Performance of the American Heart Association's PREVENT risk score for cardiovascular risk prediction in a multiethnic population.

The Predicting Risk of Cardiovascular EVENTS (PREVENT) equations, created and endorsed by the American Heart Association, provide cardiovascular risk estimates for the general population, but have not yet been tested in multiethnic populations. In the present study, in a large nationwide multiethnic sample of US veterans, the utility of PREVENT to predict the risk of total cardiovascular disease (CVD: fatal and nonfatal myocardial infarction, stroke or heart failure; PREVENT-CVD), atherosclerotic cardiovascular disease (ASCVD: fatal and nonfatal myocardial infarction or stroke; PREVENT ASCVD) and heart failure was evaluated. We assessed the discrimination and calibration performance of ASCVD prediction with PREVENT ASCVD compared with a previous risk-prediction score, pooled cohort equations (PCEs).

Atherosclerotic Cardiovascular Disease in Cardiovascular-Kidney-Metabolic Syndrome.

Atherosclerotic cardiovascular disease (CVD) remains an important cause of morbidity and mortality globally. The novel American Heart Association cardiovascular kidney metabolic health framework highlights a graded accumulation of these risk enhancers that culminates in myocardial infarction, stroke, and peripheral arterial disease. The framework is supplemented by risk prediction models that allow earlier detection in order to implement risk reduction measures.

Cardiovascular Events in Lupus Nephritis: A Systematic Review and Meta-Analysis.

Introduction: Systemic lupus erythematous (SLE) is known to be associated with cardiovascular events (CVEs). However, the incidence of CVE has not been thoroughly investigated in lupus nephritis (LN) patients. In this meta-analysis, we aimed to assess the incidence of CVE in patients with LN.

Longitudinal associations between vegetarian dietary habits and site-specific cancers in the Adventist Health Study-2 North American cohort.

Background: Associations between vegetarian diets and risk of common cancers are somewhat understood, but such data on medium-frequency cancers are scarce and often imprecise.

Objectives: The objectives of this study was to describe multivariable-adjusted associations between different types of vegetarian diets (compared with nonvegetarians) and risk of cancers at different bodily sites.

Methods: The Adventist Health Study is a cohort of 95,863 North American Seventh-day Adventists established between 2002 and 2007.

Kidney Recovery after Acute Kidney Injury: A Comprehensive Review.

Background: Acute Kidney Injury (AKI) is a common and critical condition associated with significant morbidity and mortality across various patient populations. The recovery process following AKI is complex and involves a multitude of biological, clinical, and environmental factors. Despite considerable research, there remains substantial debate regarding the exact role and significance of these factors, as well as how they interact with one another.

The Cardiovascular-Kidney-Metabolic Health Framework: Implications for Nephrology.

Metabolic risk factors, CKD, and cardiovascular disease are highly prevalent, frequently coexist, and adversely affect lifespan and health span globally. The American Heart Association (AHA) recently defined Cardiovascular-Kidney-Metabolic (CKM) syndrome to highlight the interconnectedness between these conditions, across biological and socioecological domains. The CKM health initiative of the AHA seeks to improve cardiovascular and kidney health at a population level by providing a holistic approach to the management of individuals with CKM syndrome, emphasizing CKM health across the lifespan with priority for primordial/primary prevention, improving short and long-term cardiovascular risk prediction, and presenting an implementation framework for multidisciplinary health care models across diverse health care settings.

Blood Pressure Management Strategies and Podocyte Health.

Hypertension (HTN) is one of the key global cardiovascular risk factors, which is tightly linked to kidney health and disease development. Podocytes, glomerular epithelial cells that play a pivotal role in maintenance of the renal filtration barrier, are significantly affected by increased glomerular capillary pressure in HTN. Damage or loss of these cells causes proteinuria, which marks the initiation of the HTN-driven renal damage.

Revisiting sex as a biological variable in hypertension research.

Half of adults in the United States have hypertension as defined by clinical practice guidelines. Interestingly, women are generally more likely to be aware of their hypertension and have their blood pressure controlled with treatment compared with men, yet hypertension-related mortality is greater in women. This may reflect the fact that the female sex remains underrepresented in clinical and basic science studies investigating the effectiveness of therapies and the mechanisms controlling blood pressure.

Cause-specific and all-cause mortalities in vegetarian compared with those in nonvegetarian participants from the Adventist Health Study-2 cohort.

Background: There have been mixed results reported internationally when associating vegetarian dietary patterns with all-cause and cause-specific mortalities.

Objectives: This study aimed to extend our previous results by evaluating, with a larger number of deaths (N = 12,515), cause-specific mortalities comparing different vegetarian types with nonvegetarians.

Methods: This prospective study used data from the Adventist Health Study-2 cohort.

Cardiorenal Syndrome in Right Heart Failure Due to Pulmonary Arterial Hypertension-The Right Ventricle as a Therapeutic Target to Improve Renal Function.

Cardiorenal syndrome (CRS) due to right ventricular (RV) failure is a disease entity emerging as a key indicator of morbidity and mortality. The multifactorial aspects of CRS and the left-right ventricular interdependence complicate the link between RV failure and renal function. RV failure has a direct pathophysiological link to renal dysfunction by leading to systemic venous congestion in certain circumstances and low cardiac output in other situations, both leading to impaired renal perfusion.

Patterns of Statin Therapy Use and Associated Outcomes in Older Veterans Across Kidney Function.

Background: Despite significant morbidity and mortality related to atherosclerotic cardiovascular disease, to date, most major clinical trials studying the effects of statin therapy have excluded older adults. The objective of this analysis was to evaluate the effect of initiating statin therapy on incident dementia and mortality among individuals 75 years of age or older across the complete spectrum of kidney function.

Methods: We conducted a retrospective cohort study of 640,191 VA health system patients who turned 75 years of age between 2000 and 2018.

Impact of arteriovenous fistula on flow states in the evaluation of aortic stenosis among ESKD patients on dialysis.

Introduction: An arteriovenous fistula (AVF) in patients with end-stage kidney disease (ESKD) can influence flow states. We sought to evaluate if assessment of aortic stenosis (AS) by transthoracic echocardiographic (TTE) differs in the presence of AVF compared to other dialysis accesses in patients on dialysis.

Methods: We identified consecutive ESKD patients on dialysis and concomitant AS from a single center between January 2000 and March 2021.

Sodium-glucose cotransporter 2 inhibitors and cardiorenal outcomes in kidney transplantation.

Purpose Of Review: This review aims to explore the current evidence regarding cardiovascular and kidney outcomes in patients who undergo treatment with sodium-glucose cotransporter 2 inhibitors (SGLT2i) post kidney transplantation.

Recent Findings: Summary findings from individual studies included in this review showed largely favorable results in the kidney transplant recipients (KTRs) being treated with SGLT2i.These outcomes included parameters such as allograft function, glycemic control, proteinuria, blood pressure, weight loss and safety profile, among others.

Cardiovascular Disease in Diabetes and Chronic Kidney Disease.

Chronic kidney disease (CKD) is a common occurrence in patients with diabetes mellitus (DM), occurring in approximately 40% of cases. DM is also an important risk factor for cardiovascular disease (CVD), but CKD is an important mediator of this risk. Multiple CVD outcomes trials have revealed a greater risk for CVD events in patients with diabetes with CKD versus those without.

Body Mass Index and Clinical and Health Status Outcomes in Chronic Coronary Disease and Advanced Kidney Disease in the ISCHEMIA-CKD Trial.

Objective: This study aimed to assess whether an obesity paradox (lower event rates with higher body mass index [BMI]) exists in participants with advanced chronic kidney disease (CKD) and chronic coronary disease in the International Study of Comparative Health Effectiveness of Medical and Invasive Approaches (ISCHEMIA)-CKD, and whether BMI modified the effect of initial treatment strategy.

Methods: Baseline BMI was analyzed as both a continuous and categorical variable (< 25, ≥ 25 to < 30, ≥ 30 kg/m). Associations between BMI and the primary outcome of all-cause death or myocardial infarction (D/MI), and all-cause death, cardiovascular death, and MI individually were estimated.

Plasma metabolomics profiles in Black and White participants of the Adventist Health Study-2 cohort.

Background: Black Americans suffer disparities in risk for cardiometabolic and other chronic diseases. Findings from the Adventist Health Study-2 (AHS-2) cohort have shown associations of plant-based dietary patterns and healthy lifestyle factors with prevention of such diseases. Hence, it is likely that racial differences in metabolic profiles correlating with disparities in chronic diseases are explained largely by diet and lifestyle, besides social determinants of health.

Proportional troponin changes and risk for outcomes with intervention strategies in non-ST-elevation acute coronary syndrome across kidney function.

Aims: This analysis evaluates whether proportional serial cardiac troponin (cTn) change predicts benefit from an early versus delayed invasive, or conservative treatment strategies across kidney function in non-ST-elevation acute coronary syndrome (NSTE-ACS).

Methods: Patients diagnosed with NSTE-ACS in the Veterans Health Administration between 1999 and 2022 were categorized into terciles (<20%, 20 to ≤80%, >80%) of proportional change in serial cTn. Primary outcome included mortality or rehospitalization for myocardial infarction at 6 and 12 months, in survivors of index admission.

Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association.

Cardiovascular-kidney-metabolic health reflects the interplay among metabolic risk factors, chronic kidney disease, and the cardiovascular system and has profound impacts on morbidity and mortality. There are multisystem consequences of poor cardiovascular-kidney-metabolic health, with the most significant clinical impact being the high associated incidence of cardiovascular disease events and cardiovascular mortality. There is a high prevalence of poor cardiovascular-kidney-metabolic health in the population, with a disproportionate burden seen among those with adverse social determinants of health.

A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association.

A growing appreciation of the pathophysiological interrelatedness of metabolic risk factors such as obesity and diabetes, chronic kidney disease, and cardiovascular disease has led to the conceptualization of cardiovascular-kidney-metabolic syndrome. The confluence of metabolic risk factors and chronic kidney disease within cardiovascular-kidney-metabolic syndrome is strongly linked to risk for adverse cardiovascular and kidney outcomes. In addition, there are unique management considerations for individuals with established cardiovascular disease and coexisting metabolic risk factors, chronic kidney disease, or both.

Outcomes of Severe Acute Kidney Injury in Pediatric Trauma Patients; The Trauma Quality Improvement Program Database Study.

Introduction: Acute kidney injury (AKI) has been associated with higher mortality and morbidity in trauma victims. There is a paucity of information regarding the outcomes of severe AKI (sAKI) in pediatric trauma patients. Therefore, the trauma quality improvement program database (TQIP) was used to assess that hypothesis sAKI will be associated with higher mortality among pediatric trauma patients.