Hypertrophic cardiomyopathy (HCM), the most prevalent inherited cardiomyopathy, is characterized by left ventricular hypertrophy that typically manifests with asymmetric wall thickening and is not caused by a pressure overload state or systemic disease. Despite its considerable prevalence—estimated to affect up to 1 in 200 individuals based on imaging data—it often goes undiagnosed or misdiagnosed, particularly in general clinical settings. Traditional tools, such as the electrocardiogram, although widely used, frequently yield nonspecific findings that complicate the early identification or screening of HCM. In recent years, artificial intelligence (AI) and machine learning have emerged as powerful tools with the potential to revolutionize HCM diagnosis and management. AI-driven algorithms trained on ECG and imaging data are being developed to improve early detection, risk stratification, and therapeutic monitoring in patients with or at risk for HCM. Additionally, AI has shown utility in biomarker-based prediction models, further enhancing diagnostic precision and clinical decision-making. Harnessing the power of AI may help close critical diagnostic gaps and optimize outcomes for individuals affected by HCM.
{"title":"Challenges in the diagnosis and management of hypertrophic cardiomyopathy and the promise of artificial intelligence","authors":"Isna H. Khaliq MD , Aum Solanki MD , Menhel Kinno MD, MPH , Annabelle Santos Volgman MD , Ahmet Afsin Oktay MD","doi":"10.1016/j.cpcardiol.2025.103249","DOIUrl":"10.1016/j.cpcardiol.2025.103249","url":null,"abstract":"<div><div>Hypertrophic cardiomyopathy (HCM), the most prevalent inherited cardiomyopathy, is characterized by left ventricular hypertrophy that typically manifests with asymmetric wall thickening and is not caused by a pressure overload state or systemic disease. Despite its considerable prevalence—estimated to affect up to 1 in 200 individuals based on imaging data—it often goes undiagnosed or misdiagnosed, particularly in general clinical settings. Traditional tools, such as the electrocardiogram, although widely used, frequently yield nonspecific findings that complicate the early identification or screening of HCM. In recent years, artificial intelligence (AI) and machine learning have emerged as powerful tools with the potential to revolutionize HCM diagnosis and management. AI-driven algorithms trained on ECG and imaging data are being developed to improve early detection, risk stratification, and therapeutic monitoring in patients with or at risk for HCM. Additionally, AI has shown utility in biomarker-based prediction models, further enhancing diagnostic precision and clinical decision-making. Harnessing the power of AI may help close critical diagnostic gaps and optimize outcomes for individuals affected by HCM.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"51 3","pages":"Article 103249"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.cpcardiol.2025.103256
Saeed Alshahrani , Siddig Ibrahim Abdelwahab , Manal Mohamed Elhassan Taha , Abdullah Farasani , Jobran M Moshi , Ahmad Assiri , Khaled A Sahli , Hussam M. Shubaily , Marwa Qadri , Amani Khardali , Waseem Hassan
This study provides a bibliometric overview of cardiovascular-related bibliometric research identified in the Scopus database using a title–abstract–keyword (TAK) search strategy. A total of 2,069 records were identified, with original articles (n = 1,130) and review papers (n = 596) representing the predominant document types. Restricting the analysis to these two categories yielded 1,726 documents, underscoring their central role in bibliometric reporting. A clear temporal growth was observed, increasing from a single publication in 1991 to 71 in 2025, with notable expansion after 2020. Authorship and institutional analyses revealed a strong concentration of contributions from China. Hu Y. was the most prolific author (13 publications), followed by Shou X. (7), while several others contributed five publications each. The China Academy of Chinese Medical Sciences (44 publications) and Beijing University of Chinese Medicine (41) were the leading institutions. China dominated global output with 229 publications, far exceeding the United States (25) and other contributing countries. Funding was primarily provided by the National Natural Science Foundation of China (84 publications). Frontiers in Cardiovascular Medicine was the leading journal (44 publications), followed by Medicine (United States) (28) and Heliyon (18). Thematically, over 300 cardiological subtopics were identified, spanning clinical areas such as heart failure, atrial fibrillation, and obesity-related cardiovascular disease, as well as emerging domains including artificial intelligence, autophagy, ferroptosis, non-coding RNAs, and digital health. Studies also addressed societal and environmental determinants such as gender disparities, air pollution, and psychosocial stress. Collectively, these findings demonstrate the accelerating adoption of bibliometric approaches in cardiovascular science and the field’s transition toward interdisciplinary, technology-integrated, and data-driven research directions.
本研究使用标题-摘要-关键词（TAK）搜索策略对Scopus数据库中心血管相关文献计量学研究进行了文献计量学综述。共确定了2,069条记录，其中主要的文件类型为原创文章（n = 1,130）和综述论文（n = 596）。将分析限制在这两个类别产生了1 726份文件，强调了它们在文献计量报告中的中心作用。观察到明显的时间增长，从1991年的一份出版物增加到2025年的71份，在2020年之后有显著的扩展。作者身份和机构分析显示，中国的贡献高度集中。胡颖是最多产的作者（13篇），其次是寿旭（7篇），其他几个人每人发表了5篇文章。中国中医科学院（44篇）和北京中医药大学（41篇）是领先的机构。中国以229篇论文占据全球主导地位，远远超过美国（25篇）和其他贡献国。主要由国家自然科学基金资助（84篇）。《心血管医学前沿》（Frontiers in Cardiovascular Medicine）是排名第一的杂志（44篇），其次是《医学》（美国）（28篇）和《Heliyon》（18篇）。在主题上，确定了300多个心脏病亚主题，涵盖心力衰竭、心房颤动和肥胖相关心血管疾病等临床领域，以及人工智能、自噬、铁死亡、非编码rna和数字健康等新兴领域。研究还涉及社会和环境决定因素，如性别差异、空气污染和社会心理压力。总的来说，这些发现表明了文献计量学方法在心血管科学中的加速应用，以及该领域向跨学科、技术集成和数据驱动的研究方向的转变。
{"title":"The scope of cardiology research: More than 300 topics covered through bibliometric evaluation","authors":"Saeed Alshahrani , Siddig Ibrahim Abdelwahab , Manal Mohamed Elhassan Taha , Abdullah Farasani , Jobran M Moshi , Ahmad Assiri , Khaled A Sahli , Hussam M. Shubaily , Marwa Qadri , Amani Khardali , Waseem Hassan","doi":"10.1016/j.cpcardiol.2025.103256","DOIUrl":"10.1016/j.cpcardiol.2025.103256","url":null,"abstract":"<div><div>This study provides a bibliometric overview of cardiovascular-related bibliometric research identified in the Scopus database using a title–abstract–keyword (TAK) search strategy. A total of 2,069 records were identified, with original articles (<em>n</em> = 1,130) and review papers (<em>n</em> = 596) representing the predominant document types. Restricting the analysis to these two categories yielded 1,726 documents, underscoring their central role in bibliometric reporting. A clear temporal growth was observed, increasing from a single publication in 1991 to 71 in 2025, with notable expansion after 2020. Authorship and institutional analyses revealed a strong concentration of contributions from China. Hu Y. was the most prolific author (13 publications), followed by Shou X. (7), while several others contributed five publications each. The China Academy of Chinese Medical Sciences (44 publications) and Beijing University of Chinese Medicine (41) were the leading institutions. China dominated global output with 229 publications, far exceeding the United States (25) and other contributing countries. Funding was primarily provided by the National Natural Science Foundation of China (84 publications). <em>Frontiers in Cardiovascular Medicine</em> was the leading journal (44 publications), followed by <em>Medicine</em> (United States) (28) and <em>Heliyon</em> (18). Thematically, over 300 cardiological subtopics were identified, spanning clinical areas such as heart failure, atrial fibrillation, and obesity-related cardiovascular disease, as well as emerging domains including artificial intelligence, autophagy, ferroptosis, non-coding RNAs, and digital health. Studies also addressed societal and environmental determinants such as gender disparities, air pollution, and psychosocial stress. Collectively, these findings demonstrate the accelerating adoption of bibliometric approaches in cardiovascular science and the field’s transition toward interdisciplinary, technology-integrated, and data-driven research directions.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"51 3","pages":"Article 103256"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.cpcardiol.2025.103251
Shahid Ullah Khan Phd , Mustafa H. Halawi , Mazen Almehmadi , Essam H. Ibrahim , Ramadan Taha , Khalid M. Alsyaad , Ahmed Ezzat Ahmed , Amin A. Al-Doaiss , William Thornbury
Diabetic cardiomyopathy (DCM) remains a major contributor to cardiovascular morbidity and mortality, yet its underlying mechanisms extend beyond hyperglycemia-induced metabolic stress. Emerging evidence identifies ferroptosis, a regulated, iron-dependent lipid peroxidation process, as a central driver of diabetic myocardial injury. This review synthesizes molecular insights demonstrating how chronic hyperglycemia, oxidative stress, and mitochondrial dysfunction create a uniquely ferroptosis-prone cardiac environment. Particular emphasis is placed on the NRF2 signaling network, which orchestrates antioxidant defense through the HO-1 pathway and the SLC7A11-GSH-GPX4 axis. Diabetic impairment of AMPK/AKT-dependent NRF2 activation compromises these protective systems, accelerating lipid peroxidation, mitochondrial damage, inflammation, and cardiomyocyte death. We further evaluate emerging pharmacologic and natural NRF2 activators, including sulforaphane, curcumin, dexmedetomidine, canagliflozin, and 6-gingerol, demonstrating consistent cardioprotective, anti-ferroptotic benefits in preclinical models. Despite encouraging progress, concerns regarding long-term NRF2 overstimulation, metabolic reprogramming, and oncogenic risk underscore the need for carefully optimized therapeutic strategies. By integrating mechanistic advances with translational challenges, this review highlights NRF2-ferroptosis modulation as a promising frontier for targeted DCM therapy and future precision cardiology.
{"title":"NRF2-mediated anti-ferroptotic pathways in diabetic cardiomyopathy: Mechanistic insights, therapeutic advances, and challenges in cardiovascular protection","authors":"Shahid Ullah Khan Phd , Mustafa H. Halawi , Mazen Almehmadi , Essam H. Ibrahim , Ramadan Taha , Khalid M. Alsyaad , Ahmed Ezzat Ahmed , Amin A. Al-Doaiss , William Thornbury","doi":"10.1016/j.cpcardiol.2025.103251","DOIUrl":"10.1016/j.cpcardiol.2025.103251","url":null,"abstract":"<div><div>Diabetic cardiomyopathy (DCM) remains a major contributor to cardiovascular morbidity and mortality, yet its underlying mechanisms extend beyond hyperglycemia-induced metabolic stress. Emerging evidence identifies ferroptosis, a regulated, iron-dependent lipid peroxidation process, as a central driver of diabetic myocardial injury. This review synthesizes molecular insights demonstrating how chronic hyperglycemia, oxidative stress, and mitochondrial dysfunction create a uniquely ferroptosis-prone cardiac environment. Particular emphasis is placed on the NRF2 signaling network, which orchestrates antioxidant defense through the HO-1 pathway and the SLC7A11-GSH-GPX4 axis. Diabetic impairment of AMPK/AKT-dependent NRF2 activation compromises these protective systems, accelerating lipid peroxidation, mitochondrial damage, inflammation, and cardiomyocyte death. We further evaluate emerging pharmacologic and natural NRF2 activators, including sulforaphane, curcumin, dexmedetomidine, canagliflozin, and 6-gingerol, demonstrating consistent cardioprotective, anti-ferroptotic benefits in preclinical models. Despite encouraging progress, concerns regarding long-term NRF2 overstimulation, metabolic reprogramming, and oncogenic risk underscore the need for carefully optimized therapeutic strategies. By integrating mechanistic advances with translational challenges, this review highlights NRF2-ferroptosis modulation as a promising frontier for targeted DCM therapy and future precision cardiology.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"51 4","pages":"Article 103251"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.cpcardiol.2025.103250
Fernando Garagoli , Walter Masson , Martin Lobo , Leandro Barbagelata , Guillaume Cayla , Martine Gilard , Gilles Lemesle
Background
Patients with chronic coronary syndrome (CCS) often require long-term oral anticoagulation (OAC), most commonly for atrial fibrillation (AF). Evidence on the optimal antithrombotic strategy in this setting remains inconclusive, prompting this updated meta-analysis of randomized trials comparing OAC plus a single antiplatelet therapy (SAPT) with OAC monotherapy.
Methods
We systematically searched PubMed/MEDLINE, SciELO, Latindex, LILACS, the Cochrane Library, and ClinicalTrials.gov up to November 12, 2025. The primary efficacy endpoint was all-cause death, while secondary efficacy endpoints included cardiovascular death, acute myocardial infarction, ischemic stroke, and systemic embolism, each analyzed individually. Safety endpoints comprised major and clinically relevant non-major bleeding (International Society on Thrombosis and Hemostasis [ISTH] definition).
Results
Six randomized trials including 5,924 participants were analyzed. All-cause death did not differ significantly between OAC plus SAPT and OAC monotherapy (OR 1.31; 95 % CI 0.89–1.92). Dual therapy was associated with an increased risk of cardiovascular death (OR 1.42; 95 % CI 1.05–1.92), whereas rates of myocardial infarction (OR 0.98; 95 % CI 0.60–1.57), ischemic stroke (OR 0.95; 95 % CI 0.64–1.39), and systemic embolism (OR 1.00; 95 % CI 0.20–4.95) were similar between groups. Safety outcomes were markedly worse with dual therapy, which significantly increased the risk of major bleeding (OR 2.20; 95 % CI 1.51–3.22) and major or clinically relevant non-major bleeding (OR 2.30; 95 % CI 1.72–3.06).
Conclusions
In patients with CCS requiring long-term OAC, dual therapy (OAC plus SAPT) did not reduce all-cause death nor ischemic events compared with OAC alone but significantly increased major bleeding and cardiovascular death. PROSPERO Registration No.: CRD420251239917.
{"title":"Antiplatelet therapy in patients with chronic coronary syndrome requiring oral anticoagulation: An updated meta-analysis of randomized trials","authors":"Fernando Garagoli , Walter Masson , Martin Lobo , Leandro Barbagelata , Guillaume Cayla , Martine Gilard , Gilles Lemesle","doi":"10.1016/j.cpcardiol.2025.103250","DOIUrl":"10.1016/j.cpcardiol.2025.103250","url":null,"abstract":"<div><h3>Background</h3><div>Patients with chronic coronary syndrome (CCS) often require long-term oral anticoagulation (OAC), most commonly for atrial fibrillation (AF). Evidence on the optimal antithrombotic strategy in this setting remains inconclusive, prompting this updated meta-analysis of randomized trials comparing OAC plus a single antiplatelet therapy (SAPT) with OAC monotherapy.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed/MEDLINE, SciELO, Latindex, LILACS, the Cochrane Library, and ClinicalTrials.gov up to November 12, 2025. The primary efficacy endpoint was all-cause death, while secondary efficacy endpoints included cardiovascular death, acute myocardial infarction, ischemic stroke, and systemic embolism, each analyzed individually. Safety endpoints comprised major and clinically relevant non-major bleeding (International Society on Thrombosis and Hemostasis [ISTH] definition).</div></div><div><h3>Results</h3><div>Six randomized trials including 5,924 participants were analyzed. All-cause death did not differ significantly between OAC plus SAPT and OAC monotherapy (OR 1.31; 95 % CI 0.89–1.92). Dual therapy was associated with an increased risk of cardiovascular death (OR 1.42; 95 % CI 1.05–1.92), whereas rates of myocardial infarction (OR 0.98; 95 % CI 0.60–1.57), ischemic stroke (OR 0.95; 95 % CI 0.64–1.39), and systemic embolism (OR 1.00; 95 % CI 0.20–4.95) were similar between groups. Safety outcomes were markedly worse with dual therapy, which significantly increased the risk of major bleeding (OR 2.20; 95 % CI 1.51–3.22) and major or clinically relevant non-major bleeding (OR 2.30; 95 % CI 1.72–3.06).</div></div><div><h3>Conclusions</h3><div>In patients with CCS requiring long-term OAC, dual therapy (OAC plus SAPT) did not reduce all-cause death nor ischemic events compared with OAC alone but significantly increased major bleeding and cardiovascular death. <strong>PROSPERO Registration No.: CRD420251239917.</strong></div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"51 3","pages":"Article 103250"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.cpcardiol.2025.103255
Ahmad Al-Abdouh MD , Ahmad Jabri MD , Mohammed Mhanna MD , Laith Alhuneafat MD , Fares Ghanem MD , Ibrahim Mortada MD , Omar Obeidat MD , Shareef Mansour MD , Wissam Khalife MD
Introduction
Sodium-glucose cotransporter-2 (SGLT2) inhibitors have shown significant reduction in cardiovascular mortality and heart failure hospitalization in patients with chronic heart failure. Despite their benefits in chronic heart failure, their use during episodes of acute decompensation remains under investigation.
Methods
A comprehensive literature search was performed using PubMed, Google Scholar, and ClinicalTrials.gov from database inception through September 3, 2025. The predefined endpoints were all-cause mortality, heart failure hospitalizations, and a composite of cardiovascular mortality or heart failure worsening. Outcomes were pooled using a random effects Mantel-Haenszel model. The DerSimonian and Laird method was used for estimation of τ.2 We reported effect sizes as risk ratios (RR) with 95 % confidence interval (CI).
Results
A total of eight randomized controlled trials, encompassing 4,714 patients, were included in the analysis. Among patients hospitalized with decompensated heart failure, treatment with SGLT2 inhibitors compared with standard care only (control group) was associated with a significant decrease in all-cause mortality (RR 0.72; 95 % CI, 0.58–0.90; P < 0.01; I² = 0 %), and in the composite outcome of cardiovascular mortality or heart failure rehospitalization (RR 0.68; 95 % CI, 0.53–0.86; P < 0.01; I² = 28 %). However, no significant reduction was observed in heart failure rehospitalization as an isolated outcome (RR 0.92; 95 % CI, 0.82–1.03; P = 0.16; I² = 0 %).
Conclusion
SGLT-2 inhibitors during hospitalization for acute decompensated heart failure is effective and led to decrease in all-cause mortality and a composite endpoint of cardiovascular mortality or heart failure hospitalizations.
{"title":"The early initiation of sodium-glucose cotransporter-2 inhibitors in patients with decompensated heart failure: A systematic review and meta-analysis","authors":"Ahmad Al-Abdouh MD , Ahmad Jabri MD , Mohammed Mhanna MD , Laith Alhuneafat MD , Fares Ghanem MD , Ibrahim Mortada MD , Omar Obeidat MD , Shareef Mansour MD , Wissam Khalife MD","doi":"10.1016/j.cpcardiol.2025.103255","DOIUrl":"10.1016/j.cpcardiol.2025.103255","url":null,"abstract":"<div><h3>Introduction</h3><div>Sodium-glucose cotransporter-2 (SGLT2) inhibitors have shown significant reduction in cardiovascular mortality and heart failure hospitalization in patients with chronic heart failure. Despite their benefits in chronic heart failure, their use during episodes of acute decompensation remains under investigation.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed using PubMed, Google Scholar, and ClinicalTrials.gov from database inception through September 3, 2025. The predefined endpoints were all-cause mortality, heart failure hospitalizations, and a composite of cardiovascular mortality or heart failure worsening. Outcomes were pooled using a random effects Mantel-Haenszel model. The DerSimonian and Laird method was used for estimation of τ.<sup>2</sup> We reported effect sizes as risk ratios (RR) with 95 % confidence interval (CI).</div></div><div><h3>Results</h3><div>A total of eight randomized controlled trials, encompassing 4,714 patients, were included in the analysis. Among patients hospitalized with decompensated heart failure, treatment with SGLT2 inhibitors compared with standard care only (control group) was associated with a significant decrease in all-cause mortality (RR 0.72; 95 % CI, 0.58–0.90; <em>P</em> < 0.01; I² = 0 %), and in the composite outcome of cardiovascular mortality or heart failure rehospitalization (RR 0.68; 95 % CI, 0.53–0.86; <em>P</em> < 0.01; I² = 28 %). However, no significant reduction was observed in heart failure rehospitalization as an isolated outcome (RR 0.92; 95 % CI, 0.82–1.03; <em>P</em> = 0.16; I² = 0 %).</div></div><div><h3>Conclusion</h3><div>SGLT-2 inhibitors during hospitalization for acute decompensated heart failure is effective and led to decrease in all-cause mortality and a composite endpoint of cardiovascular mortality or heart failure hospitalizations.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"51 3","pages":"Article 103255"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.cpcardiol.2025.103254
Sara Tomovic , Robert Herman , Srdjan Dedic , Nikola Boskovic , Stefan Juricic , Srdjan Aleksandric , Marina Ostojic , Ivana Nedeljkovic , Vojislav Giga , Marko Banovic
The prognosis of patients with MI has improved significantly with the recognition that early reperfusion is critical, particularly since timely percutaneous coronary intervention (PCI) became widely adopted. The invasive reperfusion era also reshaped MI diagnostics, shifting the paradigm from Q-wave vs. Non-Q-wave MI to ST-Elevation Myocardial Infarction (STEMI) vs. Non-ST-Elevation Myocardial Infarction (NSTEMI).
The current ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) paradigm have long been the cornerstone of myocardial infarction (MI) care but fail to identify many patients with acute coronary occlusion (ACO), delaying treatment and worsening outcomes. This limitation is increasingly important, since NSTEMI now represents the majority of presentations accounting for roughly 70% of AMI worldwide and many of these occlusive events are managed with delays contributing to worse outcomes. Adding to this challenge, substantial inter-physician variability in ECG interpretation for ACO has been demonstrated.
In this review, we highlight recent advances using the artificial intelligence in the evaluation of patients presenting with ECG changes suggestive of NSTEMI and evaluate its role in the detection of NSTEMI patients with acute coronary occlusion.
{"title":"Artificial Intelligence in detection of acute coronary occlusion in NSTEMI patients","authors":"Sara Tomovic , Robert Herman , Srdjan Dedic , Nikola Boskovic , Stefan Juricic , Srdjan Aleksandric , Marina Ostojic , Ivana Nedeljkovic , Vojislav Giga , Marko Banovic","doi":"10.1016/j.cpcardiol.2025.103254","DOIUrl":"10.1016/j.cpcardiol.2025.103254","url":null,"abstract":"<div><div>The prognosis of patients with MI has improved significantly with the recognition that early reperfusion is critical, particularly since timely percutaneous coronary intervention (PCI) became widely adopted. The invasive reperfusion era also reshaped MI diagnostics, shifting the paradigm from Q-wave vs. Non-Q-wave MI to ST-Elevation Myocardial Infarction (STEMI) vs. Non-ST-Elevation Myocardial Infarction (NSTEMI).</div><div>The current ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) paradigm have long been the cornerstone of myocardial infarction (MI) care but fail to identify many patients with acute coronary occlusion (ACO), delaying treatment and worsening outcomes. This limitation is increasingly important, since NSTEMI now represents the majority of presentations accounting for roughly 70% of AMI worldwide and many of these occlusive events are managed with delays contributing to worse outcomes. Adding to this challenge, substantial inter-physician variability in ECG interpretation for ACO has been demonstrated.</div><div>In this review, we highlight recent advances using the artificial intelligence in the evaluation of patients presenting with ECG changes suggestive of NSTEMI and evaluate its role in the detection of NSTEMI patients with acute coronary occlusion.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"51 3","pages":"Article 103254"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diet high in sodium is an established major risk factor for cardiovascular diseases (CVDs), yet a comprehensive and updated assessment of its attributable disease burden, particularly comparing China with global patterns over the last three decades, is lacking.
Methods
This study aims to quantify and compare the deaths and disability-adjusted life years (DALYs) of CVDs attributable to diet high in sodium in China and globally from 1990 to 2021. Using data from the Global Burden of Disease (GBD) Study 2021, we applied the comparative risk assessment framework to estimate the sodium-attributable CVD burden. Mortality and DALYs were analyzed as absolute numbers and age-standardized rates (ASRs). Temporal trends were assessed using estimated annual percentage changes (EAPCs), and future burden to 2046 was projected using an age-period-cohort (APC) model.
Results
In 2021, diet high in sodium was responsible for 1.71 million [95 % uncertainty intervals (UI): 0.36-3.81 million] global deaths and 37.77 million (95 % UI: 9.05-80.81 million) DALYs. The global age-standardized death rate (ASDR) and DALY rate (ASDAR) were 20.4 and 437.7 per 100,000, respectively. From 1990 to 2021, while absolute death counts increased by 52 %, the ASDR significantly declined (EAPC: -1.46 %). Pronounced sex and age disparities were observed, with males bearing a consistently higher burden and the elderly experiencing the highest rates but slowest improvements. In China, the 2021 ASDR (40.91/100,000) and ASDAR (837.94/100,000) were approximately double the global averages, despite substantial declines since 1990 (ASDR EAPC: -1.74 %; ASDAR EAPC: -1.85 %). Projections to 2046 indicate rising absolute numbers globally and in China, driven by demographic changes, despite continuing declines in age-standardized rates.
Conclusion
High sodium intake remains a major contributor to the global and Chinese CVD burden, with significant sex and age disparities. Although age-standardized rates have improved, the rising absolute burden underscores the imperative for more effective, targeted salt-reduction public health strategies.
{"title":"Burden of cardiovascular diseases attributable to diet high in sodium in China and the global from 1990 to 2021","authors":"Wuyang Wei , Meiyuan Chen , Jiyong Wei , Xiaoyu Zheng","doi":"10.1016/j.cpcardiol.2025.103248","DOIUrl":"10.1016/j.cpcardiol.2025.103248","url":null,"abstract":"<div><h3>Background</h3><div>Diet high in sodium is an established major risk factor for cardiovascular diseases (CVDs), yet a comprehensive and updated assessment of its attributable disease burden, particularly comparing China with global patterns over the last three decades, is lacking.</div></div><div><h3>Methods</h3><div>This study aims to quantify and compare the deaths and disability-adjusted life years (DALYs) of CVDs attributable to diet high in sodium in China and globally from 1990 to 2021. Using data from the Global Burden of Disease (GBD) Study 2021, we applied the comparative risk assessment framework to estimate the sodium-attributable CVD burden. Mortality and DALYs were analyzed as absolute numbers and age-standardized rates (ASRs). Temporal trends were assessed using estimated annual percentage changes (EAPCs), and future burden to 2046 was projected using an age-period-cohort (APC) model.</div></div><div><h3>Results</h3><div>In 2021, diet high in sodium was responsible for 1.71 million [95 % uncertainty intervals (UI): 0.36-3.81 million] global deaths and 37.77 million (95 % UI: 9.05-80.81 million) DALYs. The global age-standardized death rate (ASDR) and DALY rate (ASDAR) were 20.4 and 437.7 per 100,000, respectively. From 1990 to 2021, while absolute death counts increased by 52 %, the ASDR significantly declined (EAPC: -1.46 %). Pronounced sex and age disparities were observed, with males bearing a consistently higher burden and the elderly experiencing the highest rates but slowest improvements. In China, the 2021 ASDR (40.91/100,000) and ASDAR (837.94/100,000) were approximately double the global averages, despite substantial declines since 1990 (ASDR EAPC: -1.74 %; ASDAR EAPC: -1.85 %). Projections to 2046 indicate rising absolute numbers globally and in China, driven by demographic changes, despite continuing declines in age-standardized rates.</div></div><div><h3>Conclusion</h3><div>High sodium intake remains a major contributor to the global and Chinese CVD burden, with significant sex and age disparities. Although age-standardized rates have improved, the rising absolute burden underscores the imperative for more effective, targeted salt-reduction public health strategies.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"51 3","pages":"Article 103248"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.cpcardiol.2025.103252
Mustafa H. Halawi , Mazen Almehmadi , Essam H. Ibrahim , Ramadan Taha , Ahmed Ezzat Ahmed , Esmael M. Alyami , Theodore Whitmore , Muhammad Sohail , Fazal Rehman , Shahid Ullah Khan
Cardiovascular diseases (CVDs) remain the leading global cause of morbidity and mortality, with growing evidence highlighting the immune system as a central regulator of disease initiation and progression. Recent advances have uncovered pivotal roles for innate lymphoid cells (ILCs) and trained innate immunity (TI) in shaping cardiovascular homeostasis and inflammation. This review synthesizes current knowledge on the development, tissue residency, and functional specialization of ILC subsets, including ILC1/NK cells, ILC2, and ILC3, as well as their divergent contributions to atherosclerosis, myocardial infarction, heart failure, myocarditis, and pericarditis. ILC1 and NK cells promote vascular inflammation and plaque progression, whereas cardiac-resident ILC2s exert reparative, anti-inflammatory, and atheroprotective effects. Parallel evidence shows that TI, driven by metabolic stressors such as hyperglycemia, oxidized LDL, smoking, and a Western diet, induces persistent myeloid reprogramming that amplifies vascular inflammation and accelerates CVD. We further highlight their potential as diagnostic biomarkers and therapeutic targets, including cytokine-directed interventions, modulation of the IL-33/ILC2 axis, and epigenetic therapies. Together, these insights position ILC biology and TI as transformative frameworks for advancing precision immunocardiology.
{"title":"Innate lymphoid cells and trained innate immunity in cardiovascular disease: Mechanistic insights, immunopathology, and emerging translational opportunities","authors":"Mustafa H. Halawi , Mazen Almehmadi , Essam H. Ibrahim , Ramadan Taha , Ahmed Ezzat Ahmed , Esmael M. Alyami , Theodore Whitmore , Muhammad Sohail , Fazal Rehman , Shahid Ullah Khan","doi":"10.1016/j.cpcardiol.2025.103252","DOIUrl":"10.1016/j.cpcardiol.2025.103252","url":null,"abstract":"<div><div>Cardiovascular diseases (CVDs) remain the leading global cause of morbidity and mortality, with growing evidence highlighting the immune system as a central regulator of disease initiation and progression. Recent advances have uncovered pivotal roles for innate lymphoid cells (ILCs) and trained innate immunity (TI) in shaping cardiovascular homeostasis and inflammation. This review synthesizes current knowledge on the development, tissue residency, and functional specialization of ILC subsets, including ILC1/NK cells, ILC2, and ILC3, as well as their divergent contributions to atherosclerosis, myocardial infarction, heart failure, myocarditis, and pericarditis. ILC1 and NK cells promote vascular inflammation and plaque progression, whereas cardiac-resident ILC2s exert reparative, anti-inflammatory, and atheroprotective effects. Parallel evidence shows that TI, driven by metabolic stressors such as hyperglycemia, oxidized LDL, smoking, and a Western diet, induces persistent myeloid reprogramming that amplifies vascular inflammation and accelerates CVD. We further highlight their potential as diagnostic biomarkers and therapeutic targets, including cytokine-directed interventions, modulation of the IL-33/ILC2 axis, and epigenetic therapies. Together, these insights position ILC biology and TI as transformative frameworks for advancing precision immunocardiology.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"51 4","pages":"Article 103252"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-06DOI: 10.1016/S0146-2806(25)00262-2
{"title":"Information for Readers","authors":"","doi":"10.1016/S0146-2806(25)00262-2","DOIUrl":"10.1016/S0146-2806(25)00262-2","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"51 2","pages":"Article 103243"},"PeriodicalIF":3.3,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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