Initiating Preventive Care for Hyperlipidemia in the Emergency Department: The Emergency Medicine Cardiovascular Risk Assessment for Lipid Disorders Trial.

Background: Hyperlipidemia (HLD) is a major contributor to atherosclerotic cardiovascular disease (ASCVD). Nearly 30% of emergency department (ED) patients with chest pain have undiagnosed and/or unmanaged HLD, putting them at an increased risk of ASCVD. Although safe and effective HLD treatments exist, the ED traditionally focuses on acute care and does not offer preventive cardiovascular care services.

Effect of Hypertension on Long-term Adverse Clinical Outcomes and Liver Fibrosis Progression in MASLD.

Background & Aims: Hypertension is common in metabolic dysfunction-associated steatotic liver disease (MASLD), but its impact on long-term clinical outcomes and disease progression remains unclear. This study investigated the association of hypertension and risk of adverse clinical outcomes and progression of liver stiffness/fibrosis in MASLD.

Methods: Three multicenter prospective cohorts were analyzed: the UK BioBank (UKBB) cohort to assess the risk of adverse clinical outcomes, the VCTE-Prognosis cohort to assess liver stiffness/fibrosis progression, and the Paired Liver Biopsy cohort to assess histologic liver fibrosis progression.

Effect of PCSK9 Inhibition With Alirocumab in Patients With Probable Familial Hypercholesterolemia or Type III Hyperlipoproteinemia: Results From the ODYSSEY OUTCOMES Trial.

Background: In this post hoc analysis of the ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) trial, we evaluated the efficacy of alirocumab in patients with probable heterozygous familial hypercholesterolemia (HeFH) or type III hyperlipoproteinemia (T3HLP).

Methods: Patients had clinical HeFH if baseline low-density lipoprotein cholesterol was ≥250 mg/dL and the qualifying acute coronary syndrome event occurred before age 55 (men) or 60 years (women), or if baseline low-density lipoprotein cholesterol was ≥330 mg/dL. Patients had T3HLP if the ratio, validated using the UK Biobank database, of non-high-density lipoprotein cholesterol/apolipoprotein B was >2.

Impact of a Meds-to-Beds PCSK9i Initiation Program on LDL-C in Patients Undergoing ASCVD Revascularization.

Background: Despite proven benefits of low-density lipoprotein cholesterol (LDL-C) lowering in secondary prevention of atherosclerotic cardiovascular disease, goal achievement remains suboptimal.

Objectives: The authors tested whether early use of guideline-recommended proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i) monoclonal antibodies (mAbs) through a meds-to-beds (M2B) program improved LDL-C goal attainment postrevascularization.

Methods: Using a dedicated M2B program, we prospectively included patients undergoing coronary or peripheral artery revascularization, on maximally tolerated statin therapy, and with LDL-C ≥70 mg/dL.

The Continuum of Prevention and Heart Failure in Cardiovascular Medicine: A Joint Scientific Statement from the Heart Failure Society of America and The American Society for Preventive Cardiology.

Heart disease is the leading cause of death worldwide, with heart failure (HF) recognized as its most severe and debilitating manifestation. Though remarkable advancements have led to the establishment of life-saving and quality-of-life-enhancing medical and device-based therapies for HF, HF-related mortality trends have increased over the past decade. To combat this worldwide epidemic, care must evolve so that preventative recommendations are not siloed from HF management.

Early outcomes of contaminated midline incisional hernia repair with mesh suture.

Purpose: Mesh suture is a novel reinforcement construct designed to provide enhanced mechanical support during midline fascial closure in comparison to conventional sutures while minimizing tissue dissection and foreign body burden in comparison to use of a planar mesh. Its use in contaminated fields remains understudied. This study evaluates the early clinical outcomes following mesh suture closure in clean-contaminated and contaminated incisional hernia repairs.

ST8Sia6 overexpression protects pancreatic β cells from spontaneous autoimmune diabetes in nonobese diabetic mice.

Type 1 diabetes is characterized by the autoimmune destruction of pancreatic β cells, resulting in permanent loss of glucose homeostasis. Islet transplantation is a promising potential cure that remains hindered by immune rejection. We previously showed that ST8Sia6 expression on tumors reduced immune surveillance and hypothesized that this sialyltransferase could protect β cells from autoimmune destruction.

A comparative analysis of cardiovascular disease mortality trends attributable to risk factors in the United States and globally from 1990 to 2019: an analysis of the Global Burden of Disease Study 2019.

Background: Trends in cardiovascular disease (CVD) mortality from key risk factors both in the United States (US) and globally have not been well characterized.

Methods: This analysis utilized Global Burden of Disease (GBD) 2019 data to determine age-standardized mortality rates (ASMR) and disability-adjusted life years (DALYs) for CVDs attributed to risk factors in the US and globally. Total percentage change (TPC, 95 % CI) was calculated to assess temporal trends in CVD mortality and disease burden related to key risk factors, examining two periods: 1990-2010 and 2010-2019.

Liver Fibrosis and the Risk of Coronary Artery Disease, Stent Thrombosis, Restenosis and Adverse Clinical Outcomes.

Background And Aims: Liver fibrosis may be associated with coronary artery disease (CAD) and adverse cardiovascular outcomes, but data remain limited. This study aimed to explore the relationship between liver fibrosis and the incidence of CAD, stent thrombosis (ST), in-stent restenosis (ISR) and long-term clinical outcomes.

Methods: Two cohorts were analysed: the UK Biobank (UKB) cohort examined liver fibrosis and CAD incidence and clinical outcomes in the general population, while the Wenzhou cohort assessed its relationship with ST and ISR and long-term outcomes in post-PCI patients.

Current Clinical Trials for Treating Elevated Lipoprotein(a).

Purpose Of Review: Numerous studies have established lipoprotein(a) [Lp(a)] as an independent and modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis (CAVS). As such Lp(a) has become the focus of targeted drug therapy development with the goal of reducing Lp(a) serum concentrations and improving outcomes. This review aims to inform readers on the investigational agents currently in clinical trials and highlight key differences including dosing intervals and routes of administration that may facilitate uptake and retention of a particular potential medication in certain patient populations.

Emergency general surgery: The prevalence of non-operative consultations and importance of a registry.

Introduction: An emergency general surgery (EGS) service is a crucial component of care in a hospital. Current reviews of EGS focus on procedural-based or diagnosis-driven reviews of administrative data. However, patients evaluated by an EGS service may or may not undergo surgery.

Widespread variation in is associated with diverse melanin loss phenotypes across avian species.

Plumage pigmentation plays critical roles in survival and reproductive success in birds, from providing camouflage and thermoregulation to mediating elaborate mating displays. The genetic and developmental origins of diverse plumage pigmentation patterns remain incompletely understood in part due to limited intraspecific variation and high levels of genetic divergence between distantly related species. Domestic avian species are more tractable models for understanding the genetic architecture of plumage pigmentation, but the relevance of domestic phenotypes to plumage patterns observed in the wild is not clear.

Mesh suture repair of rectus diastasis with and without a concurrent ventral hernia.

Purpose: The optimal technique for rectus diastasis (RD) repair, particularly when a ventral hernia is present, remains undefined. Mesh suture is a novel device designed to resist suture pull-through in high-tension closures. This study evaluates the technical feasibility and early outcomes of mesh suture use for linea alba plication during open abdominoplasty, with and without concurrent ventral hernia repair.

Association of Plasma Lipoprotein(a) With Major Adverse Cardiovascular Events in MASLD With or Without Advanced Liver Fibrosis.

Background And Aims: There is uncertainty regarding the role of plasma lipoprotein(a) [Lp(a)] in predicting cardiovascular events in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). We examined the association between plasma Lp(a) concentrations and major adverse cardiovascular events (MACE) in MASLD, stratified by the severity of liver fibrosis.

Methods: This study enrolled patients with MASLD from two centres.

A Critical Appraisal of Lipid Management in the Post-Statin Era: Comparison on Guidelines, Therapeutic Targets, and Screening in a Case-Based Framework of Lipid Management.

The role of low-density lipoprotein-cholesterol in the pathogenesis of atherosclerotic cardiovascular disease (ASCVD) is well established. Lipid management remains the cornerstone of addressing ASCVD. In addition to statin therapy, there is a large and growing number of nonstatin therapies available to manage elevated cholesterol levels.

Lifestyle Interventions in Cardiovascular-Kidney-Metabolic Syndrome JACC: Advances Expert Panel.

Cardiovascular-kidney-metabolic (CKM) syndrome impacts nearly all organ systems, with progressive dysfunction leading to morbidity and mortality. The high burden of CKM syndrome requires accessible, scalable, and low-cost interventions to prevent downstream complications. Nonpharmacologic interventions targeting lifestyle factors, such as diet, physical activity, and behavioral modification, represent the cornerstone of CKM syndrome management to prevent a progressive disease and associated adverse outcomes.

Prevalence and Correlates of Lipoprotein(a) Testing in a Diverse Cohort of U.S. Adults.

Background: Once-per-lifetime lipoprotein(a) [Lp(a)] testing is recommended by multiple professional societies during cardiovascular disease risk assessment.

Objective: The purpose of this study was to assess the prevalence and identify correlates of Lp(a) testing in a real-world, diverse sample.

Methods: Participants were ≥18 years of age from the All of Us Research Study who shared electronic medical record information through 2022 (N = 266,612).

Lipoprotein X - Pathophysiology, diagnosis, and management.

Background: Lipoprotein X (LpX) was first discovered in the 1960s in patients with severe cholestatic diseases as an abnormal lipoprotein that is distinct from other lipoproteins because it is not produced through regulated pathways, contains albumin as the primary protein, and is rich in free cholesterol (FC) and phospholipids. Over the next few decades, its biochemical properties and composition were characterized.

Sources Of Material: Elevated blood levels of LpX are now also known to occur in various other conditions, such as lecithin cholesterol acyltransferase (LCAT) deficiency, graft versus host disease, and after lipid infusions for nutritional support.

Global lipoprotein (a) testing trends from 2015 to 2023.

Background: Lipoprotein (a) [Lp(a)] is a known cardiovascular disease risk factor. Recent guidelines recommend Lp(a) testing once in all individuals, especially in those with premature cardiovascular disease, and family history of cardiovascular disease. Emerging Lp(a) lowering therapies have the potential to mitigate this risk.