β blockers after myocardial infarction with mildly reduced ejection fraction: an individual patient data meta-analysis of randomised controlled trials.

Background: The effects of β-blocker therapy on clinical outcomes in patients with myocardial infarction and mildly reduced (40-49%) left ventricular ejection fraction (LVEF) are largely unknown. Four recently conducted randomised trials tested the efficacy of β blockers after a recent myocardial infarction in patients without reduced LVEF (LVEF ≥40%). However, none were individually powered to assess these effects in the subgroup of patients with mildly reduced LVEF.

Beta-Blockers after Myocardial Infarction in Patients without Heart Failure.

Background: The evidence supporting beta-blocker therapy after myocardial infarction was established before the introduction of modern coronary reperfusion therapy and secondary prevention strategies.

Methods: In an open-label, randomized trial with blinded end-point evaluation, conducted in Denmark and Norway, we assigned patients who had had a myocardial infarction and who had a left ventricular ejection fraction of at least 40%, in a 1:1 ratio, to receive long-term beta-blocker therapy within 14 days after the event or no beta-blocker therapy. The primary end point was a composite of death from any cause or major adverse cardiovascular events (new myocardial infarction, unplanned coronary revascularization, ischemic stroke, heart failure, or malignant ventricular arrhythmias).

Acute heart failure in non-cardiac surgery.

More than 64 million people worldwide have heart failure (HF), and these numbers are expected to rise. Acute HF (AHF) is the leading cause of hospitalization in patients over 65 years old and is linked to high mortality and readmission rates. AHF may also be a frequent complication in patients hospitalized for other medical reasons as well as after cardiac or non-cardiac surgery.

Cardiac structure and function in anabolic-androgenic steroid users: a 16-year follow-up study.

Background And Aim: Long-term data on cardiac changes in anabolic-androgenic steroid (AAS) users are lacking. The aim of this study was to explore the effects of AAS on cardiac structure and function during long-term follow-up.

Methods: In this prospective cohort study, AAS users and strength-trained non-users were included and examined at two time points with echocardiography and coronary CT angiography.

Adequately identifying low-risk chest pain in emergency primary care: evaluating the performance of preHEAR(T) based on two European cohorts.

Background: Differentiating cardiac from non-cardiac acute chest pain poses a diagnostic challenge, especially in primary care. The History, ECG, Age, Risk factors and Troponin level (HEART) score aid in risk stratification in hospitals, while the prehospital HEART (preHEART) score was refined for paramedics' use. However, its accuracy in emergency primary care has not been studied.

Educational methods to improve digital health literacy: a systematic review and meta-analysis for the EAPC Opti(MI)se initiative.

Aims: Digital health literacy (DHL) is essential for managing chronic diseases and promoting healthy aging. Despite its importance, evidence on how to improve DHL remains limited. This systematic review and meta-analysis assessed the impact of educational interventions on DHL among adults with chronic diseases and healthy older adults, with implications for both primary and secondary prevention.

SCAI/EAPCI/ACVC Expert Consensus Statement on Cardiogenic Shock in Women: This statement was endorsed by the Heart Failure Society of America (HFSA).

Cardiovascular disease is the leading cause of death for women worldwide, with mortality rates due to cardiogenic shock (CS) remaining exceedingly high. Sex-based disparities in the timely delivery of optimal CS treatment contribute to poor outcomes; addressing these disparities is a major priority to improve women's cardiovascular health. This consensus statement provides a comprehensive summary of the current state of treatment of CS in women across the spectrum of cardiovascular disease states and identifies important gaps in evidence.

SCAI/EAPCI/ACVC Expert Consensus Statement on Cardiogenic Shock in Women.

Cardiovascular disease is the leading cause of death for women worldwide, with mortality rates due to cardiogenic shock (CS) remaining exceedingly high. Sex-based disparities in the timely delivery of optimal CS treatment contribute to poor outcomes; addressing these disparities is a major priority to improve women's cardiovascular health. This consensus statement provides a comprehensive summary of the current state of treatment of CS in women across the spectrum of cardiovascular disease states and identifies important gaps in evidence.

Mediation Analyses Link Cardiometabolic Factors and Liver Fat With White Matter Hyperintensities and Cognitive Performance: A UK Biobank Study.

Background: Liver fat is associated with cardiometabolic disease, cerebrovascular disease, and dementia. Cerebrovascular disease, most often cerebral small vessel disease, identified by magnetic resonance imaging as white matter hyperintensities (WMHs) often contributes to dementia. However, liver fat's role in the relationship between cardiometabolic risk, WMHs, and cognitive performance is unclear.

Cardiovascular disease in breast cancer patients: a nationwide real-world evidence study 2013-20.

Aims: Various measures have been implemented in clinical practice to reduce the risk of cardiovascular complications during breast cancer (BC) treatment. The aim of this study was to investigate whether women diagnosed with BC exhibit a higher incidence of cardiovascular disease (CVD).

Methods And Results: Matched cohort study.

Asundexian or Apixaban in Patients With Atrial Fibrillation According to Prior Oral Anticoagulant Use: A Subgroup Analysis of the OCEANIC-AF Randomized Clinical Trial.

Importance: In patients with atrial fibrillation (AF), oral anticoagulants (OACs) reduce the risk of stroke.

Objective: To investigate if patients with less prior OAC exposure respond differently to a new OAC than patients with more OAC exposure.

Design, Setting, And Participants: In this prespecified exploratory subgroup analysis of the Oral Factor 11a Inhibitor Asundexian as Novel Antithrombotic-Atrial Fibrillation (OCEANIC-AF) randomized clinical trial, patients enrolled in the OCEANIC-AF trial were categorized as OAC naive or OAC experienced based on whether they had 6 or fewer weeks or more than 6 weeks of prior OAC use.

2024 Revision of the level of evidence grading system for ESC clinical practice guideline recommendations I: therapy and prevention.

The level of evidence (LOE) grading system for ESC Clinical Practice Guidelines classifies the quality of the evidence supporting a recommendation. However, the current taxonomy does not fully consider the optimal study design necessary to establish evidence for such recommendations. Therefore, two separate taskforces of clinical and methodological experts were appointed by the Clinical Practice Guidelines Committee, with the first tasked with updating the LOE grading system for therapy and prevention, and the second responsible for developing a LOE grading system for diagnosis and prediction.

Survival after myocardial infarction according to left ventricular function and heart failure symptoms.

Aims: Left ventricular (LV) dysfunction following acute myocardial infarction (AMI) is common even in the absence of signs and symptoms of heart failure (HF). Recent trials of patients with LV dysfunction post-AMI have demonstrated low event rates during follow-up. We aimed to assess the real-world prevalence and outcomes post-AMI, stratified by LV ejection fraction (LVEF) and the presence or absence of HF symptoms.

One-Hour Troponin Using a High-Sensitivity Point-of-Care Assay in Emergency Primary Care: The OUT-POC Pilot Study.

Introduction: Novel point-of-care (POC) high-sensitivity cardiac troponin (hs-cTn) tests could enhance acute myocardial infarction (MI) assessment outside hospital. This pilot study evaluates the efficacy, feasibility, and precision of the QuidelOrtho TriageTrue hs-cTnI POC assay when used by non-laboratory personnel in emergency primary care.

Methods: A prospective pilot study was conducted from April to June 2024 at the main emergency primary care clinic in Oslo, Norway.

Remnant cholesterol, plasma triglycerides and risk of cardiovascular disease events in young adults: a prospective cohort study.

Aim: To investigate if elevated levels of cholesterol carried in triglyceride-rich lipoproteins, marked by remnant cholesterol or plasma triglycerides, are associated with increased risk of premature cardiovascular disease (CVD) events in young adults.

Methods: Prospective cohort study. In year 2000, all 30-year-old inhabitants living in Oslo, Norway, were invited to the "Oslo Health Study" including a clinical examination and routine blood tests.

Rapid rule-out of acute myocardial infarction using the 0/1-hour algorithm for cardiac troponins in emergency primary care: the OUT-ACS implementation study.

Background: Acute chest pain has a high hospital referral rate due to the limited ability to exclude acute myocardial infarction (MI) in primary care. We aimed to evaluate the effectiveness of implementing the European Society of Cardiology (ESC) 0/1-hour algorithm for high-sensitivity cardiac troponin T (hs-cTnT) testing in emergency primary care.

Methods: In a prospective study (April-October 2023), the ESC 0/1-hour algorithm for hs-cTnT was implemented at the main emergency primary care clinic in Oslo, Norway.

Effect of metoprolol exposure following myocardial infarction on future cardiovascular events: a Mendelian randomization study.

Purpose: The clinical benefit of up-titration of metoprolol to a guideline-recommended target dose after myocardial infarction (MI) is unknown. Our aim was to investigate whether variation in metoprolol exposure determined by cytochrome p450 enzyme 2D6 (CYP2D6) influences the occurrence of major adverse cardiovascular events (MACE) and cardiovascular death (CV death) among patients treated with metoprolol after MI.

Method: This Mendelian randomization study was performed using individual-level data from 1554 patients treated with metoprolol after an acute MI.

Cardiogenic shock in women: From risk factors to therapy.

Cardiogenic shock (CS) in women is a serious cardiovascular (CV) event associated with a high mortality rate. Non-ischemic etiologies are the most common etiologies in women, such as stress-induced cardiomyopathy, peripartum/postpartum cardiomyopathy, heart failure-related CS, or CS due to myocarditis or valvular heart disease. Although not being the most common etiology in women, acute myocardial infarction is still an important one.

Large-scale brainstem neuroimaging and genetic analyses provide new insights into the neuronal mechanisms of hypertension.

While brainstem regions are central regulators of blood pressure, the neuronal mechanisms underlying their role in hypertension remain poorly understood. Here, we investigated the structural and genetic relationships between global and regional brainstem volumes and blood pressure. We used magnetic resonance imaging data from n = 32,666 UK Biobank participants, and assessed the association of volumes of the whole brainstem and its main regions with blood pressure.

Treatment with PCSK9 monoclonal antibodies is associated with discontinuation of oral lipid lowering therapy.

Aims: Proprotein convertase subtilisin/kexin type 9 monoclonal antibodies (PCSK9 mAbs) are recommended for high-risk patients if the low-density lipoprotein cholesterol (LDL-C) targets are not achieved with statins and ezetimibe. We studied persistence and adherence to 1) PCSK9 mAbs and 2) statins and ezetimibe in a nationwide cohort of incident PCSK9 mAb users.

Methods And Results: Information on all PCSK9 mAb users ≤80 years from 2015 through 2023 were extracted from the Norwegian Drug Registry.

Short- and long-term outcomes of patients with acute myocardial infarction complicated by cardiac arrest: a nationwide cohort study 2013-22.

Aims: To assess short- and long-term outcomes of acute myocardial infarction (AMI) complicated by out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA) in a nationwide cohort.

Methods And Results: Cohort study of AMI patients admitted to hospitals in Norway 2013-22 registered in the Norwegian Myocardial Infarction Registry. Outcomes were in-hospital and long-term mortality.