Journal of the American Heart Association

ObjectiveTo examine the association between Atherogenic Index of Plasma (AIP) and subclinical myocardial injury (SCMI), and their combined impact on cardiovascular disease (CVD) mortality in the general population. MethodsThis analysis included 7,093 participants without CVD from the Third National Health and Nutrition Examination Survey. AIP was calculated as the logarithmic ratio of triglycerides to HDL cholesterol. Participants were stratified into low or high AIP groups based on the median ...

BackgroundCardiovascular-Kidney-Metabolic (CKM) syndrome is a progressive spectrum where patients often struggle with daily exercise. The "Weekend Warrior" (WW) pattern offers a flexible alternative, but its efficacy across CKM stages remains unclear. We evaluated the association of accelerometer-derived WW activity with cardiovascular outcomes across CKM Stages 0-3. MethodsThis prospective study included 88,832 UK Biobank participants (CKM Stages 0-3). Physical activity was objectively measure...

BackgroundCardiovascular health (CVH) and genetic susceptibility to adverse left ventricular (LV) remodeling are each linked to cardiovascular diseases (CVD); however, their combined role remains unclear. MethodsFramingham Heart Study participants [n=1,255 Offspring-Exam 8 (2005-2008), n=2,835 Generation 3-Exam 1 (2002-2005)] had assessment of modifiable risk factors comprising the American Heart Associations Lifes Essential 8 (LE8) score with higher scores indicating better CVH health. A Polyg...

BackgroundPremature coronary artery disease (PCAD) continues to impose a disproportionate burden on younger adults in the United States, yet recent patterns across sex, region, race, and urbanization remain poorly defined. MethodsUsing CDC WONDER data from 1999-2023, we examined PCAD-related age-adjusted mortality rates (AAMR) for males <45 years and females <55 years, stratified by region, race/ethnicity, and urbanization. Temporal trends were assessed using Joinpoint regression to estimate an...

BackgroundThe relationship between functional tooth units (FTU) and cardiovascular diseases (CVD) risk remains understudied. This study is to investigate the association between masticatory performance, measured by FTU, and CVD incidence and CVH, and mortality among individuals with CVD using data from the National Health and Nutrition Examination Survey (NHANES). MethodsMasticatory function was measured by FTU, CVD was determined by the self-reported questionnaire, CVH was assessed using the A...

ObjectiveTo examine whether the association between smoking status and cardiovascular (CV) mortality differs by arterial stiffness, assessed by pulse pressure index (PPI), among U.S. adults without baseline cardiovascular disease (CVD). MethodsUsing data from the National Health and Nutrition Examination Survey (NHANES) 2005-2016, we analyzed 16,605 adults aged 40-79 years without baseline CVD, with mortality follow-up through December 31, 2019. PPI was calculated as (systolic blood pressure [S...

Background-Blockers (ABs) are the most commonly prescribed medications for benign prostatic hyperplasia (BPH), a highly prevalent condition. Although the ALLHAT raised concerns about cardiovascular (CV) safety of nonselective ABs for the treatment of hypertension, the comparative CV risk profile of selective 1A-adrenergic receptor (1A-AR) antagonists for BPH remains unclear. MethodsWe conducted a retrospective cohort study using the TriNetX federated research network (158 million patients acros...

BackgroundAmong patients with ST segment elevation myocardial infarction (STEMI), higher concentrations of high sensitivity troponin T (hs-cTnT) are associated with larger MI size and predict a worse prognosis. In the 2467 patient CELEBRATE trial, a single subcutaneous injection of the short-acting glycoprotein IIb/IIIa receptor blocker antagonist zalunfiban at first medical contact significantly improved the primary outcome including clinical endpoints. In this study, we assessed the impact of ...

The CMR Guide trial aims to determine whether the insertion of an Implantable Cardioverter Defibrillator based on the presence of ventricular scar/fibrosis will reduce sudden cardiac death or syncopal ventricular arrhythmia in patients with mild moderate left ventricle systolic dysfunction compared to standard care. This statistical analysis plan pre-specifies the method of analysis for every outcome and key variables collected in the trial. The primary outcome is a composite of sudden cardiac ...

IntroductionPositron emission tomography (PET) myocardial flow reserve (MFR) is a robust indicator of coronary vascular health and a strong predictor of cardiovascular risk. Clinical guidelines typically use fixed MFR thresholds (e.g., <2.0) to stratify risk, yet this approach overlooks individual variation, particularly by age and sex. We aimed to establish age- and sex-adjusted MFR percentiles and to evaluate their prognostic and predictive performance for cardiovascular risk assessment, in co...

BackgroundChronic inflammation predicts adverse cardiovascular outcomes, but mechanisms linking systemic inflammation to cardiac remodeling remain incompletely understood. We investigated associations between circulating inflammatory biomarkers and cardiac phenotypes in a population-based cohort and examined how environmental exposures and genetic susceptibility influence inflammatory responses. MethodsWe analyzed subsets of 488,079 UK Biobank participants with metabolomic and proteomic profili...

IntroductionPregnancy is a critical test of womens cardiovascular risk. Structural factors may influence long-term cardiovascular health beyond individual, social experiences. We examined associations of neighborhood-level deprivation and individual-level social vulnerability (SV) during pregnancy with postpartum blood pressure (BP). MethodsThis secondary analysis of a prospective cohort study used data from 3,728 nulliparous women in the nuMoM2b-HHS cohort followed from early pregnancy to 2-7 ...

Obstructive sleep apnea (OSA), defined as recurrent episodes of upper airway obstruction during sleep, has been associated with multiple cardiovascular and metabolic comorbidities. While prior studies have demonstrated a link between OSA and adverse cardiovascular outcomes, the strength and nature of this relationship remain controversial. We aimed to investigate the association between OSA and major cardiovascular and metabolic conditions, including myocardial infarction (MI), hypertension (HTN...

BackgroundPatients with repaired coarctation of the aorta (CoAo) remain at risk for left ventricular hypertrophy (LVH) even in the absence of hypertension. Alterations in wave reflection and the timing of reflected pressure waves may contribute to ventricular remodeling beyond pressure load alone. MethodsWe performed a cross-sectional analysis of patients with repaired CoAo. Office and ambulatory blood pressure (ABPM), non-invasive central hemodynamics, and echocardiographic indices of left ven...

BackgroundElevated resting heart rate is associated with increased mortality, but the underlying mechanisms remain incompletely understood. Subclinical myocardial injury (SCMI), defined by a Cardiac Infarction/Injury Score (CIIS) [&ge;]10, represents silent cardiac damage that predicts poor cardiovascular (CV) outcomes and may partially explain this association. MethodsWe analyzed 7,152 participants from NHANES III who underwent ECG recording and were free of cardiovascular disease. Heart rate ...

ImportanceIndividuals exposed to perinatal risk factors are at increased risk for cardiovascular and neurodevelopmental disorders. Heart rate variability, an index of autonomic nervous system function, is widely used to assess long-term health risk in these populations, yet findings remain inconsistent. ObjectiveTo quantify heart rate variability differences between individuals with perinatal risk factors (including preterm birth, intrauterine growth restriction, and low birth weight) and healt...

Background and aimsThe utility of cardiovascular and inflammatory biomarkers to detect coronary obstruction and predict survival benefit of revascularisation in chronic coronary syndrome (CCS) remains unclear. MethodsPatients undergoing coronary angiography for suspected CCS were studied. High-sensitivity cardiac troponin T (hsTnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and copeptin were measured. Diagnostic per...

ObjectivesTo investigate long-term trends in ethnic and socioeconomic inequalities in pre-stroke risk factors and treatments. Designpopulation-based cohort study Settinggeographically defined area of London, UK, 1995-2024 Participants8,515 adults with first stroke, stratified by self-reported ethnicity (62.4% White [N=5,255], 15.5% Black Caribbean [N=1,303], 13.3% Black African [N=1,122]), occupation (60.7% routine/manual occupations [N=3,964]), education (44.6% lower education [N=1,929]), an...

BackgroundPoor adherence to guideline-directed medical therapy (GDMT) in patients with heart failure (HF) with reduced ejection fraction is associated with higher mortality and hospitalization. However, its association with malignant arrhythmias and aborted sudden cardiac death (SCD) remains unclear. This study assessed the association between GDMT adherence and these outcomes in patients with an implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy with a defibrillat...

BackgroundCardiovascular disease (CVD) is the leading cause of pregnancy-related morbidity and mortality in the United States. Several studies have evaluated readmission rates in the general HF population, but in patients with pregnancy-related HF, readmissions have been understudied. This study aims to characterize the 30-day HF readmission patterns in pregnancy-related admissions to identify vulnerable patient populations. MethodsThe National Readmission Database from 2016 to 2021 was used to...