Journal: Prog Cardiovasc Dis

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<div><h4>Cardiovascular disease prevention and management in the COVID-19 era and beyond: An international perspective.</h4><i>Faghy MA, Yates J, Hills AP, Jayasinghe S, ... Dixit S, Ashton REM</i><br /><AbstractText>Despite some indicators of a localized curtailing of cardiovascular disease (CVD) prevalence, CVD remains one of the largest contributors to global morbidity and mortality. While the magnitude and impact of the coronavirus disease 2019 (COVID-19) pandemic have yet to be realized in its entirety, an unquestionable impact on global health and well-being is already clear. At a time when the global state of CVD is perilous, we provide a continental overview of prevalence data and initiatives that have positively influenced CVD outcomes. What is clear is that despite attempts to address the global burden of CVD, there remains a lack of collective thinking and approaches. Moving forward, a coordinated global infrastructure that, if developed with appropriate and relevant key stakeholders, could provide significant and longstanding benefits to public health and yield prominent and consistent policy resulting in impactful change. To achieve global impact, research priorities that address multi-disciplinary social, environmental, and clinical perspectives must be underpinned by unified approaches that maximize public health.</AbstractText><br /><br />Copyright © 2023. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 21 Jan 2023; epub ahead of print</small></div>
Faghy MA, Yates J, Hills AP, Jayasinghe S, ... Dixit S, Ashton REM
Prog Cardiovasc Dis: 21 Jan 2023; epub ahead of print | PMID: 36693488
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<div><h4>Recognizing risk factors associated with poor outcomes among patients with COVID-19.</h4><i>Rodriguez-Miguelez P, Heefner A, Carbone S</i><br /><AbstractText>The coronavirus disease 2019 (COVID-19) pandemic has affected >610 million people globally, exerting major social, economic, and health impacts. Despite the large number of global casualities and severe symptomatology associated with COVID-19, a large number of individuals remain at elevated risk of infection and severe outcomes related to poor lifestyle behaviors and/or associated comorbidities. Beyond the well-known social distance and masking policies, maintaining an active lifestyle, minimizing the consumption of tobacco products, and maintaining an adequate nutrition status are some of the key factors that, in an affordable and accessible way, have the potential to improve health and minimize COVID-19 impact. In addition, bringing awareness of the higher risks and poor prognosis of COVID-19 when other conditions are present seems to be essential to protect those individuals with the highest risks.</AbstractText><br /><br />Copyright © 2023. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 21 Jan 2023; epub ahead of print</small></div>
Rodriguez-Miguelez P, Heefner A, Carbone S
Prog Cardiovasc Dis: 21 Jan 2023; epub ahead of print | PMID: 36693489
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<div><h4>The acute and chronic implications of the COVID-19 virus on the cardiovascular system in adults: A systematic review.</h4><i>Ashton RE, Philips BE, Faghy M</i><br /><AbstractText>Despite coronavirus disease 2019 (COVID-19) primarily being identified as a respiratory illness, some patients who seemingly recovered from initial infection, developed chronic multi-system complications such as cardiovascular (CV), pulmonary and neurological issues leading to multiple organ injuries. However, to date, there is a dearth of understanding of the acute and chronic implications of a COVID-19 infection on the CV system in adults. A systematic review of the literature was conducted according to PRISMA guidelines and prospectively registered via Prospero (ID: CRD42022360444). The MEDLINE Ovid, Cochrane Library and PubMed databases were searched from inception to August 2022. The search strategy keywords and MeSH terms used included: 1) COVID; 2) coronavirus; 3) long COVID; 4) cardiovascular; and 5) cardiovascular disease. Reference lists of all relevant systematic reviews identified were searched for additional studies. A total of 11,332 records were retrieved from database searches, of which 310 records were duplicates. A further 9887 were eliminated following screening of titles and abstracts. After full-text screening of 1135 articles, 9 manuscripts were included for review. The evidence of CV implications post-COVID-19 infection is clear, and this must be addressed with appropriate management strategies that recognise the acute and chronic nature of cardiac injury in COVID-19 patients. Efficacious management strategies will be needed to address long standing issues and morbidity.</AbstractText><br /><br />Copyright © 2023. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 20 Jan 2023; epub ahead of print</small></div>
Ashton RE, Philips BE, Faghy M
Prog Cardiovasc Dis: 20 Jan 2023; epub ahead of print | PMID: 36690284
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<div><h4>Public policy for healthy living: How COVID-19 has changed the landscape.</h4><i>Whitsel LP, Ajenikoko F, Chase PJ, Johnson J, ... Radcliffe R, Faghy MA</i><br /><AbstractText>The coronavirus disease 2019 (COVID-19) pandemic had a transformational impact on public policy as governments played a leading role, working alongside and coordinating with business/industry, healthcare, public health, education, transportation, researchers, non-governmental organizations, philanthropy, and media/communications. This paper summarizes the impact of the pandemic on different areas of public policy affecting healthy living and cardiovascular health including prevention (i.e., nutrition, physical activity, air quality, tobacco use), risk factors for chronic disease (hypertension, diabetes, obesity, substance abuse), access to health care, care delivery and payment reform, telehealth and digital health, research, and employment policy. The paper underscores where public policy is evolving and where there are needs for future evidence base to inform policy development, and the intersections between the public and private sectors across the policy continuum. There is a continued need for global multi-sector coordination to optimize population health.</AbstractText><br /><br />Copyright © 2023. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 20 Jan 2023; epub ahead of print</small></div>
Whitsel LP, Ajenikoko F, Chase PJ, Johnson J, ... Radcliffe R, Faghy MA
Prog Cardiovasc Dis: 20 Jan 2023; epub ahead of print | PMID: 36690285
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<div><h4>Cardiovascular services in Covid-19 - Impact of the pandemic and lessons learned.</h4><i>Josephson RA, Gillombardo CB</i><br /><AbstractText>The coronavirus disease 2019 (COVID-19) pandemic immediately and perhaps irrevocably impacted society at large, the provision of cardiovascular (CV) care, the function and staffing of hospitals, and CV clinicians. Initially many clinicians at all career stages rose to the challenges, and support and accolades were the initial societal response. Politicization of the public health response as well as widespread misinformation and disinformation all negatively impacted CV clinicians\' roles as well diminished and, in some cases, eliminated their public and self-esteem. Unabated stress, disrespect, and a likely lack of emotional and physical respite may all have contributed to the Great Resignation. Insights gained from review of the COVID-19 pandemic may help inform changes to foster system resiliency and prepare for an improved response to the inevitable next stressor.</AbstractText><br /><br />Copyright © 2023. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 20 Jan 2023; epub ahead of print</small></div>
Josephson RA, Gillombardo CB
Prog Cardiovasc Dis: 20 Jan 2023; epub ahead of print | PMID: 36690286
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<div><h4>What has cardiac rehabilitation looked like in the COVID-19 pandemic: Lessons learned for the future.</h4><i>Ozemek C, Berry R, Bonikowske AR, German C, Gavic AM</i><br /><AbstractText>The global coronavirus disease 2019 (COVID-19) pandemic prompted widespread national shutdown, halting or dramatically reducing the delivery of non-essential outpatient services including cardiac rehabilitation (CR). Center-based CR services were closed for as few as two weeks to greater than one year and the uncertainty surrounding the duration of the lockdown phase prompted programs to consider programmatic adaptations that would allow for the safe and effective delivery of CR services. Among the actions taken to accommodate in person CR sessions included increasing the distance between exercise equipment and/or limiting the number of patients per session. Legislative approval of reimbursing telehealth or virtual services presented an opportunity to reach patients that may otherwise have not considered attending CR during or even before the pandemic. Additionally, the considerable range of symptoms and infection severity as well as the risk of developing long lasting, debilitating symptoms has complicated exercise recommendations. Important lessons from publications reporting findings from clinical settings have helped shape the way in which exercise is applied, with much more left to discover. The overarching aim of this paper is to review how programs adapted to the COVID-19 pandemic and identify lessons learned that have positively influenced the future of CR delivery.</AbstractText><br /><br />Copyright © 2023. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 20 Jan 2023; epub ahead of print</small></div>
Ozemek C, Berry R, Bonikowske AR, German C, Gavic AM
Prog Cardiovasc Dis: 20 Jan 2023; epub ahead of print | PMID: 36690287
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<div><h4>Effect of BMI on patients undergoing transcatheter aortic valve implantation: A systematic review and meta-analysis.</h4><i>Gupta R, Mahmoudi E, Behnoush AH, Khalaji A, ... Lavie CJ, Patel NC</i><br /><b>Background</b><br />The relationship of body mass index (BMI) and an \"obesity paradox\" with cardiovascular risk prediction is controversial. This systematic review and meta-analysis aims to compare the associations of different BMI ranges on transcatheter aortic valve implantation (TAVI) outcomes.<br /><b>Methods</b><br />International databases, including PubMed, the Web of Science, and the Cochrane Library, were systematically searched for observational and randomized controlled trial studies investigating TAVI outcomes in any of the four BMI categories: underweight, normal weight, overweight, and obese with one of the predefined outcomes. Primary outcomes were in-hospital, 30-day, and long-term all-cause mortality. Random-effects meta-analysis was performed to calculate the odds ratio (OR) or standardized mean differences (SMD) with 95% confidence interval (CI) for each paired comparison between two of the BMI categories.<br /><b>Results</b><br />A total of 38 studies were included in our analysis, investigating 99,829 patients undergoing TAVI. There was a trend toward higher comorbidities such as hypertension, diabetes, and dyslipidemia in overweight patients and individuals with obesity. Compared with normal-weight, patients with obesity had a lower rate of 30-day mortality (OR 0.42, 95% CI 0.25-0.72, p < 0.01), paravalvular aortic regurgitation (OR 0.63, 95% CI 0.44-0.91, p = 0.01), 1-year mortality (OR 0.48, 95% CI 0.24-0.96, p = 0.04), and long-term mortality (OR 0.69, 95% CI 0.51-0.94, p = 0.02). However, acute kidney injury (OR 1.16, 95% CI 1.04-1.30, p = 0.01) and permanent pacemaker implantation (OR 1.25, 95% CI 1.05-1.50, p = 0.01) odds were higher in patients with obesity. Noteworthy, major vascular complications were significantly higher in underweight patients in comparison with normal weight cases (OR 1.62, 95% CI 1.07-2.46, p = 0.02). In terms of left ventricular ejection fraction (LVEF), patients with obesity had higher post-operative LVEF compared to normal-weight individuals (SMD 0.12, 95% CI 0.02-0.22, p = 0.02).<br /><b>Conclusion</b><br />Our results suggest the presence of the \"obesity paradox\" in TAVI outcomes with higher BMI ranges being associated with lower short- and long-term mortality. BMI can be utilized for risk prediction of patients undergoing TAVI.<br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 16 Jan 2023; epub ahead of print</small></div>
Gupta R, Mahmoudi E, Behnoush AH, Khalaji A, ... Lavie CJ, Patel NC
Prog Cardiovasc Dis: 16 Jan 2023; epub ahead of print | PMID: 36657654
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<div><h4>Leisure-time physical activity is more strongly associated with cardiometabolic risk than occupational physical activity: Results from a workplace lifestyle modification program.</h4><i>Edimo Dikobo SJ, Lemieux I, Poirier P, Després JP, Alméras N</i><br /><b>Background</b><br />Regular physical activity (PA) plays a key role in the management and prevention of numerous chronic diseases. However, recent studies have suggested that occupational physical activity (OPA) may not always have health benefits. The aim of the present study was to examine the respective contributions of OPA vs. leisure-time physical activity (LTPA) to the variation in the cardiometabolic profile, including cardiorespiratory fitness (CRF) of employees involved in a workplace lifestyle modification program. Our study hypothesis was that LTPA would show a stronger association with indices of cardiometabolic health than OPA.<br /><b>Methods</b><br />A mobile health assessment unit was used to assess 5145 workers (3397 men and 1748 women) on site at their workplace. Assessments included lifestyle questionnaires (overall diet quality, type of OPA and level of LTPA), blood pressure measurements, blood tests, anthropometric measurements, and a submaximal treadmill exercise test to assess CRF. Results were adjusted for education, household income and age.<br /><b>Results</b><br />When workers were classified on the basis of their OPA (sedentary work, standing work, physical work, and heavy manual work), only a few significant differences in the cardiometabolic profile were observed in men, with those in the physical work category having more favorable values than sedentary workers. However, substantial and significant differences were observed among employees classified on the basis of their LTPA, these differences being observed in both men and women. For instance, waist circumference, the cholesterol/HDL cholesterol ratio, triglyceride concentrations and resting heart rate were lower in active individuals compared to inactive and moderately inactive individuals (p < 0.01). Furthermore, irrespective of whether or not employees were sedentary at work, a high level of LTPA was associated with a greater CRF (p < 0.001). Finally, we found that the lowest prevalence of hypertriglyceridemic waist (p < 0.01) and the highest score of overall diet quality (p < 0.001) were observed in active individuals, irrespective of their OPA category.<br /><b>Conclusion</b><br />Levels of LTPA were more strongly associated with cardiometabolic health than OPA in a cohort of blue- and white-collar employees. Furthermore, high levels of LTPA were found to counteract the potentially deleterious effects of a sedentary work on cardiometabolic health.<br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 21 Dec 2022; epub ahead of print</small></div>
Edimo Dikobo SJ, Lemieux I, Poirier P, Després JP, Alméras N
Prog Cardiovasc Dis: 21 Dec 2022; epub ahead of print | PMID: 36565734
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<div><h4>Systems science approaches to cardiovascular disease prevention and management in the era of COVID-19: A humpty-dumpty dilemma?</h4><i>Pronk NP, Mabry P, Bond S, Arena R, Faghy MA</i><br /><AbstractText>The coronavirus disease 2019 (COVID-19) pandemic necessitated the implementation and prioritizing of strict public health strategies to mitigate COVID-19 transmission and infection over all else. As we enter a \'recovery\' phase in which the impact of the virus recedes (but does not relent), we ask, \"How do we develop a game plan that considers prevention over management of public health threats of a more chronic nature, including cardiovascular disease?\" We frame this choice point as a \"Humpty-Dumpty\" moment for public health with enduring and potentially irreversible consequences. Citing clear examples of other public health successes and failures, we outline in detail how sustaining cardiovascular population health under complex post-pandemic conditions will necessitate decision-making to be informed with a systems science approach, in which interventions, goals, outcomes and features of complex systems are carefully aligned.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 20 Dec 2022; epub ahead of print</small></div>
Pronk NP, Mabry P, Bond S, Arena R, Faghy MA
Prog Cardiovasc Dis: 20 Dec 2022; epub ahead of print | PMID: 36563922
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<div><h4>Cardiorespiratory fitness as a vital sign of CVD risk in the COVID-19 era.</h4><i>Harber MP, Peterman JE, Imboden M, Kaminsky L, ... Arena R, Faghy MA</i><br /><AbstractText>The severe health consequences of the corona virus disease 2019 (COVID-19) pandemic have been exacerbated by the prevalence of cardiovascular disease (CVD) risk factors, such as physical inactivity, obesity, hypertension, and diabetes. Further, policy decisions during the pandemic augmented unhealthy lifestyle behaviors and health inequalities, likely increasing the global disease burden. Cardiorespiratory fitness (CRF) is a well-established biomarker associated with CVD risk. Emerging data demonstrate that high CRF offers some protection against severe outcomes from COVID-19 infection, highlighting the importance of CRF for population health and the potential for limiting the severity of future pandemics. CRF is best assessed by cardiopulmonary exercise testing (CPET), which will be an important tool for understanding the prolonged pathophysiology of COVID-19, the emergence of long-COVID, and the lasting effects of COVID-19 on CVD risk. Utilization of CRF and CPET within clinical settings should become commonplace because of lessons learned from the COVID-19 pandemic.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 17 Dec 2022; epub ahead of print</small></div>
Harber MP, Peterman JE, Imboden M, Kaminsky L, ... Arena R, Faghy MA
Prog Cardiovasc Dis: 17 Dec 2022; epub ahead of print | PMID: 36539006
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<div><h4>Impact of COVID-19 in patients hospitalized with stress cardiomyopathy: A nationwide analysis.</h4><i>Hajra A, Malik A, Bandyopadhyay D, Goel A, ... Fonarow GC, Lavie CJ</i><br /><AbstractText>Stress cardiomyopathy was noted to occur at a higher incidence during coronavirus disease of 2019 (COVID-19) pandemic. This database analysis has been done to compare the in-hospital outcomes in patients with stress cardiomyopathy and concurrent COVID-19 infection with those without COVID-19 infection. The National Inpatient Sample database for the year 2020 was queried to identify all admissions diagnosed with stress cardiomyopathy. These patients were then stratified based on whether they had concomitant COVID-19 infection or not. A 1:1 propensity score matching was performed. Multivariate logistic regression analysis was done to identify predictors of mortality. We identified 41,290 hospitalizations for stress cardiomyopathy, including 1665 patients with concurrent diagnosis of COVID-19. The female preponderance was significantly lower in patients with stress cardiomyopathy and COVID-19. Patients with concomitant COVID-19 were more likely to be African American, diabetic and have chronic kidney disease. After propensity matching, the incidence of complications, including acute kidney injury (AKI), AKI requiring dialysis, coagulopathy, sepsis, cardiogenic shock, cases with prolonged intubation of >24 h, requirement of vasopressor and inpatient mortality, were noted to be significantly higher in patients with COVID-19. Concomitant COVID-19 infection was independently associated with worse outcomes and increased mortality in patients hospitalized with stress cardiomyopathy.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 14 Dec 2022; epub ahead of print</small></div>
Hajra A, Malik A, Bandyopadhyay D, Goel A, ... Fonarow GC, Lavie CJ
Prog Cardiovasc Dis: 14 Dec 2022; epub ahead of print | PMID: 36528166
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<div><h4>The impact of the COVID-19 pandemic on cardiovascular health behaviors and risk factors: A new troubling normal that may be here to stay.</h4><i>Laddu DR, Biggs E, Kaar J, Khadanga S, Alman R, Arena R</i><br /><AbstractText>In March 2020, the Coronavirus disease 2019 (COVID-19) outbreak was officially declared a global pandemic, leading to closure of public facilities, enforced social distancing and stay-at-home mandates to limit exposures and reduce transmission rates. While the severity of this \"lockdown\" period varied by country, the disruptions of the pandemic on multiple facets of life (e.g., daily activities, education, the workplace) as well as the social, economic, and healthcare systems impacts were unprecedented. These disruptions and impacts are having a profound negative effect on multiple facets of behavioral health and psychosocial wellbeing that are inextricably linked to cardiometabolic health and associated with adverse outcomes of COVID-19. For example, adoption of various cardiometabolic risk behavior behaviors observed during the pandemic contributed to irretractable trends in weight gain and poor mental health, raising concerns on the possible long-term consequences of the pandemic on cardiometabolic disease risk, and vulnerabilities to future viral pandemics. The purpose of this review is to summarize the direct and indirect effects of the pandemic on cardiometabolic health risk behaviors, particularly related to poor diet quality, physical inactivity and sedentary behaviors, smoking, sleep patterns and mental health. Additional insights into how the pandemic has amplified cardiovascular risk behaviors, particularly in our most vulnerable populations, and the potential implications for the future if these modifiable risk behaviors do not become better controlled, are described.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 05 Dec 2022; epub ahead of print</small></div>
Laddu DR, Biggs E, Kaar J, Khadanga S, Alman R, Arena R
Prog Cardiovasc Dis: 05 Dec 2022; epub ahead of print | PMID: 36481209
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<div><h4>Differential effects of overweight/obesity depending on the severity of heart failure complicating acute myocardial infarction in Japan.</h4><i>Matsushita K, Kojima S, Hirakawa K, Tabata N, ... Kaikita K, Tsujita K</i><br /><b>Background</b><br />The existence of a paradoxical association between overweight/obesity and survival benefits, the so-called obesity paradox, in heart failure (HF) as well as coronary artery disease (CAD) remains contentious. Previously, we reported that a past history of CAD negated the obesity paradox in the general population with acute HF. Herein, we further focused on HF complicating acute myocardial infarction (AMI) and compared the prognostic effects of overweight/obesity with respect to the severity of HF.<br /><b>Methods</b><br />We conducted a multicenter retrospective study of 7265 consecutive patients with AMI. The severity of HF was categorized according to the Killip classification. Overweight/obesity was defined as a body mass index (BMI) of ≥25 kg/m<sup>2</sup>. The interaction between overweight/obesity and the Killip classification for in-hospital mortality was tested in the entire cohort. Multivariable logistic regression analyses were performed to examine the effects of overweight/obesity on in-hospital mortality.<br /><b>Results</b><br />Across the entire study cohort, 1931 patients had HF. Overweight/obesity had a significant association with reductions in in-hospital mortality in patients with mild HF (Killip class II; odds ratio [OR], 0.284; P = 0.019). Conversely, overweight/obesity was a significant risk factor for in-hospital mortality in patients with severe HF (Killip class IV; OR, 2.152; P = 0.001). The effects of overweight/obesity on in-hospital mortality in patients with moderate HF (Killip class III) were intermediate between those with mild HF and severe HF.<br /><b>Conclusion</b><br />Opposing effects of overweight/obesity on in-hospital mortality in patients with mild HF versus severe HF were demonstrated, suggesting a balance between beneficial and deleterious effects of overweight/obesity may be inclined toward the latter with the severity of HF complicating AMI.<br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 05 Dec 2022; epub ahead of print</small></div>
Matsushita K, Kojima S, Hirakawa K, Tabata N, ... Kaikita K, Tsujita K
Prog Cardiovasc Dis: 05 Dec 2022; epub ahead of print | PMID: 36481210
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<div><h4>The response to the COVID-19 pandemic: With hindsight what lessons can we learn?</h4><i>Faghy M, Arena R, Hills AP, Yates J, ... Lavie CJ, Smith A</i><br /><AbstractText>The purpose of this paper is to put forward some evidence-based lessons that can be learned from how to respond to a Pandemic that relate to healthy living behaviours (HLB). A 4-step methodology was followed to conduct a narrative review of the literature and to present a professional practice vignette. The narrative review identified 8 lessons: 1) peer review; 2) historical perspectives; 3) investing in resilience and protection; 4) unintended consequences; 5) protecting physical activity; 6) school closures; 7) mental health; and 8) obesity. As in all probability there will be another Pandemic, it is important that the lessons learned over the last three years in relation to HLB are acted upon. Whilst there will not always be a consensus on what to emphasise, it is important that many evidence-based positions are presented. The authors of this paper recognise that this work is a starting point and that the lessons presented here will need to be revisited as new evidence becomes available.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 05 Dec 2022; epub ahead of print</small></div>
Faghy M, Arena R, Hills AP, Yates J, ... Lavie CJ, Smith A
Prog Cardiovasc Dis: 05 Dec 2022; epub ahead of print | PMID: 36481211
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<div><h4>Updates on obesity and the obesity paradox in cardiovascular diseases.</h4><i>Tutor AW, Lavie CJ, Kachur S, Milani RV, Ventura HO</i><br /><AbstractText>The prevalence of obesity has reached pandemic proportions worldwide and certainly in the United States. Obesity is a well-established independent risk factor for development of many cardiovascular diseases (CVD), including heart failure, coronary heart disease, atrial fibrillation, and hypertension. Therefore, it is logical to expect obesity would have a strong correlation with CVD mortality. However, a substantial body of literature demonstrates a paradox with improved prognosis of overweight and obese patients with established CVD compared to lean patients with the identical CVD. Surprisingly, similar data has also shown that cardiovascular fitness, rather than weight loss alone, influences the relationship between obesity and mortality in those with established CVD. The impact of fitness, exercise, physical activity (PA), and weight loss and their relationship to the obesity paradox are all reviewed here.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 05 Dec 2022; epub ahead of print</small></div>
Tutor AW, Lavie CJ, Kachur S, Milani RV, Ventura HO
Prog Cardiovasc Dis: 05 Dec 2022; epub ahead of print | PMID: 36481212
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<div><h4>Equitable well-being, social trust, and the economy: An integrated health system\'s perspectives on the long-term implications of COVID-19.</h4><i>Pronk NP, McEvoy C</i><br /><AbstractText>To address organizational concerns related to the longer-term implications of coronavirus disease 2019 (COVID-19) and generate priorities for organizational focus, we facilitated an in-depth dialogue and discussion among health system leaders who collectively represented medical, public health, and business expertise. Key insights and observations were identified, prioritized, collected, discussed, and organized into overarching themes. A set of five overarching themes that are considered important themes to be addressed by the larger health system emerged. The five observed themes include: 1) Health disparities persist; 2) physical activity, healthful diet, and healthy weight reduce severe COVID-19 health outcomes; 3) an urgent need exists to rebuild social trust; 4) partnerships and collaborations among public health, business and industry, and health care are central to rebuilding social trust and implementation of equitable and sustainable solutions; and 5) health, well-being, and healing are business imperatives.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 03 Dec 2022; epub ahead of print</small></div>
Pronk NP, McEvoy C
Prog Cardiovasc Dis: 03 Dec 2022; epub ahead of print | PMID: 36473506
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<div><h4>The association of disparities in neighborhood median household income and mortality in patients admitted to the hospital with atrial fibrillation.</h4><i>Dhore-Patil A, Crawford M, Nedunchezhian S, El Hajjar AH, ... Sidhu G, Marrouche N</i><br /><b>Background</b><br />Lower neighborhood median household income (nMHI) is associated with increased adverse outcomes in patients with atrial fibrillation (AF). However, its effect on mortality is yet unknown.<br /><b>Methods</b><br />Data from the regional United States (U.S.) electronic medical records database, Research Action for Health Network (REACHnet), was extracted for adult patients with AF at Tulane Medical Center over 10 years. Annual nMHI & neighborhood high school graduation (HSG) data was collected from the US Census bureau. Only African Americans (AA) and Caucasians (CC) who had socioeconomic data were included. Low nMHI and low HSG were defined as ≤$25,000 & <90% respectively. High nMHI and HSG were defined as >$50,000 & ≥90% respectively. Primary endpoints were all cause and cardiovascular (CV) mortality. Cox-proportional hazard ratios were used to evaluate the endpoints.<br /><b>Results</b><br />We included 4616 patients diagnosed with AF. During a median follow up of 4.6 years, 434 patients died of which 32.7% patients had CV mortality. There was a stepwise decrease in incidence of both all-cause and CV mortality as nMHI increased. Patients with low nMHI had the greatest risk of all-cause mortality (HR 1.9, C.I. 1.2-3.2, P 0.004). The association between low nMHI and all-cause mortality persisted after adjusting for age, sex, race, HSG and stroke risk factors using CHA<sub>2</sub>DS<sub>2</sub>VASC, delta CHA<sub>2</sub>DS<sub>2</sub>VASC scores and oral anticoagulant use. CV mortality followed a similar trend as all-cause mortality, however, this association was not significant after adjusting for the above variables. Apart from low nMHI, CHA<sub>2</sub>DS<sub>2</sub>VASC delta CHA<sub>2</sub>DS<sub>2</sub>VASC were statistically significant independent predictors of both all-cause and CV mortality.<br /><b>Conclusion</b><br />Low nMHI is an independent risk factor for all cause and CV mortality in AF. Higher burden of co-morbidities is the driving force behind this disparity. Future studies should evaluate the role of educational and therapeutic intervention in these populations to reduce mortality.<br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 30 Nov 2022; epub ahead of print</small></div>
Dhore-Patil A, Crawford M, Nedunchezhian S, El Hajjar AH, ... Sidhu G, Marrouche N
Prog Cardiovasc Dis: 30 Nov 2022; epub ahead of print | PMID: 36462553
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<div><h4>COVID-19 and elite sport: Cardiovascular implications and return-to-play.</h4><i>Faghy MA, Ashton REM, Parizher G, Smith A, ... Gough LA, Emery MS</i><br /><AbstractText>Curtailing elite sports during the coronavirus disease 2019 (COVID-19) pandemic was necessary to prevent widespread viral transmission. Now that elite sport and international competitions have been largely restored, there is still a need to devise appropriate screening and management pathways for athletes with a history of, or current, COVID-19 infection. These approaches should support the decision-making process of coaches, sports medicine practitioners and the athlete about the suitability to return to training and competition activities. In the absence of longitudinal data sets from athlete populations, the incidence of developing prolonged and debilitating symptoms (i.e., Long COVID) that affects a return to training and competition remains a challenge to sports and exercise scientists, sports medicine practitioners and clinical groups. As the world attempts to adjust toward \'living with COVID-19\' the very nature of elite and international sporting competition poses a risk to athlete welfare that must be screened for and managed with bespoke protocols that consider the cardiovascular implications for performance.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 30 Nov 2022; epub ahead of print</small></div>
Faghy MA, Ashton REM, Parizher G, Smith A, ... Gough LA, Emery MS
Prog Cardiovasc Dis: 30 Nov 2022; epub ahead of print | PMID: 36462554
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Abstract
<div><h4>Association of pessimism with cardiovascular events and all-cause mortality.</h4><i>Krittanawong C, Maitra NS, Khawaja M, Wang Z, ... Charney DS, Levine GN</i><br /><AbstractText>Poor psychological health is associated with Takotsubo cardiomyopathy, cardiac syndrome X, coronary microcirculatory dysfunction, peripheral artery disease, or spontaneous coronary artery dissection. Data regarding pessimism, cardiovascular disease (CVD) events and mortality and all-cause mortality remained inconclusive. This systematic review and meta-analysis aim to provide an overview of the association between pessimism, CVD outcomes and mortality. A systematic search of electronic databases was conducted from inception through July 2022 for studies evaluating pessimism and adverse outcomes. A total of 17 studies published between 1966 and July 2022 met our inclusion criteria, for a total of 232,533 individuals. Pooled hazard ratios were calculated in random-effects meta-analyses. Based on pooled analysis of adjusted HRs, pessimism was associated with adjusted HR of 1.13 (95% CI 1.07-1.19) for all-cause mortality with minimal heterogeneity (I<sup>2</sup> = 28.5%). Based on pooled analysis of adjusted HRs, pessimism was associated with adjusted HR of 1.30 (95% CI 0.43-3.95) for CHD mortality, adjusted HR of 1.41 (95% CI 1.05-1.91) for CVD mortality, and adjusted HR of 1.43 (95% CI 0.64-3.16) for stroke. In conclusion, pessimism seems to be significantly associated with a higher risk for and poorer outcomes from CVD events than optimistic styles. There are genetic and other bases for these life approaches, but behavioral, cognitive and meditative interventions can modify patients\' level of pessimism, hopefully leading to better medical outcomes. Testing this theory would yield highly useful and practical data for clinical care.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 30 Nov 2022; epub ahead of print</small></div>
Krittanawong C, Maitra NS, Khawaja M, Wang Z, ... Charney DS, Levine GN
Prog Cardiovasc Dis: 30 Nov 2022; epub ahead of print | PMID: 36462555
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Abstract
<div><h4>Dietary management of dyslipidemia and the impact of dietary patterns on lipid disorders.</h4><i>Agarwala A, Petersen K, Jafari F, Kris-Etherton PM</i><br /><AbstractText>Dyslipidemia is a major risk factor for atherosclerotic cardiovascular disease and a healthy lifestyle is the first line of therapy for treatment A healthy dietary pattern is a cornerstone for treating elevated low-density lipoprotein-cholesterol (LDL-C) and triglycerides (TG), both of which are hallmarks of dyslipidemia. Much research has been conducted evaluating the effect of different dietary patterns on LDL-C and TG, both eucalorically and with weight loss. Herein we review studies that have evaluated the effects of different dietary patterns on LDL-C and TG. Within the context of a healthy dietary pattern, constituent food and nutrient intake impacts LDL-C and TG lowering. Food- and nutrient-based recommended for lowering both LDL-C and TG, will also be reviewed. Finally, the suitability of popular diets for patients with dyslipidemia will be discussed. First line intervention for patients with dyslipidemia is lifestyle intervention. Lifestyle interventions, including dietary intervention, should be individualized and customized to patient preferences to achieve clinically relevant lipid/lipoprotein improvements.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 18 Nov 2022; epub ahead of print</small></div>
Agarwala A, Petersen K, Jafari F, Kris-Etherton PM
Prog Cardiovasc Dis: 18 Nov 2022; epub ahead of print | PMID: 36410416
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Abstract
<div><h4>Considerations for treatment of lipid disorders during pregnancy and breastfeeding.</h4><i>Kaur G, Gulati M</i><br /><AbstractText>Adequate management of lipid disorders during pregnancy is essential given the association of dyslipidemia with adverse pregnancy outcomes. While there are physiologic changes in lipid levels that occur with normal pregnancy, abnormal alterations in lipids can lead to increased future risk of atherosclerotic cardiovascular disease. There are inherent challenges in the treatment of dyslipidemias during pregnancy and the postpartum period given the lack of adequate data in this population and the contraindication of traditional therapeutic agents. However, it remains of utmost importance to optimize screening and identification of patients at high-risk for atherosclerotic cardiovascular disease so that proper counseling can be provided and the risk for pregnancy complications and downstream cardiovascular complications can be addressed. In this review, we summarize the literature on the association of dyslipidemia in pregnancy with adverse outcomes and discuss considerations for the management of lipid disorders during both pregnancy and breastfeeding.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 15 Nov 2022; epub ahead of print</small></div>
Kaur G, Gulati M
Prog Cardiovasc Dis: 15 Nov 2022; epub ahead of print | PMID: 36400231
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<div><h4>Statin associated muscle symptoms: An update and review.</h4><i>Dicken W, Mehta A, Karagiannis A, Jain V, ... Sperling L, Cassimatis D</i><br /><AbstractText>Statin therapy has been shown to have a significant effect on lowering of low-density lipoprotien cholesterol (LDL-C) levels. This subsequently results in cardiovascular (CV) benefit through reduction in major adverse CV disease (CVD) events and overall mortality. Although there is well proven clinical benefit, statin therapy may be discontinued in some patients, and the most common cause for discontinuation is concern for statin-associated muscle symptoms. However, the data on the true prevalence of these symptoms is mixed and continued studies are showing that the symptoms may be less prevalent than previously believed. With statin-associated muscle symptoms being the most common reason for a patient to not be on statin therapy, it is important for physicians to understand how to evaluate for and manage these symptoms. This manuscript provides an overview of statin associated muscle symptoms so that physicians may be able to better manage patients on statin therapy and continue to use these medications when indicated to best reduce future risk of CVD for patients.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 15 Nov 2022; epub ahead of print</small></div>
Dicken W, Mehta A, Karagiannis A, Jain V, ... Sperling L, Cassimatis D
Prog Cardiovasc Dis: 15 Nov 2022; epub ahead of print | PMID: 36400232
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Abstract
<div><h4>Review of recent clinical trials and their impact on the treatment of hypercholesterolemia.</h4><i>Parham JS, Goldberg AC</i><br /><b>Purpose of review</b><br />Cardiovascular disease is the leading cause of death in the United States with incidence expected to increase in the coming decades. Recent years have produced a variety of new and novel therapeutics aimed at reducing the global burden of cardiovascular disease. This review highlights these recent advancements.<br /><b>Recent findings</b><br />In addition to more rigorous therapeutic thresholds for traditional LDL lowering agents such as statins, recent studies have developed new pathways of lipid lowering for both typical cardiovascular disease and complex, genetic lipid disorders. This includes inhibition of the cholesterol synthesis enzyme ATP citrate lyase with bempedoic acid, prevention of PCSK9 mRNA translation with inclisiran, inhibition of the lipoprotein lipase inhibitor angiopoetin like 3 protein with evinacumab and the use of anti-sense oligonucleotides to lower lipoprotein(a) levels. Icosapent ethyl, while remaining a topic of debate and controversy, demonstrates efficacy in cardiovascular risk reduction when all available data are examined. Lastly fibrate therapy continues to produce negative results in terms of cardiovascular disease reduction.<br /><b>Summary</b><br />Recent years have yielded breadth and depth to cardiovascular treatments. This expanded armamentarium will allow for more effective and more consistent treatment and prevention of cardiovascular disease.<br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 15 Nov 2022; epub ahead of print</small></div>
Parham JS, Goldberg AC
Prog Cardiovasc Dis: 15 Nov 2022; epub ahead of print | PMID: 36400233
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Abstract
<div><h4>The associations between exercise and lipid biomarkers.</h4><i>Sulague RM, Suan NNM, Mendoza MF, Lavie CJ</i><br /><AbstractText>Cardiovascular diseases (CVD) remain the leading cause of death globally, and further efforts are being undertaken to understand and modify CVD risk factors, such as dyslipidemia (DLD), hypertension, and diabetes. The sedentary lifestyle of most individuals today contributes to the prevalence of these conditions. Uncontrolled dyslipidemia serves as a fertile ground for atherosclerotic plaque formation, while lipoproteins (Lp) act as cofactors for inflammatory processes that cause plaque destabilization leading to subsequent CVD events. As such, many health experts and institutions continue to emphasize the importance of cardiorespiratory fitness (CRF) and muscular strength (MusS) with the intent to reduce atherogenic lipoproteins and proprotein convertase subtilisin kexin type 9 (PCSK-9) expression. Concordantly, the two modes of exercise training (ET), such as aerobic ET (aET) and resistance ET (rET) have both demonstrated to improve CRF and MusS, respectively. Although both modes of ET were shown to independently reduce mortality, participation in both forms resulted in a more pronounced improvement in cholesterol levels and CVD-related mortality. Though reduction of adiposity is not a pre-requisite to achieve better control of DLD through increased CRF and MusS, the beneficial effects of physical activity on the inflammatory processes linked to atherosclerosis are almost always associated with a simultaneous decrease in overall adiposity. It is therefore essential to promote both aET and rET, including weight loss in order to attenuate the risks stemming from atherosclerosis and its proinflammatory components.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 15 Nov 2022; epub ahead of print</small></div>
Sulague RM, Suan NNM, Mendoza MF, Lavie CJ
Prog Cardiovasc Dis: 15 Nov 2022; epub ahead of print | PMID: 36400234
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Abstract
<div><h4>Clinical conundrums involving statin drug-drug interactions.</h4><i>Lamprecht DG, Saseen JJ, Shaw PB</i><br /><AbstractText>Statins are the cornerstone of pharmacologic therapy for the prevention and treatment of atherosclerotic cardiovascular disease. While they are generally considered safe, statins can be affected by drug-drug interactions (DDIs) that increase their systemic exposure increasing the risk for statin-associated muscle symptoms. These interactions are primarily mediated through metabolizing enzymes such as cytochrome P450 isoenzymes and membrane-bound drug transporting proteins including P-glycoprotein and organic ion transporting polypeptide . Recognition and avoidance of clinically significant statin DDIs is important to ensure their safe use. Conversely, concern over statin DDIs that are not clinically significant may lead to inappropriate underutilization or avoidance of statins in patients who would benefit from them. While many statin DDIs are well-characterized, we present several others that are less-well-established which may warrant clinical attention.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 15 Nov 2022; epub ahead of print</small></div>
Lamprecht DG, Saseen JJ, Shaw PB
Prog Cardiovasc Dis: 15 Nov 2022; epub ahead of print | PMID: 36400235
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<div><h4>Guidelines for the management of hyperlipidemia: How can clinicians effectively implement them?</h4><i>Dembowski E, Freedman I, Grundy SM, Stone NJ</i><br /><AbstractText>Guidelines support lowering cholesterol to decrease atherosclerotic cardiovascular disease (ASCVD) risk across the entire lifespan with intensive lifestyle intervention, as well as statin and non-statin pharmacotherapy for those at highest risk. Modest improvements in the initiation, use, and adherence to statin therapy in patients with ASCVD have occurred over the past decades. However, studies continue to document a less than desired implementation of guidelines highlighting a substantial and persistent treatment gap. The success of implementation depends on the consideration of a variety of barriers that exist throughout the healthcare delivery system. Further research is needed to comprehensively evaluate these barriers in order to develop appropriate and sustainable interventions to improve guideline implementation.</AbstractText><br /><br />Copyright © 2022. Published by Elsevier Inc.<br /><br /><small>Prog Cardiovasc Dis: 14 Nov 2022; epub ahead of print</small></div>
Dembowski E, Freedman I, Grundy SM, Stone NJ
Prog Cardiovasc Dis: 14 Nov 2022; epub ahead of print | PMID: 36395880
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This program is still in alpha version.