Elevated Lipoprotein(a) Levels and Massive Ruptured Root and Ascending Aortic Aneurysm.

Background: Rupture of a root and ascending aortic aneurysm is a rare, life-threatening condition requiring prompt recognition and surgical intervention. Elevated lipoprotein(a) levels have been implicated in vascular pathology but are less studied in thoracic aneurysms.

Case Summary: A 61-year-old man who presented with severe dyspnea and chest tightness was found to have a 7.

The Emerging Role of Aldosterone Synthase Inhibitors in Overcoming Renin-Angiotensin-Aldosterone System Therapy Limitations: A Narrative Review.

The renin-angiotensin-aldosterone system is integral to cardiorenal health, with aldosterone controlling fluid balance, blood pressure and cardiac remodelling. Despite the widespread use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and mineralocorticoid receptor antagonists, 'aldosterone escape' persists, contributing to treatment failure and adverse outcomes. Steroidal mineralocorticoid receptor antagonists also cause hyperkalaemia and anti-androgenic effects, limiting their use.

Semaglutide promotes bone marrow-derived progenitor cell flux toward an anti-inflammatory and pro-regenerative profile in high-risk patients: the SEMA-VR CardioLink-15 trial.

Background And Aims: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce major atherosclerotic cardiovascular events in individuals living with either diabetes or obesity. Since the turnover of vascular regenerative (VR) stem and progenitor cells has been demonstrated to modulate vessel repair and atherothrombotic risk, this study aimed to determine the effect of the GLP-1RA semaglutide on the levels of circulating VR cells.

Methods: SEMA-VR CardioLink-15 was a randomized translational trial of usual care vs.

Vascular regenerative deficiencies in people with elevated lipoprotein(a): the Lp(a)-VRCE CardioLink-16 translational study.

Aims: Lipoprotein(a) [Lp(a)] is a causal risk factor for atherosclerotic cardiovascular disease (ASCVD); however, the relationship between Lp(a) and the capacity for vascular repair remains unclear. Depletion of vascular regenerative (VR) progenitor cells has been shown to be a novel indicator of compromised vascular repair in people living with cardiometabolic disorders. The purpose of this study was to determine if elevated levels of Lp(a) modify VR cell content properties.

Comparison of Myocardial Mechanics Post Mitral Valve Repair with Leaflet Preservation vs. Leaflet Resection: A Sub-Analysis of the Randomized CAMRA CardioLink-2 Trial.

Background: Prior studies comparing leaflet resection vs. leaflet preservation for surgical repair of mitral regurgitation (MR) caused by prolapse have focused predominately on measurement of left ventricular ejection fraction without adjusting for loading conditions. This post hoc sub-analysis evaluated subclinical differences in myocardial mechanics pre- mitral valve (MV) repair, immediately after, and 1-year post-repair, as well as differences between leaflet resection and preservation strategies.

Continuous glucose monitoring in noninsulin-treated type 2 diabetes: A critical review of reported trials with an updated systematic review and meta-analysis of randomised controlled trials.

Aims: We aimed to review the observational and randomised clinical trial evidence and provide pragmatic recommendations for using continuous glucose monitoring (CGM) in individuals living with noninsulin-treated type 2 diabetes (T2DM).

Materials And Methods: We first undertook a narrative review of observational studies that enrolled noninsulin-users or mixed populations of noninsulin and insulin-users with T2DM as well as randomised controlled trials (RCTs) that enrolled mixed populations with T2DM. We then performed a systematic review of the RCTs that specifically enrolled noninsulin-treated populations with T2DM and compared CGM to BGM/usual care.

Impact of Sex and Age on Trends of Mortality From Infective Endocarditis in High-Income Countries.

Background: Characteristics of infective endocarditis vary by age and sex.

Objectives: The aim of the study was to identify how age and sex impact mortality due to infective endocarditis in high-income countries.

Methods: The World Health Organization mortality database was analyzed to determine trends in mortality from infective endocarditis in the United Kingdom, Germany, France, Italy, Japan, Australia, the United States, and Canada between 2000 and 2021.

GLP-1RAs for peripheral artery disease: A remarkable STRIDE in the right direction.

With the rising prevalence of T2D worldwide, peripheral artery disease (PAD) now affects >230 million individuals globally. In the recent STRIDE trial, Bonaca et al. demonstrated that semaglutide improved walking capacity and hemodynamic parameters and slowed PAD progression in patients with T2D.

Contemporary Prevention and Management of Postoperative Delirium in Cardiac Surgery Patients.

This review examines the prevention and management of postoperative delirium in cardiac surgery patients, a frequent complication linked with significant mortality, morbidity, prolonged hospitalization, and cognitive decline. The aim was to consolidate current evidence on postoperative delirium pathophysiology, risk factors, diagnostic approaches, and pharmacologic and non-pharmacologic interventions. A PubMed/MEDLINE database review was conducted through October 2024, identifying studies that evaluated the relationship between cardiac surgery and the occurrence of postoperative delirium.

Emerging Implications of Elevated Lipoprotein(a) Levels in Coronary Artery Bypass Graft Surgery.

Background: Coronary artery bypass grafting (CABG) remains a cornerstone in the management of coronary artery disease (CAD). In nonurgent surgical revascularization cases, preoperative optimization of modifiable risk factors can improve outcomes. There is increasing interest in the relationship between lipoprotein(a) levels and the risk for ischemic cardiovascular disease, particularly how CABG outcomes are in turn affected.

Perioperative and periprocedural management of GLP-1 receptor-based agonists and SGLT2 inhibitors: narrative review and the STOP-GAP and STOP DKA-2 algorithms.

The GLP-1 receptor-based agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2i) are major twenty first century breakthroughs in diabetes and obesity medicine but there are important safety considerations regarding the perioperative and periprocedural management of individuals who are treated with these agents. GLP-1RAs have been linked to an increased risk of retained gastric contents and pulmonary aspiration while SGLT2i can be associated with diabetic ketoacidosis. This manuscript provides a narrative review of the available evidence for perioperative and periprocedural risks in people prescribed GLP-1RAs and SGLT2i.

Valvular Heart Disease-Related Mortality Between Middle- and High-Income Countries During 2000 to 2019.

Background: Valvular heart disease (VHD) management has evolved rapidly in recent decades, but disparities in health care access persist among countries with varying socioeconomic backgrounds.

Objectives: The purpose of this study was to investigate global mortality trends from VHD and assess the difference between middle- and high-income countries.

Methods: We obtained mortality data from the World Health Organization Mortality Database for VHD and its subgroups (rheumatic valvular disease [RVD], infective endocarditis [IE], aortic stenosis [AS], and mitral regurgitation [MR]) from 2000 to 2019.

Disparities in mortality rates from aortic aneurysm and dissection by country-level income status and sex.

Objective: To investigate the impact of national income level and sex on mortality trends from aortic aneurysm and dissection in addition to all aortic disease as a whole.

Methods: Using data from the World Health Organization mortality database, we conducted an analysis of mortality trends from aortic disease between 2000 and 2019, Countries were categorized into middle-income and high-income countries (MICs and HICs) on the basis of income level. Age-standardized and sex-specific age-standardized mortality rates per 100,000 persons, along with male-to-female mortality ratios, were calculated.