and lipoprotein (LDL, VLDL and HDL) particle diameters (n = 115,078). Inverse variance weighted method (IVW) was used to calc ulate the causal estimates. Weighted median (WM)-based method, and MR-Egger, leave-one-out method were applied as sensitivity analysis.\u0000 \u0000 \u0000 \u0000 Greater ALM had a statistically significant positive effect on HDL particle diameter (MR-Egger: β=0.055, SE = 0.031, p = 0.081; IVW: β=0.068, SE = 0.014, p < 0.001), and a statistically significant negative effect on VLDL particle diameter (MR-Egger: β= −0.114, SE = 0.039, p = 0.003; IVW: β= −0.081, SE = 0.017, p < 0.001). Similarly, greater HGS had a statistically significant positive effect on HDL particle diameter (MR-Egger: β=0.433, SE = 0.184, p = 0.019; IVW: β=0.121, SE = 0.052, p = 0.021), and a statistically significant negative effect on VLDL particle diameter (MR-Egger: β=−0.416, SE = 0.163, p = 0.011; IVW: β=−0.122, SE = 0.046, p = 0.009). There was no statistically significant effect of either ALM or HGS on LDL particle diameter.\u0000 \u0000 \u0000 \u0000 There were potentially causal associations between both increasing ALM and HGS, and increasing HDL particle size and decreasing VLDL particle size. These causal associations may offer possibilities for interventions aimed at improving CVD risk profile.\u0000","PeriodicalId":505595,"journal":{"name":"European Heart Journal Open","volume":"10 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140244248","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}
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