Atherosclerosis is a pathophysiological process common to a range of cardiovascular diseases. We reasoned that considering clinical presentations of atherosclerosis across the coronary, peripheral, and cerebrovasculature as a single entity would enhance statistical power to identify rare genetic variation driving pathological processes across multiple vascular beds.

The Helix Research Network program is a large population genomics initiative that screens an all-comers population of patients for Centers for Disease Control and Prevention Tier 1 genetic conditions, including familial hypercholesterolemia (FH). We evaluated changes in clinical management and low-density lipoprotein cholesterol (LDL-C) levels among patients we identified to have FH.

Patients with intermediate-high risk pulmonary embolism (PE) have an elevated right-to-left-ventricular (RV/LV) diameter ratio and are at risk of early clinical decompensation and mortality. Reperfusion therapy aims to rapidly relieve acute RV pressure overload and normalize hemodynamics. STORM-PE is the first reported randomized controlled trial (RCT) to test the efficacy and evaluate the safety of mechanical thrombectomy (MT), specifically computer assisted vacuum thrombectomy (CAVT) with anticoagulation (AC) compared to AC alone.

Animal models are an essential part of preclinical research, serving to protect patients through safety and efficacy studies before human trials begin. Prior to the passage of the Food and Drug Administration (FDA) Modernization Act 2.0 in 2022, animal studies were generally required by regulators in preclinical safety evaluations. This Act amended the Federal Food, Drug, and Cosmetic Act to clarify that while animal testing had been the default standard, it is no longer a mandatory requirement for regulatory filings involving drugs and biological products1. Additionally, the Act explicitly specifies in vitro, in silico, and in chemico testing as alternatives to assess pre-clinical safety and efficacy. The FDA and others refer to these alternative platforms as New Approach Methodologies (NAMs) with an emphasis on the 3Rs of replacing, reducing and refining the use of animal testing2. This shift opens new pathways for developing and evaluating precision therapies in cardiovascular disease particularly if human-derived, genetically accurate models can outperform animal studies in predictive power and translatability.

Patients with prior ischemic stroke are at high risk for recurrent stroke and other major adverse cardiovascular events (MACE). The benefits of achieving very low levels of low-density lipoproteins-cholesterol (LDL-C) in such patients is unclear.

There are currently no robust clinical markers for assessing prognosis in patients with heart failure (HF) with recovered left ventricular ejection fraction (LVEF). This study sought to investigate whether NT-proBNP (N-terminal pro-B-type natriuretic peptide) measured at the time of LVEF recovery is an independent predictor of prognosis among patients with HF with recovered LVEF.

Cardiovascular disease (CVD) causes more than 50% of deaths in patients with advanced chronic kidney disease (CKD). Clinical studies suggest that kidney-derived factors contribute to CVD development in CKD, independently of co-morbidities. However, to date, no kidney-specific humoral risk factor that triggers direct cardiotoxicity has been identified. In this cross-sectional study, we investigate how, in CKD patients, circulating extracellular vesicles (EVs) facilitate pathological kidney-heart communication, thereby causing cardiotoxicity, impairing cardiac function, and contributing to heart failure (HF) progression.

Randomized trials of venous thrombolysis to prevent postthrombotic syndrome have produced mixed results. A method to identify patients most likely to benefit from interventional treatment is needed. This study evaluated a contrast-free, magnetic resonance-based multisequence thrombus imaging (MSTI) technique to characterize deep venous thrombi and predict susceptibility to thrombolysis.

Patients with cardiovascular conditions like heart failure (HF) often exhibit significant heterogeneity of the risk of clinical events. In clinical trials, large risk heterogeneity can result in an underestimation of treatment effects derived from Cox proportional hazards models. This occurs due to selection bias when estimating the hazard ratio, stemming from a disproportionate reduction of event-free patients in the control group compared with an effective active group over time, ultimately reducing the statistical power. Therefore, it is important to explore alternative analysis methods for outcome trials that are robust with respect to risk heterogeneity.

Patients with heart failure tend to experience higher rates of hospital readmissions compared with other ambulatory care-sensitive conditions. In Sweden, the nationwide Care Coordination Act (CCA) was introduced in January 2018 with the goal of improving care coordination, resulting in a reduction of readmissions and length of stay. There is insufficient knowledge regarding the effect of this reform on patients with heart failure.

The COVID-19 pandemic, caused by SARS-CoV-2, has led to the first approval of mRNA vaccines in humans. By producing the full-length SARS-CoV-2 Spike protein, they induce protective antiviral immunity. Acute myopericarditis (AMP) development after vaccination has repeatedly been reported; however, the pathogenesis of this complication remains elusive.

Nitric oxide (NO), generated by the endothelial NO synthase (eNOS), regulates vascular tone and endothelial homeostasis to counteract vascular inflammation. Most eNOS is localized at the cell membrane or in the Golgi apparatus, but the enzyme is also present in the endothelial cell nucleus. Here, we assessed the relevance of nuclear eNOS and NO signaling for endothelial cell function.

Impaired efferocytosis of macrophages within advanced atherosclerotic plaques leads to plaque deposition and rupture, ultimately resulting in atherothrombotic events. Effective restoration of efferocytic capacity in lesional macrophages remains a challenge in atherosclerosis treatment.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, characterized by atrial fibrosis, a crucial substrate facilitating its initiation and persistence. CKAP4 (cytoskeleton-associated protein 4) has been associated with fibroblast activation; however, its involvement in atrial remodeling and AF susceptibility remains unclear.

A 3-dimensional hyperboloid model has been proposed to characterize ventricular tachycardia (VT) circuitry. We sought to characterize the geometric features of viable corridors, derived from late gadolinium enhanced cardiovascular magnetic resonance, that participate in VT circuitry in ischemic cardiomyopathy.

Cardiovascular and metabolic health are influenced by the circadian system, which regulates 24-hour rhythms across numerous physiologic processes. Disruptions to circadian rhythmicity can adversely affect cardiometabolic function and health. Given the importance of circadian health to overall human health, this scientific statement provides an overview of the circadian system and key behavioral factors that can synchronize or desynchronize these rhythms, including light exposure, food intake, physical exercise, and sleep timing. We also summarize the literature on associations between circadian health and cardiometabolic health indicators, such as excessive weight, type 2 diabetes (T2D), hypertension, and cardiovascular disease. We discuss strategies to improve circadian health and reduce circadian disruptions, focusing on interventions that target the key synchronizers of circadian rhythms and involve appropriate timing of exposure to these synchronizers. These include morning bright light exposure and avoidance of light at night, as well as appropriately timed sleep, meals, and exercise. Clinicians, researchers, policymakers, and the public should recognize the role of circadian rhythms in maintaining and promoting cardiometabolic health and focus on identifying modifiable behaviors that can improve them.

Little correlation exists between the burden of ischemia and severity of angina in patients with stable coronary artery disease. This placebo-controlled, n-of-1 study investigated the relationship between ischemia, the collateral circulation, and symptoms in stable coronary artery disease. Additionally, it explored the association between progressive collateral recruitment and ischemic preconditioning.