Daily Cardiology Research Analysis

RATIONALE & OBJECTIVE: The linkage between cardiovascular disease (CVD) and kidney disease and the importance of promoting cardiovascular health (CVH) to prevent them are increasingly recognized. This study investigated the associations of ideal CVH and its longitudinal change with cardiovascular-kidney outcomes in young adults. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: From nationwide health screening data, we identified adults aged 20-39 years without prior CVD or kidney disease who underwent baseline health examinations in 2009-2010 (N = 3,836,626). EXPOSURE: Using a modified American Heart Association Life's Simple 7 construct excluding dietary data, the participants were categorized according to the number of ideal CVH components they met. Participants who underwent follow-up health examinations between 2011 and 2014 (N=2,728,675) were additionally categorized by the combination of baseline and follow-up CVH scores. OUTCOME: A composite of cardiovascular or kidney event. Cardiovascular events included myocardial infarction, ischemic stroke, heart failure, and death from CVD. Kidney events included incident chronic kidney disease, kidney replacement therapy, and death from kidney disease. ANALYTICAL APPROACH: Cause-specific proportional hazards model. RESULTS: During a median follow-up of 12.1 years, 134,317 composite cardiovascular or kidney events occurred. Multivariable-adjusted risk of the event decreased stepwise with higher CVH scores (for a CVH score of 6 vs 0: HR, 0.32 [95% CI, 0.30-0.34]). An increase in CVH score from baseline (2009-2010) to follow-up (2011-2014) examination was associated with lower risk of the event (HR, 0.86 [95% CI, 0.86-0.87] per+1 CVH score change). Moreover, the risk was lower in participants who maintained high CVH scores at both baseline and follow-up examinations than in those who newly achieved a high CVH score at follow-up examination (HR, 0.87 [95% CI, 0.86-0.87] per+1 baseline CVH score). LIMITATIONS: Diet data were not included in CVH score. CONCLUSIONS: In young adults, achieving and maintaining high CVH was associated with reduced risk of cardiovascular-kidney outcomes. PLAIN-LANGUAGE SUMMARY: Cardiovascular disease (CVD) and kidney disease are closely connected, influencing each other from an early age. We explored whether achieving and maintaining good cardiovascular health (CVH) in young adulthood was associated with the prevention of future CVD and kidney disease. Our findings showed that young adults with better CVH had a lower risk of developing these conditions later in life. Improving CVH over time led to reduced risk, and maintaining good CVH from the start was even more beneficial. These results highlight the importance of achieving and sustaining good CVH early in life to help prevent CVD and kidney disease over time.

BACKGROUND: Takotsubo cardiomyopathy (TTC) is a stress-induced condition with limited evidence-based treatment options. Beta-blockers are commonly used, yet their efficacy remains uncertain. This meta-analysis evaluates the impact of beta-blocker therapy on mortality and recurrence in TTC patients. METHODS: We systematically searched PubMed, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Semantic Scholar, alongside trial registries and grey literature, for studies from inception to March 2025. Included studies examined adult TTC patients treated with beta-blockers versus controls, reporting all-cause mortality and recurrence. Odds ratios (ORs) with 95 % confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed with I RESULTS: Nineteen studies (n = 11,167 patients, predominantly female, mean age 59-74 years) were included. Beta-blocker therapy significantly reduced all-cause mortality by 28 % (OR 0.72, 95 % CI: 0.62-0.84, p < 0.001; I CONCLUSIONS: Beta-blockers significantly reduce long-term mortality and recurrence in TTC. While mortality benefits are consistent across study designs, recurrence outcomes show methodological sensitivity, with stronger evidence from mixed and retrospective studies. Benefits are more pronounced with sustained therapy, with no variation by EF. These findings support beta-blocker use in long-term TTC management, though randomized trials are needed to confirm causality and optimize protocols.

BACKGROUND: Circulating C-type natriuretic peptides (CNPs) predict adverse outcome in women presenting with ST-elevation myocardial infarction. OBJECTIVES: The purpose of this study was to determine the prognostic impact of a high proCNP concentration in women with angina pectoris but no obstructive coronary artery disease (ANOCA). METHODS: In a prospective cohort of women with ANOCA, we assessed the baseline associations between proCNP concentrations in plasma and clinical data. Moreover, we performed exploratory partial least squares regression (PLS) analyses for correlation patterns of proCNP with 185 cardiovascular plasma markers. We included 1,508 women in baseline/follow-up analyses and 1,598 women in PLS analyses. Follow-up analyses included all-cause death and a composite endpoint of cardiovascular events, where we calculated HR estimates from crude and adjusted (age, creatinine) Cox proportional hazards models. RESULTS: A high proCNP concentration (223 women) was associated with hypertension (P = 0.001), diabetes mellitus (P < 0.001), and postmenopausal status (P < 0.001) but not age (P = 0.13). PLS analyses showed that proCNP concentrations were positively associated with atherosclerotic markers and negatively associated with pro-inflammatory markers. For high proCNP, we found an increased risk of all-cause mortality (HR CONCLUSIONS: In women with ANOCA, a high circulating proCNP concentration is associated with a distinct cardiovascular risk profile beyond pro-inflammatory biomarkers and an increased risk of all-cause mortality.