C-reactive protein and cardiovascular risk among women with no standard modifiable risk factors: evaluating the 'SMuRF-less but inflamed'.

Background And Aims: Interventions in preventive cardiology traditionally focus on four standard modifiable cardiovascular risk factors (SMuRFs): hypertension, dyslipidaemia, diabetes mellitus, and smoking. Yet, a substantial proportion of incident cardiovascular events accrues for individuals with none of these factors, particularly among women for whom cardiovascular disease remains under-detected and under-treated. The utility of the inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) was evaluated to detect cardiovascular risk in SMuRF-less women participating in the prospective NIH-funded Women's Health Study.

Accelerating Drug Translation: Role of Coronary Computed Tomography Angiography Plaque Imaging Candidates as Surrogate Biomarkers.

There is an unmet need for new pathways to evaluate therapeutic targets and drugs for coronary artery disease (CAD). The use of major adverse cardiovascular events as a primary outcome is advantageous for rigor, but challenges related to large sample size requirements, long study durations, and associated costs and risks remain major disincentives for key stakeholders. Until now, a robust, well-validated surrogate biomarker for cardiovascular events that reflects atherosclerosis itself has been lacking.

The Global Syndemic of Modifiable Cardiovascular Risk Factors Projected From 2025 to 2050.

Background: Cardiovascular diseases (CVDs) are the leading cause of global mortality. Understanding epidemiologic trends in the modifiable risk factors driving CVDs is essential in designing effective countermeasures.

Objectives: The aim of this study was to forecast geospatial trends of modifiable cardiovascular risk factors, namely high systolic blood pressure (SBP), high fasting plasma glucose, high body mass index (BMI), high low-density lipoprotein cholesterol, and tobacco use from 2025 to 2050.

Changes to the serum lipidome and their relation to coronary plaque in the first six months after acute myocardial infarction.

Background And Aims: The measurement of lipid species in blood holds promise for identifying new biomarkers associated with coronary atherosclerosis. Here, we examined for relationships between circulating lipid species and coronary plaque changes following acute myocardial infarction (MI) in patients on guideline-recommended treatment.

Methods: In this post-hoc analysis of the INFLAME study, patients presenting with MI underwent serum lipidomic analysis and coronary computed tomography angiography (CCTA) during admission and at 6-month follow-up.

Novel CAC Dispersion and Density Score to Predict Myocardial Infarction and Cardiovascular Mortality.

Background: Coronary artery calcification (CAC) provides robust prediction for major adverse cardiovascular events (MACE), but current techniques disregard plaque distribution and protective effects of high CAC density. We investigated whether a novel CAC-dispersion and density (CAC-DAD) score will exhibit superior prognostic value compared with the Agatston score (AS) for MACE prediction.

Methods: We conducted a multicenter, retrospective, cross-sectional study of 961 patients (median age, 67 years; 61% men) who underwent cardiac computed tomography for cardiovascular or perioperative risk assessment.

First myocardial infarction: risk factors, symptoms, and medical therapy.

Background And Aims: Despite the implementation of clinical risk algorithms based on traditional risk factors, the global burden of atherosclerotic cardiovascular disease has continued to rise over the past decades. There are few real-world data on prevalence of both symptoms and risk factors prior to myocardial infarction (MI). This study aimed to investigate the prevalence of documented coronary artery disease risk factors, documented symptoms, physician visits, and preventive therapy uptake prior to first MI.

Computed Tomography Coronary Angiography Versus Stress Echocardiography in a Rapid Access Chest Pain Clinic.

Background: Outpatient rapid-access chest pain clinics (RACPCs) investigate and manage low-to intermediate-risk chest pain. Several non-invasive investigations have been employed for RACPCs, including stress echocardiography (SE) and computed tomography coronary angiography (CTCA). However, research on the influence of these tests on diagnosis and management in this setting is limited.

Evaluating the Role of Lipoprotein(a) in Enhancing Risk Stratification for the Presence and Extent of Subclinical Coronary Artery Disease Burden - A BioHEART-CT Study.

Aims: Lipoprotein(a) [Lp(a)] has regained attention as an independent cardiovascular risk factor, particularly given emerging therapies entering late-phase clinical trials. Here, we aim to examine the association of Lp(a) with CAD and the potential of Lp(a) as an enrichment criterion for identifying individuals more likely to benefit from screening for subclinical CAD with CT imaging.

Methods: We analysed data from 1,718 adults undergoing CTCA for suspected CAD enrolled in the BioHEART study.

National Survey of Rapid Access Chest Pain Clinics in Australia.

Aim: Rapid access chest pain clinics (RACCs) are an innovative outpatient pathway that allows low-intermediate risk patients to avoid hospitalisation. However, the extent of RACCs in Australia is unknown. We aimed to identify Australian RACCs and describe the characteristics and landscape of this model of care in Australia.

The efficacy and safety of low dose colchicine in atherosclerotic cardiovascular disease - A systematic review and meta-analysis.

Aim: Colchicine has recently been approved for the treatment of atherosclerotic cardiovascular disease (ASCVD). Since then, three large trials of colchicine in ASCVD have failed to reach their primary endpoints.

Method: A systematic search of PubMed, Embase and Cochrane Central Register of Controlled Trials was performed (PROSPERO registration: CRD42024616378).

Heart matters: the unique landscape of cardiovascular health in women.

Cardiovascular disease (CVD) remains the leading cause of death globally, despite significant public health efforts. The identification and targeting of modifiable risk factors - including hypertension, dyslipidemia, diabetes mellitus, smoking and obesity - have led to significant improvements in patient outcomes over the past 60 years. However, current strategies based on this model have been shown to underestimate CVD risk in women and they are less frequently targeted compared to men.

Polymorphic tandem repeats influence cell type-specific gene expression across the human immune landscape.

Tandem repeats (TRs) - highly polymorphic, repetitive sequences dispersed across the human genome - are crucial regulators of gene expression and diverse biological processes, but have remained underexplored relative to other classes of genetic variation due to historical challenges in their accurate calling and analysis. Here, we leverage whole genome and single-cell RNA sequencing from over 5.4 million blood-derived cells from 1,925 individuals to explore the impact of variation in over 1.

Rationale and design of the TeleClinical Care Cardiac (TCC-Cardiac) trial: A pragmatic randomized trial of adjunctive virtual models of care in the secondary prevention of cardiovascular events.

Background: Digital health interventions have potential to improve outcomes in high risk cardiac patients through remote monitoring and patient education but introduce accessibility issues among patients who lack suitable smartphones. We will evaluate the effectiveness and scalability of the TeleClinical Care Cardiac (TCCCardiac) platform, that aims to reduce hospital readmissions and improve adherence to care.

Methods: A pragmatic, all-comers trial with nested randomization, where patients being discharged home following an admission with acute myocardial infarction (MI) or decompensated heart failure (HF) are divided into 3 cohorts pragmatically, based on their access to technology.

Unmet Needs and Opportunities for Australian Innovation and Clinical Research to Improve Quality of Life and Outcomes in Patients With Peripheral Artery Disease.

Peripheral arterial disease (PAD) is characterised by atherosclerotic stenosis or occlusion of arteries that leads to reduced blood flow to the limbs. PAD is associated with a very high rate of cardiovascular morbidity and mortality making the health and economic burden of PAD substantial. Despite high-quality evidence and international guidelines recommending conservative medical management of risk factors, and exercise and lifestyle interventions, surgical revascularisation (open or endovascular) remains the main treatment for PAD.

Mortality in ischaemic stroke patients without standard modifiable risk factors: An analysis of the Riksstroke registry.

Introduction: Little is known of the long-term prognosis of patients with acute ischaemic stroke in the absence of standard modifiable stroke risk factors (SMoRFs). In acute coronary syndromes, patients without modifiable risk factors have a higher mortality rate. We analysed data from the Swedish Stroke Register to determine survival of patients without SMoRFs following an ischaemic stroke.

Cardiovascular-Liver-Metabolic Health: Recommendations in Screening, Diagnosis, and Management of Metabolic Dysfunction-Associated Steatotic Liver Disease in Cardiovascular Disease via Modified Delphi Approach.

There is a new awareness of the widespread nature of metabolic dysfunction-associated steatotic liver disease (MASLD) and its connection to cardiovascular disease (CVD). This has catalyzed collaboration between cardiologists, hepatologists, endocrinologists, and the wider multidisciplinary team to address the need for earlier identification of those with MASLD who are at increased risk for CVD. The overlap in the pathophysiologic processes and parallel prevalence of CVD, metabolic syndrome, and MASLD highlight the multisystem consequences of poor cardiovascular-liver-metabolic health.

Expression of Myeloperoxidase in Patient-Derived Endothelial Colony-Forming Cells-Associations with Coronary Artery Disease and Mitochondrial Function.

Background And Aims: Myeloperoxidase (MPO) plays a critical role in the innate immune response and has been suggested to be a surrogate marker of oxidative stress and inflammation, with elevated levels implicated in cardiovascular diseases, such as atherosclerosis and heart failure, as well as in conditions like rheumatoid arthritis and cancer. While MPO is well-known in leukocytes, its expression and function in human endothelial cells remain unclear. This study investigates MPO expression in patient-derived endothelial colony-forming cells (ECFCs) and its potential association with CAD and mitochondrial function.

A Call to Action to Improve Cardiac Arrest Outcomes: A Report From the National Summit for Cardiac Arrest.

Sudden cardiac arrest (SCA) represents a major cause of premature mortality globally, with enormous impact and financial cost to victims, families, and communities. SCA prevention should be considered a health priority in Australia. National Cardiac Arrest Summits were held in June 2022 and March 2023, with inclusion from multi-faceted endeavours related to SCA prevention.

Clinical outcomes and coronary artery lesion characteristics of young patients with ST elevation myocardial infarction and no standard modifiable risk factors.

Background: Among ST-elevation myocardial infarction (STEMI) patients, those with no standard modifiable risk factors (SMuRFs: hypertension, diabetes mellitus, hypercholesterolemia, and smoking) have higher 30-day mortality than those with SMuRFs. Differences in coronary lesion characteristics remain unclear.

Methods: Data from STEMI patients aged ≤60 years from the Asia Pacific Evaluation of Cardiovascular Therapies Network (Australia, Hong Kong, Malaysia, Singapore, and Vietnam) was retrospectively analysed.